5/21: Sammy - AMPS 152; +6 125; +8 141; PMPS 163; Questions!

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Tina & Sammy

Tina & Sammy

Member Since 2010
Yesterday's Condo

Okay, so here I am again needing a bit of advice. Yesterday, Sammy saw a tiny bit of GREEN, but so far today he hasn't seen any. With this morning's dose he has had 6 cycles on the new .25u dose. So as a kitty returning from remission, when would you consider giving the next increase.

I know the protocol states that you should hold the dose ten cycles once GREEN has been seen, but seeing how he was seeing so much green before on the lower dose and now he isn't seeing it as much on the higher dose, should I consider increasing sooner rather than later?

I did speak to the doctor about a possible infection, but she didn't think he would be dropping back down if there was an infection present. She thinks he would rise up and stay up. Is this what others have found? Even with fluids?

Should I reconsider taking him in to have him tested for infection? Again I don't want to spend the money unless it is truly warranted.

Right now I am just so confused about what is happening with his numbers. I was so certain he was close to remission again and now we are increasing instead of decreasing. Could someone please help me to understand whey this might be happening.
 
As I have paid attention, with returning kitties, you want to be a little more aggressive... If I remember correctly, it's like every 6 cycles is long enough.
I would think the insulin influences the drops, and possible infection influences not being able to stay down.
If he has a history of infections, then I would definitely be inclined to stay on top of it.

infection would explain his numbers.

imho and my feeble memory....o_O
 
I think I'd hold this dose one more cycle....it's possible that the drop from 105 to 79 yesterday morning set him up for a little bounce

If he's not getting green by tomorrow morning, I think there's room for an increase

Hopefully you'll hear from some others soon too!
 
rhiannon and shadow said:
As I have paid attention, with returning kitties, you want to be a little more aggressive... If I remember correctly, it's like every 6 cycles is long enough.
I would think the insulin influences the drops, and possible infection influences not being able to stay down.
If he has a history of infections, then I would definitely be inclined to stay on top of it.

infection would explain his numbers.

imho and my feeble memory....o_O
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Yes, that is how I understand it as well, but I didn't know if it still stood once you start seeing the GREEN, but since we are increasing again after seeing a lot of GREEN I just didn't know if I really had to wait the full 10 cycles.
 
Chris & China said:
I think I'd hold this dose one more cycle....it's possible that the drop from 105 to 79 yesterday morning set him up for a little bounce

If he's not getting green by tomorrow morning, I think there's room for an increase

Hopefully you'll hear from some others soon too!
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I thought the drops had to be more than 50 points in about a hour to send them for a bounce, or is that just a general concept?
 
Sorry for not having the spreadsheet updated earlier. I thought I had updated it earlier today, but apparently I only updated the local copy on my computer. The spreadsheet is fully updated with last nights numbers and this mornings. This morning's nadir was 125 at +6, but last night's nadir was 91 at +9. He might have dropped more before going back up to 152 for AMPS this morning.
 
Another thing that is very confusing is that his nadir is all over the place the last few cycles.

5/18 AM - nadir +6 - 155
5/18 PM - nadir +6 - 127
5/19 AM - nadir +4 - 172
5/19 PM - nadir +6 - 120
5/20 AM - nadir +1.75 - 73
5/20 PM - nadir +9 - 91
5/21 AM - nadir +6 - 125
 
Tina & Sammy said:
I thought the drops had to be more than 50 points in about a hour to send them for a bounce, or is that just a general concept?
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Going from 105 to 79 is about a 25% drop in less than 2 hours.....that's the same as dropping from 200 to 150 in 2 hours...or 300 to 225, etc. etc.

It's not so much the number of points as it is percentage dropped
 
Chris & China said:
Going from 105 to 79 is about a 25% drop in less than 2 hours.....that's the same as dropping from 200 to 150 in 2 hours...or 300 to 225, etc. etc.

It's not so much the number of points as it is percentage dropped
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Got it, I always thought it was the points I didn't realize it was more about the percentage. Thanks for setting me straight on that.

Hopefully that is what is causing the mini bounce today. So should I hold a few more cycles to see if it is a bounce or should I go ahead and increase to .5 u tomorrow unless I see some GREEN tonight?
 
I've always understood it was points dropped, not percentage - you're looking at the speed of the drop. Maybe someone else will add their 2 cents worth about the topic.

Today's am cycle just looks like a normal cycle to me with a nadir somewhere around that 125. Right now it looks like this dose can get him perhaps as low as the 70's.

Since he's back out of remission, i'd look at the protocol guidelines and lean towards the more aggressive side of the suggestions.
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.
 
julie & punkin (ga) said:
I've always understood it was points dropped, not percentage
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Just because it's an interesting topic....I would almost think it has to be more of a percentage thing just because it just seems logical because if you're saying it has to be a certain number (like 50 points an hour) it doesn't take into consideration where they're starting at at all. I totally understand that if you're starting at 400 and drop 100 points in 2 hours, that's a very fast drop, but if you're only starting at 100, wouldn't a drop down to 75 in the same time period possibly have the same effect?

Like I said, just seems like an interesting discussion which is why I tagged some of the other folks
 
Chris & China said:
Just because it's an interesting topic....I would almost think it has to be more of a percentage thing just because it just seems logical because if you're saying it has to be a certain number (like 50 points an hour) it doesn't take into consideration where they're starting at at all. I totally understand that if you're starting at 400 and drop 100 points in 2 hours, that's a very fast drop, but if you're only starting at 100, wouldn't a drop down to 75 in the same time period possibly have the same effect?

Like I said, just seems like an interesting discussion which is why I tagged some of the other folks
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That sure makes sense to me. It's similar to meter variance and how the lower the BG, the smaller the difference between the pet and human meters.
 
If you take that example further, a cat starting at 70 that dropped 17 points (25%) by +2 to 53 would be enough to cause a bounce.

I haven't seen it.
 
It's not specific number of points or percentages. It's by cat. ECID. Some cats can drop 70 mg/dL/hour and not trigger a bounce. Others can drop less and bounce to the sky. It's also difficult to know how much the change is per hour uless you are testing every hour.

For example, if Gracie is at 250 at AMPS and 150 at +2, she could have dropped any combination of numbers to get there. In other words, maybe she dropped 30 the first hour and 70 the second. Or maybe 100 in one hour.

I try to not specify a number...it's just a fast drop that can trigger a bounce. The specific amount of drop depends on the cat and it's liver.
 
julie & punkin (ga) said:
If you take that example further, a cat starting at 70 that dropped 17 points (25%) by +2 to 53 would be enough to cause a bounce.

I haven't seen it.
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That makes sense too. Also if the drop from 70 to 53 triggered a bounce I don't think we would know if it was the drop or the cat not being used to being that low. I guess ECID it is.
 
Marje and Gracie said:
It's not specific number of points or percentages. It's by cat. ECID. Some cats can drop 70 mg/dL/hour and not trigger a bounce. Others can drop less and bounce to the sky. It's also difficult to know how much the change is per hour uless you are testing every hour.
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Thank you, Marje.
In all my years here I've never seen so much talk about percentages or points dropped in relation to bounces as I have lately.
It's neither. It's the cat! ECID! :)
 
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