1/9 Mary Grace AMPS 327-Dosecrease ?

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marygracemom

marygracemom

Member Since 2013
Good Morning LL!!

My question is should I hold the dose for a few more cycles, it seems with every increase, she is bouncing and/or NDW and by the time she starts to level out and to get a lower nadir, it is time to increase and we start the whole bouncing cycle over. Just wondering, and any advice would be appreciated. I also see others use R to bring down high numbers from bounces, is this something I should consider doing?
Thanks in advance. I really appreciate all the help, support and wisdom that you all give!!
 
Hope you're having a fabulous day over there :-D And hoping you get some dosing experienced eyes on this post today. It will be so nice to see our sweet Mary Grace find that breakthrough dose soon ;-) :smile:
 
As aggravating as it it, bouncing is something that just about every kitty experiences when striving for that perfect dose. When you increase the dose, Mary Grace's numbers are getting a bit better each time, a little more blue each time. That will trigger a bounce, but that's the natural course. You still need to increase the dose. Personally, I would increase every three days, but YOU have to feel comfortable with that. The bouncing is a good sign that her numbers are responding. It's a major pain in the rear, but an indication that things are working. You just may be nearing that breakthrough dose (one can hope)!!
 
Hey Kim, hope you are having a good day. Mary, my sweet Mary is now the house bully. cat(2)_steam

Hey Patty, I know she's ready for an increase but what I wonder is by slowing down the bounces it might make her liver not so panicky?? Probably sounds silly. Her nadirs seem better when I've gone more than six cycles. I'm scared that I'm just climbing this high dose ladder and she will keep bouncing, and before long she is taking a huge dose, which is fine, but then it's less likely remission would ever happen. :YMSIGH: I just want to do what's the absolute right thing to make her healthier and happy.

Hope you all have a great evening. Sending healing vines to all in need
 
She does have an interesting looking spreadsheet. she's hitting blues about every day and a half, though, which is pretty good.

Here's the part of the protocol that addresses increases:

Increasing the dose:
Hold the dose for 3 - 5 days (6 - 10 consecutive cycles) if nadirs are less than 200 before increasing the dose by 0.25 unit.
if your cat is new to numbers under 200, it is recommended to hold the dose for at least 8-10 cycles before increasing.
when your cat starts to see nadirs under 100, hold the dose for at least 10 cycles before increasing.
After 3 days (6 consecutive cycles)... if nadirs are greater than 200, but less than 300 increase the dose by 0.25 unit.
After 3 days (6 consecutive cycles)... if nadirs are greater than 300 increase the dose by 0.5 unit.
Click to expand...

I don't know that i would call her "new to numbers under 200" though, when she's seeing them frequently. nevertheless, as long as she's bouncing from them, maybe that would still be considered not used to them.

One thing that might be helpful, however, is that once a cat passes 3.0u we sometimes recommend moving to a 0.5u increase rather than a 0.25u increase for the norm. As long as you're going to be home, you could try the next increase at 0.5u instead.

I think with her clearing bounces fairly quickly, i wouldn't try using R on her yet. Most of the time the cure for bouncing is getting the cat to the appropriate insulin dose and patience. I don't think she's quite to the right dose yet.

If she gets to 6u and we're still seeing the same kind of numbers, you might want to consider having her tested for the most common high dose conditions - acromegaly and iaa. if you want to do that, we can talk about it. it's just a blood test but it has to be sent to Michigan State University to be analyzed. http://animalhealth.msu.edu/Bin/Catalog.exe?Action=Search&SPECIES=Feline&PAGE=6&Page=7 The two pertinent tests are Insulin Like Growth Factor - 1 and the Insulin Autoantibodies.

Is she getting any food past the nadir of her cycles? I'm wondering if that might be contributing to her higher preshot numbers.
 
I think she is due a dose increase and I would hold the dose ten cycles if she's in blue like she is.

One point about R: for a cat that is bouncy, we use only to stop the bounce from going higher. I agree with Julie that I think you need to give her some time to let the Lantus work before you throw R in the mix.
 
Hey Julie and Marje, thanks for the replies!! Hope you both are off to a good start for the day (TGIF!)

That's why I was confused because the protocol said to hold the dose longer if new to numbers under 200. So I wasn't sure. Thanks for your input. I increased this morning to 5.5. Should I continue or change tonight's dose to 6.00? I will get her tested for the possible issues if she doesn't level out. Also thanks for explaining why/when R is used. I do think she clears the bounces fairly quickly, she just keeps having them!! :YMSIGH:
And she does not eat anything after meal/shot time and +1, +2 (food spread out over those times) except for freeze dried chicken at testing.
There is no food left out for my civies that she can get into.
 
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