? 02/09 Eddie AMPS 320 +3 342 PMPS 266 +2 169 +3 117 +5 121

I'm beginning to wonder that if a kitty has acromegaly, has had hypophysectomy and SRT, is TR the way to go? Does Eddie's SS suggest that his oscillation have less to do with DM than with tumour de/activation. Am I doing Eddie a disservice by doing TR. He earned reductions often result in an increase down the road.

I realize he has gone from 11, 12, 13, 14, 15 units and back down again to where we are at 7.75 u (which is really difficult to measure on U100 syringes, btw). But I'm just reflecting on the fact that, strictly speaking, Eddie is not "diabetic" in the same way as other DM kitties here.

This may be just a reflection. Not even a question. But am I doing the right thing using TR with an acrokitty (esp since ECID)?

@Wendy&Neko
 
My goal with Neko was to keep her below renal threshold as much as possible. Especially since acro is hard on kidneys by itself. Following SLGS won’t get you there as you reduce even sooner and hold bad doses too long. TR is more aggressive but safe with the requisite testing. Do you have another dosing method in mind?

Eddie is diabetic, under the classification of “other types of diabetes”. Given that approx one in four diabetics has acromegaly, Eddie is not alone. Only unique here in having both hypophysectomy and SRT. Lots of SRT kitties have followed TR. as have those using cabergoline, that can be a much faster path down dose.

Look at some other spreadsheets of non acro kitties ( as far as we know since usually untested), you will find lots of up and down in dose. Especially those that have been diabetic longer.
 
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The other thing I would add is what do you see as the alternative?

Lower reduction point? I will admit that makes me a bit uncomfortable... although cabergoline is not the same as SRT, when I saw action it behaved similarly...and 70 was a nice comfy place.

SLGS? Seems it would be worse to me. Reducing below 90? He'd have earned far more reductions. Holding the dose for longer? Those streaks of pinks and reds held longer?
 
FrostD said:
The other thing I would add is what do you see as the alternative?

Lower reduction point? I will admit that makes me a bit uncomfortable... although cabergoline is not the same as SRT, when I saw action it behaved similarly...and 70 was a nice comfy place.

SLGS? Seems it would be worse to me. Reducing below 90? He'd have earned far more reductions. Holding the dose for longer? Those streaks of pinks and reds held longer?
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And @Wendy&Neko

Hello, it's been a long day. I was up at the university for the afternoon and for the first time back teaching in person in two years. It also meant I couldn't do any more testing before I gave Eddie (and the crew) dinner, so I have no idea if he went into blue this afternoon.

I do know that TR is much better, more accurate and safer than SLGS but I was also concerned that maybe because of acro Eddie might be different than kitties with diabetes and no acro. I do know it is more prevalent than people -- even vets-- think (I have a hypothesis about this but it's for another time). So, I was just thinking out loud.

I would not lower his reduction point. I think though that I was thinking because he's an acro cat, maybe we rush into reduction when in fact his numbers are a function of the fluctuation I mentioned. I was up through the night with Bhooma ( @Bandit's Mom )because Eddie started to go blue. @+5 124.

I'm concerned about TR because now that we are back in person, I'm signed up to do a couple of lectures at other universities, the first one being March 16 which will require me to be away for two nights. I do not know anyone who can test period, never mind into the day or night. I have someone who can give insulin but that's as far as it goes and so I worry.

Anyway, these are just my random, but concerning, thoughts. It's because it's all on me every day and every night and if I have to travel even for overnight, there's a risk.

Thanks for listening.
 
An option is TR but with a higher reduction point, especially if you cannot monitor. When you are away, we would suggest a pet sitter dose, low enough for him to stay safe.

I wouldn’t call TR safer that SLGS as kitties on TR are allowed to run lower. Which is OK if you are monitoring more.
 
Wendy&Neko said:
An option is TR but with a higher reduction point, especially if you cannot monitor. When you are away, we would suggest a pet sitter dose, low enough for him to stay safe.

I wouldn’t call TR safer that SLGS as kitties on TR are allowed to run lower. Which is OK if you are monitoring more.
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Thank you. Knowing that you would be able to suggest a safe dose while I was away really relieves anxiety, even the anticipated kind.
 
If you're concerned that reductions are premature, you could also say something like 2 x below 76, or 3x. That was my original plan because pre-cab he would sometimes dive down, but it was only a one cycle thing.
 
FrostD said:
If you're concerned that reductions are premature, you could also say something like 2 x below 76, or 3x. That was my original plan because pre-cab he would sometimes dive down, but it was only a one cycle thing.
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Melissa, this is what I needed to hear! I did not realize that I could modify the terms of an earned reduction. I just thought if he goes low one time he earns a reduction. What I see in the SS is the dive, the reduction and then the climb back towards a higher dose. I will try this TR method and see if it breaks the pattern. I have a month before I have to be away for two nights to try it out.
Thank you, again. :cat::)
 
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