06/28 Mister +11.5 163 PMPS 165

MisterBillie

MisterBillie

Member Since 2022
No idea how do format title, whatever. See spreadsheet. I am beyond frustrated. Been stuck in super high numbers for months until today, the literal day before my consult for SRT at the University of Minnesota. He didn't eat as much as he normally does today, which never happens. Now I can't get him to test above 200 for his PMPS.

His +11.5 was 162 and his +12 is 165.

Now what? I have a needle loaded with 28 units of Levemir. I call BS on this being a breakthrough dose, it's just because he hasn't eaten even half of what he normally does today.
 
It doesn’t look like it’s typical for him to have a Levemir late nadir, but it is possible. Even if you reduce his dose, he has a very large depot that will influence the pm cycle anyway. Can you monitor him tonight ?
 
Suzanne & Darcy said:
It doesn’t look like it’s typical for him to have a Levemir late nadir, but it is possible. Even if you reduce his dose, he has a very large depot that will influence the pm cycle anyway. Can you monitor him tonight ?
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Yes, I can monitor him. He keeps me up practically all night anyways with the logistics of wet food
 
I wonder why his appetite was off today. It’s true that cats in lower numbers don’t usually eat as much, but his numbers today weren’t that much lower than normal (until just now in blues.)
 
Suzanne & Darcy said:
I wonder why his appetite was off today. It’s true that cats in lower numbers don’t usually eat as much, but his numbers today weren’t that much lower than normal (until just now in blues.)
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I switched to a new food recently, now he's pretending he doesn't like it as much even though he loved it more than his previous food for the first four days
 
MisterBillie said:
Yes, I can monitor him. He keeps me up practically all night anyways with the logistics of wet food
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I don’t like the not eating though. If you needed to bring his numbers up with food, it could be more difficult. You can either stall more, or shoot a reduced dose or Of course the full dose. I might shoot a reduced dose if he’s really not eating well. But if you think he would eat a different food (being picky) then maybe you should feed him that before you make up your mind which way to go.
 
It’s best to start a new condo each day as more likely to be seen. Your subject bar would not catch attention. The new one should have a ? and say something like Ambg 86 should I shoot? That will get more attention.
 
Posting here cause it's the latest thread I see. See the note above about posting each day with the link to the previous thread. That keeps threads shorter and more readable for those trying to help. POSTING GUIDELINES PLEASE READ

Congrats on that first green! :D That's awesome to see. In your previous post here, the possibility of cabergoline working was raised. As it's two weeks since you started every day, that's definitely a possibility.

Those Levemir late nadirs do take some getting used to. On the other hand, you do have probably 4 hours until the next dose takes effect and starts lowering his numbers, so you do have time to get food into him. I liked Levemir a lot for that reason. You will have to get used to shooting green numbers though. Lower greens get a little more "interesting". ;)

A couple other housekeeping items. On the +11 last night, the green is shown as a lime green. Could you change it to dark green. Lime has a special meeting here. :eek: ie below 50 and time for HC. Also yesterday, AM+4.5 of 201 is shown as blue, but should be yellow. Those of us who read spreadsheets are pretty wired to read the colours a certain way, so getting those right is important to us.
 
Hmm, that tag isn't showing up in my alerts at all.

Congrats on shooting green! And no, I don't think it's strictly appetite related.
 
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Here you go!
 

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Excellent, thanks for the input. At this point he's back to eating what I'm putting in front of him. So it must be the Cabergoline. Wow if so.

And of course I'm shooting green. I am not for a moment going to skip a shot and go back to high number hell for 6 months.

The real question is, at what point do I start doing increases or decreases
 
MisterBillie said:
Excellent, thanks for the input. At this point he's back to eating what I'm putting in front of him. So it must be the Cabergoline.

Wow if so
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I’m just so excited for you. I remember when this started happening in my cat. So I hope you will forgive my excitement! But I know I keep saying it… but I am really stoked up about this!
 
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MisterBillie said:
Excellent, thanks for the input. At this point he's back to eating what I'm putting in front of him. So it must be the Cabergoline. Wow if so.

And of course I'm shooting green. I am not for a moment going to skip a shot and go back to high number hell for 6 months.

The real question is, at what point do I start doing increases or decreases
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Just a word of caution - if this is cabergoline (or the IAA, or the tumor slowing down for a bit) you might some funky BG and dose movements and sometimes it may be better to do a BCS (big chicken shot, a one-time reduced shot) or skip. If you post here we can definitely help.

You don't have a dosing method in your signature, and the one in the SS is MPM which is ProZinc. Looks like you've been attempting TR? There aren't quite enough tests for it to be full blown TR (missing some extra ones day and night).

Link to dosing sticky as a refresher - https://www.felinediabetes.com/FDMB...-low-go-slow-slgs-tight-regulation-tr.210110/

I think the majority of us with acro cats follow TR; however, we typically customize the reduction point. I used 70 as a reduction point after starting cabergoline just for extra cushion, that seems to be a common starting point. Once.you see how he does in these numbers at these doses with the possible IAA/cab/acro effects you'll be able to fine-tune the best reduction point and when to increase and decrease.

For now definitely hold this dose for at least 5 days to see how he does. He may earn a reduction on you - See what @Wendy&Neko thinks about reduction point.
 
Suzanne & Darcy said:
I’m just so excited for you. I remember when this started happening in my cat. So I hope you will forgive my excitement! But I know I keep saying it… but I am really stoked up about this!
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Pink on pink on pink for months/years is disheartening! Always exciting when a cat gets close to regulation, doubly so for the acros because it feels like a hopeless road many days (says the woman whose cat only made it up to like 14U :rolleyes:)
 
Switching to TR then. The last two days I've basically been doing TR

My increase and decrease amounts at this level are 1u instead of 0.25, and 2u instead of 0.5 mentioned in the guide, correct?

How many units would a BCS be? I'm at 28u now.

Edit: Wow, two PMPS back to back were the same exact number
 
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A BCS is either 1/2 or 2/3 of a dose. It sort of depends on the cat. I'd start with a half dose BCS, and if that's too much, go to 2/3. If you start to get a couple quick reductions earned in a row, then that's the point you start getting very cautious, and thinking about increasing the reduction point. The IM folks at CSU suggested I go to 70 when Neko started zooming down, it worked for her, so that's what I've been suggesting for people following TR. When cabergoline starts taking effect, you really have to be cautious, it can be a fast ride down. Skipping shots or BSC shots, back to back reductions, whatever it takes to keep Mister safe.

Think of increase/decrease amounts as a percent of the total dose. So something in the order of around 10-15% of total dose. Note for any lurkers. this is for higher dose kitties only and special circumstances like Mister.
 
Fur shot completely ruined the low numbers streak it looks like, will update numbers tonight when I get a chance (edit: numbers updated). In the high 200s/mid 300s now.

There's now fairly hard large lumps in his skin where I'm injecting him, this never happened with ProZinc. This had been happening even before the fur shot in the last few weeks.
 
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I had the same trouble with Mr Kitty, but I never saw a difference in numbers or pain or anything so I kept with same area but tried to alternate.

Although do you mean like possible scar tissue, or it's the insulin sitting there for a bit before absorbing?
 
FrostD said:
I had the same trouble with Mr Kitty, but I never saw a difference in numbers or pain or anything so I kept with same area but tried to alternate.

Although do you mean like possible scar tissue, or it's the insulin sitting there for a bit before absorbing?
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I'm not sure TBH what scar tissue "feels like". It's just lumps that are large in surface area.

Back in blues baby. Yeah!
 
And just like that, back to high numbers. TR is a waste of time when he's this high in numbers, right?

I am moving forward with scheduling SRT at either UMN, IA State, or UW
 
Why would TR be a waste of time? It’s important to keep increasing every six cycles, if necessary based on his numbers (and pink certainly warrants that.). Those high numbers are very hard on his body and even if you are doing SRT, he can benefit from being in better numbers in the short term. You don’t know that he can’t get into healthier numbers with increased insulin. Believe me, I do understand your frustration! I really do.
 
What I meant was the only reason to test 6 times a day (TR) vs. 4 times a day (SLGS) would be if you are actually in low numbers.

I just increased to 30u, that's the entire syringe. If I go to 32u, I would have to use two syringes.

At this point, I highly doubt there is some kind of magic unit number where he will never not need an increase.
 
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