4/29 Cobb PMPS 193

[Suzanne & Cobb(GA)]

Yesterday

What a nice 24+ hours from Cobb! We had some thunderstorms this morning, which usually stress Cobb out pretty bad. Could be contributing to the higher AMPS. I'm gave a little more R than my scale calls for...experimenting to see if Cobb is bouncing to stop it in its tracks or if it is the antibodies grabbing on to get ahead of them. I want to keep him under 250 definitely, but his time in blue is spoiling me and I find myself wanting more and more. :roll: I'm hard to please. :lol:

Lots of prayers today for those in the communities affected by the tornadoes that ripped through yesterday. I hope none of you were in those areas. We managed to dodge the storms overnight. It looks like it went north of ATL. But another round is expected today. I hate hate hate this time of year. I'd rather a hurricane any day of the week...at least those you can anticipate and prepare for. They don't drop out of the sky like a tornado can!

Have a great day!

~Suzanne

 

[Sandy and Black Kitty]

Re: 4/29 Cobb AMPS 293(1.5uR) +2 298 +4 174

Hi there
Great job tweaking the R this morning - it produce the desired result - back to blue! :RAHCAT
I wonder if he will see some green this cycle?

Happy to hear you were spared tornadoes last night -
Fingers crossed you don't see any today. . .

 

[Chris & China (GA)]

Re: 4/29 Cobb AMPS 293(1.5uR) +2 298 +4 174

Well look at you Suzanne! You're getting to be quite a pro at figuring out when best to give the R and Cobb is responding so well lately too!

I know how you feel..we get addicted to those pretty blues and greens and when we get anything else, we somehow feel like we failed or something. That's when it's important to remind ourselves that we're not in charge!

Hope the storms continue to go around you and everyone stays safe.

 

[Sandy and Black Kitty]

Re: 4/29 Cobb AMPS 293(1.5uR) +2 298 +4 174 +6 226(.75uR)

(High dose kitty BG beatdown in progress. . .)

Since this is a first, monitor closely. Not only for safety but also to have the valuable data on the effects of today's experiment

 

[Suzanne & Cobb(GA)]

Re: 4/29 Cobb AMPS 293(1.5uR) +2 298 +4 174 +6 226(.75uR)

(High dose kitty BG beatdown in progress. . .)

Since this is a first, monitor closely. Not only for safety but also to have the valuable data on the effects of today's experiment

I figured it's time to get serious. We've got the diagnosis. We've had a dental. Two vets have ruled out any other issues. SO...it's up to me and Cobb now. Looks like I'm going to have to be aggressive.

Note to lurkers: I feel it bears repeating...DO NOT copy any dosing that is done with Cobb. He is a high dose, insulin-resistant, possible acro, cat. Copying dosing (with either Lantus or R insulin) could put your cat at risk, especially with the R as it is very harsh and some cats respond quickly to drops of it. Keep your kitties safe!

 

[Sandy and Black Kitty]

Re: 4/29 Cobb AMPS 293(1.5uR) +2 298 +4 174 +6 226(.75uR) +7

I figured it's time to get serious. We've got the diagnosis. We've had a dental.

Knowledge is power (as the saying goes). Well done!

I'm a little antsy based on my experience with BK, which is all I can speak to. Naturally ECID.

Although BKs mouth was a wreck and his first dental 8 teeth were removed, the minute we got home he was his usual crazy self.
(maybe a little crazier due to being high on pain killers) We had no complications.
It was on the 8th day post dental that a very wild ride, lasting 2 months began.

Today is day 7 for Cobb. . .just sayin' ;-)

 

[Ella & Rusty & Stu(GA)]

Re: 4/29 Cobb AMPS 293(1.5uR) +4 174 +6 226(.75uR) +7 178 +8

Hi Suzanne,
You are doing great with your "experiments". Keep him in the blue! Yay for those BLUE surfs!

Lookin' good, Cobb.

Have a fine evening,

Ella & Rusty

 

[Suzanne & Cobb(GA)]

Re: 4/29 Cobb AMPS 293(1.5uR) +2 298 +4 174 +6 226(.75uR) +7

I figured it's time to get serious. We've got the diagnosis. We've had a dental.

It was on the 8th day post dental that a very wild ride, lasting 2 months began.

Today is day 7 for Cobb. . .just sayin' ;-)

Deep breaths. :lol:

So I know you don't "kill" the antibodies. Where do they go? BK required a lot of insulin to overcome the antibodies. Where are they now? Inactive? Can they come back?

Also, how did you decide how much of a reduction to take? Starting at that 8th day the dose seems to bounce around a bit, and BK didn't dip below 50 when you took a reduction (at first glance - I'm still studying). What was your thought process?

 

[Wendy&Neko]

Re: 4/29 Cobb AMPS 293(1.5uR) +4 174 +6 226(.75uR) +7 178 +8

Great job hanging onto those blues today - they are definitely addictive.

When making decreases at this point, take them down by the same amount you'd do increases. One technique you can use for high dose kitties after you've had a low, is to do the following shot with half (or less) insulin, then follow up with the new reduced dose. This helps reduce the depot as you do not want a large depot to get ahead of you. I only did this trick once but you do get a feel for when kitty is telling you they need less insulin and how quickly you need to go down. I've also seen some people go down a bit more for safety, then work the dose back up if it was too much of a drop. I also temporarily changed my reduction number to 70 from 50 when we were on a roll. And I stuck to that as long as it worked.

Hope you guys are safe from the storms today.

 

[Suzanne & Cobb(GA)]

Ending the cycle in blue! Yay! First test was 216, second was 193. I grabbed the second to see if I should/could give a small dose of R. If the second test had been higher than the 216, I might have given .25 or .5uR. But the second test led me to believe meter variance and the real BG was not higher. That was my plan of attack anyway...feedback?

 

[Rebekah]

Hey!

Checking in to say hi, and to say wow! Fantastic work you two! Everything is crossed over here that the beat down is super duper pooper successful!

Go Cobb!

Rebekah

 

[julie & punkin (ga)]

nothing like hindsight to make things clear. if i hadn't seen the +2.5/243 I'd have said great choice to pass on the R. I still think at the time, there wouldn't have been anything to suggest that you needed R at pmps. Because it's night, i think i'd pass on using R for the rest of this cycle.

He is looking fantastic! nothing like 2 days of blue for the little guy - you're doing great. Chris is right, of course, that if he weren't doing well, that wouldn't mean that you are doing something wrong. it's hard not to make that connection. But your best efforts are working - so kudos!

If you get to the point where you need to do reductions, i did what Wendy suggested. If I had low numbers or anticipated a reduction, i gave a 50% dose and then returned to a "new" lower dose with the following shot. So if i was shooting 15u and he had low numbers, the next shot would be 7 or 8, then i would return to 14.5u for the following shot and hold that until punkin had low numbers again. I do think that helped to not have constant low numbers one cycle after another. With a larger depot you want to let it drain to equalize for a new lower dose. That strategy worked for us.

I don't know all the answers about the iaa, but my understanding is that the insulin binds to the antibodies and can be released at any point - i don't think an event triggers it, it is a random occurence as far as i know. So the bound insulin and antibodies are in the blood stream, and if they are released, the insulin is then available to do its thing with the glucose in the blood, resulting in lower numbers as though you had given more insulin. Fortunately, you are experienced with low numbers and you monitor a lot, so if this point comes, you will handle it like you do other low numbers - it might go on for a long time, or you might need more carbs (karo) than you've needed before. i don't know about this part, but that's my understanding how it works. hopefully sandy will come back on and be able to give you better information.

 

[Sandy and Black Kitty]

Hello there

A lovely couple days for Cobb.

Also, how did you decide how much of a reduction to take? Starting at that 8th day the dose seems to bounce around a bit, and BK didn't dip below 50 when you took a reduction (at first glance - I'm still studying). What was your thought process?

My thought process was "Oh sh!t - now what?!?"

Back in 2008-2009 there was no tribal knowledge of IAA - not even among the wise ones of the time.
There were no previous examples to guide us - none.
We were in uncharted territory, way far away from any protocol, flying by the seat of our pants.

That being the case, when there were any doubts we always erred on the side of saftey.

I believe that PM shot on 12/17/2008 (the 8th day post dental) was our first (of many) BCSs.
After Jojo explained what a BCS was and that it was always an option for high dose kitties, she and I basically went back and forth with dose suggestions until we arrived at a Lantus dose that we both felt comfortable would keep BK safe. We didn't worry about it not being perfect, or even enough at those times.
If knew if the numbers went high I could just whip out the R

Once the first big slide started , the challenge was to try and stay ahead of the momentum of BKs rapidly decreasing insulin needs. It was not easy.
The dose seeming to 'bouncing around' is our stumbling and tumbling during an almost a free fall down a very long dosing ladder.

So I know you don't "kill" the antibodies. Where do they go?

From what I''ve read, in general for all types antibodies - in humans -
The average life span of most antibody molecules is roughly a few weeks. The antibodies produced as a result of the initial stimulation remain in the bloodstream for a long period of time, with about half the quantity disappearing after a few weeks and half the remaining disappearing after another few weeks, and so forth.
Continued antigen stimulation continues the antibody response.

in humans insulin antibodies are thought to be sequestered by the reticuloendothelial system and destroyed there.

BK required a lot of insulin to overcome the antibodies.

Yes, BK required a lot of insulin. . . .an 84% IAA test result is considered 'extreme' resistance.

Where are they now? Inactive?

Funny you should ask.
After the first glimmer that the IAA had broken and things were turning around for BK, I wanted to have him tested again, to see if the result would be lower.
His vet told me to save my money - there would be no difference. At my insistence she sent another blood sample to MSU. The results were the same - 84%.
I figured it was like someone who has been exposed to TB - they always test positive.

I had BK re-tested recently. To my surprise, the result was 5%
(that's right, five percent. . .single digit)
I'm still digesting it all.. .

Can they come back?

That's a good question - although I certainly hope they never will, I don't see why not.