? 28March2020/Maxi/AMPS357/CABERGOLINE?/Lantus + R Newbie

[bambinaki]

Last thread: http://www.felinediabetes.com/FDMB/...ergoline-lantus-r-newbie.227577/#post-2549244

KNOW ABOUT CABERGOLINE?

I'd like to confirm that Maxi's medicine, which we just received and have never tried before, is exactly the right formulation.

The label says:
30MCG/ML SUS
Give 1 ML daily by mouth

Per the research and your knowledge/experience, is this right for Maxi's Acromegaly?

Can you advise on the best method of introducing Cabergoline into his treatment?
Of course it's necessary to consider his history and current situation.
We don't want to have too many moving parts so we can make clear judgments on what works.

Maxi's on his 5th cycle of 5.5 units of Lantus and his 9th cycle of R, of which he's up to 1 unit.

Any and all input appreciated.

It would be great to get guidance from someone who is well versed with cabergoline.

Thank you


@Sandy and Black Kitty @Wendy&Neko

 

[Sandy and Black Kitty]

It’s time to see what happens if you widen the scale range and fine tune it a bit.

R scale (for now)
PS 350 or higher, 1.25u R
PS 300 - 349, 1u R
PS 275 - 299, 0.5u R

Tonight will be cycle 6 of 5.5u Lantus. Starting tomorrow AM cycle it’s time for an increase to 6u Lantus (NO R).

What do you think?

 

[bambinaki]

It’s time to see what happens if you widen the scale range and fine tune it a bit.

R scale (for now)
PS 350 or higher, 1.25u R
PS 300 - 349, 1u R
PS 275 - 299, 0.5u R

Tonight will be cycle 6 of 5.5u Lantus. Starting tomorrow AM cycle it’s time for an increase to 6u Lantus (NO R).

What do you think?

So, tonight while Maxi is still at 5.5, I should still give only 1u R if he's 300 - 349 even though that dose has not seemed to do anything so far?

What do I think? I think I'm grateful for your guidance, which I will follow.

Please also tell me the minimum testing I must do.

Thank you

 

[Wendy&Neko]

1u took Maxi down 90 points a couple nights ago - you don't want to go over 100 or you can set up a bounce. Tonight is cycle 6, depot should be filling up for 5.5 so that alone might cause some action.

 

[bambinaki]

1u took Maxi down 90 points a couple nights ago - you don't want to go over 100 or you can set up a bounce. Tonight is cycle 6, depot should be filling up for 5.5 so that alone might cause some action.

OK, so I will follow the R scale above.

Thank you

 

[bambinaki]

1u took Maxi down 90 points a couple nights ago - you don't want to go over 100 or you can set up a bounce. Tonight is cycle 6, depot should be filling up for 5.5 so that alone might cause some action.

...and what about the testing schedule for tonight?

 

[Sandy and Black Kitty]

So, tonight while Maxi is still at 5.5, I should still give only 1u R if he's 300 - 349 even though that dose has not seemed to do anything so far?

What do I think? I think I'm grateful for your guidance, which I will follow.

Please also tell me the minimum testing I must do.

Thank you

Things are not always as they seem. Consider the unmeasurable potential effects of R. As an example, it may have helped the bounce following the yellow streak from going into the red.

 

[Sandy and Black Kitty]

Get a +2 and +4 for starters

 

[bambinaki]

Get a +2 and +4 for starters

Sandy, thank you.
May I ask now what to do at +4 if this number or that number in case you're not able to answer me right away 4 hours from now?
Is it possible to tell me now that I can go to sleep for the night at +4 if his number is --- and I should test again at +6 if his number is ---?
(With my "new online" job + Maxi, I've been running on 4 hours of sleep for umpteen days. That said, Maxi comes first.)
Thanks again

 

[bambinaki]

Things are not always as they seem. Consider the unmeasurable potential effects of R. As an example, it may have helped the bounce following the yellow streak from going into the red.

I understand what you mean about the R possibly keeping the bounce numbers lower than they might have been without the R. However, since R is short-acting, do you think it would have been in his system that long?

 

[Wendy&Neko]

R doesn't stay in the system that long, but it lowers the numbers such that Lantus has a lower number to work with. Which is what it does best.

 

[Sandy and Black Kitty]

I see the +2 is 335, at a similar drop as 3/26/PM.
See you at +4

 

[Sandy and Black Kitty]

Sandy, thank you.
May I ask now what to do at +4 if this number or that number in case you're not able to answer me right away 4 hours from now?
Is it possible to tell me now that I can go to sleep for the night at +4 if his number is --- and I should test again at +6 if his number is ---?
(With my "new online" job + Maxi, I've been running on 4 hours of sleep for umpteen days. That said, Maxi comes first.)
Thanks again

If at +4 he is yellow test again at +6, if +4 is pink you can probably call it a night.

 

[Wendy&Neko]

Karen, Sandy and I were mulling over the cabergoline. I think you'll be OK to start it tomorrow if you want to. We'll just keep it in mind with the R experiments. The nice thing about R, is that if the cabergoline does start bring down the numbers, you don't have to worry about as large a Lantus depot. As far as cabergoline dosing - as I've mentioned before - you are starting on the low end of the dose range. That's OK, it can be adjusted later if needed.

 

[bambinaki]

If at +4 he is yellow test again at +6, if +4 is pink you can probably call it a night.

OK. Thank you!

 

[bambinaki]

Karen, Sandy and I were mulling over the cabergoline. I think you'll be OK to start it tomorrow if you want to. We'll just keep it in mind with the R experiments. The nice thing about R, is that if the cabergoline does start bring down the numbers, you don't have to worry about as large a Lantus depot. As far as cabergoline dosing - as I've mentioned before - you are starting on the low end of the dose range. That's OK, it can be adjusted later if needed.

OK. I'm ready to start tomorrow because I'm anxious for something help Maxi. However, I'm also nervous about it. Do you feel pretty comfortable that it's a safe drug?

Thank you!

 

[Wendy&Neko]

So far, the only side effects we've seen on cabergoline is some mild GI issues, mostly showing up as being picky about food. But not something that has lasted more than a few days.

 

[bambinaki]

I think the Cabergoline experiment will be more valid if I give it to him tonight instead of this morning during his first cycle at the increase to 6 units of Lantus.
We should get a pure picture of his reaction to 6 units.
So I'll give him the Cabergoline tonight.

@Wendy&Neko @Sandy and Black Kitty

 

[Olive & Paula]

When I started caber it was mid afternoon, but a lot of times I would be late. I switched to 1 hr before PMPS a time I knew I was always home for.

 

[bambinaki]

When I started caber it was mid afternoon, but a lot of times I would be late. I switched to 1 hr before PMPS a time I knew I was always home for.

The instructions on the bottle say to give it with food, which means I would give it immediately after PMPS.

 

[Olive & Paula]

The instructions on the bottle say to give it with food, which means I would give it immediately after PMPS.

I would follow instructions. Mine doesn't say with or without food. It could be to prevent upset tummy.

 

[bambinaki]

I would follow instructions. Mine doesn't say with or without food. It could be to prevent upset tummy.

Yes, I will.

I'm pretty anxious about the possibility of the medicine making Maxi feels worse that he already does. I'm really hoping it makes him feel much better, though!