4/23 Gus PMPS 566 +3 502

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bev5477

bev5477

Member Since 2011
I'm trying to apply what I learned from Libby about giving R. I remember she said that R isn't given cycle 2-4. We're currently in cycle 3 so we wait to see what Mr. Man does today. Wouldn't it be great if he just lowered himself to 300s. I'd be thrilled. My money is on more R tomorrow AM. ~O) ~O) ~O) Happy Satfurday.
 
Re: 4/23 Gus AMPS HI

I probably did say that, but since he is HI I'm thinking he has room for some R. My thought pattern is that even if the Lantus dose does kick in during this cycle, the Lantus probably won't start working until at least +3. Maybe some R would bring him down some so the Lantus will have a better place to work from. Know what I mean? How do you feel about 0.25 or even skinny 0.5 of R this morning?

I'm trying not to contradict what I said earlier, but I think both of us are starting to learn Gus's patterns a bit better and can see where we have room to tweak things. I know that even if he does drop more than we expect, you are able to manage lower numbers if they come.
 
Re: 4/23 Gus AMPS HI

Good Morning Libby. I'm glad you're suggesting R in this cycle. I'd really like to bring him lower, the sooner the better and I wasn't looking forward to waiting 2 more cycles to do it. It is now +2 and I think he can handle a skinny .5. Don't you. Of course, PS test before the R. And I don't take it as contradicting yourself, I take it as Gus is a contradiction.
 
Re: 4/23 Gus AMPS HI

not a contradiction, just a learning experience. ;-)

I like the idea of skinny 0.5, go for it if you're comfy with it.
 
Re: 4/23 Gus AMPS HI

Gave R.5S at L+2.2 . Comfy is a relative term. My range of 'comfy' has undergone a huge revision since FD! Will definitely get +1R,2,&3. Thank you Libby
 
Re: 4/23 Gus AMPS HI

did you get a PS reading for the R? It would be good to know if he is starting at HI or if he came down some on his own.
 
Re: 4/23 Gus AMPS HI

Bev, amazing patience and changes you must be going through right now. Watching your story unfold and the care you are taking with Gus.
No doubt you are in excellent hands with Libby. My Tommy is up to 10.5U right now and his numbers aren't as high but kind of like Gus he'll respond to a new dose and then wham back up to the red floor he goes. I've been in contact with Libby also about starting R if this continues.
I hope you start to see the numbers that will make the both of you feel better and that you don't come any where near the amt i have to give Tommy right now.
Gus is one lucky Kitty to have you!
I hope you have a happy day :-D
 
Re: 4/23 Gus AMPS HI

Just this past Monday, I met with Gus' new vet and he was pretty good, despite making some widely generalized comments. :roll: One of them being that he has read a 'study' (non-specific) that shows most FD cats convert at about .5U/lb body wt. Interesting concept for some cats. However, I have seen most cats doing well here, on much, much lower doses than that. Obviously, the R has an effect on Gus, but his liver is evidently uber-protective. But, I'd rather have a liver doing its job than one that was semi-operational. He's the best patient in the world, not that I'm biased or anything!
 
Re: 4/23 Gus AMPS HI; +1R556; +2R505

Libby, Is what's happening with Gus something that you've encountered before? Are his R #s an indication that he isn't resistant?
 
Re: 4/23 Gus AMPS HI; +1R556; +2R505

for me, it's hard to say at this point whether I think Gus is insulin resistant due to an underlying condition, or just because his numbers have been high for so long. They all build up glucose toxicity when they stay in high numbers for a while, and it can take a good bit of insulin to break through. Then when they break through, they usually will go through a bunch of dose reductions fairly quickly. So his resistance could be just that, or it could be some other condition.

We used to start suggesting acro testing when a cat got to around 5 units BID without much response. Now, I don't automatically consider 5u to be "high dose." We're seeing more cats that get to that dose (and higher) and still break through and go down the scale normally. Now I don't start thinking "high dose" in most cases until 7-8 units, unless there are other clues on the spreadsheet. In the German forum they see even more higher doses than we do (though they don't do acro testing very much, so some of those could indeed be undiagnosed acros).

Gus's super high numbers do make me wonder what is going on, but he is getting a good response to fairly small doses of R so who knows? We have seen acros who respond that well to small doses of R (Jazzy is one, and Mouf is another). I have also seen IAA cats who don't respond well to Lantus but have a tremendous response to R. The same is true for cats without these conditions, though.

Have you read through the What We Know sticky in the High Dose forum on this board? There are simple blood tests that can identify acromegaly and IAA, and if you are curious then it might be worthwhile to consider running those tests. I do think there is a possibility Gus has one of those conditions, but I wouldn't say it's a for sure thing. In any case, at this point regardless of whether he has another condition or not, our job is to give him whatever amount of insulin he needs and keep him safe in the process. Some cats never even get up to 1 unit, others need far more. Lucy got to 4.25 units BID before she turned around and eventually went OTJ. Randi's Max got up to 6 units and looked for all the world like a resistant cat, and he went OTJ. They like to prove us wrong!
 
Re: 4/23 Gus AMPS HI; +1R556; +2R505

Bev: Just dropping in to say I really admire all you are doing, your wonderful patience, and your great questions. Hang in there...he'll come down.
 
Re: 4/23 Gus AMPS HI; +1R556; +2R505; +3R401

YAY for GUS!!! Getting down to 401, good job Bev. It's nice to see numbers that aren't HI.
Gus is a very lucky kitty
 
Re: 4/23 Gus AMPS HI; +1R556; +2R505; +3R401

wow!

Yep, please get a +4. We might be running into the thing where the R nadir is coinciding with Lantus onset - is it about +5 from his Lantus now? We probably gave the R too late in the cycle, but then again, it's bringing him down and that's a good thing.

Unfortunately he will probably bounce from this drop. You know what to do if he does, though. Once he gets past his Lantus nadir (maybe after +7), if it looks like he is heading for the moon then you can shoot more R then. It seems like 0.25 was a good R dose for him and s0.5 might be a bit much, or at least a bit too much to give in the front half of the cycle. In the last half of the cycle, there is less pull from Lantus so you can often get away with a bit more R.

I'm heading out soon for the rest of the afternoon, but you're doing great.
 
Re: 4/23 Gus +2R505; +3R401; +4R301

Libby, NOOOOO, don't go!!!. Just kidding, I'll be fine. I understand the coinciding nadirs. Could pose a problem in the lower #s, but not with my guy today. I'll watch him carefully and give the R if needed. +7L is in about 30 minutes. Wonder what I'll find. I'll follow your instructions.
 
Re: 4/23 Gus +7=594; R.25Fat

That bounce took no time at all. I can hear his liver screaming from here. Gus got a fat .25 of R at +7 and I'll get +1R,+2R, and +3R. That will bring us up to +10 and a 2 hour rest until PMPS.
 
Re: 4/23 Gus +1R 562; +2R 454; +3R 550

I won't bother with a +4R. I'm wondering if I should give Gus another shot of R with his Lantus tonight. Libby, if you're around...do you agree. I think R.25(F) would be good.
 
Re: 4/23 Gus +1R 562; +2R 454; +3R 550

I'm fairly certain Gus would do OK with R.25 and Lantus this PM but not 100% , so I'll wait on it and just give Lantus. Maybe he's had enough R and the Lantus will bring his #s down!!! :lol: Oh, Please!
 
Re: 4/23 Gus +1R 562; +2R 454; +3R 550

I think you'll make the right decision whatever that might be for Gus. Dropping in to see how you both are doing this evening.
Have a good night and here's to Lantus bringing down his numbers. What a couple of days you've had. You have got to be exhausted.
Squirrel and Tommy
 
Thanks for all the kind words. The person who really is doing great is Libby. She has such a calm confidence. I respect R very much, but I'm not terrified of it as I was when we first started dosing it. What a help she has been for Gus. Who, btw, is sound asleep with a very full tummy. I'm going to step out of this condo and see what's happening in the neighborhood. Everyone enjoy what's left of the evening.
 
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