11/10 remi PMPS 129,+2 122,+4 117advice needed reduce dose ?

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phlika29

phlika29

Member Since 2014
Well yesterday was a bit of a roller coaster as remi was sick, went low on glucose and was generally off colour. In the end he was only assist fed high carb liquid food.

viewtopic.php?f=9&t=128141

By this morning he seemed brighter so I gave him 2mg of ondansetron again and then showed him a little of his usual low carb wet food and he decided it was okay to eat! So he had just a little and then half an hour later he had a little more. I was all set to take him off to the vets but now I wonder about waiting to see how he goes for the day. I do tend to think that the potassium supplement upset his tummy and made him vomit. On Tayna's CKD website it does mention vomiting can be an issue with potassium supplements.
http://www.felinecrf.org/potassium.htm

I've emailed the vet (3 times! In the last 24 hours) and will see what he suggests. I guess I will have to switch to tumil k and see how he does on that or maybe go back to just a drop in his food of kaminox. Either way I still think he needs a supplement as today he is very weak.

Today he is :

AMPS 108
+1 108
+2 103
+8 133

Thankyou to all the people that helped me yesterday and since I have joined the forum. I really couldn't have done this without you all.
 
Re: 11/10 remi AMPS 108,+1 108

Good to hear that Remi is feeling better and eating. What a roller coaster yesterday! :YMHUG: I hope you get some answers from the vet today. There have been a few kitties here on tumil k.
 
Re: 11/10 remi AMPS 108,+1 108, +2 103

Hi Wendy

Yes what a nightmare. My vet said as he is feeling better just to monitor him today. He feels it might well have been the supplement but said you can get the same reaction with Tumil k. He advised to slowly reintroduce the kaminox and if it ends up happening again then at least we know it was that. So my plan is to leave it a day or two for his stomach to settle and then to just add one drop in the morning and one at night.

Remi is on a very high protein diet and I am thinking that maybe there is one that is more suitable. I guess potassium levels vary between brands. So I will research that I guess next.

One other thing. With the dose reduction he has just gone into the blues. Is that okay? What level am I trying to keep him under 120?
 
Re: 11/10 remi AMPS 108,+1 108, +2 103, +8 133-new dose ?

So now I am a little worried about Remi's reduction to 0.75. He earned a reduction yesterday because he feel below 50 but that was because in part him not feeling well and do not eating enough and throwing up.

But today the new dose has seen him higher than ideal so what should I do? Go back up? Wait for longer? Fatten the dose?! I am keen to keep him in the greens but don't know if he will settle on this dose or not and he must still have his shed from the 1 unit.

Any advice gratefully received.
 
Re: 11/10 remi AMPS 108,+1 108, +2 103, +8 133-new dose ?

Hi. I'm so glad Remi is doing better. Do keep up the 2ng of ondansetron twice a day until all is normal. I then taper by going to once a day for several days and if the appetite slows go right back to twice a day. Give him a chance to feel really good before totally discontinuing. My CRF kitty Tiffany was on a ton of potassium and did okay. I tried a little with Max and he wouldn't eat his food so I stopped and his went back to normal. Regular potassium gluconate from the pharmacy is the same as tumilk and a lot cheaper. I then bought NOW Brand which only requires 1/8 teaspoon. It is powdered and I put a tiny amount in each meal. You might try that if you are dosing it all at once divide it over the whole day and night.

No dosing advice but this could be bouncing which can take a few days to clear. Someone will advise you on dosing though. Have a great peaceful day.
 
Re: 11/10 remi AMPS 108,+8 133-advice needed new reduce dose

Sorry just wanted to bump this in case anyone had any thoughts about the new dose before I give tonight dose.
 
Re: 11/10 remi PMPS 129-advice needed new reduce dose ?

His PMPS IS 129 much higher than I am used to. Is this number okay to stick to 0.75 dose. Or go back to 1 unit?

PMPS 130
+2 122
+4 117
 
Re: 11/10 remi PMPS 129-advice needed new reduce dose ?

Okay I hedged it between 1unit and 0.75. When I look at the tight regulation protocol sticky it doesn't really give all that much information about what a failed reduction is. Can someone tell me what numbers I should be aiming for.

Do I ideally want remi to always stay under 120 at all times? Above what nadir number would be seen as a failure or does a failure mean any increase in numbers? When I reduced last time I got a couple of higher readings but then it was straight back down to business. But today he was a fair bit higher than before. Would that only get worse or would that settle.
 
Re: 11/10 remi PMPS 129,+2 122,+4 117advice needed reduce do

For the moment, I'd stick with this dose for at least 6 cycles unless the numbers are really not like Remi. Frequent changes in dose can result in wonky numbers. Also, remember that when nadirs are below 200, you hold a dose for 5 cycles.
 
Re: 11/10 remi PMPS 129,+2 122,+4 117advice needed reduce do

Thanks for your reply. I will hold the dose. I reviewed remi's spreadsheet and he had a run of blues a week or so ago before he settled into the greens so hopefully that will happen again.

As Mel reminded me on the relaxed forum patience is required at this point
 
Re: 11/10 remi PMPS 129-advice needed new reduce dose ?

phlika29 said:
Okay I hedged it between 1unit and 0.75. When I look at the tight regulation protocol sticky it doesn't really give all that much information about what a failed reduction is. Can someone tell me what numbers I should be aiming for.

Do I ideally want remi to always stay under 120 at all times? Above what nadir number would be seen as a failure or does a failure mean any increase in numbers? When I reduced last time I got a couple of higher readings but then it was straight back down to business. But today he was a fair bit higher than before. Would that only get worse or would that settle.
Click to expand...
I'll offer a different opinion than Sienne's, just to give you something to think about. ;-) If Remi were my cat, since he has been pretty much all green for almost 2 weeks, I would be fighting like crazy to get him back there ASAP. That is, of course, provided that you are willing and able to do the testing/feeding to keep him safe.

You're right, his numbers are higher than usual, they are above "normal," and you know he is capable of surfing "normal." So if he were mine, I would fatten the dose and try to pull the numbers back down. It might only take a cycle or two before you need another reduction, but you seem like you're prepared for that sort of thing.

Regarding failed reductions, here is how we have clarified that in our Tight Regulation sticky:

If an attempted reduction fails, go right back up to the last good dose as soon as you see kitty's numbers trending upwards. You don't have to hold the reduced dose for a certain number of cycles before taking the dose right back up. The guidelines listed under the topic "Increasing the dose" do not apply to a failed reduction.

Please use common sense in this situation. The "last good dose" is not the dose that just dropped kitty into the 20s or 30s. You want to resume momentum by finding a dose in-between the dose that dropped kitty too low and the reduced dose.
Click to expand...

That's my 4 cents. ;-) What are yours?
 
Re: 11/10 remi PMPS 129,+2 122,+4 117advice needed reduce do

Hi Libby

I gave the 0.75 dose this morning before reading your post but although I know I need to be patient as Sienne said I really want to keep remi in the normal numbers and so am inclined the fatten the dose as you suggest.

My reasoning is that I can monitor remi quite a lot and he wasn't on the 1 unit for all that long before he went below fifty. When he went below fifty he hadn't eaten as he was unwell and so although I know he still earned his reduction I knew he might struggle with it.

I use a metal ruler to measure against remi's syringes so 2.5mm is 1 unit and 2mm is 0.75. There are no markings in between those lines but if I line up the plunger to I between them that would be fattening the 0.75 dose wouldn't it? Is that in effect the same as skinnying -sp? the 1 unit. I am not sure I can get any more accurate than that. I can't rely on the syringe markers they are just much out.

Having said all that this morning his AMPS 6.2 / 111 so that is in the normal range isn't it? Under the 120. But ofcourse that was after the fattened dose last night. So unless he goes green today I think I will fatten tonight.

Many thanks

Sarah
 
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