3/30 Mr. Grey PMPS 105

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Rick & Mr. Grey

Rick & Mr. Grey

Member Since 2012
New day blue day for Mr Grey 24 hours since 9u dose. 3rd cycle 9u Lantus, fed LC for breakfast the birds are chirping outside. He wants OUT :-D . Mr grey was outside today for a few hours came in and tested +9 93 fed LC snack. PMPS 91 :-D
To shoot or not to shoot, that is the question ?
 
Re: 3/30 Mr Grey AMPS 119 PMPS 91 Dose Advice

gotta bump you up.

when you need help...

post a new message...
if you edit the first post , it doesn't always get seen.....
 
Re: 3/30 Mr Grey AMPS 119 PMPS 91 Dose Advice

Mr grey was outside today for a few hours came in and tested +9 93 fed LC snack. PMPS 91 To shoot or not to shoot, that is the question ?
 
Re: 3/30 Mr Grey AMPS 119 PMPS 91 Dose Advice

Can you delay 30 minutes and test again to see if he is coming up?
 
Re: 3/30 Mr Grey AMPS 119 PMPS 91 Dose Advice

Yes this is similar to last night I guess that was my lesson. I'm testing @ +12.5
 
Re: 3/30 Mr Grey Dose Advice AMPS 119 PMPS 91;+12.5 94

Hi Rick

Well.....he's done really well without that shot last night. Just surfing along tonight, too.

He has a pretty large depot going so this "could" still be depot from the 9.25u. He also has not earned a reduction under the protocol. BUT, if you feel more comfortable reducing him with the understanding that you "might" have to take him back up, it's your call. I can't guarantee that you won't have a cycle tonight where you are having to feed to keep his numbers safely up. It could be a repetition of yesterday's a.m. cycle but I don't know. I would prefer that you feel comfortable with a dose that allows you to shoot him bid.

What are you comfortable with?
 
Re: 3/30 Mr Grey Dose Advice AMPS 119 PMPS 91;+12.5 94

Marje I'm assuming you've noticed I took him down to 9u on the 28th PM shot. I think I'd be ok with a delayed shot tonight of 8.75u lowering off protocol.Doing my best to understand you. :smile: Testing @ +13
 
Re: 3/30 Mr Grey Dose Advice AMPS 119 PMPS 91;+12.5 94

You haven't delayed that long....if you are still only 30 minutes late, you can still shoot the 9u dose.

Sorry....what I'm saying is you have options:
  • shoot now and shoot 9u; get a +1 and +2
  • continue to stall until he rises and shoot 9u; get a +1 and +2
  • shoot now but reduce his dose to 8.75u so you are comfortable shooting on time; BUT...you might have to increase the dose because he hasn't actually earned a reduction. you still need a +1 and +2

The choice is yours; I just wanted you to be aware if his depot is still full (and seems like it is), you might be steering with more HC tonight.
 
Re: 3/30 Mr Grey Dose Advice AMPS 119 PMPS 91;+12.5 94

He just tested +13 105 I should shoot 9u and follow with plan a. shoot now and shoot 9u; get a +1 and +2 AND I still need to feed him supper right ?
 
Re: 3/30 Mr Grey Dose Advice AMPS 119 PMPS 91;+12.5 94 +13 1

So if I shoot now 11:15pm how do I enter the data into the ss from this point on. I've already been entering based on a no shot just take a look at his ss. Should his supper be LC or HC or both ? THanks !
 
Re: 3/30 Mr Grey Dose Advice AMPS 119 PMPS 91;+12.5 94

Rick, you have the best understanding of how hard you've had to work (with food) to keep Mr. Grey in safe numbers. When Neko started zooming down the dosing scale, I was originally going down by .5 units at a time, and I was decreasing the dose if she was hovering in the 50's and 60's with lots of HC. She probably would have gone below 50 if I hadn't carbed her up. She was telling me she needed less juice. Here's the quote from the Roomp/Rand study:

Reduce dose by 0.25-0.5 IU depending on if cat on low or high dose of insulin
Click to expand...

However, the .25U reductions may work to keep Mr. Grey in nicer numbers longer. Just thought I'd mention the option.

Because Mr. Grey is on a higher dose of insulin, draining the shed like you did last night with a missed shot can be a good thing. Another strategy I've seen elsewhere (and done myself), was to do 1/2 regular dose for one cycle.

For food, you could give his regular meal and maybe see what his +1 test is to see if he needs HC then.
 
Re: 3/30 Mr Grey Dose Advice AMPS 119 PMPS 91;+12.5 94 +13 1

Just shot 9u
For food, you could give his regular meal and maybe see what his +1 test is to see if he needs HC then.
Click to expand...
I will do just that. Since the shot was delayed by 1 hr 15 minutes how do I enter the numbers into the ss ?
 
Re: 3/30 Mr Grey Dose Advice AMPS 119 PMPS 91;+12.5 94 +13 1

Just like you did yesterday. The A.M. +11 block for today will have "91 @ 12; 94 @ 12.5". In the "PMPS" column, put 105 @ 13.

Could you please update your subject line now, Rick? Just put "3/30 Mr. Grey PMPS 105". Thank you!
 
Thank you very much Marje I'm learning so much from you. You're a good soul and an awesome pet lover. Thanks for being there ! :smile:
 
So does Liz! :-D :-D

Thanks, Rick. Wendy is a great resource with her experience with Neko and Libby is going to pop in tomorrow, I believe, to give you some other thoughts on Mr. Grey's trip down the dosing scale.

You might find Maxs SS interesting. He went up to 6u and then came speeding down. We don't know if Mr. Grey is IAA, acro, both, or neither but there's alot of good info in Maxs SS.

Any numbers yet?
 
I looked at Max's ss. When he went OTJ it seems he stayed in the green but on the slightly low side. Was this a successful remission ?
 
Yes...Max was in remission until he crossed the Bridge unexpectedly. As long as a cat stays in normal numbers 50-120, the remission is successful OR if they even have blips into a higher number but bring themselves back down. Barbara's Tuffy often gave her a higher number in the morning (e.g. 141) but a few hours later would be at 32. You have to scroll down a long way...it took Tuffy some time to go OTJ.
 
Max was undiagnosed but may have been IAA positive. Max is not a great example; I am not clear why his data is used so frequently.
Max and my Shadoe were dx about the same time, and their doses rose together. When Max went OTJ suddenly, I then looked into testing Shadoe for IAA and acro. She was positive for acro; Max was not tested.
Watch the heart as many acro cats have heart issues.
I know of one acro cat who was diagnosed early only because the vet recognized the condition; the cat was on insulin for only a few months, got one shot of 7u dose then suddenly went off insulin. Had that vet not had another client with an acro cat, no testing would have been done.
Gayle
 
I don't necessarily want to confuse matters but I do want to offer a different/complementary perspective. My basic assumption here is that Mr. Grey is a high dose cat. With that assumption, either you're seeing insulin resistance breaking or the pituitary tumor revving down (i.e., less growth hormone is being secreted so numbers come down).

With high dose cats, you often have to toss the protocol out of the window. Rather, you will have to use your gut to decide when or if to reduce the dose. In some cases, you'll need to reduce more than 0.25u or skip a shot so that you let the depot catch up with a dose reduction. I haven't looked at Randi's Max's SS in some time but I'm fairly certain you'll see some skipped shots. (In fact, there are cases with non-high dose cats where you need to skip a shot for the same reason.)

I think you're going to need to gauge whether these numbers mean that you should reduce Mr. Grey's dose. I don't want you to be in a position where his numbers tank. If he's acro, that may mean a teaspoon or two of HC isn't going to cut it. You may need to think in much larger quantities since an acro cat's pancreas is a working pancreas and it will pump out it's own insulin in response to food.

I may be worrying unnecessarily. However, i do want you to have the big picture so you can make good decisions and keep Mr. Grey safe.
 
We use Maxs data to show how fast a cat can come down the dosing scale and how flexible the caregiver needs to be. With a cat coming down the scale that fast, you have to set the protocol aside. It doesn't really matter why the cat comes down that fast. The point is flexibility.

I wanted Rick to be aware of that....he needs to be flexible. It's probably a good idea to seriously think about reducing his dose before he throws you a really low number.
 
Well as of now I'm stalling PMPS dose. See my 3/31 condo. Whenever I do shoot again I think we may have to lower the dose to 8.75u.
 
Oliver went off insulin in 10 days; his last shot was 5u, then he never needed another shot.
Max's numbers look like IAA breaking, and the same thing happened to Oliver who tested positive for IAA and acro. Oliver broke to all greens the first week of June 2010, then continued as just acro.

Without testing Mr. Grey, there is no way to know if he will react like Max, like Oliver, or even like Harley or Do Lou.
 
So Oliver was cured of Diabetes symptoms in 10 days on Insulin, but his Acro continues. So since then are you only dealing with his Acro and what is he like with Acro ?
 
Rick & Mr. Grey said:
So Oliver was cured of Diabetes symptoms in 10 days on Insulin, but his Acro continues. So since then are you only dealing with his Acro and what is he like with Acro ?
Click to expand...

I am just seeing this post now, sorry about that....

Cats with acromegaly are not diabetics. They have diabetes because they are acromegalic.

Please think of a faucet. If the faucet is turned off there's no more water, yes? The same goes for the growth hormone output from the pituitary tumor...... no output, no need for the extra insulin.

And yes, Oliver is still off insulin as are a few other acro cats.
Oliver's last shot of insulin was 3units of Levemir on Jan07, 2012.

You have an acro cat, and if you want the testing done, I think you will need to get a decent vet because yours is not worth much if you are ignored.

Even if you do not have the IGF-1 testing done, and you find you no longer need to give any insulin, I would strongly suggest that you continue testing. It does not have to be daily, or any particular schedule, but just do spot checks or even once a week. An acro off insulin can and do go back on insulin.
 
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