? 05/31 Mowgli AMPS 101, +6 76, + 9.5 70, PMPS 88 Dose Advice

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@Wendy&Neko

We have been monitoring Mowgli's nadirs and got a reading under 70 yesterday so we decided to reduce the evening dose to 11.5u (new reduction threshold based on our discussion the 28th). Unfortunately, however, we had a scheduling miscommunication and no one was home for Mowgli's evening shot (hence the 1.5hr delay). Today, we got a reading of 70, but I'm hesitant to reduce again since we are only two cycles removed from the last 12.5u cycle. On the other hand, wouldn't we expect his numbers to be a bit higher since we gave last night's shot 1.5hrs late on top of reducing the dose?

BTW, I am perfectly happy trying to reduce his dose even more, but will wait for further advice on here.

Thanks!

 

The larger depot can influence 4-6 cycles after a reduction, so you are likely still seeing the 12.5 units in action.

Have you started cabergoline yet? When you do, could you put a separate line in the spreadsheet indicating that. That helps me figure out if there is cabergoline influencing the numbers, in which case I'd be a lot more conservative.

One thing to keep in mind, can't remember if I've suggested this yet. But when a cat on a larger dose earns a reduction, sometimes it can be helpful to do a BCS (big chicken shot) or reduced dose one time only, to help reduce the depot. Something like 1/2 or 2/3 of the normal dose. If he's just under 70 it might not be an issue, but if a lot lower, then a good technique if you have something like cabergoline in play. Nothing worse than a large overfull depot!

 

Hi Wendy!

Yes, we started Cabergoline the morning of the 29th. I wrote it in the notes section of the sheet, but will add a line to make it clearer. So the reduction we took yesterday was one day after the start of Cabergoline. I figured that it's impossible to know if Cabergoline has had any effect yet, but I preferred to err on the side of caution.

Thanks for the advice on the BCS for large dose kitties earning a reduction. At this point would it be better to stick to 11.5u and wait for the depot to stabilize or maybe do a BCS tonight? It looks to me like the 12.5u dose is still in effect since we are seeing similar numbers to yesterday before the reduction. Tonight's PM shot is coming up in 45 minutes.

 

Update: PMPS came out at 88, so I decided to give Mowgli a BCS of 8.0u to be conservative considering Cabergoline is now on board. He has had very good numbers lately!

Welcoming suggestions on a new dose for tomorrow morning.

 

The fastest I've seen any cabergoline action is 7-10 days, often longer to start. But sometimes there are GI issues early on. I noticed you said he vomited.

You could try 11.5 units again - I think that 70 was from the 12.5 depot. If he does go off his food, you could reduce again for safety.

 

Thanks again! We will go back to 11.5u in the morning.