? Post-SRT dosing...

Yes. Let’s see what happens today. He had some yellow yesterday, I see. The long string of pink could be a bounce.

I find myself disbelieving the blue 121 on the evening of 3/26. At +2 380, +3 121, and + 4 290? Really? Were those Libre readings?

If things continue on in pinks, I would increase up to 13 units. Try to get a ketone test later today after the insulin has kicked in.
 
Suzanne & Darcy said:
Yes. Let’s see what happens today. He had some yellow yesterday, I see. The long string of pink could be a bounce.

I find myself disbelieving the blue 121 on the evening of 3/26. At +2 380, +3 121, and + 4 290? Really? Were those Libre readings?

If things continue on in pinks, I would increase up to 13 units. Try to get a ketone test later today after the insulin has kicked in.
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I'm hoping it's just a bounce, as well. Would I increase tonight or tomorrow morning?

Regarding the 121, I have a note in the Remarks section that it is likely a compression low on the Libre from him sleeping on it. Obviously, it's not right.

I put this morning's ketone value in the Remarks section. 0.3 is pretty good for him, especially when he's in high numbers. Do I need to take another one later today?
 
What would you think about taking him back up to 14 units. I think you could do it as long as you’re prepared to handle any low numbers (and I think you are.)
 
Suzanne & Darcy said:
What would you think about taking him back up to 14 units. I think you could do it as long as you’re prepared to handle any low numbers (and I think you are.)
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I stayed with 13u tonight. Although Buster has been in the mid to high 300s, he wasn't acting like it, if that makes sense. So I hoped it was just a bounce. He has come down a bit since dinner so we will see what happens overnight. If he stays high again, I will prbly increase to 14u in the morning. Thank you for taking the time to look at his info. :)
 
Yes. I meant to say that you should wait until the morning, because he usually doesn’t bounce for more than 2/3 cycles.
I wasn’t sure how anxious you were to get him back into green. I see he has a green today. I hope he will stay there for some hours yet.
 
We got some green for a bit yesterday but, after his dinner, it shot up & stayed up. I know we usually increase in 1 unit increments but I decided to try 13.5u this morning. Was just hoping a bit more would give a little boost...
 
I think it’s okay to try a tweak of the dose. It either works or it doesn’t. You aren’t tied to it for a long time. I had thought to suggest it as well. I think last night’s numbers were a bounce. He probably will stay high-ish today and come down sometime tonight. He had a beautiful cycle yesterday. We don’t want to push him too low.

Aside from his numbers, tell me how he is doing in general. Is he happy? Is he feeling more secure now that he’s been home for a while. Is he wanting to hang out with y’all? Appetite? Activity?
 
Suzanne & Darcy said:
I think it’s okay to try a tweak of the dose. It either works or it doesn’t. You aren’t tied to it for a long time. I had thought to suggest it as well. I think last night’s numbers were a bounce. He probably will stay high-ish today and come down sometime tonight. He had a beautiful cycle yesterday. We don’t want to push him too low.

Aside from his numbers, tell me how he is doing in general. Is he happy? Is he feeling more secure now that he’s been home for a while. Is he wanting to hang out with y’all? Appetite? Activity?
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You were right! He has stayed high most of the day. I'm really hoping that his numbers will decrease tonight...

All in all, he's doing really well. Considering everything he has gone through, he still has his sweet moments & purrs.
He sleeps a lot. His appetite is still strong (thank goodness).
On his better days, I'm trying to get him to move around more. His neuropathy has gotten better but it's good days & not so good days. He's been on the methylcobalamin & folic acid since February. He moves around extremely well, even 'runs' at mealtimes. I was just hoping there would be less plantigrade involved.
But, I'm not going to be greedy. He's moving, talking, eating, & POOPING!
Thanks to you & this community he's doing so much better than we ever would have expected when this started in Nov 2024. :bighug:

Now if we could just get this bg lower & regulated... :banghead:
 
Suzanne & Darcy said:
I think it’s okay to try a tweak of the dose. It either works or it doesn’t. You aren’t tied to it for a long time. I had thought to suggest it as well. I think last night’s numbers were a bounce. He probably will stay high-ish today and come down sometime tonight. He had a beautiful cycle yesterday. We don’t want to push him low.
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Well, so much for that experiment.
I didn't want to put him through another high cycle, especially since he was already in the red this morning, so I increased to 14u. Hope that was the right decision...
 
Madm4444 said:
Well, so much for that experiment.
I didn't want to put him through another high cycle, especially since he was already in the red this morning, so I increased to 14u. Hope that was the right decision...
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Well, I know you can keep him safe! Paws crossed for better numbers.
 
Not a great run over here. It's been awhile since we've had 2 red AMPS days in a row. Staying with 14u. Do you agree?

Hope all is well with your gang at home. How's Marcus doing?
 
Madm4444 said:
Not a great run over here. It's been awhile since we've had 2 red AMPS days in a row. Staying with 14u. Do you agree?

Hope all is well with your gang at home. How's Marcus doing?
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Yes. I agree. See if you can hold it for six cycles and see what you want to do next. I just looked at his spreadsheet and did a big sigh. I can imagine how you feel.
 
Thanks for asking about Marcus. He’s been vomiting so I put him back on Cerenia for a while. I know I need to find a food that works for him. Every time I think I have found one to try there’s something wrong with it. Most recently it was a food too high in phosphorus. I don’t know how old he is exactly, but he’s no spring chicken and I don’t want to tax his kidneys on top of everything else.
 
Tomorrow you may want to increase. Let’s see what happens today. I like some blue I see on there, but it did not last long enough. Things are going to improve for Buster. It can take a while. We have to wait for some of those old tumor cells to die off.
 
Suzanne & Darcy said:
Tomorrow you may want to increase. Let’s see what happens today. I like some blue I see on there, but it did not last long enough. Things are going to improve for Buster. It can take a while. We have to wait for some of those old tumor cells to die off.
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Paws crossed.

It was also terrible timing for the Libre replacement. He was in those blues when we had to take him in. Not sure if the stress halted a nice run.

But I'm really surprised with no responses at night for days. None.

I have switched his snacks/treats to the CatManDoo large freeze-dried pieces (only small pieces of them b/c they're huge). It helps to have pieces for when we do exercise up & down the stairs (we used to use Greenies before his dx). Could this be impacting his bg? They are just chicken but are dry.

It doesn't seem like a pancreatitis episode because he's in relatively good spirits & doesn't seem to be in pain. I hope it's not an infection of some sort. I can't stand the thought of having to take him to the vet - again.

As you can tell, my 'patience pants' are in the wash... :rolleyes:
 
No. I don’t think it looks like an infection or even pancreatitis because you say he feels well and is eating well — and he is having a response to the insulin with those blues and even the yellows. He probably just needs more insulin for the time being. I bet the trip to the vet did hijack the cycle yesterday! He’s had enough of vets and was probably worried about what was going to happen next!
 
And I don’t think giving the snacks is impacting his BG. It’s just pure freeze dried meat with no additives. It’s the same kind of treat we recommend giving at test time.
 
@Suzanne & Darcy

Could you pls take a look at Buster's spreadsheet?
No decrease at all. We thought something might be wrong with the Libre because it read HI all day. We did a check with AlphaTrak3 at AMPS +9 and the number was even higher than AMPS.
Do you have any idea what might be going on?
His neuropathy seems a little worse today. I don't know if that is because his numbers have been high or if the numbers are high because he has pain.
Or maybe neither?
Should we hold this dose? Was a full unit increase too much? Not enough?
My head is spinning...
 
Any further Libre info since what I see on the spreadsheet? As to dose, ten percent added to 14 would be 15.4 so 15.5 would be close to that. Beyond that I wouldn’t go just yet. Maybe he’s bouncing from those last blues? I know that last red I see on his SS isn’t much, but I am hoping for better?
 
I take it back. I misspoke. He’s not bouncing from the blue. He came down after that. I see you gave 15 again tonight. I hope something will break (a good break) for Buster!
 
Suzanne & Darcy said:
I take it back. I misspoke. He’s not bouncing from the blue. He came down after that. I see you gave 15 again tonight. I hope something will break (a good break) for Buster!
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Unfortunately, I didn't see your post until after I already gave the dose. Obviously, 15u wasn't enough.
Given the miserable day that he had today, Do you think that 0.5 extra unit will be enough to move the meter or should 16u be the next dose if everything remains the same?
 
Madm4444 said:
Unfortunately, I didn't see your post until after I already gave the dose. Obviously, 15u wasn't enough.
Given the miserable day that he had today, Do you think that 0.5 extra unit will be enough to move the meter or should 16u be the next dose if everything remains the same?
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Who knows at this point how he will respond. It’s crazy. I think an increase to 16 units would be a 15 percent increase (from the 14 units) and that if he’s going to stay so high all the time you could try it. But I would hold it for 6 cycles before increasing again.
 
I chose to stay with 15.5u for another cycle since we had a good string of yellows yesterday. How long do you think I should stay with this dose?

But I can tell that his neuropathy is really bothering him so I'm not sure if that his impacting his numbers.
He's been on methylcobalamin since early Feb and I added the folic acid in early March.

Should I consider something stronger to help with his pain? (I'd really rather not but I hate to see him struggling).
 
So you feel he’s in pain? Maybe some Gabapentin? Have you ever used it before? Or Buprenorphine? You should ask your vet. I just would not give him anything that would be hard on his kidneys (like Onsior or Metacam.)
 
He's acting okay. Still jogging to get food. Still eating well. I'm not sure if he's actually in pain since he's still choosing to move around some. He's not walking on his hocks completely but far more than before. Yes, he can still do some jumping but I can see that he can't push off his legs as well. I will check with the vet. I'm also concerned about pain meds & constipation...

Also, there has been no movement in his numbers today. I increased to 16u tonight. The plan is to hold this for 6 cycles per your previous post. Paws crossed.
 
@Suzanne & Darcy

Could you pls look at his numbers? I'm getting really nervous that something is wrong...

Like you & @Wendy&Neko & all the acro parents say, there is no 'normal' for acro kitties but to have little to no response? Is something like this common?
 
Wow. How discouraging! I am sorry. You are dealing with acromegaly as well as IAA. It’s not like he has no response, but it’s been bad the last few days. There are too many factors in play for us to know if it’s the tumor pulsing out growth hormone and/or IAA flaring up. Maybe it’s time to think about making the switch to Lantus? I don’t know if it will help, but perhaps it’s time to try. I would love to see Buster in better numbers than these and for him to feel better!
 
I've seen a cat take 3 months to respond to SRT. SRT neuters the tumour cells, it doesn't kill them. That means they can't replicate but you still have to wait for them to live our their cell life span. CSU told me it takes at least 2 weeks before you see an impact, it's only been 3 for Buster.

Not sure why you increased from 13 units when you did. He had seen down to the 80's on that dose. I'm not sure what dosing method you are following, but MPM says you hold each dose 3-6 cycles and you've been rushing increases faster than that. Now is a time for more caution. I'd hold the dose for the longer side of things, especially if seeing under 100's.
 
Suzanne & Darcy said:
Wow. How discouraging! I am sorry. You are dealing with acromegaly as well as IAA. It’s not like he has no response, but it’s been bad the last few days. There are too many factors in play for us to know if it’s the tumor pulsing out growth hormone and/or IAA flaring up. Maybe it’s time to think about making the switch to Lantus? I don’t know if it will help, but perhaps it’s time to try. I would love to see Buster in better numbers than these and for him to feel better!
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Wendy&Neko said:
I've seen a cat take 3 months to respond to SRT. SRT neuters the tumour cells, it doesn't kill them. That means they can't replicate but you still have to wait for them to live our their cell life span. CSU told me it takes at least 2 weeks before you see an impact, it's only been 3 for Buster.

Not sure why you increased from 13 units when you did. He had seen down to the 80's on that dose. I'm not sure what dosing method you are following, but MPM says you hold each dose 3-6 cycles and you've been rushing increases faster than that. Now is a time for more caution. I'd hold the dose for the longer side of things, especially if seeing under 100's.
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Just finished 4 cycles at 16u, about to start the 5th.
As time goes on, he is peeing more & more. And few to no drop in numbers. It is difficult to see him like this.
Do you just wait it out for 6 cycles hoping it will kick in?
Please know that I am not being flippant at all about this. I just wonder if others have gone through scenarios like this, where it gets worse before it gets better...
 
Yes. Grayson (spreadsheet here) was on 16 units when he had SRT mid July 2012, he got up to 50 before turning it around 4 months later. However, the original 16 units was by no means a good dose for Grayson, he barely had brief glimpses of uppermost 100's. Grayson took longer than most. The IM vet at CSU told me it takes from a few weeks to months before impacts of radiation are seen. Neko was an outlier. First time in took days (on the way home), second time just shy of two weeks. Both times she was on a dose seeing greens regularly going into SRT.

The 6 units gives time for him to get over any bounce. Maybe after a bounce is over he'll see better numbers.
 
Nice! :D. If Suzanne doesn't get back in time, I'd stay with this dose for a bit. She knows more about Prozinc dosing than I do.
 
Where are those patience pants…. I can’t find mine anywhere…. bottom of the dirty clothes basket? No, probably in a drawer somewhere because I have not worn them for so long.
 
@Suzanne & Darcy
@Wendy&Neko

Ladies, could you please review Buster’s spreadsheet?

Today is the 6th cycle on 16u since the blue/green numbers of 4/11/25. There’s seems to be no more response. He is still peeing a lot and his ketones are okay but creeping up. I think 17u should be his PM dose. Do you agree or am I missing something?
 
Bounces can last six cycles, today AM is cycle 6. Let's see what he does closer to the end of the cycle.
 
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