12/14 Eddie AMPS 250 +3 200 +5 133 +8 175 PMPS 290 +2 313

My guess is a flat yellow cycle. Sometimes that’s is followed by an active one as you have seen before. What’s your guess?
 
tiffmaxee said:
My guess is a flat yellow cycle. Sometimes that’s is followed by an active one as you have seen before. What’s your guess?
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With Eddie, it's so hard to know since SRT is the wild card in this deck. I'm going to do a +3 and see what happens but I have a feeling we are nearing another milestone. The only challenge with Eddie seems to be in the 8u-7.5 u. The former results in going low and the latter in going high. But 7.75u isn't enough either...
 
@FrostD @tiffmaxee @Wendy&Neko

This particular choreography is familiar, n'est ce pas? I'll do a +7 or +8 to confirm the slide into blue. The point is, though, that this dance seems always to lead to decrease from 8u to 7u or 7.75 u or 7.5 u and then have to increase again. But we are only into the 6th cycle as of PMPS tonight, sooooo....
 
Well he's a little consistent at least? I understand the frustration of reducing and increasing, but have to be safe when he hits those lower numbers because you never know when it might be "real" SRT kicking in
 
Well, we found our way into the blue zone a couple times today so maybe Eddie is liking the 8u. We've completed six cycles and I think we reassess after 8 cycles, which is tomorrow.
 
I had asked about the IAA (today? Yesterday? What is time? Lol) because that's part of the challenge...those antibodies can be a real pain.

When you were giving pred in the AM, was it at shot time? And when you switched to PM was it also shot time?
 
Hi yes to Pred at shot time. The last couple days been trying at 5:00pm, +8.5 after morning shot. Maybe I should try for +4.5 after morning shot. He’s on physiologic dose, very small, .125 mg/once daily.

The IAA test was about 8/9 months ago. The vet places no weight on IAA so for him it was a non-issue.
 
Nothing like a +2 after 8u insulin to be higher than PMPS. This has happened 4 nights in a row...

Clearly, I need, once again, to step away from the car. :cat::rolleyes:
 
I'm not sure why the vet "places no weight" on it? If he tested positive, that means his body is producing more than usual antibodies against insulin - so his body is attacking the insulin, making less of it available (therefore contributing to higher insulin requirements usually). There's nothing to be done about it but wait it out and try to keep him in a good BG range, but the tumor makes that a balancing game
 
The vet in question is really old-school but is also the only internist within the region. He's nearly-retired and works only 2 days/week. I got the IAA test because I demanded it when he said it would be of no consequence. What he means is, he has no time to be dealing with a cat with acromegaly and all the procedures and treatments that go along with it, including IAA and a tumour that is necrotizing (a term used by the WSU neurologist). He is happy to write prescriptions. When dealing with insulin, he advises a set dose and one is to give it for a week and then do a curve to see how we're doing, not test daily. As I mentioned to Wendy somewhere, he finds there's "too much colour" to deal with on the spread sheet, so you can see what I dealing with here as far as local veterinary support goes.
 
@FrostD Do you have any thoughts on this direction today? +6 104 given the Prednisolone timing?

It's the 8th cycle is it not that reassessment happens? He seems to be doing so very well & into the blues in the middle of the day. I'm happy about that but then we swerve upwards after that. is it Prednisolone timing I wonder? This is a rhetorical question but I'm kept hopping by Eddie's choreography.
 
Jodey&Eddie said:
@FrostD Do you have any thoughts on this direction today? +6 104 given the Prednisolone timing?

It's the 8th cycle is it not that reassessment happens? He seems to be doing so very well & into the blues in the middle of the day. I'm happy about that but then we swerve upwards after that. is it Prednisolone timing I wonder? This is a rhetorical question but I'm kept hopping by Eddie's choreography.
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That's why I had asked about pred timing. I had been doing some reading for Mr Kitty's possible IBD/SCL diagnosis, and was reading it can stay in the system up to 36 hours. And was wondering about the trend of diving about +2/+3 (so around 16 hours after pred, so possibly affected by pred wearing off? I'm not sure I haven't had time to go back and look at what you said). Then when you switched to PM giving it, his dives switched to AM cycle for the most part.

The 103 is nice, curious what Wendy has to say. I do think you have room for an increase, but 0.5 might be too much
 
FrostD said:
That's why I had asked about pred timing. I had been doing some reading for Mr Kitty's possible IBD/SCL diagnosis, and was reading it can stay in the system up to 36 hours. And was wondering about the trend of diving about +2/+3 (so around 16 hours after pred, so possibly affected by pred wearing off? I'm not sure I haven't had time to go back and look at what you said). Then when you switched to PM giving it, his dives switched to AM cycle for the most part.

The 103 is nice, curious what Wendy has to say. I do think you have room for an increase, but 0.5 might be too much
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o
The Pred schedule is really quite challenging. Mostly what I know about Pred is that it can contribute to 'insulin resistance and coupled with IAA, well, let's use your word "shenanigans"!
It's easy to see why consulting with the vet, especially the one in question here, is not an effective way to go. So, I'm going to slowly move the Pred to AMPS +4 or +5. i will be back to teaching in person in January and will need to work something out with testing and TR in relation to medications that he receives: Prednisolone (.125mg/1daily), Thyroxine (0.1mg/BiD) and Desmopressin (DDAVP 0.05mg in the morning and 0.025mg at night).

There has to be a way of figuring out the Pred-thing...
Thanks, Melissa.
 
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