Re: 9/30 Toby's PMS=284+3=276
just an observation on the last 3 dose increases:
9/19 increased to 4.5 - following the second shot at that dose he got into yellows
9/24 increased to 5.25 - following the 3rd shot at that dose he got into yellows
9/29 increased to 6.25 - following the 2nd shot he got into yellows
I think I would not linger more than 6 cycles on any dose at this point unless you see blue numbers. If he remains 200's+ and you wanted to increase after 4 cycles, I think you could make a case for that, given how well you monitor him.
Usually when kitties get to 6u per shot we start talking about testing for high dose conditions. The most common is acromegaly, a benign tumor on the pituitary gland that puts out a growth hormone. The growth hormone does a couple of things - it causes the body to grow, first the soft tissues, eventually the bones. It also blocks the insulin receptors in the cells, so that you have to give increasing amounts of insulin so that enough will get into the cells. A voracious hunger is a typical common symptom with acro.
The next most common is iaa - insulin auto antibodies. The body creates antibodies that bind up the insulin so it's not immediately available. As Sandy says, the insulin is "taken hostage." IAA doesn't have any obvious physical characteristic, just the larger dose.
The least common is called Cushing's disease. It's a benign tumor on the adrenal glands. That one is relatively rare and usually fairly obvious - the skin becomes very fragile and will literally tear when it's touched.
I'll just bring those up with you (i don't think we've talked about them before - shoot me if we have!) so you can think about it. Testing is done by a blood test sent to Michigan State University's Veterinary Lab. It's simple, straightforward and tells us what's going on so we know what dosing strategy might be best to suggest. Here are a few links that you might look at:
Acromegaly Interesting Posts from the Past
Acromegaly the Basics
....this one has a link at the bottom that Wendy has added about iaa.
That's enough to start with. Take a look and see what you think. There are many high dose kitties around - punkin had acro, Wendy's Neko has both iaa/acro, Sandy's BK had iaa, Suzanne's Cobb has iaa and likely acro also, and Marilyn's Polly has both iaa and acro. They are still the same sweet kitties we've always loved, no matter how much insulin they need. :YMHUG:
julie