2018.03.16 - Emmett - AMPS 19.5/351, +2 20.5/369 Last night 5.9/106 ...future dose advice needed??

Previous: 2018.03.15

Hey all. So as we can see by Emm's chart, he was up at 19.5/351 this morning, +2 he's 20.5/369.

He had a really good day yesterday night, and as you can tell from my previous post, I was prepping for a low AMPS number today should it present itself.

+2 @ 369 is odd. Although, I haven't been home a lot at +2. That said, due to the number being at 5.9/106 (could have gone lower but I dosed off) -- should I be thinking about increasing? At 2.5 IU he's almost hitting that 100 mark, so I'm not sure whether to hold it or increase by maybe 0.25 iu.

Obviously, we'll see how he does today. I'll be checking every 2 hrs or more.


Thanks!


Rob

 

Or perhaps Emmett is getting too much? Reading all the info, I'm not sure whether it's too much or too little....

 

He was heading for greens last night so it appears to be a bounce going on. It can take a while for kitties to get used to lower numbers and stop bouncing. I don't think an increase is advised just yet but I am no pro. Let's see what others say...

 

I have to say...it's very flat today. Wth? Emmett is being difficult. He seems quite content though. It's odd, I'm kinda with you that I don't think this should indicate an increase either...but I dunno...

 

another reading +4, 20.0/360

 

He’s bouncing from lower numbers he’s not used to. It can take several cycles to clear. It’s a save some strips kind of day. I wouldn’t test again until PMPS.

 

@Bobbie And Bubba
@Stacy & Asia
@julie & punkin (ga)

What do you think?

 

lol, I was just thinking that. Emmett making me burn through these strips!

 

He is bouncing, but I think you're good to increase by .25 since you haven't seen green yet. Once you get something below 100 for the first time, you would hold the dose for 10 cycles before evaluating further (unless he goes under 50, of course). Up to you if you want to increase tonight or wait until the morning, as long as you can monitor).

 

With the 106 I would hold a little longer if my cat. If you decide to increase you will need to be able to be around to test often should he drop.

 

@Stacy & Asia

Well...I did have a brief moment of green way back on March 2. But never to be seen again and I held that same dose for 7 cycles after the green.

 

He most likely hit greens last night

 

well, that's the thing. If he had greens, which he probably did judging by his +5 number -- this may be a good dose.

and like you said, may just be a bounce from the low. It's just too weird, he usually fluctuates...this is too flat to
draw any conclusions...but I'm a beginner

Perhaps he'll give me something to work with tonight.

 

I agree with Stacey. If you didn't see greens, they didn't happen. Even if you had seen high greens, I would still say increase, You've held this dose longer than necessary for TR. The protocol says to increase every 6-10 cycles. You have held the dose for 13 cycles. Emmett needs more juice.

 

Guess I’m too conservative.

 

I don't think there is a wrong answer here, just different approaches. Following TR, many of those increases were held longer than necessary, which leaves the door wide open to glucose toxicity, there's a lot of pink on that SS. Because Rob is capable of monitoring closely, and it's the weekend, I think it's a good strategy to carry on with TR and try to stave off having to go to a higher dose because he held increases for too long. The goal is to spend a significant amount of time in a good range before settling in a dose (from Tilly's page):

"When the cat first begins to have daily nadirs in the normal range of a healthy cat (50 to 80 mg/dl) and spends significant amounts of time in this range each day, stop increasing the dose."

 

I see your point Stacey but I’d still have held just one or two more cycles. Good he can monitor closely.