7/30 Mister AMPS 88, +5 55... SRT in a couple weeks

MisterBillie

MisterBillie

Member Since 2022
Been dealing with heavy insulin resistance since January when he was first diagnosed. OF COURSE right before his SRT, I am finally seeing some breakthrough numbers for the 2nd time only. Did my first dose decrease last night from 36u to 34u.

Could this be due to the change I mentioned in the notes of my spreadsheet on 7/29, where I switched from skruff shots to finding some flabby skin near shoulder blade / side of chest area? I got the idea that he might have from lipodystrophy from all the skruff shots from this article here: https://petdiabetes.fandom.com/wiki/Injecting_insulin

I am going to ask the doctors about it, but what should the timing of withholding insulin prior to the bloodwork day (August 1st), CT scan day (August 9th), and the actual SRT block of days (August 17th)?
 
And also, for this days upcoming PMPS, if I see numbers below 100, should I do another consecutive decrease from 34u to 32u?
 
Neko earned her first reduction (going below 50 since I was following TR for dosing) a couple days before we hit the road for SRT. Cats and their timing! :rolleyes:

Did you feel any lumps or thickness where you've been injecting? I shot Neko mostly just below the shoulder blades for almost 5 years, just alternating sides and trying to go in a circle. Never had a problem with it.

MisterBillie said:
And also, for this days upcoming PMPS, if I see numbers below 100, should I do another consecutive decrease from 34u to 32u?
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We determine doses based on nadirs, or how low the dose takes the cat. Today's numbers were likely from the 36 unit depot. Having said that, at Mister's size of dose, think dose size changes of 10-15%, so you could have reduced by at least 3 units, maybe 4. So you could reduce another unit or two tonight.

MisterBillie said:
I am going to ask the doctors about it, but what should the timing of withholding insulin prior to the bloodwork day (August 1st), CT scan day (August 9th), and the actual SRT block of days (August 17th)?
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I expect there should be no change to giving insulin before blood work. As for SRT, it involves anaesthesia, so they'll likely suggest you do a half dose the morning of the SRT. Do you know the check in time yet? Mine was earlier than my usual AMPS, partly because of a different time zone, so I had to move Neko's dose time up for a few days before, so that I could give her insulin before dropping her off.
 
Okay, I will go to 32u tonight if he tests below 100. Or if not 100, which threshold should I use do you think? Edit: he tested 79, lowered his dose again to 32u.

The CT Scan on August 9th and the SRT (August 17, 18, and 19) are at 6:30am. I'm more worried about the previous days PMPS nadir hitting in morning when he's undergoing SRT.

Wendy&Neko said:
Did you feel any lumps or thickness where you've been injecting?
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Yes, there is a thickness/lump where I was injecting him in the skruff with the tent method.

The only other place on his body where I can tent the skin is his left side near his shoulder blade. Everywhere else the skin is too tight.
 
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They should be monitoring him fairly regularly during his day for SRT. It's quite a few days yet to SRT, and a lot can happen to doses in that time. Post a couple days before hand and we can discuss some options.

As for tonight's dose, I wouldn't have dosed based on the PMPS. But instead lowered to 32 regardless. Note, it's time to look again at the Dosing Methods Sticky Note and decide which you want to follow. I usually suggest some tweaks to cats post SRT, when it's in an active phase. SRT neuters tumour cells, so it becomes more active when those cells finally die off. The SRT action can happen in fits and spurts, with times you hold the dose for a while in between. When the dose needs seem to be dropping fast, you'll need some tricks to help keep him safe, especially with his larger dose/larger depot. One trick is that when he earns a reduction, you can do a half or two thirds dose the following cycle, to help drain the depot some, before returning to his newly reduced dose the cycle after that.

First all green cycle - awesome! Hope you can still get some tests in tonight.
 
Pure greens all night.

Paging @FrostD , curious what your take is on these greens out of nowhere.

Definitely wondering if I go down to 30u tomorrow morning or 28u, hmm...
 
He's been surfing in safe numbers. This is the 36 unit depot that's been influencing the cycle. The larger depot can influence up to six cycles, maybe more in larger doses. If you want to interrupt the string of greens, you could do that one time half dose I mentioned above. So 16 cycles in the AM, followed by going back to 32 units.
 
Hard to say whether it's another breakthrough due to IAA/acro effects, or maybe a little cab. Whatever it is, I'm glad to see these nice numbers!
 
Wendy&Neko said:
As for SRT, it involves anaesthesia, so they'll likely suggest you do a half dose the morning of the SRT. Do you know the check in time yet? Mine was earlier than my usual AMPS, partly because of a different time zone, so I had to move Neko's dose time up for a few days before, so that I could give her insulin before dropping her off.
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They recommended doing a half dose the morning of with no food.

He's on a Depot style insulin, which means the injection to be given on the morning of the CT scan injection really has no bearing on his numbers until the depot adjusts over a 24-72hr period. His body's insulin depot from the previous 1-2 days is what will be actively affecting him during his CT scan appointment.

So whatever changes to his insulin dosing prior to the appointment should happen the day before I would think, right?
 
But you are doing a half dose on the insulin, depot will be slowed down by doing that. If he’s been seeing low but safe green on the dose the days before, you can go even smaller in dose or skip in the AM.
 
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