12/14 Crystal dosing advice please

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suki & crystal (GA)

suki & crystal (GA)

Member Since 2014
Can someone have a look at Crystal's SS please and advise me if I'm going in the right direction? She has been on 7uBID since Thursday but is still in the mid to high 300's, the yellow levels seem to have disappeared. I think I need to get more post PM shots but she tends to be out and about in the evening while the weather is still mild - what would be a good time to test her? Her AMPS test is currently running high in the mornings, by which time she had eaten any food at bedtime that I have left for her so it's not a food spike, what could be causing this and is it a concern?

She is now back to normal following a bad attack on constipation last weekend (thanks to all those who offered support and advice), I now add a little olive oil and some squash to her raw diet mix and that appears to be working.

Lastly, should I take off "not following TR regulation" from my signature now - I'm following the slightly modified protocal for increasing the dose (or at least I think I am?).

Suki & Crystal
 
I'm glad the constipation is in the past and Crystal is feeling better now.

I think you can take off the "not following TR regulation" from your signature.

I think you just need to keep doing what you're doing, and depending upon the PMPS, of course, I would try to get a +5 or a +6 in the night times, for now. When she starts having lower numbers that will change and you may need to test more frequently.
 
I'm glad the problems with constipation are past. You might want to consider adding some water to her food, as well. (The water is really good for our kitty's kidneys.)

I think you need to increase. Given that Crystal's nadirs are pretty consistently above 300, you might want to consider increasing to 7.5u. If nadirs are over 300, increasing by 0.5u is fine. If nadirs are lower than 300 routinely, then the increase is by 0.25u.
 
It's good to hear that things are moving smoothly now. Adding a tsp or two of water to each meal really helps.

I agree with the others, it's time for an increase. It's the nature of acromegaly that sometimes you'll see better nadirs on a dose, then the nadirs won't be as good on a higher dose. Just keep plugging away. Increase every 6 cycles until you see start seeing regular blues. Since your dose is over 5 units, the increases will always be .5U now, unless you are seeing a lot of green nadirs (below 5.5) and just want to tweak a bit. Think of the dose increase as a percentage change. A .5 unit change at 7 units is the same as a .25U change for someone on 3.5 units. Over 10 units, it can change to 1 unit increases.
 
I would stay on the "increase 0.5u every 4-6 cycles" plan until you are having a significant change in the colors on her spreadsheet - regular blues showing up, for example. She is really too high still. Constantly over 250 isn't good for her organs.

I'd also get at least 1 test in the pm cycle - even if it's +10. As you continue increasing the dose, you want to make sure you catch it when you're finally getting some better numbers, and cats often show their lowest numbers in the pm cycle.

Keep being persistent. It probably feels like you're not making progress, but cats often don't show much of a change in their BGs until all of a sudden you're getting to a good dose and it'll seem like the better numbers popped up out of nowhere. You're getting there. I think you've taken a look at Peg & Toby's condo and spreadsheet. You can see Peg didn't hold a dose longer until he was at 12u and his overall BGs were better & showing lots of blues and greens instead of predominantly red/pinks.
 
Hi Dyana, Sienne, Wendy and Julie - thanks for all your advice, I have tonight increased Crystal's dose to 7.5u. I have been mixing water with her food since her constipation attack, plus a little olive oil as well and it seems to have made a difference. I've also managed to obtain some syringes (from ebay) with the half unit markings as they seem to be like hen's teeth here in France (at less than half the price too) so that will make my dosing a lot more accurate. I can only shoot her in the scruf as she tends to be able to turn round and give me a good bite if I go any lower, but I've noticed that the tissue is becoming much thicker in this area, I wonder if this is making absorption more difficult? I think I'll dig out a pair of old gloves and try for a flank shot tomorrow and see if that makes any difference.

Suki & Crystal
 
Even if you're continuing to shoot in one area (scruff, for example) do move the poke spot around. I saw one suggestion that said for a newly diagnosed cat to have the vet shave a spot about the size of a watch face, then think in terms of shooting around the clock. So today shoot 1 and 1:30, tomorrow 2 and 2:30, the next day 3 and 3:30, etc. You don't want to repeatedly shoot in the same spot because cats can develop little hard skin spots.
 
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