03/22 Eddie AMPS 223 +2 218 +7 176 PMPS 245 +2 135 +3 81 +4 88

Jodey&Eddie&Blue

Jodey&Eddie&Blue

Member Since 2021
Good morning,

Here's yesterday's story.
https://felinediabetes.com/FDMB/thr...0-3-92-4-88-5-115-fur-shot-last-night.260983/

@FrostD @Wendy&Neko

Would either/both of you take a look at the past 2 days (SS). As you know I thought something "interesting" happened the night I was away and had a sitter come in to give the shot. Was it a fur shot? I didn't smell insulin but then I didn't get back until after the shot. Did Eddie vomit after he got the shot? What happened?

Then look at last night's numbers. We went into the green zone as we were on the 17th and trended into blue.

Right now I don't know what to think. Who was that masked man? Anyway, the question is now: do I stay at 7.5 or do I go back to 7.75?

I'll be honest these nights going into +4 and +5 are really getting to me.
 
I think that last sentence is your answer. I could argue there might be enough room for an increase, but I'm pretty happy with the 80s. Plus you have to balance sleep, work, etc. So, if that's getting tiring I definitely would not increase
 
FrostD said:
I think that last sentence is your answer. I could argue there might be enough room for an increase, but I'm pretty happy with the 80s. Plus you have to balance sleep, work, etc. So, if that's getting tiring I definitely would not increase
Click to expand...
Thanks, Melissa. I have a question though (when don't I?) : if the 7.5 dose is already keeping me up at night, what difference would the 7.75 make in those terms? Probably not much. The question then becomes, What is better or best for Eddie? He seems to hover between the two doses and it's hard to know if the SRT is playing a role here regarding acromegaly. We've gone over that ground many times and it's a guessing game for the time being. In consultation with the oncology radiologist, she is saying that in time another CT would tell us where we are & if there's regrowth, well, to do one more round of SRT or not.
 
There's really not all that much room for an increase. If you did, I suspect it would be short lived again...but possibly keep you up later, plus there's the days you aren't home during the day.

If it were me I would try an increase in hopes of nudging nadirs down a bit - question is, are you happy with the 80s/90s or would you like to see it a little lower, even if it means sleep continues to be affected?
 
I realize you didn’t ask me … but I think Eddie quite likes the 7.5u dose. I know the pressure to do the best we can, but what are you realistically hoping for? A nadir of 79 instead of 88? On an Alphatrak? When your reduction number is only 76? And remember, meters can have a 20 percent variance, meaning that that 88 could be a 70. I caution you against being too “greedy” with the numbers or too much of a perfectionist.

You’re seeing greens and are at times propping those numbers up with food. What happens those times you don’t catch the drop and therefore don’t intervene with food? Is he actually earning a reduction but you’re just not seeing it? Then the resulting bounce tempts you to want to increase…

It also seems that Eddie likes to take his good ole time settling into a dose. Who knows, he might even be angling to drop down to 7.25u soon. One can hope.

With your current schedule and not always being available to get BG tests/feed, and understanding how hard it is to stay up late, I’m pondering exactly what it is that will make you happy and allow you to relax a bit. Given that he’s staying in the greens/blues/lower yellows on an AlphaTrak and is a post-hypophestomy post-SRT acro, and you can’t realistically be available 24/7 to test/feed/micromanage, I’d argue that allowing Eddie to ride the green/blue/yellow wave and avoid major bounces *is* in his best interest (and probably yours too).

That’s just my humble opinion. I hope I didn’t offend by tossing my thoughts out there.
 
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I think you need to take a good hard look at your goals for Eddie, and what exactly you can do to achieve that. A lot of it is just up to Eddie. In my case, I wanted Neko to be under renal threshold as much as possible, without losing too much sleep over it. For Neko, that meant keeping her nadirs around the 70's on a human meter. This gave her, and me, a much better quality of life.

Jodey&Eddie said:
He seems to hover between the two doses and it's hard to know if the SRT is playing a role here regarding acromegaly. We've gone over that ground many times and it's a guessing game for the time being. In consultation with the oncology radiologist, she is saying that in time another CT would tell us where we are & if there's regrowth, well, to do one more round of SRT or not.
Click to expand...
We've talked about this before. There is one word for you - patience! SRT neuters tumour cells, you don't see any change in dose due to SRT until those neutered tumour cells die off. This can take a while. I've seen a cat take 3 years to go OTJ after SRT, and many more, like Neko, that didn't go OTJ at all, in fact, that's the majority of SRT cats. Instead they ended up on smaller doses and less of the acro side effects, giving much better quality of life, and longer life. Which is a good thing. Neko once went 3 months on the same dose, cause her nadirs were where I wanted them, and those darned tumour cells were taking their time. We've also talked about the risk of a second CT and SRT, specifically with respect to the heart. Proof here that even a second SRT won't guarantee remission and poses dangers to life.

Things you could do: (1) buy a comfier pair of patience pants. :p (2) Try Levemir to see if it flattens him out more so you aren't as bothered by the bouncing. Note, this bothers you more than him, and you do have to deal with different nadir timing. (3) You need to realize that you need to somehow learn to have a diabetic cat, and a life. There is only so much you yourself can do with Eddie's tumour.

Side note, he's only had 1 pink on 7.5 units, more higher numbers on 7.75 units. Not a lot of difference between the two doses in the amount of lower blues and greens.
 
JL and Chip said:
I realize you didn’t ask me … but I think Eddie quite likes the 7.5u dose. I know the pressure to do the best we can, but what are you realistically hoping for? A nadir of 79 instead of 88? On an Alphatrak? When your reduction number is only 76? And remember, meters can have a 20 percent variance, meaning that that 88 could be a 70. I caution you against being too “greedy” with the numbers or too much of a perfectionist.

You’re seeing greens and are at times propping those numbers up with food. What happens those times you don’t catch the drop and therefore don’t intervene with food? Is he actually earning a reduction but you’re just not seeing it? Then the resulting bounce tempts you to want to increase…

It also seems that Eddie likes to take his good ole time settling into a dose. Who knows, he might even be angling to drop down to 7.25u soon. One can hope.

With your current schedule and not always being available to get BG tests/feed, and understanding how hard it is to stay up late, I’m pondering exactly what it is that will make you happy and allow you to relax a bit. Given that he’s staying in the greens/blues/lower yellows on an AlphaTrak and is a post-hypophestomy post-SRT acro, and you can’t realistically be available 24/7 to test/feed/micromanage, I’d argue that allowing Eddie to ride the green/blue/yellow wave and avoid major bounces *is* in his best interest (and probably yours too).

That’s just my humble opinion. I hope I didn’t offend by tossing my thoughts out there.
Click to expand...

Oh, please no, I'm not offended in the least! I really appreciate you sharing your thoughts here. I think you're spot on about testing irregularity with regards to work. I honestly am not looking to be happy about this. I think my fondest wish is that the tumour would die off, Eddie would go into remission, like his brother Blue, with whom I've been dealing with acromegaly (surgery, fractionated radiotherapy and SRT) since February 2018. I know it's not realistic to want Eddie to be the same as Blue but I can always hope, I guess.:cat:
 
Wendy&Neko said:
I think you need to take a good hard look at your goals for Eddie, and what exactly you can do to achieve that. A lot of it is just up to Eddie. In my case, I wanted Neko to be under renal threshold as much as possible, without losing too much sleep over it. For Neko, that meant keeping her nadirs around the 70's on a human meter. This gave her, and me, a much better quality of life.


We've talked about this before. There is one word for you - patience! SRT neuters tumour cells, you don't see any change in dose due to SRT until those neutered tumour cells die off. This can take a while. I've seen a cat take 3 years to go OTJ after SRT, and many more, like Neko, that didn't go OTJ at all, in fact, that's the majority of SRT cats. Instead they ended up on smaller doses and less of the acro side effects, giving much better quality of life, and longer life. Which is a good thing. Neko once went 3 months on the same dose, cause her nadirs were where I wanted them, and those darned tumour cells were taking their time. We've also talked about the risk of a second CT and SRT, specifically with respect to the heart. Proof here that even a second SRT won't guarantee remission and poses dangers to life.
I did not realize SRT could take up to 3 years. They told me between 3-9 months. I guess, as I said to JL @JL and Chip my fondest wish is that Eddie will follow his brother, Blue, into remission after SRT (he also had fractionated radiotherapy). I'm just becoming aware that in spite of testing into the night that he might be slipping into lower numbers during the day as well. Like right now I got back in time for a +7 and he's in the blue zone meaning that he may well have gone lower in between +2 and +7.

He's currently been the most consistent on the 7.5 this time around, which suggested to me that something is going on, perhaps with the SRT, but I also know I'm hypothesizing cause and effect.

Things you could do: (1) buy a comfier pair of patience pants. :p
:cool:

(2) Try Levemir to see if it flattens him out more so you aren't as bothered by the bouncing. Note, this bothers you more than him, and you do have to deal with different nadir timing.
Looks like nadir for Eddie is +3, +4, +5. Would Levemir provide a later nadir?

(3) You need to realize that you need to somehow learn to have a diabetic cat, and a life. There is only so much you yourself can do with Eddie's tumour.
Honestly, I've been learning this since 2017 when Blue was first diagosed with DM and then acromegaly in Dec. 2017, followed by the long trajectory of his treatment. It seemed a twist of fate when Eddie was diagnosed in mid-2020 with DM only to have acromegaly confirmed in Dec. 2020. I've had to put on patient pants so often that I've gone through a few pair. Maybe I should get some new ones for spring.

Side note, he's only had 1 pink on 7.5 units, more higher numbers on 7.75 units. Not a lot of difference between the two doses in the amount of lower blues and greens.
Click to expand...
Yes, and that one pink is in the mystery zone where it might have been related to a fur shot...

Thank you.
 
I don't think he will need higher carbs after this. Let's see the +4.
(Trust him to do this on a night when you're tired and want to go to bed soon after the shot. LOL!)
 
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