12/21-22 Andy - 293 pmps; 213 +6; 233 +7; 214 amps

Mandy & Rex said:
It looks like you may have to increase. No greens in a few cycles.
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Mandy - I am confused - the TR protocol states if nadirs are less than 200 to hold for 3-5 days before increasing - he had 191 on 12/20 and just now was 191 so I was assuming to hold 3-5 days after today unless he hits <200 again and if he does the hold starts over again? Is this wrong? :confused: Thx
 
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With TR, we increase every 6 cycles if there's no greens. Andy is not new to FD, so it's better to increase sooner than later. However, if you think the bounce is clearing, do not increase on that cycle. The cycles are based on when you start that particular dose. If the numbers are coming down as a whole, then you would want to hold a bit longer to see if the numbers continue to come down on that dose.

I hope this makes sense.
 
Mandy & Rex said:
With TR, we increase every 6 cycles if there's no greens. Andy is not new to FD, so it's better to increase sooner than later. However, if you think the bounce is clearing, do not increase on that cycle. The cycles are based on when you start that particular dose. If the numbers are coming down as a whole, then you would want to hold a bit longer to see if the numbers continue to come down on that dose.

I hope this makes sense.
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Maybe it is "my" interpretation that is wrong - on the TR protocol it states when nadirs are less than 200 to hold for 3-5 days. He had nadir below 200 today so I was assuming to hold for another 3 days. ?? That seems different than just if there are no greens. So still confused on this. Especially since he is a bouncy kitty.
 
@Wendy&Neko would probably explain it better than I can. We don't want one to hold a dose too long or glucose toxicity may come into play. She can also look at your SS and give more advice.
 
Mandy & Rex said:
@Wendy&Neko would probably explain it better than I can. We don't want one to hold a dose too long or glucose toxicity may come into play. She can also look at your SS and give more advice.
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Yes - can see how that could happen. I have been trying to follow that protocol maybe too tightly? Last year, we got stuck in a rut :banghead: and I just gave up when I could not get him regulated. I am trying not to let that happen again. With 20 other kitties and 7 different diets, FD can be overwhelming sometimes. So I would really like to understand what to do for my little man.

One more thing - I will not be able to monitor on Tuesday so need to add that to the situation. Given the status quo, I could increase on Wed. Thank you again!
 
After a reduction is earned, you wait until the bounce is cleared before deciding if the reduction has succeeded or failed. It is considered success if he's back to greens on the lower dose. This is the 13th cycle after the reduction, so you know it's just the depot and dose of the 1.25 units giving you the numbers you are seeing. He's only getting to high blues now, so plenty of room for an increase back. Mandy is right that you don't want to hold onto a dose too long that isn't giving him good numbers. It doesn't take long for glucose toxicity to set in. However, I totally understand Tuesday being a busy day.

The holding for 3-5 days if you see blue part of the protocol is in the "increasing the dose" phase, when you are trying to get up to that good dose. What you want to look at is the "reducing the dose" phase where it talks about attempted reductions.
 
Wendy&Neko said:
After a reduction is earned, you wait until the bounce is cleared before deciding if the reduction has succeeded or failed. It is considered success if he's back to greens on the lower dose. This is the 13th cycle after the reduction, so you know it's just the depot and dose of the 1.25 units giving you the numbers you are seeing. He's only getting to high blues now, so plenty of room for an increase back. Mandy is right that you don't want to hold onto a dose too long that isn't giving him good numbers. It doesn't take long for glucose toxicity to set in. However, I totally understand Tuesday being a busy day.

The holding for 3-5 days if you see blue part of the protocol is in the "increasing the dose" phase, when you are trying to get up to that good dose. What you want to look at is the "reducing the dose" phase where it talks about attempted reductions.
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I totally missed that part on the reducing. :banghead: Just when I think I understand, there is a twist!

Well, he bounced again tonight to 376 :( - usually see this after the blues like today. I assume it would be safe then to take him up to 1.5 tomorrow morning - I am around both Sun and Mon to monitor and I could leave a snack on Tues just in case? He is really a tricky boy - he must like all the extra attention. (Do the highs resulting from a bounce also lead to toxicity?)

Thank you so much for helping us.
 
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