? 2/29 acro Kokkinoulis AMPS 77, +2 81, +5 93 + 8 101 PMS 89 Dose 2.0 again. Opinions what happens?

[Kokkinoulis]

Dear all,

@Wendy&Neko, @Bandit's Mom @Marje and Gracie , @tiffmaxee , @Chris & China (GA), @Sienne and Gabby (GA) @Chris & China (GA)

I decreased more Kokkinoulis dose to 2 iu to clear the depo and to understand how actually insulin needed after the surprisingly good BG values at green and blue despite the successive continuous recent declines

We are not following now exactly the TR protocol since acro Kokkinoulis is probably a special case and I don't know how to proceed. I sent the results to the vet but I don't think he will know what to say as he has never had a cat with acromegaly before. I rely more on your own experience.

Previous post: https://www.felinediabetes.com/FDMB...s-amps-111-dose-advising.287117/#post-3156661

 

[Bandit's Mom]

The depot might take up to 6 cycles to adjust to a reduction for larger doses. Some cats also race down the dosing ladder after hitting a break-through dose.
I don't have experience with acromegaly - Wendy is our go-to person for acro cats.

Good to see that he is doing so great on the BG front!

 

[Marje and Gracie]

I would hold this 2u dose right now, Gabriella. Let’s see what he does through today’s and tonight’s cycle. If we see him start to trend up above 120, then we will need to increase the dose.

 

[Kokkinoulis]

It was a surprise that the preshot was 89 so I hold the dose of 2iu...Do anyone has an opinion what happens? I am thinking about breaking of glycotoxicity after low numbers and/or IAA overcome ...

I would hold this 2u dose right now, Gabriella. Let’s see what he does through today’s and tonight’s cycle. If we see him start to trend up above 120, then we will need to increase the dose.

It was a surprise that the preshot was 89 so I hold the dose of 2iu...Does anyone has a opinion on what happens? I am thinking that he is breaking out glycotoxicity after low numbers and/or IAA overcome

 

[Marje and Gracie]

It was a surprise that the preshot was 89 so I hold the dose of 2iu...Do anyone has an opinion what happens? I am thinking about breaking of glycotoxicity after low numbers and/or IAA overcome ...


It was a surprise that the preshot was 89 so I hold the dose of 2iu...Does anyone has a opinion on what happens? I am thinking that he is breaking out glycotoxicity after low numbers and/or IAA overcome

He “could” be overcoming the IAA because of the higher doses of insulin. Sometimes those high doses can overcome the IAA. It’s also possible his tumor is waning.

 

[Wendy&Neko]

Sorry for not getting back to you - I didn't see the tag. And I was out of town today.

Did you start the cabergoline yet? In addition to what Marje mentioned, he could be breaking through some glucose toxicity. When that happens, it can be a quick drop down to a better dose. But let's see what happens when the larger depot drains.

Here is the link to yesterday's post. The one you linked was the day before.

 

[Kokkinoulis]

Sorry for not getting back to you - I didn't see the tag. And I was out of town today.



Did you start the cabergoline yet? In addition to what Marje mentioned, he could be breaking through some glucose toxicity. When that happens, it can be a quick drop down to a better dose. But let's see what happens when the larger depot drains.



Here is the link to yesterday's post. The one you linked was the day before.

Thanks a lot for your reply. No. I did not started the cabergoline yet. I will start it today before the evening preshot. His BG numbers are still good. A little be elevated.Maybe I have to increase a little. We will see.