11/15 Charlie AMPS 248, +2 207, +4.5 222, +8 264, PMPS 290

Charlie'sMom22

Charlie'sMom22

Active Member
Yesterday

Tomorrow's increase can't come fast enough. Literally lol.

He was doing well yesterday and this morning, but since then he's been back under the bed all day. That seems to be his tell that his BG is about to go up. I think he was probably doing well yesterday because he'd gotten used to the 200s.

@Wendy&Neko for the sake of humoring me, can we talk about what options I have if his BG starts running away? He got up to 7u last time--that's a looong way to go from .5. It would really help my anxiety to have some sort of plan in place.

I hope everyone is having a lovely (and safe) caturday!
 
Tonight will be cycle 6 at this dose. Per TR, you can increase by 0.25 units tomorrow morning, provided not greens are seen before then. This time, stick with TR, no reducing the dose unless earned. Read through the protocol, let me know what questions you have and what you mean by "options".
 
Wendy&Neko said:
Tonight will be cycle 6 at this dose. Per TR, you can increase by 0.25 units tomorrow morning, provided not greens are seen before then. This time, stick with TR, no reducing the dose unless earned. Read through the protocol, let me know what questions you have and what you mean by "options".
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He’s almost certainly going into the 300s tonight. If he does—and if he’s still there at AMPS—I want to increase by .5 tomorrow even though his nadirs have been under 300 so far (though tonight’s won’t be if my hunch is correct). I strongly believe that this is my only chance to get ahead of the climb.

I feel that I have a pretty good sense of his patterns now: he has a switch and when it’s flipped on, his BG goes up steadily and extremely fast. Conversely, when it switches off, he comes down in dose steadily and extremely fast.

When I say “options” I’m wondering whether there’s a way to get ahead of this before it’s too late, if it’s not already. Fast tracking dose adjustments, doing larger dose adjustments, etc. I know it’s not protocol, but we’ve done things outside of protocol with him before. He’s a weird cat. Open to all ideas. Thanks
 
You are right, fast tracking is not protocol, it's already an aggressive suggestion for situations that have proven they need it. That means all 300+. That is not Charlie at this point. Ditto with larger dose adjustments. You've already switched back to TR which is a more aggressive dosing protocol. There are safety mechanisms built into it.

Charlie'sMom22 said:
I’m wondering whether there’s a way to get ahead of this before it’s too late, if it’s not already.
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You have a feeling that he's on the way up quickly, but no proof. He's only been above 200 for 4 cycles. 5 days since he last saw a green.

I dealt with a similar situation with Neko when her pituitary tumour came roaring back. Mid July 2015. I did a dental to deal with a bony growth on her jaw. That may have contributed to her high numbers but ultimately it was the tumour regrowth that may have also caused the jaw bony growth. I also started using Regular insulin, with the help of some experienced folks here. Caveats - I didn't use it until it was clear her numbers were rising, followed TR as written, and most importantly, I had a proper acro diagnosis and knew what I was dealing with. We don't with Charlie. What if he just has a p'titis episode, UTI, or tooth that needs taking care of? Always check with the vet so eliminate other conditions. Third day without poo and then it was smelly. I wonder if that is p'titis or something else?
 
Wendy&Neko said:
You are right, fast tracking is not protocol, it's already an aggressive suggestion for situations that have proven they need it. That means all 300+. That is not Charlie at this point. Ditto with larger dose adjustments. You've already switched back to TR which is a more aggressive dosing protocol. There are safety mechanisms built into it.
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Okay, I understand. We'll wait and watch and I'll ask again later if need be.

Wendy&Neko said:
I dealt with a similar situation with Neko when her pituitary tumour came roaring back. Mid July 2015. I did a dental to deal with a bony growth on her jaw. That may have contributed to her high numbers but ultimately it was the tumour regrowth that may have also caused the jaw bony growth. I also started using Regular insulin, with the help of some experienced folks here. Caveats - I didn't use it until it was clear her numbers were rising, followed TR as written, and most importantly, I had a proper acro diagnosis and knew what I was dealing with. We don't with Charlie. What if he just has a p'titis episode, UTI, or tooth that needs taking care of? Always check with the vet so eliminate other conditions. Third day without poo and then it was smelly. I wonder if that is p'titis or something else?
Click to expand...
I see that. Ugh, I'm sorry. It's really hard to watch their numbers climb and not be able to intervene and stop it immediately.

I'm working with an IM vet to figure out what the root cause of these episodes are. He's had probably 7 of them since May. In a recent one they did an xray and saw that he had a TON of gas. She thinks his severe gut dysbiosis is causing these episodes as well as the motility issues and recent high numbers. She thinks it's starting in his gut and then maybe causing systemwide inflammation. I think so too. At this point he can't really eat anything besides plain boiled chicken without triggering some sort of flare. And I've tried a lot of things. Hoping the GMP and FMT from animalbiome help him enough that I can get his diet back on track and get some real nutrients into him. That may take weeks though.

He also has an echocardiogram coming up in December because his ProBNP test came back moderately elevated. In the meantime, I'm trying to limit vet visits as much as humanly possible because of how stressed he gets. It's been getting worse every time. I can't even really have friends come to my house now because of how traumatized he is. The stress plus the CKD and possible heart disease mean that I may never be able to get a definitive diagnosis. So I'm kind of between a rock and a hard place here. Basically if the AB stuff doesn't work then we can maybe try a non-corticosteroid? After that then... I don't know. There aren't many levers left to pull.
 
So sorry this is all happening again, Jess. 😞🫂 At the very least, I guess, take heart that you've broken him out of one of those horrible cycles once before and can do it again.
 
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