07/14 Baxter| amps 144, +2 117, +7 154, pmps 213, next amps 67 as of 07/15 need help with dose review!

Baxterandbess

Baxterandbess

Member Since 2025
It seems odd to me that Baxter starts to dip into greens a cycle or two after his dose increases, but then gradually climbs back up? Definitely happier with these numbers the last couple of weeks and he looks a million times better... may even need to discuss his sub q schedule with the vet actually (and the yucky ear we probably need a pcr for) but just wondering if this is a pattern that shows up with high dose kitties? Should I still raise his dose a half unit or is a quarter a safer increment now that we are seeing mostly blues? Any words of wisdom appreciated!


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Baxterandbess said:
It seems odd to me that Baxter starts to dip into greens a cycle or two after his dose increases, but then gradually climbs back up? Definitely happier with these numbers the last couple of weeks and he looks a million times better... may even need to discuss his sub q schedule with the vet actually (and the yucky ear we probably need a pcr for) but just wondering if this is a pattern that shows up with high dose kitties? Should I still raise his dose a half unit or is a quarter a safer increment now that we are seeing mostly blues? Any words of wisdom appreciated!


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Hi Bess, is Baxter on any medication for the acro? I don’t see any notes in your signature about that.

I see that pattern with Ivy at times. First few days look good with nicer BG, then the dose can loose fizzle.
So I usually give her an increase.

I am not giving you dose advice, especially since he’s an acro kitty.

Maybe Wendy can suggest what to do.
You could use the prefix question mark in the drop down menu and put “Dose review” in your field for some help.
 
Staci & Ivy said:
Hi Bess, is Baxter on any medication for the acro? I don’t see any notes in your signature about that.

I see that pattern with Ivy at times. First few days look good with nicer BG, then the dose can loose fizzle.
So I usually give her an increase.

I am not giving you dose advice, especially since he’s an acro kitty.

Maybe Wendy can suggest what to do.
You could use the prefix question mark in the drop down menu and put “Dose review” in your field for some help.
Click to expand...
He is not on any medication for the acro.. I have been trying to find information about cabergoline to send to my vet because they just have what antech shows them about treatment options. They keep giving me the switcheroo there and it felt like we were getting somewhere then they gave me another vet and I swear it's like they don't look at the charts!

I hope Wendy can help! I am glad I didn't increase last night because he spit up before having a low amps. He's OK now but I need to figure out what the heck is about that correlation... He's acting like nothing happened, and i think it would be more obvious if he had a hypo overnight.. before finding this page I was happy to have him below the renal threshold for maybe 50% of the time at most. I know we are getting closer but yeeesh this stuff makes me nervous!!

I gave him a .25 unit reduction and some carbs to be on the safe side... we'll see how he does.. gonna check on him periodically between errands today.
 
Baxterandbess said:
It seems odd to me that Baxter starts to dip into greens a cycle or two after his dose increases, but then gradually climbs back up?
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I see green, then his body reacting to the unfamiliar green and bouncing, then the bounce breaks and he goes down to green again. The last two times I count six cycles between the cycles with green. This pattern shows up with high and low dose diabetics. What you want to look for is if the greens he gets are still at the same level, or creeping up, or worse, disappear. That would be a sign of insulin resistance of some kind.

Since he touched the 60's, I'd experiment with a 0.25 unit increase. He's on a fairly good dose with some greens, you just want to tweak it a bit, hence the smaller increase at this size of dose. Some cats are sensitive to smaller changes in insulin. You need to experiment and see if Baxter is.
 
Wendy&Neko said:
I see green, then his body reacting to the unfamiliar green and bouncing, then the bounce breaks and he goes down to green again. The last two times I count six cycles between the cycles with green. This pattern shows up with high and low dose diabetics. What you want to look for is if the greens he gets are still at the same level, or creeping up, or worse, disappear. That would be a sign of insulin resistance of some kind.

Since he touched the 60's, I'd experiment with a 0.25 unit increase. He's on a fairly good dose with some greens, you just want to tweak it a bit, hence the smaller increase at this size of dose. Some cats are sensitive to smaller changes in insulin. You need to experiment and see if Baxter is.
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Hm... So would you say now that I've reduced his dose to just kind of "start over" back on 6.5 units for another 6 cycles, or go ahead and see how he does on 6.75 tomorrow? Or would it be better to see how he does on just the 6.25 for a few days first?

his igf-1 test was done a year ago but it was >1200... I'm not sure if that determines the degree of insulin resistance but he is responding to a much lower dose than I've seen many acro cats on.

I guess what really startled me was seeing a number lower than any nadir I've detected (ever) as his preshot number this morning, and he threw up clear liquid sometime overnight... Baxter is NOT used to healthy blood sugar levels, so I can see his body thinking it's hypoglycemia when it's not... worth mentioning he also gets famotidine for his tummy. This just the third time now he's spit up shortly before an "uncharacteristically" low (normal) bg reading.
 
Since MSU changed their IGF-1 testing methodology, the majority of cats positive for acromegaly have come back with >1200 as the result. Even with the older system, I never saw a correlation between the IGF-1 value and insulin dose. The folks at Colorado State University where Neko had radiation therapy said they hadn't seen any relation between IGF-1 number and tumour size. The cats there for treatment all got CT scans of the pituitary.

It's hard to say how low he went overnight between the +3 test and this morning's AMPS. Next time you get a low AMPS like that, do not feed, and test again 15-20 minutes later. That'll tell you whether he's on his way up, or still going down. That'll give you a clue whether he had been even lower. You would reduce his dose if he went below 50. We just don't know if he went there.

I think I'd stick with the 6.5 units for a bit to see if he can get down to the same type of nadirs again. You don't have a lot of room to increase.
 
Wendy&Neko said:
Since MSU changed their IGF-1 testing methodology, the majority of cats positive for acromegaly have come back with >1200 as the result. Even with the older system, I never saw a correlation between the IGF-1 value and insulin dose. The folks at Colorado State University where Neko had radiation therapy said they hadn't seen any relation between IGF-1 number and tumour size. The cats there for treatment all got CT scans of the pituitary.

It's hard to say how low he went overnight between the +3 test and this morning's AMPS. Next time you get a low AMPS like that, do not feed, and test again 15-20 minutes later. That'll tell you whether he's on his way up, or still going down. That'll give you a clue whether he had been even lower. You would reduce his dose if he went below 50. We just don't know if he went there.

I think I'd stick with the 6.5 units for a bit to see if he can get down to the same type of nadirs again. You don't have a lot of room to increase.
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That makes sense thank you!!
 
Wendy&Neko said:
Since MSU changed their IGF-1 testing methodology, the majority of cats positive for acromegaly have come back with >1200 as the result. Even with the older system, I never saw a correlation between the IGF-1 value and insulin dose. The folks at Colorado State University where Neko had radiation therapy said they hadn't seen any relation between IGF-1 number and tumour size. The cats there for treatment all got CT scans of the pituitary.

It's hard to say how low he went overnight between the +3 test and this morning's AMPS. Next time you get a low AMPS like that, do not feed, and test again 15-20 minutes later. That'll tell you whether he's on his way up, or still going down. That'll give you a clue whether he had been even lower. You would reduce his dose if he went below 50. We just don't know if he went there.

I think I'd stick with the 6.5 units for a bit to see if he can get down to the same type of nadirs again. You don't have a lot of room to increase.
Click to expand...
I wonder if CSU has any good information compiled. I wish I could get Baxter SRT... I think it could possibly be too much anesthesia even if I could feasibly find a way to pay for it.
 
Yes! I have been talking to my vet about it... although it feels like we are restarting the same conversation whenever I bring it up again.
 
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