? Theodore Dose Question

tiffmaxee said:
I see. To follow TR an all wet diet is needed. I understand why you can’t do that and think custom dosing is probably appropriate. I saw Wendy has been on on the one condo I saw. Did she suggest anything about dosing? Tagging a few for input. @Wendy&Neko @Sienne and Gabby (GA)

@Marje and Gracie
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Yes they said to follow TR even with the dry. I had to get some issues resolved (AlphaTrak2 was acting up so I was sent a new one) along with getting a new vial as my doctor wanted to be on the safe side before we increase further.
 
NadineTheodore said:
Yes they said to follow TR even with the dry. I had to get some issues resolved (AlphaTrak2 was acting up so I was sent a new one) along with getting a new vial as my doctor wanted to be on the safe side before we increase further.
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For any lurkers this advice is only for Nadine. Please do not copy.
 
I suspect that he's bouncing today, hence the numbers aren't showing much movement.

Our suggestions were that you could temporarily increase as if you were following TR, until you get to better numbers. This is what we meant by fast tracking. The vet has suggested that acromegaly may be a possibility, in which case you need to be more aggressive in getting to good numbers. However, with the accelerated increases, there has to be increased testing for safety's sake. You need to get at least 4 tests per each day, 2 in the AM and 2 in the PM. The second one in the PM needs to be at least 2 hours after shot time, so we can see if that is an active cycle. We don't want to miss any lows hidden by bounces the rest of the time. If you see a big drop from the preshot number to the +2, you may need to do another later test, to make sure there aren't any hidden lows.

Many cats go lower at night. We decide how to change the dose based on how low the dose is taking the cat. It's entirely possible for a cat to go low and night, then bounce for several cycles, especially during the day. My cat once went three months dropping low at night (and earning reductions) then bouncing during the day. If I'd only looked at her day time data, I would have though she needed an increase, but it was the opposite.
 
Wendy&Neko said:
I suspect that he's bouncing today, hence the numbers aren't showing much movement.

Our suggestions were that you could temporarily increase as if you were following TR, until you get to better numbers. This is what we meant by fast tracking. The vet has suggested that acromegaly may be a possibility, in which case you need to be more aggressive in getting to good numbers. However, with the accelerated increases, there has to be increased testing for safety's sake. You need to get at least 4 tests per each day, 2 in the AM and 2 in the PM. The second one in the PM needs to be at least 2 hours after shot time, so we can see if that is an active cycle. We don't want to miss any lows hidden by bounces the rest of the time. If you see a big drop from the preshot number to the +2, you may need to do another later test, to make sure there aren't any hidden lows.

Many cats go lower at night. We decide how to change the dose based on how low the dose is taking the cat. It's entirely possible for a cat to go low and night, then bounce for several cycles, especially during the day. My cat once went three months dropping low at night (and earning reductions) then bouncing during the day. If I'd only looked at her day time data, I would have though she needed an increase, but it was the opposite.
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Thank you Wendy. I upped him to 3.25 tonight. I will test twice tonight. The vet doesn't think he has acro but they have to list every possibility. His liver/spleen and one kidney was slightly larger although he is a larger than normal cat and no changes in the size since 2019. He always was larger. They also suggested we could do another ultrasound when he was hospitalized/DKA to check if there was increased growth in his organs 4 months from now. Would you wait a little to test for Acro or do it right away? He's been quite costly lately so I am just trying to rationalize.
 
I wouldn't bother with an ultrasound to see if he has larger organs. The blood test for acro (IGF-1 test) is way cheaper than an ultrasound.
 
Wendy&Neko said:
It is flat, well within meter variance. Numbers wobble around during bounces. You'll see the numbers go down more in a non bounce cycle.
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So technically I am still bouncing correct? Sorry I get confused. I liked my +6 number today but this evening my +2 is making me anxious again---when I don't see decreases I wonder if I missed the dose somehow.
 
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