2/19 Zoot! AMPS=111; +3=83; +5=72; +9.5=67; +10.5=75: PMPS=52; 20 min=74; +1=97; +2=91; +4=95

I guess I am not certain whether I stay at the reduced dose of 1.25 units or go back up to the original 1.5 unit that his was on for two days. I understand I start my cycle count over.

I dose in a few minutes, so probably won't get the answer in time, but seems I would stay at 1.25 units. It would be good to get guidance for the future, though. Thanks!

Yesterday's thread: http://www.felinediabetes.com/FDMB/...uced-dose-1-99-3-98-5-96.225834/#post-2529402

 

Depending on the circumstances, if you shoot a reduced dose because you get a lower than expected pre-shot, you go back to your original dose.

Ultimately with TR, you would work your way down to shooting any number over 50. Because would be able to shoot low, you would not be in the position of having to reduce the dose (a "BCS" or big chicken sh*t dose) in order to shoot.

 

Thank you. I have a couple of questions.

It sounds like you are saying that I probably should have gone back up to the 1.5 unit - does the protocol indicate that anywhere - I rely on the sticky note, but is there another source that people use that has more detail on TR?

How do I know whether a one-time reduced dose should become a reduction? I based my decision on the fact that we had to skip a dose then reduce a dose. Would other people have shot both of those levels, risking a hypo, after newly going to a higher dose?

Should I increase to 1.5 again this afternoon or just stay at 1.25 now? Do I hang on to 1.25 or 3 days or until the numbers indicate I need to increase? Would that be this guidance "Hold the dose for 3 - 5 days (6 - 10 consecutive cycles) if nadirs are less than 200 before increasing the dose by 0.25 unit." ?

Thanks again

 

Since you are following TR, a reduction is earned when the BG falls below 50 (for a cat that has been diabetic for less than a year).

I guess what Sienne meant was that over time we should grow comfortable with shooting any number over 50. And shoot the full dose and not a token dose.

This is what the TR protocol says about failed reductions:

• If an attempted reduction fails, go right back up to the last good dose as soon as you see kitty's numbers trending upwards. You don't have to hold the reduced dose for a certain number of cycles before taking the dose right back up. The guidelines listed under the topic "Increasing the dose" do not apply to a failed reduction. Please use common sense in this situation. The "last good dose" is not the dose that just dropped kitty into the 20s or 30s. You want to resume momentum by finding an in-between the dose.

In your case, Zoot did not earn the reduction to 1.25. however if you gave a token dose because you weren't comfortable giving the full dose at a lower than usual pre-shot, I think you could have gone back to 1.5 this morning. You would then count 6 cycles to hold 1.5 from this morning and not from the original increase to 1.5.

I hope someone will correct me if I'm wrong!

 

I'm glad Zoot stayed safe last night. Since he didn't earn a reduction, you would normally go back to the dose you were shooting (1.5 units).

 

Hmmm - but this wasn't a failed reduction; it was more like a failed increase, right (we increased the dose from 1.25 to 1.5 three days ago)? Wouldn't that mean that the "last good dose" would have been 1.25 and not the failed 1.5? and does that guidance apply with increasing doses? Granted, he did not drop into the 20s and 30s but I don't want to risk a hypo.

I think I get what you are saying, though, that his number were high enough to continue to shoot at the 1.5 units.

But at this point, given that I shot 1.25 this AM, what am I supposed to do tonight?

Thanks.

 

1.5 would be a "failed increase" if Zoot fell below 50 on it and you had to go back down to 1.25. since he didn't it isn't a failed increase.
like sienne said, our ultimate goal is to keep our cats in the green and be able to shoot green pre-shots.

i'm not sure about this, but i think you can go back to 1.5 but would then need to hold it for 6 cycles starting tonight.

 

Okay - got it! Thanks.

 

That was what I was thinking after I read the responses. @Sienne and Gabby (GA) does that sound reasonable? Of course we will see what testing looks like - I will get a +2 in 20 minutes.

 

If you shoot a reduced dose for one cycle, you go back to your original 1.5u dose and hold it for 3 days/6 cycles. You only "reduce" the dose if numbers drop below 50.

There's no such thing as a "failed increase." If you increase and then your cat's numbers drop due to a test below 50, it's simply your kitty telling you the dose is too high.

 

Edited - it was actaully +9.5 (not +8.5)

So at +9.5 we are at 67. Any thought about what this means in terms of increasing the dose back to 1.5 Units? I plan to do the full dose but I am definitely nervous about it. Maybe his numbers will be higher at PMPS.

 

At +10.5=75 so will see in another hour where he is, but doing full dose and monitoring tonight as late as I can.

 

@Nan & Amber (GA) Can you help? PMPS is 52. I need to feed him, should I skip?

 

Can you stall and test again in 20 minutes?

 

Yes, another brief stall if you can would be great. If you can't stall any longer, I think you might want to skip. 52 is shootable under TR, but only with a lot of data. He did well yesterday shooting low 80's but that's pretty much the only info we have right now.

 

I can stall 20 mins and shoot if he let's me - he is beside himself for food at this point. But if it is still low, I will not shoot and just start anew tomorrow morning at a 1.25 dose - he may not have "earned" a reduction, but this is telling me 1.5 would be too high - I shot 1.25 this AM but was told I should have given the full dose. Sigh. I am not comfortable with the protocol at all.

 

I can understand your hesitation...

Do you have any freeze dried chicken or salmon on hand? You can feed a couple pieces of that to ease his hunger pangs...I know Luci wants her food when she wants it...and doesn't like those delays either.

I'd love to see his numbers come up just a tad - he's been in the lagoon surfing all day and it would be great if he'd stay there tonight - but it would mean testing every few hours to make sure he's not dipping too low - especially at 1+,2+ and 3+...

You'd also have to make sure you have all your hypo supplies on hand - HC and MC foods, karo syrup and plenty of test strips...

 

He is 74 now. I will dose him but I think 1.25 is where I am going to remain. Not 1.5

 

If you had shot the 1.5 this morning there is a good chance he would have earned the reduction today. I think it's a good idea to shoot 1.25. Make sure you get a +1 and a +2.

 

As @Wendy&Neko often says, 'you're the one holding the syringe' and you get to make the final determination on the dose.

I see on the history that although he didn't 'earn' a reduction, it does appear he's doing very well on this new reduced dose...and I can understand not going back to the original 1.5 after reducing...

I suppose at this time it's best to follow your instincts and since he has been in the lagoon all day, leave well enough alone as far as the dose goes - he was very close to the 'below 50' line tonight...I personally would not have wanted to push him by increasing the dose tonight...but that's just me.

Let's just keep a close eye on him tonight and hope that he continues to surf safely - above 50.

 

I plan on monitoring closely - I am running out of test strips - only have about 8 on hand, but I can switch to my husbands OneTouch Verio - I don't like it cause it needs more blood. Groan. He has had so much testing, his poor ears are so tender .

 

The good thing (I predict) is that he is going to get a lot of food tonight

 

Are you using the antibiotic ointment after each test? Luci likes one brand so much she wants to lick it off!

Uh oh on the strips...I used to be so nervous about running out of strips I was running to Walmart every week - never getting lower than having 200 on hand in the backup box at all times. I finally ordered the OneDrop subscription service (of course, you can't tell them you're going to use it for a pet)...and I love it - just upload the numbers via Bluetooth and order more strips - I always have a box of 300 that are unopened as back up...

Best of luck tonight!

 

Oh yes the Neosporin + pain relief every time. Oh, OneDrop sound fabulous - I will check it out. Thanks!

 

Oh Zoot...don't make anything easy, now!
You're so brave...I'm so scared of reaching this stage even though I know it's a GOOD stage to be in!

 

You can see his spreadsheet- he really want to go into remission - we had one failed attempt in Jan. He is a great cat, and I am lucky his numbers are so good - just wish I could figure out what to do! I am a bundle of nerves at anything that is near or below 100. But like I say - he is going to get lots of food tonight, and that is his driving force in life, so we are probably good !

 

+1=97!!!!!!!!!!

 

Perhaps are cats are related; Buzzy lives to eat lol

 

=

 

Read thru... from ‘19 to today, your SS- great SS, full of data!
SOooo dedicated and diligent. At minimum, you deserve to be commended.
Dang girl, I wanna be like you .
Great job
BTW... Zoot! Is very handsome

 

Ha! I'm just lucky that i feed him and that makes him forget how much he hates me for constantly poking him. Some people here are like practically doing curves ever day. But thanks! I am fortunate to have a good patient boy to deal with. I think he is handsome too. And BTW, Nelli is quite beautiful too - love her markings)

This is all very intimidating, so I just keep my head down and plug along.

 

Actually, not something I often say. What I usually say is, can you monitor, do you have plenty of strips and high carb food? 8 is way too few strips to be making bold moves with the dose. Any chance you can send someone to get more strips? You will need at least one for tomorrow morning too. Always keep a spare bottle in the hypo kit going forward.

Glad you shot tonight. Paws crossed for a nice steady surf in healing numbers.

 

I have a backup One Touch Verio meter with lots of strips that I can use till I get the new batch on Friday. I cannot believe i went through 100 strips in just two weeks.

 

Zoot! is such a great guy - he is going to let me sleep tonight!