? 1/25 Akila PMPS 261 - delayed new dose reaction?

Prior: http://www.felinediabetes.com/FDMB/...2-96-4-121-6-109-8-81-10-139-pmps-271.189583/

So after decreasing to .75u on the 14th, all seemed about the same for a week. I was happy! Then she had a little roller coaster ride on the 21st and 22nd and now her PMPS and AMPS are pretty consistently higher. Is this a delayed reaction to the lower dose? Something to do with her depot (a concept which I just have not really synthesized yet, even though I've read that sticky thread at least twice)? The numbers haven't swung terribly wildly, it's not like she's getting over 300 or anything, but I am a little bummed.

I shouldn't even say this out loud, but there's possibly, maybe, very hopefully some indication that the chemotherapy for her pemphigus might be having an effect...we need to give it at least another month, but if it does...well it's really our only hope for cutting back on or getting rid of her steroid dose. And I can't lie, particularly with her numbers a couple weeks ago, as we decreased to .75u, I was dreaming about the possibility of her going OTJ if the steroids are out of the picture!

 

Think of the depot like a "timed release" medication.....the first time you give Lantus, a little goes to work and the rest goes "in the depot" and is slowly released over the rest of the cycle. Until the depot is "Full", there's not enough in it to "release" the correct amount that corresponds to the dose.

Each time you change the dose, the depot has to stabilize again, so you can get some wonky numbers until it's "releasing" the correct dose again.

Does that make any sense?

 

Yeah, I do sort of get that concept. Does it usually have a delayed reaction? Like I was actually surprised I *didn't* get wonky numbers for a whole week after her decrease. I haven't read nearly as much as I'd like to yet, but I feel like when I've read other threads, I've seen others experience some sort of reaction to a dose change more quickly. Maybe it took the depot a while to realize it wasn't actually as full as it thought it was and it was releasing more than it "should" have the first week after decrease?

No big deal, just curious at things going differently than I expected. Overall, I remind myself that we're still doing pretty well and patience is key to let her body react over time as well as my data collection.

 

For the first (usually) up to 6 cycles after you decrease, the depot is still releasing more than the "new" dose

It takes up to 6 cycles for the depot to "drain" down and stabilize at the new, lower dose.

The other concept that can be hard to figure out is New Dose Wonkiness (NDW)....this is when you increase the dose (and you'd think the numbers would come down) but they go up instead!! We don't know why this happens, but it happens often enough that we have an abbreviation for it!...LOL