4/4 Cobb AMPS 216 +2.5 302 +5.5 218 +7.75 188 PMPS 135

Yesterday

Happy Friday!!

A quiet night. Looks like Cobb had a nice surf, although he did ask for some food around 2:30 this morning.

He looks good on this dose. But would he do even better with a bit of an increase? Maybe .5u more? Possibly get to lower 100s? I'm waiting for my half unit syringes to get here, although I could ballpark it until then. Thoughts?

Re: 4/4 Cobb AMPS 216

Morning Suzanne and Cobb!

He's starting to show improvement. This is great news!!!! If you want to try an increase, how would you feel about giving him 0.25u instead of 0.50? He may surprise you and lower his #s with 0.25, but then, he may not. With FD, you can never tell what a kitty will do unless you try it.

It's a thought, and perhaps worth a try. You can wait to see what others have to say about that before making a decision, if you'd like.

Good luck, and have a great day! :YMHUG: You're both doing an awesome job too, btw.

Re: 4/4 Cobb AMPS 216 +2.5 302 +3.5 244

Just thought I would check in - I like these numbers for Cobb!

I think whether you adjust the dose depends on what your goal for Cobb is at this point. With Jazzy, I knew she was acro so my goal was not necessarily to get her into "healing" numbers because her pancreas didn't need to heal. I figured out that she felt best when she was under 180 (which was probably her renal threshhold), so that's where I tried to keep her. Jazzy was a moody seal point diva, so it was easy to tell when she felt good and when she didn't. :lol: She didn't seem to care whether she was in the low 100s or mid 100s, as long as she was under 180.

I haven't kept up on whether you have received a high dose diagnosis for Cobb. If you are going for tight regulation, then I would probably continue adjusting the dose according to those guidelines. If you are going for nice and flat under renal threshhold, then Cobb is almost there. In that case, you can probably just start tweaking the dose to get to the range you want. You'll have to experiment to see what size dose changes work for Cobb (and that will probably change as time goes on). *Probably* at 19 units, an adjustment of 0.25u wouldn't even be noticed. It might not be necessary to change by whole units anymore, though. You can study Jazzy's spreadsheet to see the things I tried and the results I got. I tried to take good notes so her spreadsheet could be used as a tool for future high dose cats.

Re: 4/4 Cobb AMPS 216 +2.5 302 +3.5 244 +5.5 218

Good luck with whatever you decide on the dose I hope Cobb will slide down a bit more for you today, too. Have a great Friday!

Re: 4/4 Cobb AMPS 216 +2.5 302 +3.5 244 +5.5 218 +7.75 188

Good job squishing that pink with the R today Suzanne. I agree that Cobb is looking pretty good and now is time for just some fine tuning. And that you'll have to experiment to see what best works for Cobb. I've seen both Cindy/ Tip and Nancy Pepper use .25U increases for tweaking doses in the mid-teens and 20's. Other cats need .5U to see a difference.

If you are still waiting for your 1/2 unit syringes you could always move your dose to the bottom of unit line. A .25U changes shows just a bit of light under that line.

Did you vet say when you might expect the IAA results back?

I'm sending lots of blue vibes your way for the rest of the day.

Re: 4/4 Cobb AMPS 216 +2.5 302 +3.5 244 +5.5 218 +7.75 188

Hi all, I'm glad that I am finally feeling like the R is working. I'm figuring out when it works for Cobb, and I suppose taking a bit of a "risk" when trying to use it to squish a bounce in the beginning of the cycle. I just couldn't wait another couple of hours today to see how high he would go after the expected nadir. But I think Cobb's nadir jumps around. It seems to be a bit unpredictable, which I've been told is a bit of a hallmark for IAA.

I think I'm going to go with a .5 increase tonight. See what it does for 4 cycles and then adjust again accordingly. I can probably eyeball .5unit.

The vet said she'd probably have the test results in 7-10 days. I'm going to call tomorrow morning and check on it, especially since MSU should have run the sample earlier this week.

Libby, you asked what my goal is. For now, it is to keep Cobb definitely under 250, but as low as possible. If that means greens, great. If it is blues, that's fine too. He seems to feel best in the under 200. That is also when I notice his appetite is more normal - as long as it's steady or a slow slide, not a quick drop. Ultimately, I hope he won't need 19-20 units of insulin, but if that is what it takes, that is what it takes.

A question though...if he is acro and IAA. Does that mean he has a working pancreas or not? Assuming he is both (since we would have to assume that), should my goal be for healing numbers? Just curious...

Interesting news I learned today. The University of Georgia vet school is building a new state of the art animal hospital on campus. Starting next year, they will offer SRT when they move in. At least that is their intention. I got this email from one of the vets there: "Right now we have IMRT, which improves targeting, but not to the level of SRT, so it would be more fractions, treating M-F for likely 4 weeks. If you are interested I can ask our radiation oncologist." I've asked for more information. Does anyone know what IMRT is? What are fractions? Again, just curious...gathering info...

Re: 4/4 Cobb AMPS 216 +2.5 302 +3.5 244 +5.5 218 +7.75 188

Exciting news on SRT at U of Georgia. One of the issues with SRT for animals is that there have been so few places that offer it and it's always involved a trip and time away from home. There is a description of radiation therapy on the CSU website, but basically a fraction is a dose. You want to give a certain total amount of radiation and they divide that into doses or fractions. Current radiation technology usually means several doses over 4 weeks and SRT allows 3 sessions in a week, after one day of imaging and prep. And from what I've seen, seems to be cheaper because there are less sessions.

Neko is both acro and IAA - I've occasionally seen her pancreas at work, but not predicable. :roll: "Healing" numbers in TR help heal the pancreas but do not affect the acro tumor. Dealing with the acromegaly is more important that dealing with the IAA. For me, the IAA just means more extreme bouncing and variable onset/nadir and often delayed bounces. I try to keep Neko at a dose which maximizes time under renal threshold and has some green. As long as Neko keeps on seeing green, she bounces less. Cobb is much flatter on Lantus than Neko ever was. You are doing a great job with him.

Gotcha! Thanks Wendy!

We're definitely seeing an improvement in numbers. I'm very happy about that! Since his preshot tonight was in the lower 100s, I upped him by .5. I had been thinking 1 unit, but went conservative instead. Hope that's a good fine tuning decision.

gee, nothing to say as all of your questions have been answered! so i'll just wave hi! *waves*

Cobb looks super today!