1/6 Cobb AMPS 114 +11 76 PMPS 153

[Suzanne & Cobb(GA)]

Yesterday's Condo

These doses! So small!! I need a magnifying glass! I'm just kidding. It's so nice to see that I only have about 1/6th of the syringe filled up instead of having to wait for all the air bubbles to dispense when you draw up 20, 30 units. So inconvenient. LOL.

I expected to see a little higher number for Cobb this morning, but I'm guessing that 7u depot is still in effect.

I have questions this morning!!!

1. I know the depot is getting smaller with the smaller doses. At what point do we say Cobb doesn't have a "large" depot any more? Just curious.

2. Obviously I don't want to move Cobb down TOO quickly as he earns reductions. As the depot continues to get smaller, I would assume, there's less risk of that depot "getting ahead" of me. Do I continue to take reductions under 70 as we've been doing to avoid that large depot getting ahead of us? Do I wait until/if we get down to 5 units and adjust then and start taking reductions under 50? When would you start easing down .25u at a time instead of the .5u (I think I asked that before, but I don't remember the answers)?

3. Does a high dose cat always play by high dose rules? (I know, ECID.) What I'm asking is...since I kinda made up the rules for Cobb, as one who has a big gulper sometimes has to...is there a time when I start following the protocol more strictly than I have been?

Points to ponder for all of you this morning. I look forward to your answers -- although I fear your answers are going to be...you're going to have to try and see what happens. Rules, people! I need rules!

~Suzanne

 

[Wendy&Neko]

G'day Suzanne - just wait until you start the .25U changes, then you might really need a magnifying glass.

OK - here's my attempt to answer the questions, but with guidelines.
1. What is a large depot? We consider testing for high dose when kitty is at 6U, we suggest going from .25U changes to .5U changes when kitty goes up to 5U, and somewhere in one of Dr. Jacquie Rand's publications she refers to "high dose" as being over 3 U. So, somewhere in there. Can you say ECID? I knew you could.

2. I can only tell you about my experience and one or two others that I've paid attention too as we went down scale. .5U changes stopped working for me when we got to 3.5u-4U. I've seen the same with one other (non acro) cat. For me, at about the same time I went to drops below 50. Although honestly, if she's doing overnight surfs in the 50's, I'll often reduce for safety/sleep, but do a smaller reduction like .125U. You'll have to see what works for Cobb.

3. You have to think about what your goal is with Cobb. Obviously we'd all love remission, but who knows if it's possible.If you want to try for it, then follow TR a little closer. For me, I want to maximize Neko's time under renal threshold and over time I've observed that for her, a dose with a nadir of 70 does that. She's also now sensitive to changes of .125U, but that's not something I've seen any other people owned by acrocats do. I also use BD syringes that have lines that can be out as much as .4U, so I went to caliper dosing and that helped me do the .125U changes. The other thing you have to consider is, if Cobb is an acrocat, does he have a working pancreas? Which means, how well does he respond to carbs? Part of the "high dose rules" is keeping kitty safe given that their pancreas may be "helping" you out in low numbers when you don't want it to. Most high dose condition cats basically follow TR at smaller doses, but they may skip the "go to .1U before going off insulin" step, cause it's not about going easy on a newly functioning pancreas.

 

[Suzanne & Cobb(GA)]

Regarding #3, I honestly don't know what my goal for Cobb is. Of course, I'd love him to not need insulin any more. It would make mine (and I know everyone's) day so much easier! But is that realistic? I don't know. If you ask Matt, yes, the goal is remission.

Question from that...since we've been playing by the high dose rules -- do we then follow the protocol for long term diabetics (reduce after 3 dips under 50)?

I guess now is when those acro results might be helpful...we have Cobb's annual visit coming up at the beginning of April. I doubt our current vet would gouge us for the blood test, especially because it might satisfy her curiosity as well...hmmm...

 

[tiffmaxee]

Nice numbers but sooo much to ponder. I must say I get the part about needing to keep the kitties safe and needing sleep. So many variables. I wish it was more clear cut but that's just a dream of mine.

 

[Wendy&Neko]

do we then follow the protocol for long term diabetics (reduce after 3 dips under 50)?

Again, you have to see what works for Cobb. Longer term diabetics tend not to hold reductions as well, so that's why it's harder for them to earn reductions. It keeps them in nicer numbers longer. I've found that smaller reductions work better for Neko - a couple of times I've waited for 2 drops under 50. Under 40 always gets a reduction. But I also know Neko usually comes up nice with her high carb food. If I had a cat that didn't come up easily with high carb, I'd be more conservative.

I'd suggest taking reductions as you do now, and if you find they aren't holding, then modify the strategy. That shouldn't change whether he's on 10 units or 2 units.

 

[Suzanne & Cobb(GA)]

I feel the 153 is artifical inflated due to stress. Somehow we got locked out of our garage, inside the house - which would have been salvageable except our cars and garage door openers were in the closed garage. So we had a ton of hammering while Matt and our neighbor took the door off the hinges...thus leading to, I believe, a stress induced BG spike.

 

[Marilyn and Sheldon]

My head hurts! Rules? No rules? ECID? High dose? Not high dose?

Ah, phooey. Polly and I are just dancing to whatever music moves us! Kinda like my favorite road trips. Don't know where we're going, turns based ohhhhhh-that-looks-fun.

Any detours, faulty maps, or washed out roads? Well, we'll just come to LL and yell, HELP!!! I am soooooo glad some of you understand all this!

Marilyn and Polly

BTW. Cobb is amazing. Suzanne, get those calipers ready!