9/16 Atlas, AMPS 433

[Beth & Atlas]

I am thinking I will be holding at this 1.5u for a few more days. We're getting nice numbers in one part of the cycle and this crazy bounce in the other half. The protocol says in phase 2 to hold the dose when this happens and disregard the high numbers? They should clear in 24 hours. The few other experienced eyes on this agree that holding the dose is the course of action to take.

The problem I see in looking at his chart is he gets down into normal range...then his liver panics and we have rebound for 12-24hours. Then with no dose change he gets back into those normal numbers...and bounce again. I don't know how to minimize this issue. I am being told to have patience at this point. The protocol warns against considering this somogyi rebound. They say to focus on the nadirs. Which with him bouncing around...one day it might be 300+ and the evening it is 72? Waiting is all I think I can do!

Any dose changes should be considered after 5-7 days in a cat responding normally. Or every 3 days in cats who are high dose.

Atlas's liver needs to relearn he is safe at low numbers. We're essentially resetting his system. If we up this too soon we could miss his correct dose. This is our 6th day (today) and the beginning of our 11th cycle.

Unfortunately with the really severe weather scheduled for today, doing a lot of testing today will be meaningless, as Atlas does stress quite badly over rain & storms.

Yesterdays numbers were all high and flat again. This I am believing is a hard bounce/rebound from the day before.

Of course any insight and thoughts would be GREAT at this point. And yes, even being told to have patience AGAIN is ok!!

 

[Tena and Curry(GA)]

I wish I could provide saga advice at this point....Hoping others will come along and provide some valuable information for you.

Hope the weather is not too crazy there for you and Atla today.....And hope Atla's shows you some lower numbers.

 

[Beth & Atlas]

I feel like a ping pong ball in a coffee can.

What is wrong here? Atlas cannot stay in these high numbers, it is not acceptable. We're into our third week and there is really no noticeable improvement. Where is the crash and sustained low numbers? He was getting better duration on Humilin N.

This is more than frustrating at this point.

 

[Pat+Raja+Shadow (GA)]

Which was your PMPS Blue? I see that you increased the dose....good luck with that and I hope you will see some nicer numbers from that increase.

 

[Beth & Atlas]

I am sorry, I just keep looking at these god awful numbers and wondering where is this insulin going? These are the times I wish I had a test for insulin potency. At least then ....

I am sitting here near tears.

 

[Libby and Lucy]

Actually, the counterregulatory hormones that cause the high bounces can stay in the system for up to 72 hours. It's not uncommon for it to last that long in cats that are just starting to get low numbers. The usual course of action at this point is to wait at least 3 days after a green before increasing, unless it is obvious that the bounce has cleared earlier than that. We want to be sure that any bounce has cleared before increasing the dose. He hit 73 on this dose - what if, when the bounce clears, he tries to go back down there (or a little lower), PLUS you have increased the dose too? Once you know your cat well, you might know that it's ok to increase sooner than 3 days. We don't really know that for Blue. He has hit green only one other time since you have been here, and that time you also increased after 24 hours.

The guidelines about holding the dose for so many days kind of go out the window once the cat starts hitting green. Then you have to stop adjusting dose based on the calendar, and start adjusting it based on the cat.

I guess what I'm saying is, have patience. :smile: Do I think Atlas needs an increase? Yes, probably. But don't rush things. Working up to the dose according to protocol will give you a LOT of peace of mind once Atlas starts getting low preshots. You'll know how you got to your dose and you'll be confident that it's safe.

 

[Ronnie & Luna]

Me too, I'm wondering what the PMPS was.

And....you need a lot of patience! Bounces happen, higher numbers happen, I know!!
I was there too.
It felt like forever and ever. I didn't believe it either - patience and he'll get there when he gets there, yadda yadda...
Frustrations, and tears and just downer days of high numbers.

Hang in there Blue, it'll happen.
Besides, look at those nice greens the other nite!

Keep an eye on Atlas with the increase ok? Despite the weather.


:YMHUG:

 

[Pat+Raja+Shadow (GA)]

Blue....tears are a good release. But I have learned that no amount of tears or gnashing of my teeth will change one single thing about this sugar dance.
Patience and following the protocol are the things to focus on, NOT the amount of days on insulin.
It might sound simplistic to you but it is what does work in the end.

Do your testing, post your numbers and follow the experienced people here. Each one of our kitties is different from the others, but they do eventually respond at some time or another. I hope you feel a little better now and will face the new day with renewed enthusiasm, or at least with the feeling of sadness lifted a little.