11/26 Eddie AMPS 216 +8 221 PMPS 322

What is the "SRT protocol" you mention on 11/23 on the spreadsheet.

I like the blues, would like them a touch lower.
 
What is the "SRT protocol" you mention on 11/23 on the spreadsheet.

I like the blues, would like them a touch lower.

I met with the IM vet; the discussion was about the Prednisolone dose and how long Eddie might be expected to be on the higher dose than he was prior to SRT. We also talked about the phone meeting I had with the radiation oncologist as a follow-up to this treatment. Eddie was on 10mg once a day for two weeks and now he's on 5mg. Prior to SRT he was on .625 mg once a day. The reason for the higher dose as you probably know is to control inflammation after radiation. We also discussed rebound/bounce and Let X = the Unknown where it comes to radiation effects. The IM vet was reflecting on the current dose and I had a Zoom meeting with him and showed him Eddie's spreadsheet.

Another Let X=the Unknown moment is about the dose and the question of should he stay at this dose to avoid a hypo while the SRT does what the SRT is supposed to do: interrupt the tumour growth and, therefore, the GH secretion and, therefore, the insulin resistance.

I'd like to see more blues, too, but am not quite sure how to get there from here...
 
Thanks for the explanation. When I hear "protocol", I was thinking dosing, but it wasn't. More an explanation of what might possibly happen post SRT. Of course ECID. I do remember the higher dose of pred, and questioning it, at it wasn't standard practice at any of the other places giving SRT, unless it was needed. Neko never had it. But it's over now and any impacts of higher pred should be long gone.
Another Let X=the Unknown moment is about the dose and the question of should he stay at this dose to avoid a hypo while the SRT does what the SRT is supposed to do: interrupt the tumour growth and, therefore, the GH secretion and, therefore, the insulin resistance.
A good question. Of course, it can take months for SRT effect to start working. In the mean time, Eddie would be largely above renal threshold, letting IAA take control, and adding in some glucose toxicity. What I was hoping for was a dose somewhere that looks better, ideally nothing over 400, but not risky.

Tomorrow would be the 7th day since he's seen anything under 150. If he didn't see anything in the 90-149 range tomorrow, he'd be due an increase per SLGS. You could always split the difference and do a 0.5 unit increase. Note, once you have the ability to monitor more and follow TR, it would be a 1.0 unit increase.
 
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