2/5 Rooh pmps 318 +2 243, amps 171 +1 192 Dose Question

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Jmeli

Jmeli

Member Since 2014
In the past 5 days Rooh's dose has been held consistently at 3.25
We have seen Nadirs as low as 75 and peaks as high as 566.

Am I at Phase 3 yet for "holding the dose"?

And looking at the study, in phase 3 it isnt clear to me - Is this increase/decrease done daily based on the previous cycle?
 
Did you skip the PMPS dose on 2/3? Your spreadsheet has no entries

If you did, the "cycle count" started over, so you'd hold the 3.25 for at least 6 cycles after the skip
 
Sounds good, I will wait until tomorrow morning to dose increase unless Im just feeling like staying up late tonight. I will be around tomorrow to watch him.

This is where I am confused.. when he was on 3.5 u on 1/24/15 he went down to 42. Is that going to happen again, and if/when it does, I go back to 3.25 U but how long do i stay at 3.25 then?

Am I in phase 3 and is that done on a daily basis?
 
Yeah, that was always confusing for me too. Sometimes a kitty will bounce around in dose - back and forth - as the pancreas works to heal and potentially sputters back to life. So while 3.5u was too much that particular cycle, it might not be anymore.

Given the numbers on your SS, Rooh needs some more insulin. So you figure go up to 3.5u and see how it works. The right dose for him may be somewhere in between. And then someone who has used calipers would be able to help you better. I never did, so I can't comment on how to use them.

What do you mean by Phase 3?
 
Ok, no, that is not done on a daily basis. You want to hold the dose for at least 6 cycles initially before you make any changes.

If Rooh were to dip below 50 at any time, you would reduce the dose and your cycle count starts over.

Since you are going to increase Rooh's dose today, I wouldn't say you're in phase 3 yet because you haven't found a dose that consistently keeps Rooh in numbers between 50-200 (according to the protocol). Are you doing SLGS or TR? If you're pursuing TR, your BG range will be even smaller -- 50-120.
 
Mel...when I've been looking at your condo's and making suggestions, I've been using the Tight Regulation Protocol to make my suggestions and I think most of us have been doing the same.

The TR protocol we use here is a little different from the Queensland protocol, but it's one we've seen works the best to get kitties into remission. Here's the Tight Regulation Protocol we use here

Pretty blue numbers there for Rooh this morning!!
 
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Chris & China said:
Mel...when I've been looking at your condo's and making suggestions...
Click to expand...
Thanks Chris. As you can see I am a little confused, not really knowing which protocol to follow.
According to the TR protocol i should be increasing .5units then.. That seems like to much for Rooh considering his past with that much dont you think?

I am looking at the two and trying to figure out what the difference is between them, I have not figured it out yet. Can you clue me in?
 
No, you wouldn't increase by .5

You're in this part right now
Increasing the dose:
  • 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.
    • if your cat is new to numbers under 200, it is recommended to hold the dose for at least 8-10 cycles before increasing.
    • when your cat starts to see nadirs under 100, hold the dose for at least 10 cycles before increasing.
  • After 3 days (6 consecutive cycles)... if nadirs are greater than 200, but less than 300 increase the dose by 0.25 unit.
  • After 3 days (6 consecutive cycles)... if nadirs are greater than 300 increase the dose by 0.5 unit.
Click to expand...

Rooh is starting to see some blue nadir's, so you hold the dose a little longer and only make .25u increases

And YES...comparing TR to SLGS!! You got it!!
 
Got it.. so it looks like the difference between TR and Queensland is TR only looks at Nadirs and not Peaks?
 
Queensland is TR too....the protocol here is just a little more aggressive

They're both "Tight Regulation" ....that means you're trying to keep your cat in a narrow range of BG numbers

With SLGS, increases aren't done as often and reductions are earned when they drop below 90 instead of 50 like on TR...it's designed for people who have chosen (for whatever reason) that TR isn't for them.

TR gives your cat the best chance at remission...and although we've had cats on SLGS go OTJ, it doesn't happen as often
 
The TR protocol used here and the QLD one that you have are both based on the same earlier protocol. The board has made a few minor tweaks based on years of experience with what works best with most cats. They are all pretty much the same thing though, as Chris says, the protocol used here is slightly more aggressive. We tend to test a lot more often than they did in the QLD study so can be that bit more aggressive and have found that works a little better for most cats.
 
The Queensland protocol that you linked is the same as what we use here on FDMB. There are a few modifications that we incorporate based upon the experience of the members here over the years since the Rand/Roomp (Queensland) protocol was first published. But they are essentially the same.

I agree that you could increase by 0.25u. Even though it got Rooh in the 40's before, you lost a little momentum with the furshot and the reduction to 3.0 before he'd earned it. Now you're having to go back up in dose to get on track again. It's possible it will get him in the 40's again, but you know how to bring his blood sugar up if it does. It's pretty clear that for right now, the 3.25u isn't going to get him into green numbers. The goal is to get everything in green, not just the nadirs. Would you like some spreadsheets to look at that show how that happens? It's pretty cool. It's like you go up in dose until things click, and then BOOM, green spreadsheet. Ideally, of course - some kitties have to add their own unique flair, but most cats can do this and then you are in that phase 3 that you were referring to.
 
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