6/16, Susie, 253 AMPS
- Thread starter Summer and Susie (GA)
- Start date
Summer and Susie (GA)
Member Since 2020
@FrostD writes:
"Her name is Pippi, she's rat terrier and beagle (body of a rat terrier, tricolor and appetite of a beagle). It's one of those things that you know is coming with old age, but especially bittersweet since she's been with me through college, marriage, and two kids. Hopefully all we have to do is remove it and she'll be ok for a little while, though that does mean radiation for Mr Kitty is now out of the picture."
I'm so sorry to hear about Pippi. Sounds like she is pretty special to you. Hard to make a decision about which beloved pet to help when expenses are so high. Hope the tumor removal for Pippi will give her many more happy years in your company. I have heard the radiation therapy for acromegaly is very expensive.
"Her name is Pippi, she's rat terrier and beagle (body of a rat terrier, tricolor and appetite of a beagle). It's one of those things that you know is coming with old age, but especially bittersweet since she's been with me through college, marriage, and two kids. Hopefully all we have to do is remove it and she'll be ok for a little while, though that does mean radiation for Mr Kitty is now out of the picture."
I'm so sorry to hear about Pippi. Sounds like she is pretty special to you. Hard to make a decision about which beloved pet to help when expenses are so high. Hope the tumor removal for Pippi will give her many more happy years in your company. I have heard the radiation therapy for acromegaly is very expensive.
Bandit's Mom
Member Since 2019
The only explanation I can think of - assuming all else is fine with her clinically - is glucose toxicity. You are doing the right thing in taking her up every 3 days. Once she hits the breakthough dose, she may come back the dosing ladder as fast.
I can think of only two examples off the top of my mind:
Look at Butters in Oct 2020 - she went up from 0.5U to 4.25U before turning around:
https://docs.google.com/spreadsheet...R3-hgldFQg77eAqdlQOMNhVNiUVY0uGSHb2jB/pubhtml
Henry in Oct 2020 who also went from 0 to 4.75U and came back down faster:
https://docs.google.com/spreadsheet...mPldCL2zOzzolQR8CnLKrz4CthDU9g8CG6OC7/pubhtml
carfurby (GA)
Member Since 2012
Sometimes you will see an immediate response to a dose increase and then it goes away. You just have to keep increasing until you find a dose that will bring her numbers down more consistently. It also looks like Susie still bounces from blue. I think yesterday was a bounce from the blues the night before. 
Summer and Susie (GA)
Member Since 2020
I see two those big changes, within two months, for both those kitties. This gives me hope. I guess something that I never really understood, that also gives me hope, is that you continue up the ladder as high as you need to to achieve those good greens then the kitties pancreas, hopefully, starts to heal a little and the doses slowly get decreased to accommodate the bodies changes and production of its own insulin. On average, what percentage of cats on this site never get to the point where the pancreas heals (or slightly heals) on its own and have to stay in high dosing numbers for the rest of their lives? Just a rough guess. Thank you, Bhooma. You always help explain things like no one else can. I know this has been mentioned to me before and I also know the longer a cat is in high numbers the harder it is to get their pancreas to start to heal a bit.
Bandit's Mom
Member Since 2019
I haven't been around long enough to have that data!
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FrostD
Member Since 2020
Just anecdotally from all the spreadsheets I've looked at, most "long timers" (I think of Henry, Butters, Pearl) seem to be on a maintenance dose of 2U or less, many times less than 1U even. Those on higher doses or in higher numbers often have something underlying, or additional medications in the picture, etc. (basically all acro and IAA cats, Ruby, Minnie, Mo when he was around).
Summer and Susie (GA)
Member Since 2020
Good point about those underlying medical conditions that impede the glucose numbers.
JaxBenji
Member Since 2020
Have you ever read the TR background linked in the Dosing Method sticky (I copied the links below). The last paragraph of the first link talks about how many cats stay in phase 3 (holding the dose) or phase 4 (reducing the dose). I personally always interpreted this as in TR gives the best chance at remission but my first goal for Jax was always regulation as if I had his diabetes regulated, it was one less thing to worry about. So, personally, I got over the mental block of increases and decreases and adopted the motto given to me by others "the cat needs, what the cat needs".
I also like to remember the pancreas of cat is "special" in that beta cells heal - how COOL
. But it also means one has to adjust doses up and down as the function of the pancreas fluctuates. One cannot simply set the dose and forget it.
Tight Regulation with Lantus or Levemir for Diabetic Cats
Management of Diabetic Cats with Long-acting Insulin - summary published in 2013
Happy Reading
I also like to remember the pancreas of cat is "special" in that beta cells heal - how COOL
. But it also means one has to adjust doses up and down as the function of the pancreas fluctuates. One cannot simply set the dose and forget it.Tight Regulation with Lantus or Levemir for Diabetic Cats
Management of Diabetic Cats with Long-acting Insulin - summary published in 2013
Happy Reading
Summer and Susie (GA)
Member Since 2020
I did read about the stages a long time ago. In fact, I asked someone about them when I first started on this site. I think it was Marje and she said we really don't pay attention to the stages. I know I have read the Tight Regulation article but will reread it. I'll also look at the Management of Diabetic Cats with Long-acting Insulin. I'm giving Susie one more day (today) on this current dose and will increase again tomorrow morning unless numbers drop. With her numbers continually going up and see no point in waiting. She is acting really, really well. I guess she likes the higher numbers. She constantly purrs and is coming out of the bedroom a lot to walk around. So, at least clinically, she seems to be fine but I have to get these numbers down.Have you ever read the TR background linked in the Dosing Method sticky (I copied the links below). The last paragraph of the first link talks about how many cats stay in phase 3 (holding the dose) or phase 4 (reducing the dose). I personally always interpreted this as in TR gives the best chance at remission but my first goal for Jax was always regulation as if I had his diabetes regulated, it was one less thing to worry about. So, personally, I got over the mental block of increases and decreases and adopted the motto given to me by others "the cat needs, what the cat needs".
I also like to remember the pancreas of cat is "special" in that beta cells heal - how COOL
Tight Regulation with Lantus or Levemir for Diabetic Cats
Management of Diabetic Cats with Long-acting Insulin - summary published in 2013
Happy Reading
Summer and Susie (GA)
Member Since 2020
JaxBenji
Member Since 2020
I can't speak for Marje of course but personally I never worried about stages either - I was just pointing it out as a resource and background
The second link (the "summary") is a link to a download (a PDF) - your browser may be blocking it or something to that effect.
You'll get there
Summer and Susie (GA)
Member Since 2020
Thank you. It is always nice to have encouragement.I can't speak for Marje of course but personally I never worried about stages either - I was just pointing it out as a resource and background
The second link (the "summary") is a link to a download (a PDF) - your browser may be blocking it or something to that effect.
You'll get there
Summer and Susie (GA)
Member Since 2020
I'm seeing some improvement in Susie's +4, +5 and +6 this morning. They are lower and flatter and it looks like her nadir is changing again. She hasn't shot up quickly - yet.
Summer and Susie (GA)
Member Since 2020
@Bandit's Mom I'm thinking about holding the dose through one more day (tomorrow). I have seen a very different am cycle today. Lower (for the most part) and flatter. She just had her lowest +8 since 6/1 and her nadir seems to be changing again. I don't know what is going to happen tonight, if anything, but at this point I would like to hold through day four and see what happens. What do you think?
I know you are supposed to look at nadir numbers when deciding to hold or increase and only one of hers was under 200 on this dose but a couple of others came pretty close.
I know you are supposed to look at nadir numbers when deciding to hold or increase and only one of hers was under 200 on this dose but a couple of others came pretty close.
Diane Tyler's Mom GA
Member Since 2018
♥
Bandit's Mom
Member Since 2019
You've seen a similar cycle on 6/4 (AM) at 1.75U. Unless you see green on a dose, I would increase every 3 days.
Just keep in min the 20% meter variance when looking at numbers. Don't kill yourself testing so much day and night. She has been largely flat for the last few days. Test more in active cycles where there is a noticeable drop at +2. I'm saying this only because I don't want you to burn out by the time you reach the breakthrough dose. When you get there, you will have to test a lot - and probably a lot more if she decides she wants to come down the dosing ladder as fast as she went up it!
Summer and Susie (GA)
Member Since 2020
Okay. Unless I see a green tonight I will increase tomorrow. I'll test tonight at +2 to see what she is doing. Last night she dropped 60 points from PMPS to +1.5 so I expected to see a pretty good cycle. It never happened and that surprised me. I don't like to test as much as I did today but I saw a different trend and wanted to follow up with it. Susie will be thrilled to hear that I am testing too much and should back off. I'll get my regular +2 and maybe a +5 and +7 and base my decision tomorrow morning on those numbers. Will prepare my calipers for tomorrow morning for 2.75 units. Thank you, as always.
Katherine&Ruby
Member Since 2020
Summer, I'm glad to see you're getting the hang of this. The best thing for you right now is to keep increasing the dose as soon as 6 cycles pass and you don't see any green. The faster you can get ahead of the numbers, the better chance of the healing numbers showing up. It's been proven on this forum that 6 cycles is enough time to see how a dose works for any cat when you're following TR. Holding a dose too long just prolongs the toxicity and makes it harder for you to fight against it. Right now I'm trying to gain control of Ruby's numbers and I get antsy because waiting three days seems very long as I watch her numbers climb from the steroid, but I hold back because I don't want to miss the right dose. You will find it for Susie soon enough and then her pancreas will start sputtering. Then the real fun (and much needed healing) starts!
Summer and Susie (GA)
Member Since 2020
You are in such an entirely different situation. You are dealing with so much more than glucose levels you are not comfortable with and I respect you even more. You abandoned the OTJ trial because your Ruby needed so much more attention for her additional medical problems. You made her medical concerns the main attention. You are thinking about Ruby - and what she needs right now. Don't ever feel like you failed this OTJ trial. You are doing what she needs to keep her safe. I think about the both of you everyday and pray that your beautiful girl, and you, will find good health. Thanks, as always, for your support. I think I know what I have to do now.
Stay in there, Summer. Keep investing, and both you and Susie will see the return. Don't let the frustration get the better of you... you'll find the right dose. I know it.
Also, echoing your sentiment about how incredible @PerfumedCatMom is. I'm grateful people like Katherine are around to set such amazing examples. <3
Also, echoing your sentiment about how incredible @PerfumedCatMom is. I'm grateful people like Katherine are around to set such amazing examples. <3
Summer and Susie (GA)
Member Since 2020
Katherine is always supportive and never condescending. She shares her "true life" experiences in a gentle but firm way. I love the people on this site who can advise with understanding and guide with compassion.Stay in there, Summer. Keep investing, and both you and Susie will see the return. Don't let the frustration get the better of you... you'll find the right dose. I know it.
Also, echoing your sentiment about how incredible @PerfumedCatMom is. I'm grateful people like Katherine are around to set such amazing examples. <3
Katherine&Ruby
Member Since 2020
Thank you, but I don't feel like I "failed" the OTJ trial. It wasn't a test of my abilities. I was hoping Ruby didn't need insulin anymore but her little body has ideas of its own and I'm responding and going on for the ride. I always appreciate your kind thoughts in support of us, Summer.
Bandit's Mom
Member Since 2019
I would have thought so too, but after the 257 at +5 (which was flat from +1.5), you could've stopped testing.
Today she was flat as a pancake all day!