11/15 Weezer AMPS 209, +4 252, +8.25 263, PMPS 218

All is well in Weezer World.

Yesterday’s Condo

Prayers for all of our friends in need of healing, strength and comfort today.

Recap of yesterday
AMPS 225
+2 231
+6.25 219
PMPS 172
+2.25 214
+4 218
+7 227
+9.5 199

This morning is cycle 6 at 4.5 U. I know that the modified protocol used here calls for an increase to 4.75 tonight. But I’m not convinced that is best for Weezer. At 4.25 she was in blue territory every day. The tight regulation protocol would have kept her at that dose 5-7 days. But with the modified protocol, I was encouraged to increase to 4.5 after 3 days to maintain the momentum. That made sense, but what actually happened was just the opposite. Last night was her first trip to blue in the three days she has been at the increased dose. While it is true that last night’s PMPS was her lowest PMPS, it seems that would only be significant if her PS is usually her highest of the cycle, but that is not the case; her cycles are flat. I think she needed more time to work the 4.25 dose. I am strongly inclined to take her back to 4.25, allow her shed to drain to that dose (how long would that take?) and give her time to see what that dose does for her. Or at least, to stay at 4.5 longer. I would appreciate comments about this, based on Weezer’s unique response to date, ECID. While I’m asking about this, is there documentation for the modified tight regulation protocol?

Wishing a kitty day for all, plenty of purrs, play, sunny spots and lots of love.

Re: 11/15 Weezer AMPS 209

Morning Linda, just stopping in to check in and say hello to you and Weezer. Those are very good questions. It might help to get more opinions by adding a (?) mark in your subject line. Have a nice day.

Re: 11/15 Weezer AMPS 209, dose question

Hi Linda,

I don't know of any documentation to support the modified protocol....just the collective experience of hundreds of caregivers over several years.

If you don't see movement, you want to increase. Staying at a dose that is producing consistently higher numbers than you want will not help bring the numbers down. All that does is allow Weezer to sit in those higher numbers longer, and make it harder to bring them down (ie: need more insulin to reach a breakthrough dose). I would not hold the dose longer than 6 cycles until you see some real movement. You haven't seen a breakthrough yet.

I know it's frustrating to see no results, but you just have not reached a good dose yet. Weezer saw his best results on Humulin when he was on 6 units...I would not be surprised to see him need a similar dose of Lantus.

This is not unique....we have seen this with many cats. I will try to dig up some SSs for you to look at.

Re: 11/15 Weezer AMPS 209, dose question

I agree with Laurie.
Keep moving forward. . .
(Be the Tank)

Re: 11/15 Weezer AMPS 209, dose question

Good morning! No dosing advice here, but wanted to stop in and say hello. Hope you get the answers you need to help you make an informed decision. Thank you for all of your good thoughts. I really appreciate it. Have a wonderful day!

Re: 11/15 Weezer AMPS 209, dose question

I agree with the others on doing the 6 cycle increase until you see movement. Some cats may need a bit more insulin to get that breakthrough than others. Some may need less to see a breakthrough. Before Blackie was on Lantus, she was getting 8 units of ProZinc 2x a day (this was the day that I started her SS). The highest that she's been on with the Lantus was 5u. I, too, was getting concerned with the amount that was going into her, just like I'm sure that you are, too. I know it's extremely frustrating when all of the other kitties are showing lower #s, and yours isn't, yet. There have been many a time when I thought for sure that Blackie wouldn't get to where she is now. It took me some time to figure out that changing her diet would also help, and it did. Plus her losing a bit of weight (she still needs to lose 0.50 lb., but otherwise she looks great!). Trying to figure out the right combination of food and everything else can sometimes be difficult, but you WILL get there.

We're ALL behind you, girl. You both are doing very well. Hang in there... It WILL happen, and only she can tell you when that'll be. When it does, you'll be . :lol:

Re: 11/15 Weezer AMPS 209, dose question

The advice I am getting always mentions until you see movement. We did see movement, at 4.25. When I increased to 4.5 her bg went back up. I really think she just needs a little more time on a dose. Please understand I am not arguing, I have no ego in this game. I just want to do the best I can for her and I am totally open to the collected wisdom. But I don't want to base her treatment on the norm if her response has been unique.

Re: 11/15 Weezer AMPS 209, dose question

Read the modified protocol a little more carefully. If the majority of the time nadirs are below 200, you hold the dose for 5 days. Also, with a dose increase, you can run into NDW (new dose wonkiness). There's not a good explanation for this phenomenon but it happens -- you increase the dose expecting numbers to be lower and instead, they are higher for several cycles. I would see what today looks like.

There is a trade off when it comes to holding the dose. If your cat isn't seeing reasonable numbers, holding the dose for overly long can result in glucose toxicity. In other words, your cat gets used to being in those higher number and it's harder to get the numbers to come down. You've got to weigh the pros and cons of holding the dose.

Re: 11/15 Weezer AMPS 209, +4 252, dose question

Hope & pray for some movement for Weezer--Take a wait & see for right now..I think he will get better numbers in a day or two--You have received some learned advice--Hugs & lub from us!!

Re: 11/15 Weezer AMPS 209, +4 252, dose question

(((LInda))) Some cats are slow responders....this is true. But Sienne is right...you do not want her to get used to higher numbers because then you just have to keep going up and up. She will breakthrough eventually. I know you saw some blue numbers at 4.25u but not enough.....

Hang in there...you are doing absolutely awesome. Really.....and I know you are worried about her. But she will respond.

Re: 11/15 Weezer AMPS 209, +4 252, dose question

DH and I have reviewed all of the advice and comments received today and decided to increase to 4.75 tonight. Looking back at her experience on 4.25 I do believe I should have held there and given her another day or two to work it. But it probably wouldn't make sense to go back there now. If she works this next increase the way she did 4.25 I will give her the extra time to see what she can make of it. But for now, onward and upward! Many thanks for all of the advice. The people of forum are just amazing!

I feel for ya, Linda!! I don't know if I've seen a flatter cat. Right now, I'm debating in my head if I would prefer that or the cat on a trampoline that I seem to be dealing with over the past couple months. Either way, I think we're both lucky we're not bald by now from tearing our hair out!!! Good luck with the dose increase. I know that breakthrough dose is coming soon...I can feel it!!!

hi guys - Wishing you much luck with the new dose. I hope this is the one! Right Weezer?

I too totally understand the frustration, the worry. You are doing great - keep on truckin'!

best of luck with the new dose!

((((linda))))) it is hard - we want to do the best possible thing for our cats, but it's SO hard to discern what that is. i do trust the collective wisdom here, and having seen more than 30 cats go off of insulin since february, i can see this protocol works. hang in there, it'll come!