Re: 10/18 Blackie AMPS 101, +3 56, +6 74
Hey Angela
I am just responding to your PM about Blackie's numbers. I see on the SS you took her up because you felt the 4u dose wasn't holding. The 49 yesterday morning was from the 4u dose depot. So that would have been three times under 50 for her which should have earned a reduction.
I know you are worried about her PMPS increasing and want to take her dose up to bring that number down. Just remember that we don't dose based on PSs..right? We dose on nadirs and her nadirs are getting below 50.
I understand, too, that you want her in green numbers all the time....we all would love for that to happen with our babies
so I don't fault the goal at all. But remember, normal healing numbers are up to 120. There are several OTJ kitties who throw AMBGs or PMBGs that are 120 or a little higher and then their pancreas brings them down into green. I don't think it is the PSs close to 120 that will prevent her from going OTJ. The PSs are the last numbers to come down.
IMHO, I think she is doing great. Sometimes it's hard for us to see the forest for the trees. I do this with Gracie, too, and have to have other eyes on her SS. I am very hesitant to suggest that you increase her dose when she's getting nadirs in the 40s.
I know you are thinking of taking up her dose and I know you will test her. But I believe you will have to feed her medium or high carb food to bring the nadirs up enough to take the dose up so she doesn't bottom out. You did a feeding trial before and didn't like the results because her nadirs did come up. I might be dense so please forgive me but I'm not sure if we're talking about something different here now? Bottom line is I don't think it's a good idea to feed MC/HC food solely in order to shoot more insulin so you can bring down the PMPS.
I think the best course of action is to take her back down as soon as she gets below 50 because she was headed that way anyway. If the goal is remission, then the dose has to come down. By not giving her earned reductions, you put her at risk of being overdosed and you aren't making progress towards remission. As hard as it is, I'd try not to focus on that one number...the PMPS. Focus on all the spectacular numbers she has and how much time she is spending in those healing numbers. :mrgreen: She looks fantastic!! Really!!!
