Acro question: How to know when to increase dose?

Discussion in 'Acromegaly / IAA / Cushings Cats' started by Blue, Apr 3, 2010.

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  1. Blue

    Blue Well-Known Member

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    Dec 28, 2009
    I am wondering how I go about determining when/if Shadoe needs her dose increased.

    Shadoe was up to 14uLantus, then several things happened all at once, with the result being her dose dropping quickly down to 2.5u Lev. At one point, I was decreasing every shot till we got to 2.5 and here we have been for a week,

    We have been going along nicely with blues and greens after some yellow amps, then all of a sudden we get a 425! I can think of nothing that could have caused that spike, so I considered just a blip and continued on.

    Unfortunately, her numbers seem to have changed; she got to 155 at +6, but then came back up again. I get the feeling that the party is over now, or will be soon.

    So, to my question: How do I know when to increase and by how much?
     
  2. Carolynn FletcherGA & RobbieGA

    Carolynn FletcherGA & RobbieGA Member

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    Dec 28, 2009
    Hi Gayle!

    With Fletch I increase every 6 shots by 0.5u if he's staying yellow/pink and by 0.25u if he's getting blue. Having to increase after decreases is something that happens... too bad we couldn't control the IGF-1/GH, huh? :?

    Hope this helps...
     
  3. Blue

    Blue Well-Known Member

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    Dec 28, 2009
    Yes, thanks that does help.

    I have been a bit worried because even though we decreased crazy fast, we had been looking good at 2.5u - nice blues and greens, with a bit of yellows.
    Now all of a sudden, reds at the end of a cycle! I guess I had been lulled into a false sense of security, more worried about keeping her in bloo and not the low greens, so to see her swing in entirely the other direction, then stay pink and now a flat yellow, with tests of 265 265 and 270, I can see something is happening.

    She did get nadir 155 yesterday, so I had planned to count 6 cycles and then see what`s happening then. Really high, I will use R at ps but I am hoping we don`t get to that point and she comes down a bit.

    There is so much I don`t know, and so few to ask. There`s no way I would decrease Oliver`s dose by 4u like I did with Shadoe, but with Shadoe I have been just pulling numbers for doses out of the air. After getting up to 14, and making it down to 2.5, I am dreading any increases but I suppose they are to be expected, so best to prepare.

    I will stay put if no pinks or higher I guess.
    thanks for your guidelines.
     
  4. Carolynn FletcherGA & RobbieGA

    Carolynn FletcherGA & RobbieGA Member

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    Dec 28, 2009
    (((Gayle))) Believe me, dosing Fletcher has pretty much always been by the seat of my pants and a wing & a prayer. When we first started up the dosing scale, there were even fewer people who even shot above 4u bid... now at least many are aware that some kitties DO need crazy doses so you don't feel as alone as we did then.

    Obvious question: what's different during the PM cycle that can account for the higher numbers? What about using R for the PM dose or giving a different amount of Lev then (hey, we already deviate from the protocol with our acrocats, so different AM & PM doses may work)?

    I know I'm not a dosing expert with Lev, so take all this with however small a grain of salt is needed...
     
  5. Blue

    Blue Well-Known Member

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    Dec 28, 2009
    Thanks! you got me smiling with that last reply!

    Protocol? What protocol? We don't need no stinkin' protocol! haha_smiley
    I wish I could remember what show I heard that - I just plugged in the word 'protocol'
    While I do like rules, at the least for a guideline, I have never been good at following them. My logic is that if it does not suit, then don't follow it. The downside of that logic is the inevitable "now what?"

    I'll have to stare at her ss a bit, go glassy eyed and see what I see. As for changing am and pm doses, I would have to ask some other Lev people and see what they say. Interesting idea though and I'd try it if someone thought Shadoe would benefit from that style of dosing.

    I think I may lean more to using R to pull a higher number down because Shadoe a good surfer and not really a bouncer, thank goodness. Changing doses for am and pm makes me think about what that would do to the shed, and there would have to be some planning to know when to do the higher dose, like the am shot to be higher and the benefit realized in the next cycle when a lower dose was given but then you would be running on the shed ... naw, R is easier. Quick n dirty, bring the number down, then coast to the next shot.
    Still, I wonder who has already discussed this issue; their thoughts would be interesting to hear.
     
  6. Phoebe_TiggyGA_NortonGA

    Phoebe_TiggyGA_NortonGA Well-Known Member

    Joined:
    Dec 29, 2009
    Charlie says the original was from Treasure of the Sierra Madre - - and later used in Blazing Saddles




    Stinking badges
    From Wikipedia, the free encyclopedia
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    "Badges?... We don't need no... stinkin' badges!" is one of the most frequently quoted, misquoted, and parodied movie quotations in history. In 2005, it was chosen as #36 on the American Film Institute list, AFI's 100 Years... 100 Movie Quotes.
    [edit] Origin

    The original quotation comes from the 1948 film The Treasure of the Sierra Madre with Humphrey Bogart. In one of the scenes in the movie a Mexican bandit leader, Gold Hat (played by Alfonso Bedoya), is trying to convince Fred C. Dobbs (played by Bogart) and company that they are the Federales.

    Dobbs: "If you're the police where are your badges?"
    Gold Hat: "Badges? We ain't got no badges. We don't need no badges! I don't have to show you any stinkin' badges!"[1]

    This in turn was adapted from B Traven's 1927 novel upon which the movie was based:

    "All right," Curtin shouted back. "If you are the police, where are your badges? Let's see them."
    "Badges, to god-damned hell with badges! We have no badges. In fact, we don't need badges. I don't have to show you any stinking badges, you god-damned cabrĂ³n and ching' tu madre! Come out from that ****-hole of yours. I have to speak to you."
     
  7. Blue

    Blue Well-Known Member

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    Dec 28, 2009
    Thanks! I just LOVE that line and use for all sorts of situations!
     
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