3/7 Merlin AMPS 335/ +2 325 / +6 329/ PMPS 428

No, do not increase. It has been only 3 cycles since the lime greens. We do not look at the highs, only the lows. He just needs to come back down from the bounce.
 
Not look at the highs?!? I couldn't take my eyes off them last night. Merlin was dealing with them better than I was :nailbiting: But I know what you mean as far as TR protocol. I'm really curious what his +6 will be.
 
A couple changes for your spreadsheet. You have two entries for March 5th. Another way to show that you shot late is to put “1.25 @ +15” or whatever the delay was. A delayed shot acts a bit like a reduction, so that can also impact negatively on the numbers.

I was reading back on your previous posts, and you mentioned “leaking protein” I think. Did the vet mention a urine protein/creatinine ratio test? It’s not that expensive and good to know if Merlin is experiencing proteinuria. Neko had that. It can be an early sign of kidney disease, but can also be easily controlled with benazapril. Uncontrolled proteinuria is hard on kidneys and will make kidney disease progress faster. If you haven’t had it done recently, a blood pressure check is also a good idea. And should be part of the diagnosis process for what is causing proteinuria.

Nice to see Merlin drifting down today. That was quite the bounce!
 
His +6 is not exciting. I hope he at least stays flat till his PM dose and doesn't start shooting to high numbers again.

The leaking micro-proteins is some other type of kidney disfunction that the usual tests do not show. I guess It's a precursor to developing manifest kidney disease. There is a special test for it. I am going to call the vet and get more details and maybe get Merlin tested. I hate to have them draw blood for it as he totally freaks out at having blood taken and his highest BG numbers when he was stable would come from the stress. Like 125 to 410. Claws and teeth everywhere. I think the vet techs lost more blood than he did for that recent battery of tests. One time they had to sedate him. Guess I should get it done when he is in the green zone.
 
The UPC ratio test is not inckuded in the regular set of tests. Sounds like Merlin might be tricky to get a blood pressure test too. I had several epic failures the first couple times with Neko. Her BP skyrocketed at the vet, but her BG went down. Go figure.
 
I called the vet and asked specifically what kidney related testing was done on Merlin. Since he has historically had great kidney function and he did not, in her opinion look like he had issues, she ordered a SDMA test be done since they were able to get so much blood. Merlin's test came back smack dab in the middle of the normal range. She said the SDMA is the test that will show the earliest indications of kidney dysfunction onset. UPC is the test used after renal failure is manifest. Apparently, SDMA is a relatively new test that detects renal issues earlier. Prior to it, UPC was the go to test. Here are details regarding SDMA:

- Biomarker for kidney function Symmetric dimethylarginine (SDMA) is excreted by the kidneys. SDMA more accurately reflects glomerular filtration rate (GFR) in dogs and cats. Earlier than creatinine, SDMA increases as early as 25% loss of kidney function, making SDMA more reliable in both acute or active kidney injury and chronic kidney disease. Creatinine cannot identify kidney issues until almost 75% of kidney function is lost. It is an early test tool for detecting kidney disease in cats and dogs.
- SDMA is less impacted by extrarenal factors than creatinine, including body condition, advanced age, and disease state.
- SDMA is also not affected by lean body mass, making it more reliable for assessing kidney function in animals with chronic kidney disease or other conditions that result in weight and muscle loss, such as hyperthyroidism or diabetes.

I was thinking UPC was another blood test. UPC just needs a urine sample, no blood.
 
That's great that Merlin's SDMA is normal - also great that he is now in pinks rather than red/black
From your spreadsheet, it looks like you are getting next to no sleep. As I said yesterday, the only good things about high readings, especially at night, are that you can get a good night's sleep, as you don't have to worry about hypos.
 
I agree about the high and sleep. But I don't mind if it helps me get the right dose for him. I don't suffer alone. He wakes up every time I need to get blood so he gets just as sleep deprived as I do. Tonight he seems pretty well hydrated so I'm skipping today's subq fluids. His PMPS went red @ 428. I hope he nadirs at least pink and stays there all the way to the AMPS. then we both can get some nice sleep.
 
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