04/26 Eddie AMPS 376 +2.5 398 +6 344 PMPS 376 +2 288 +6 131

Jodey&Eddie&Blue

Jodey&Eddie&Blue

Member Since 2021
Good morning,
Here's yesterday's story:

https://felinediabetes.com/FDMB/threads/04-25-eddie-amps-376-pmps-340-2-277-6-130.262466/

Note: he went into PMPS +6 130 so I've held dose @ 8u in service to depot-building. Will hold for the day and if I can't get another blue by AMPS tomorrow, will do the increase to 9u, which brings us full circle to where we were before Eddie's misadventures during sedation for the CT scan.

I should add he's doing great with the 5 Ps.
 
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I'm inclined to say hold til after bounce breaks because I don't like increasing in the same cycle as a possible bounce break (especially if you have to be away) but up to you. TR says hold 3-5 days if blue nadirs, but we also know 9U was his last good dose
 
@ +6 344. Given +6 last night (PMPS +6) I'm not sure how to read this. Perhaps increase tomorrow (27th) since it will be 3 days on 8u.
 
Why rush the increase? He hit nice blue last night and you’re likely seeing a bounce right now. You also don’t know that you caught the lowest number. I’d personally ride out the bounce (keep the same dose) and then try to get more mid-cycle tests to see what this dose can do. I’d argue that the last good dose might have been lower than 9u. At 7.5-8u he was still seeing nice blues and you didn’t really get tests to see if there were lower numbers before increasing. Not saying you did anything wrong, but catching the lowest number is really key to making best dosing decisions, IMHO (I believe in testing more the lower the numbers get).

Also, for what it’s worth, I think you were wise to slow-walk the increases. Eddie wasn’t normal for days and wasn’t eating properly, and given all of the variables, it’s possible that going straight back to 9u could have caused problems. We don’t have the parallel universe to know, but I believe in the mantra “first do no harm.” Also, with your time restrictions and end of term commitments and inability to test non-stop (which is just real life), I think your decision was practical.

I’ll go back into the woodwork now. I’m not sure anyone appreciates my comments from the sidelines but I feel obligated to speak up occasionally. I too have been there, done that, and felt the pain. Give Eddie a scratch on the head for me.
 
With that lowish blue last night, you could definitely bold the dose 8 cycles and get a better idea of how he's doing on this dose. Still way too much pink and red on this dose for my taste though. I prefer keeping cats under renal threshold as much as possible.
Jodey&Eddie said:
I should add he's doing great with the 5 Ps.
Click to expand...
That's the best news!
 
If he were my cat I would increase. There's still a long way down to your reduction point, he's seeing a lot of higher numbers still. Wendy mentioned renal threshold, and with the recent UTI it's also important - the bacteria thrive on the excess sugar in the urine, so while we hope his antibiotics knocked it out, I've seen many return quickly.

Remember that with IAA we've found that keeping them lower, ideally greens, helps the most. So while the nadir is more what I would call an "ok blue", he's not staying there very long.
 
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