12/29 Ivana AMPS=356, +2=295, +4=259, +6=239, +10.5=151, PMPS=135, +2=194, +4=230, +9=304

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Tara & Ivana (GA)

Tara & Ivana (GA)

Member Since 2015
Yesterday's post

Ivana is now in her 7th cycle on the 1.25u dose. Prior to this dose, she'd been in the pinks (with some yellows) for a while, and then straight after her first shot at 1.25u she went into the blues. She immediately bounced, but as yet has not recovered from that bounce. Even though she's had a full 6 cycles on this dose, I'm reluctant to increase just yet as she has a history of diving, and I'm wondering if maybe the fact that she'd been in pinks for so long means that this bounce is taking a bit longer than usual to clear? I think I might give it another couple of cycles to give her a bit more time to clear without the danger of me increasing at the same time that she's clearing. Thoughts?
 
Good to hear it's not just Ivana being weird! Her and Sheba do seem to be trampolining partners... I will see what she does today.
 
today is the 3rd day counting forward from the blue streak - i think it's the 29th for you, right? I'd be looking for her to clear it sometime today.

It's not a great idea to increase the dose as she's clearing a bounce because some cats get a lot of momentum going that way.

From the Tight Reg sticky::
Increasing the dose:
  • Hold the dose for 3 - 5 days (6 - 10 consecutive cycles) if nadirs are less than 200 before increasing the dose by 0.25 unit.
    • if your cat is new to numbers under 200, it is recommended to hold the dose for at least 8-10 cycles before increasing.
    • when your cat starts to see nadirs under 100, hold the dose for at least 10 cycles before increasing.
  • After 3 days (6 consecutive cycles)... if nadirs are greater than 200, but less than 300 increase the dose by 0.25 unit.
  • After 3 days (6 consecutive cycles)... if nadirs are greater than 300 increase the dose by 0.5 unit.
Also, Libby had a good explanation about why doses are held the length of time they are, including about increasing on bounces, here.

Where it looks like Ivana lost good regulation was when the dose decreases were too large, specifically on 12/16. Maybe you've already noticed that - I'm not laying blame at all, just saying that one can learn a lot by looking back at the spreadsheet and trying to see what worked and what didn't work. When she got to the 40's on the 16th, she was likely there because of the depot from the 1.25u still giving out, and skipping a shot followed by a decrease to 0.5u looks like it was probably a little too much of a reduction for her. Just something to note as you move forward - because sure enough if you've had a situation before, you're very likely to have it arise again!!

You always want to apply what you know about Ivana - has she ever taken more than 6 cycles to clear a bounce before? If so, then you could wait longer. If you think she usually clears them in 3 days or less, then she should have cleared it by now.

I think i'd give her the 8 cycles total because she is definitely new to blue.
 
If you take a look at the Tight Regulation Sticky, it allows for holding the dose 6-10 cycles if you see nadirs under 200. But since you haven't seen any green at this dose (which is the goal), I'd be tempted on increase sooner, not later. Maybe give her today to see what she can do. That +2 looks promising.
 
julie & punkin (ga) said:
Where it looks like Ivana lost good regulation was when the dose decreases were too large, specifically on 12/16.
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Yep I agree - this was because she earned a reduction the day before going to the pet-sitter, so we did a pet-sitter reduction (which we had planned), and a reduction because she earned one (that we didn't plan), so it was a 0.5u reduction instead of the usual 0.25u reduction. As it turns out, she ended up going low at the pet-sitters on that double-reduced dose anyway - and that was also the reason for the skipped shot for the pet-sitter too. Unfortunately that little trip turned out to have really wrecked her :(

julie & punkin (ga) said:
I'm not laying blame at all, just saying that one can learn a lot by looking back at the spreadsheet and trying to see what worked and what didn't work.
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You can blame me if you like, if it means I can do things better! I know for sure and certain I've made mistakes in this dance, I'd rather have them pointed out than risk doing them again :) Once she gets back on track, I'm planning to print out her spreadsheet on A3 so I can see everything at once, even if just the colours not the actual numbers, because I really feel like there's a pattern I'm missing. She's been on Lantus for 4 months now, and she's not improving - I need to look at any changes I can make or anything else I can do to get her sorted.

julie & punkin (ga) said:
Also, Libby had a good explanation about why doses are held the length of time they are, including about increasing on bounces, here.
Click to expand...
Re-reading this, I'm wondering if next time Ivana earns a reduction, maybe I should shave the dose instead of doing the full 0.25u reduction. Will think more on that when the time comes.

Wendy&Neko said:
That +2 looks promising.
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I really hope so Wendy! Paws crossed.
 
Tara, there are so many things I see now when I look at Punkin's ss that I wish I'd done differently . . . but I remind myself now that at the time, I did the best I could, knowing what I knew then. I erred on the side of caution because of his acromegaly and SRT. I can look and find fault with his ss, but if i were to do things over again, I might make the same decisions again - I wanted to keep him safe and with acro there is always the possibility that the tumor will die/turn off and suddenly the dose will be unneeded and a major hypo could result. So . . .

You just do the best you can - there's no place for blame. Everyone here is already going the second mile for their sweet kitter, and wouldn't be here if they didn't love him/her an incredible amount. I was only pointing out those things to help you analyze them for the future.

:bighug:
 
Atta girl Ivana, back to blues :cool: I think I will keep this dose for tonight as it seems she's only just clearing the bounce in the last few hours, and I want to see what she can do at this dose.
 
I agree Julie, we all do the best we can. It sounds like you had your work cut out for you with several different conditions that Punkin had, I guess I'm lucky in comparison seeing that Ivana is in perfect health apart from her diabetes. It just kills me that she's gone though all these pokes and shots for 4 months and she is no better off now than she was before. At least, it doesn't seem it, maybe she is... I don't know...

Anyway I'm going to sign off for a a few hours before I get too upset - having a bit of a down day today, got told by the vet that one of our chickens only has a few days left due to an impacted ovary duct. They hide their illnesses so well, we had no idea until this morning that anything was even wrong :(
 
WOO HOO for the blue! Bounces are so frustrating! I sure hope Ivana can get a bit more regulated soon.

Sorry to hear about your chicken. I used to have chickens and every time one passed it was heartbreaking. They do hide it so well! Hugs to you and vines to Ivana!
 
Thanks Laura, yes it's definitely heart-breaking. Poor Midori has gone downhill even in the few hours I was at work today, and she's now stopped eating - not even interested in corn :-( Apparently the only two options for her are surgery (poor prognosis) or antibiotics (also poor prognosis), so I dare say we will be scheduling her final vet visit soon :-(

In other news of a happier kind, Ivana was still blue at PMPS, and still blue at +2 - yeah!!!
 
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