3/11 Asia AMPS 274

http://www.felinediabetes.com/FDMB/threads/3-9-asia-pmps-166-3-156.192341/

Didn't get around to posting yesterday, nothing eventful happening. Asia is trucking along, being a cat. We are nearing the end of her 6 weeks of antibiotics. Vet thinks 8 weeks is overkill, I sure hope she's right about that. Asia has tolerated the antibiotics well enough that I'd rather do the 8 weeks than risk 6 weeks being just under what is needed and being right back where we started some time later, likely with more resistant bacteria.

This reduction is looking like a failed reduction thus far, trying to be patient as I drained the depot a bit and want to give it 6 cycles to build back up, but the trend is not looking good, she will be pink in an hour if she isn't already.

This has been a recent pattern of hers, waffling between doses where the lower isn't good enough and the higher is great for a time, until she builds up momentum and the depot is overly full and she earns a reduction. I wonder if it makes any sense to keep her on the working dose and intentionally drain the depot a bit every 8 cycles or so (or when I see the momentum building, which is apparent) to see if she can maintain without careening downhill into lime greens? Or I might try the 3 under 50, but I don't see how that will change much as a reduction would decidedly happen in short order if the depot was overfull regardless, right? Does having multiple under 50s on a dose make a reduction more likely to stick? Not sure why it would, but since it's in the protocol, I guess some have had success with it?

Seems to me, strictly following TR would have her be at a good dose for a time, earn a reduction, be at an insufficient dose for a time until raising it right back up again. Alternating 8 cycles (ish) good numbers and 6-8 cycles of higher numbers, rinse, repeat. To what end? I realize she can change things up on me at any time, but until that time, as long as she's waffling, what's to be done about it?

This is her first reduction on Lev, so I'm giving it due time to see what happens, but just musing on what to do if this pattern continues like it did with Lantus as I don't see how it would be an insulin specific issue.

 

To be clear it is 3 times between 40-50 on 3 separate days. Under 40 warrants an immediate reduction.

It’s all about safely spending as much time as possible in the healing numbers so that burned out beta cells have a chance to heal enough to return to the work of producing the insulin Asia requires on a full time basis.

Healing has its own timetable.
Hang in there

 

She's been bobbling around so I think she has a good chance to work this reduced dose. It seems to me when it's a failed reduction the numbers go consistently upwards and when they are still in bounce mode they bobble around like she is doing. I wouldn't be surprised if she gives you a flat yellow cycle today and then drops tonight. Fingers and Paws crossed.

 

Yes, I should have stated it explicitly for others reading my condo. Thanks for adding that.

Healing would be amazing, but at this point, it would be a sweet bonus and is not my goal. The odds are not in her favor for remission on several fronts: age, pancreatic insult, infection (kidneys), chronic infection potential (teeth that cannot be removed) and I accept it. My goal is to do the least further damage to her kidneys and keep her below renal threshold as much of the time as possible, which I would like to be all the time.

 

Sweet! I do hope you're on to something.

 

I hope Asia surprises you and heads down today.

 

Work the juice Asia! Surprise your Mama Bean and show her some blue!

 

Looks like Asia decided against pink

 

She was probably pink in +1 if not +2 as well, but if I didn’t catch it, I’m happy to pretend it didn’t happen.

 

❤️❤️❤️

 

Cycle six after the BCS and a mostly flat yellow cycle. Hmmm.

If Neko wasn't green at preshot, no reason to test before onset. If you don't see it, it didn't happen.

 

Your crystal ball is working, Bobbie!

 

Exactly!