6/7/2018 Thomas AMPS 410, +5 257, PMPS 91, IAA results

Previous June 6, 2018

Gave 11 units last night and Thomas's sugar immediately increased. Went back to 11.5 units this morning but was also considering 11.25.

Our vet called with the IAA results, 44%. IGF results are not back yet. I'm hoping for tomorrow or the next day. Does being IAA positive change my dosing guidelines/protocol at all?

 

Sorry about the IAA results. I got those results first too. Neko was around that same amount.

Not sure what you are doing for dosing, up I found it best to just stick with TR. Thomas earned a reduction down to 11 units a couple night ago. Hold that dose and wait for the bounce to be over before deciding if the reduction has failed.

As far as dose strategy, IAA means you do have to try to keep green in the picture. Don't linger over any dose that isn't giving you a green, when you are in dose increase mode. TR says to hold a dose giving green for 6-10 cycles. Don't hold any longer unless you are getting lowish greens. With IAA, I found that a dose would do what I called going stale. It would start out looking good, but the good numbers would fade away and I needed to increase again.

When you get to dose decrease mode, and you will at some point, you may need to be cautious. The antibodies can randomly grab or release injected insulin, which makes things less predictable. And finally, IAA is said to be self limiting. It goes away after around a year, though it was 9 months with Neko. At that point, reductions can be fast and furious.

 

I'm tagging @Sandy and Black Kitty. She has a great deal of experience with IAA. (Black Kitty was our first diagnosed IAA kitty!)

 

Sorry for the results.

 

As the dose continued to increase I knew there had to be an explanation. Here's hoping that it's only IAA because at least it is rate limiting. I'm definitely concerned for when his body stops making antibodies. I love my Thomas.

 

On my to do sometime when I have spare time list (yeah - what's that?), is a post on IAA. In the meantime, here's a post I did a while ago summarizing some of the information about IAA. There's been a couple of intersesting posts since then, including one in Think Tank.

As for when the IAA stops, it's not like one day they need 10 units and the next they need 1. But it can be a bumpy road with reductions every few days, and some reductions larger than protocol suggests, combined with some skipped or reduced doses to drain the depot. We can help you when that happens.