? Methos 6 Apr 25 amps 100 vomiting

SmallestSparrow

SmallestSparrow

Very Active Member
I may have made a decision before anyone reads this and I’ll come back to find and post my last thread. Methos vomited twice yesterday, at first I thought it was from his K tablets but the second time he hadn’t had any meds (but did have three greenies). His current dose has been bouncing back and forth between 3.75 and 4.0 (one too little and the other too much).

his amps was 100 and with a pill pocket (68% 3 cal) and 30 cal (1/2 can) MC proplan (14%) he is 30 min later 168. Normally I’d give his 4 (or since he’s had trouble on 4 his previous 3.75) by now except for the vomiting. He got cerenia at last cycle’s +9 and has kept breakfast down. He ate the proplan well but generally it takes a lot of effort to get him to eat so I don’t know how much I can count on him eating well all day

should I give him less this cycle, like 3 or 3.5?
 
You can always give him honey if he is dropping low and not eating/not keeping food down.

Why so many dose changes in the last week? (No rush to answer this).
 
Yes. Thanks for your help. If you see a small s or f next to a dose that’s my notation for a syringe that wouldn’t allow as exact a measure as I’d like, usually after several attempts (generally because a plunger is uneven after drawing up) so I make my best estimate if it is a slightly larger or smaller dose. Overkill probably but I’m the type who avoids parallax when drawing up and takes off my glasses so my high myopia gives me magnified vision. All in the hopes I will control as many variables as possible in denial that his tumor makes it all moot.

there were variation beyond that this past week. Large S and F is me purposely choosing to err one way or the other on a dose and there were variation between 3.5 and 4. This is because he has no in between at doses of around 4–he’s either pink all day on zero carb, or blue all day only if I feed MC. He especially a problem with nadir at PS. AAHA says late nadirs are too much overlap and an unequal dose between cycles can push the nadir to where it belongs—while that does seem to help he then remains high. so I was in desperation trying to see if unequal dose would work but keep the bg from going too high

Several vet lectures I’ve read say a late nadir coupled with the phenomena this site calls “bouncing” is a sign of too much insulin—-that the “normal” cycles are actually ones with rebound hyperglycemia being made “normal” by too high insulin, then the “low” cycles are when then reactive hyperglycemia wanes after 72 hr. Essentially the opposite of what this forum holds. I’ve asked about this a lot here with no clear resolution in my head.

It could also be around 4U is the tipping point for his insulin resistance. Or it could be his tumor is just going to pump out unpredictable amounts of cortisol and aldosterone, and 4 U is just so much that the wonkiness is magnified.

I think I may never have a dose that I can give him and only test four times a day. Today was just complicated by the fact that in addition to his usual anorexia I couldn’t be sure he’d keep food down.

he may be high but I hope not too much on 3.75. I appreciate your help
 
Here is the link to your last post about Methos here. I'm happy to see you are shooting blue preshots more often now. They've been resulting in some lovely flat blue cycles - when he doesn't bounce. Is last night and today a record long blue streak? :cool:
SmallestSparrow said:
AAHA says late nadirs are too much overlap and an unequal dose between cycles can push the nadir to where it belongs—while that does seem to help he then remains high. so I was in desperation trying to see if unequal dose would work but keep the bg from going too high
Several vet lectures I’ve read say a late nadir coupled with the phenomena this site calls “bouncing” is a sign of too much insulin—-that the “normal” cycles are actually ones with rebound hyperglycemia being made “normal” by too high insulin, then the “low” cycles are when then reactive hyperglycemia wanes after 72 hr. Essentially the opposite of what this forum holds. I’ve asked about this a lot here with no clear resolution in my head.

It could also be around 4U is the tipping point for his insulin resistance. Or it could be his tumor is just going to pump out unpredictable amounts of cortisol and aldosterone, and 4 U is just so much that the wonkiness is magnified.
Click to expand...
We've had many people try uneven dosing, and with our dosing methods used here, it just doesn't work. Plus it makes it even harder to find out what dose he should be at. Have you considered trying calipers? They can help you gain consistency in dosing plus get those in between doses. I found it helped me, even with my girl on higher doses, and two secondary conditions (IAA and acromegaly).

Maybe AAHA is talking about "in general" with late nadirs that includes other insulins, but not so true with Lantus. The late nadir is a very common phenomenon that happens when bounces break. It's not a sign of too much insulin, just a sign the bounce is breaking. And it promotes the "bouncing means the dose should be reduced" myth that floats around. Bouncing is a sign of a cat being in numbers they aren't used to, or steep drops. Full stop. Of course, this long stretch of blue for Methos is likely to cause the same, but in the mean time his body is spending quality time in good numbers.

Of the spreadsheets of cats with Cushings that I've looked at, I haven't seen daily variations in resistance that mean you need to constantly tweak the dose. Admittedly, most of them were pituitary Cushings but I can't think that would be hugely different. It's easier to look at the nadirs, and use that as an indicator of whether the dose needs to be changed. Especially with depot style insulins. You are making dosing decisions harder than it needs to be.
 
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