? Need advice on increasing dose

I know TR says to hold 10 cycles when starting to see nadirs under 100 but does that still stand when not seeing nadirs under 100 for 6 days? She hasn't seen any greens in six days and has been on this dose for 6 cycles so could i possibly be ok increasing already? Thank you all!

 

I have an opinion on that, but I think high dose kitties play by a slightly different set of rules than the rest of them. I’d see what @Wendy&Neko thinks.

Still nice to see all this blue and a lot less yellow!

 

Hi Debra,
to quote the TR 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.

Summer is not exactly new to blue, and the blues she has been getting are not low blues, so looks to me like she needs more juice.
Let's see if Wendy agrees.

 

I agree with Gill. Summer isn't brand new to numbers under 200 so I would evaluate the dose every 6 cycles. Like Gill, I'll defer to Wendy, though.

 

Hi Debra
I think Summer is ready for more juice. I would increase to 8 u. I became diligent on increases, if warranted every 6 cycles. I apologize for asking if its already been addressed but are you planning on getting Summer tested for high dose conditions? Knowing if one or both conditions are in the mix can help with dosing strategy. More I think with IAA, as you want to stay on top of dose increases to try and break through and "beat" the antibodies.
BTW Summer has beautiful eyes, such a cutie!!

 

Hi i am really starting to consider getting summer tested for high dose conditions but really am unsure at what test is mostly needed and the least expensive. It is suspected summer has cushings by the vet but she has not been tested for it yet. I haven't pursued it because i have decided not to treat for cushings if she does have it. For financial reasons and mostly because i have heard and read how hard either treatment will be. Whether it be the drugs for the cusings or the surgery, i just don't want to put summer through that. Does that make me a terrible kitty mom? Maybe it does but i can't see putting her through all of that. I hope you all can undestand. I love summer and i am willing to test for the much needed test so maybe we can get an idea as to why she is a high dose kitty. And hopefully it will help with her dosing if we all know what is going on with her?? Idk but maybe it will. Does anyone know what test is most needed here?? I think Tuxedo mom may know if someone can tag her for me so she can see my post here. I would appreciate it. Thank you all so much from summer and i.

 

I'll tag Mary Ann @Tuxedo Mom for you I am sure she will have some insight, and @Wendy&Neko (just tagging her again in case she didn't get the first one) Neko was a highdose cat with Acro and IAA.

I think it would be helpful to know what you are dealing with as it can help with dosing decisions, but I'm not sure which of the three tests would be the 'most important' or indeed what the costs would be.

 

Thank you so much!!

 

You're welcome

 

Not treating does not make you a horrible kitty mom. Mary Anne did not treat her Cushings kitty, and Purrdy wasn't treated either. They are the last two regulars here with Cushings kitties. By far the majority of acro kitties are not treated either, other than trying to get them in good blood sugar numbers. And managing any symptoms as they show up.

Speaking of which, good to see that increase. If I saw really low blues, I might hold on for an extra couple cycles, but otherwise no need to hold onto amdose that isn't seeing green, especially for kitties with some sort of insulin resistance going on.

 

Testing for Cushing's can be done relatively cheaply with the UCCR test ( urine creatinine cortisol ratio). It involves collecting a urine sample at home so there is no stress and having your vet send it to an outside lab that does this test. Although I never treated Tuxie for his pituitary-dependent Cushing's it was, for me, good to know what I was dealing with and made it easier to make good dosing decisions based on his needs.

The Acro and IAA tests are done at Michigan State University with a blood test drawn at your vets. IF Summer is IAA rather than Cushing's or Acro, many kitties reach a point where the insulin resistance "breaks", so it is good that you are doing a great job of monitoring. Nice to see some greens popping up now.

 

I so agree about most treatments. If you were to decide on getting tests done for Acro and IAA the actual fee from MSU is inexpensive. The costs are blood draw at the vet an overnight shipping charges. The MSU cost for the test for IAA is $18 and $58 for IGF-1 growth hormone. I believe in total it was roughly $260 for both through my vet. I makes sense to do both at the same time as you are already drawing the blood and shipping to MSU for one test mind as well test for the other too! I think when we are dealing with high dosers we hope our kitties come back and only test positive for IAA. Like Mary Ann said the resistance will eventually break. Black Kitty and IAA and went OTJ.
Most treat with with just whatever the insulin needs are. I did try Carbergoline for Beenie as she had both Acro and IAA. It was financially manageable and I hadn't heard of any bad side effects from other cats on it. I was hopeful since Marvin went OTJ even with Acro!
Feel free to ask questions. If I'm not on, just PM me, I don't mind I'm just not on line much.


ETA- The MSU links didn't quite work. The code for the IAA test is 20031 and for Acro 20005