? 03/17 Gizmo PMPS=302, +2=389, +4=332, +5.5=294 *Question re: dose increase and BG #'s*?

03/16 +11 267

AMPS 303

And we are bouncing again.

Hope everyone has a green St. Patrick's day! A wee bit o' luck of the Irish be on ye.

TGIF.

 

I hope Gizmo clears the bounce soon.

 

I wish our kitties didn't love the trampoline.

Please come on down Gizmo.

 

PMPS 302
History:
AMPS=303, +2=255, +5.5=221

 

+2=389

This is the highest BG he has had since the dose increase. I just don't understand - he hasn't even had low numbers to bounce from (not for a couple of days).

This was what I was referring to as always chasing the green numbers. He will get one/two good readings shortly after the dose increase and then nothing higher blues and yellows and now purples. Even his 2nd dip down on this dose was just in the low blues. I seriously doubt he will ever get that low again on this dose. It is just how he is. Once he gets the good numbers they are never that good again (or very, very rarely).

Is this glucose toxicity? I did a little reading on it today and it almost seems that way to me. He is now back to the dose that we started on in Oct 2016 and if I do a dose increase it will be the highest he has ever been on.

Tomorrow AM cycle will be the 10th cycle from the last green - should I do a dose increase tomorrow PM cycle? I feel like if I don't keep on pushing this until he responds it will just keep going up and up.

 

Whats the WCR? All Ps in place? Any possibility of pain? Appy normal?

I see in your signature that you are following TR, however I also see you reduce after 3 dips to 70 and that you hold the dose (for an unspecified length of time) if nadirs are under 150...what is the reasoning behind this?

 

I don't know what that is?

He doesn't play like he used to but, for him, yes. In fact, poo has been wonderful lately.

ETA - he is currently hunting mayflies that got into the house when the doors are opened I think that counts as playing.

None that I can tell. Maybe arthritis? But still mobile, jumping with no issues.

Yes. But doesn't seem as food driven as he used to be. Now he can relax away from laying beside his food bowl and doesn’t jump up and running to it immediately after it turns but 8/9 times he eats all his fuds in his autofeeder.

I changed from SLGS because I was ready to start tightening up the numbers. He has never held a dose decrease. It is a slow raise in the AM/PM PS numbers (and nadirs) and we increase the dose back up.

I think it was Gussie's Mom (or Carfurby) that suggested this regiment. I think the hold if Nadirs were under 150 was because of my work schedule.

I am even questioning if the food is too high carb, but I am truly think I am ok there. IDK, I just don't understand the one/two times low numbers and then teeter/todder back up to the higher numbers. It is like he never fully recovers from the bounce (if that makes sense).

 

I think he may be getting over a pancreatitis flare. It was a mild one (if that is what is was). He has seemed back to normal for about two weeks.

ETA - he had a dental cleaning, no issues, no extractions (gingivitis) on 02/16 and had full BW & urinalysis on 02/14 (labs on lab tab on SS) - no new issues or concerns.

 

He doesn't appear, to me, to have glucose toxicity and what you are observing isn't uncommon. I've seen it in other cats. It's possible that when he got a little green, he "might" have had better absorption that day.

What makes it a little difficult for me, in making a suggestion, is that you aren't doing TR with the caveats you have. It might be better to change your signature block to read "individual dosing; do not copy" or to actually do TR as it is written.

I don't understand what the recommendation is based upon that you hold for three drops below 70 or hold the dose if nadirs are below 150. I think what would help him most is if you can try to do either TR or SLGS consistently because the current approach is not working.

If he doesn't hold reductions and you are going to do TR, then let him go between 40-50 three times before you reduce.

If he were my cat, I wouldn't get attached to a dose or worry that he might have to go up higher than he's been before. I would increase his dose as long as you can monitor.