12/9 Zeke AMPS=106;+9.25=337;PMPS=326;+4.25=92;+5=84

Status
Not open for further replies.
MrZ

MrZ

Member Since 2013
Well, the day started off promising but Zeke just continued to rise throughout the cycle to pink. As per New Dose Wonkiness (NDW) and Failed Reductions, you should go back to the most recent good dose if numbers start trending higher after a reduction. Do you think I need to wait a little longer before concluding the reduction given on 12/8 has failed? I'm thinking that today's activity was just a bounce from the huge drop yesterday from 496 (which was a bounce from the lows on 12/7) to 102. Would you agree? Should I hold at 1.5u for tonight's PM and if I don't see a green take him back up to s1.75? I don't want to jump the gun but I also don't want to hold a failed reduction either. Advice would be greatly appreciated.

Zeke's yesterday
 
Re: 12/9 Zeke AMPS 106; +9.25 = 337 Reduction Question

there's no exact length of time to assess if a dose reduction has failed. with today's amps of 106 followed by a +9.25 of 337, that looks like a bounce. i'd wait for the bounce to clear before deciding that it's failed. you don't want to increase during a bounce and end up overdosed when the bounce clears.

better to be safe than in a hurry.
 
Re: 12/9 Zeke AMPS 106; +9.25 = 337 Reduction Question

It can be hard to tell if a reduction has failed, if you're not giving a new dose enough time, or if there's a bounce. In this instance, I agree with Julie -- it looks like Zeke is bouncing so I'd wait.
 
Re: 12/9 Zeke AMPS 106; +9.25 = 337 Reduction Question

Thanks for confirming my conclusion that he's bouncing and I need to wait. The question of course is for how long? I'll see how he does tonight. If I see a green then I know the reduction is good - at least for now.

I tend to post my dosing questions a little ahead of time because I like getting your input earlier so I can consider your comments and make a decision come shot time when time might not allow for a post and a wait for response. Any additional guidance to consider would be greatly appreciated.

Thanks,
Laura and Zeke
 
Re: 12/9 Zeke AMPS 106; +9.25 = 337 Reduction Question

I gave Zeke to back to back reductions (PM 12/6 and AM 12/8) for the reasons stated in my original post here. That's why I'm asking now about how long I should wait until making the determination that this is a failed reduction - I don't want to keep him at a failed dose too long. At this point I'm kinda holding my breath to see if my decision to take that second reduction was a good one.

Here's an excerpt of the Protocol that I'm a little concerned about at this time.

If the cat will not stay in the normal range after a reduction, immediately increase the dose again to the last good dose. Sometimes, a cat can even manage to keep its BGs low for a day or two, but then the BGs begin to rise again because the beta-cells haven't recovered enough yet...... Reducing the dose too quickly generally does not work: most cats do not go into remission with fast reductions.

Would you have done anything differently?

Please don't get annoyed at my asking these questions and appearing to be impatient. That is not the case. I just want to give Zeke the best hope for remission or at least help him get to a state of regulation as soon as possible.
 
Re: 12/9 Zeke AMPS 106; +9.25 = 337 Reduction Question

Laura --

I think you're wanting hard and fast rules. It's really hard to give a "rule" that's going to fit every situation. The hard part is that there can be a bounce after getting a number that causes you to reduce the dose. Trying to tease out if it's a bounce vs. a failed reduction can be difficult and probably needs to be assessed on a case by case basis.
 
Re: 12/9 Zeke AMPS 106; +9.25 = 337 Reduction Question

it doesn't annoy me that you're asking questions, laura. you're obviously considering all the angles and trying to figure out how to make the best possible decisions for Zeke. But i agree with sienne, with FD, there aren't hard and fast rules on so much of this. we just can't tell ahead of time.

i do remember wondering why the advice when i was starting was almost always "let's see how this cycle plays out." it can be aggravating to hear! :lol: but now i totally get it - it's easier (and most accurate) to see what's going on when you're looking at a spreadsheet that's up to the minute and be able to say "this is what i see right now." cats can be so unpredictable and at each point on this journey there can be forks in the road ahead that you don't see until you're at them.

for example, i'm looking at zeke's ss right now and can say that definitely looked like a bounce in this morning's cycle that was starting to clear about pmps. it looks like he's already beginning to clear it with the 269 at +2. the question is, is he completely going to clear the bounce or is this one of those "hovering not quite high but still too high cuz i'm still on a bounce" test results? by morning, that might be clear.

i think your plan of action is good - if he really does clear this bounce by morning you'll probably see him back in lower blues again in tomorrow's am cycle. if that happens, then you can feel confident the bounce is over, and if you don't see greens after the bounce has cleared, then you could go back up in dose. if he comes down to greens, then assume the reduction is working.

is that as clear as mud? ;-) :-D just ask if you have more questions.
 
Re: 12/9 Zeke AMPS=106;+9.25=337;PMPS=326; +4.25 = 92

Well, Zeke's in green so I'll stick with this dose until numbers dictate otherwise. Of course, with this huge drop this cycle, I'm expecting a bounce in the next cycle or so. I'm happy about the green though.
 
Re: 12/9 Zeke AMPS=106;+9.25=337;PMPS=326;+4.25=9;+5=84

Super to see him in green!

One other thing that can sometimes complicate things is the .....depot! A dose can affect up to six subsequent cycles once you reduce the dose. Most times it's more like 3-4 cycles.

Glad to see him clear so quickly.
 
Unfortunately, I took a back-to-back reduction that failed so who knows when Zeke will start seeing these good of numbers again. Very frustrating and makes me very :cry: :cry: :cry: :cry: :cry: :cry: :cry: :cry: and extremely discouraged.
 
Status
Not open for further replies.
Back
Top