3/6 Bronx AMPS 50, stalling, token shot?

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Bronx's dad (GA)

Bronx's dad (GA)

Member Since 2016
Good morn all. Bronx is much lower than normal and I never had to deal with an AMPS this low. Give a token shot? How much do you think? Thanks!
 
Nan & Amber said:
Did you re-test? (I have no experience with high-dose conditions, so I can't offer any advice on dose).
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No, but I did retest 3 times at +6 last night since that # was oddly low and they were all around 57. He jumped to 87 an hour after that because I fed him. He ate this morn and do expect the number to be a little higher but still stalling on the shot. I do have R to keep him down during the day if I just skip the Lev completely.
 
Doodles & Karen said:
If you can monitor him I think shooting the full dose or a slight reduction is a good idea...maybe 33u or 32u as the new dose?
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Almost interested to see what happens with no shot.


Sienne and Gabby (GA) said:
I would tread very carefully here. If the tumor is putting out far less growth hormone, you could easily be giving too much insulin. .
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That's what I am worried about, he has been trending lower the last few days. Thanks for tagging Wendy & Julie but they are probably still sleeping.
 
Looks like you've decided to skip this morning. Another option is to shoot at +18, so what would normally be your +6, then skip tonight's shot and shoot on time in the morning. That gives you two 18 hour cycles instead of three 12 hour cycles. It's just another option to skipping.

I think I'd probably go ahead and take a reduction as though Bronx had dipped under 50. He would be close enough for me, so I'd drop by 10% to 31-32u for his next shot.

He's sure looking great! Good job managing his numbers!
 
I think you saw Jacks recent run down the ladder. I can't say whether it was the tumor letting up for a bit or the IAA taking a break. We took a lot of quick reductions, and went through a good amount of HC food. If something is changing in Bronx, then take reductions when they are needed, no need to wait a certain amount of time. The large depot in our acro kitties makes reductions a little more challenging.

Since you skipped this morning, it will be good data to see how he does. This is a new chapter in Bronx's story, and you will have to learn new tricks and patterns now that he is in such good numbers. Jack likes token doses, 50-75% of normal, but ECID. It was also recommended to me that when doing a reduction at these higher doses it is sometimes a good idea to do a token dose before the reduction to drain the depot a little bit, otherwise that big depot train keeps them in low numbers while it slowly adjusts. Today's skip will help drain the depot and you can pick up tonight with the new dose.

Good to see such nice colors on Bronx's sheet, what a change from that sea of pinks he was stuck in before.
 
julie & punkin (ga) said:
Looks like you've decided to skip this morning. Another option is to shoot at +18, so what would normally be your +6, then skip tonight's shot and shoot on time in the morning. That gives you two 18 hour cycles instead of three 12 hour cycles. It's just another option to skipping.

I think I'd probably go ahead and take a reduction as though Bronx had dipped under 50. He would be close enough for me, so I'd drop by 10% to 31-32u for his next shot.

He's sure looking great! Good job managing his numbers!
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Thanks Julie! Yes, I never thought we would be here in greens and blues when we were stuck for months in red & pink.
 
saltycat said:
Jack likes token doses, 50-75% of normal, but ECID. It was also recommended to me that when doing a reduction at these higher doses it is sometimes a good idea to do a token dose before the reduction to drain the depot a little bit, otherwise that big depot train keeps them in low numbers while it slowly adjusts. Today's skip will help drain the depot and you can pick up tonight with the new dose.

Good to see such nice colors on Bronx's sheet, what a change from that sea of pinks he was stuck in before.
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I also like what Julie recommended about shooting at +6 at a reduced dose & then skipping PMPS shot.
 
This made me smile! After months of increases and a bunch of blacks and red - Bronx earns a reducie!!

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Morning Paul. :coffee::coffee: You were right, I was sleeping, although alternating days (ie. tomorrow) I would have been out rowing on the water at your preshot time. Guess Bronx found a way to make sure you were wide awake today.:eek:

An alternate strategy for you this morning would have been to wait 15-20 minutes and retest, to see if Bronx's numbers were stable or rising. With Neko, she would occasionally pop me a number in the 40's for AMPS. I would stall and not feed (usually take a shower to get away from the complaints), then test again, and she would invariably be rising. Since Levemir kitties can often nadir around prehost, and be quite a few hours before onset, it can be safer to shoot those lower numbers. However, since you've only shot green once and it was high green, I'd wait until you have a little more experience shooting lower down before shooting that 50. Or wait until the numbers come up a bit to a shootable number. And side note, when you shot that green the other night, I see no tests that night - you really do need to test when you shoot low. We always recommend getting a +1 and a +2 when you shoot your lowest to date.

And next time he earns a reduction, do try that one time reduced dose after the reduction is earned. Try first a 50% reduced dose, then see how that does. With Neko I found the first time she went down the dose ladder that I didn't need to reduce because she bounced so much. Second time around I reduced to around 2/3 dose. When they want less insulin and they want it now, you don't want that large depot around.

I like the idea of the reduction earned.:) It's a much more fun thing to do. And since you are going to be starting the cabergoline trial soon, I think you need to have him on a dose that has a bit more margin for error at the bottom end. With Neko, I could often tell when she was angling for a reduction as her nadirs would start to move down. With 2 days in a row without R and that 57 last night, Bronx gave you a good signal something was up. In general, the fact that you've barely been using R is a good heads up. I hope you have a good supply of high carb food.
 
Wendy&Neko said:
Morning Paul. :coffee::coffee: You were right, I was sleeping, although alternating days (ie. tomorrow) I would have been out rowing on the water at your preshot time. .
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Hi Wendy. Rowing at 0430, nice! We are still pretty cold here on the east coast. What do you think of what Julie recommended shooting at a reduced dose at +6 which just came in at 178 & then skip PMPS shot? Maybe 30u?
 
Depends on how much you can monitor. The only time I did the 18 hour thing (could not be home for AMPS), I shot the full dose at +18, then at +18 again. Doing two 18's is like skipping a cycle, which by itself will drain the depot. If you want to drain it a bit more, then you can shoot a smaller dose at +18 and go to your new dose, 31-32U tomorrow morning. If you can monitor more you can shoot the 31-32 now and going forward. The option of just skipping today and shooting tonight is still on the table. You do have R as a tool.
 
he's sure sucking down the R this evening! I hope the Lev kicks in soon.

Good job navigating the options that everyone gave you above. It's good to see what the different choices are and I like that you're asking for additional information on the options.

Part of what you are doing now is seeing "if I do x, then what is the result?" That helps you understand how things are working in Bronx's body and you can refer back and consider those results as you move ahead.
 
julie & punkin (ga) said:
Good job navigating the options that everyone gave you above. It's good to see what the different choices are and I like that you're asking for additional information on the options.

Part of what you are doing now is seeing "if I do x, then what is the result?" That helps you understand how things are working in Bronx's body and you can refer back and consider those results as you move ahead.
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Thanks Julie. Next time I will try the token dose or do the 18 hour shot. Skipping was the safest thing I guess and today was a learning day. Thanks again!
 
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