2018.06.22 | Emmett • Dose advice? | AMPS • 292

Previous: June 21

So, highest reading in the last 4 days (7 cycles).

I gave him 7 iu again this morning...not sure if I should have or stuck with the 6.75 iu...?

Anyway, he's been at home for the week, but came up to the cottage last night...his even was relatively good, but some reason spiked over the night. Now, he maaaay just be bumping from the 41 yesterday, but I read on Tilly's page that if the dose doesn't hold then to go back to the previous dose...not sure we follow that here, but please let me know.

We'll see how the day goes. Here at the cottage there's 3 (yes, THREE) other cats and 2 dogs. I'm not sure if it's enough to get him excited or anxious (whichever it is) to raise the BG's that much...

Also, could he be eating something outside? Like does grass have carbs? lol



Rob

@Wendy&Neko @Stacy & Asia @Bobbie And Bubba @carfurby @Sienne and Gabby (GA) @Tracey&Jones @Christie & Maverick @Mandy & Rex @Red & Rover (GA) @Gill & George

 

BG's can rise due to stress so may have some higher numbers through your cottage visit. I think there is a bounce factor in there as well. Keep testing to watch to see if he drops as clearing the bounce may carry him with some momentum into lower numbers.

Reading the TR protocol...you don't need to hold the reduced dose but I would also take into account the situation at hand..is there bouncing going on, is there other stress factors at the moment? Is it really a failed reduction? Keep testing...that will tell the story because as much as we theorize..Emmett may have other plans.

Have fun at your cottage!



REDUCING THE DOSE:
The TR Protocol is an aggressive method in itself. The modified version of the protocol is slightly more aggressive. Let's keep all our kitties in the Lantus & Levemir ISG safe by suggesting and taking appropriate reductions.

• If kitty drops below 40 (long term diabetic) or 50 (newly diagnosed diabetic) reduce the dose by 0.25 unit. If kitty has a history of not holding reductions well or if reductions are close together... sneak the dose down by shaving the dose rather than reducing by a full quarter unit. See additional notes in the next paragraph about drops into the 20s and 30s. Alternatively, at each newly reduced dose... try to make sure kitty maintains numbers in the normal range for seven days before reducing the dose further.
• Please do not let yourself become complacent or blasé about drops into the 20s or 30s. Please ask for advice immediately.
• If your cat drops into the 30s, a full reduction of 0.25u is recommended. There are very few exceptions given for caregivers who have collected years of data and KNOW their cat's response to the combination of insulin and food backwards, forwards, and inside out.
• Caregivers whose kitties have "High Dose" conditions may find the need to reduce in whole units or more.
• 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 a dose in-between the dose that dropped kitty too low and the reduced dose.
• Since 2006 we've encouraged those practicing Tight Regulation to attempt reducing the dose from 0.25u to 0.1u before stopping insulin completely. During a two week OTJ trial, you want to see mostly green numbers (under 100) with only a few random blue numbers between 100 - 120 to help ensure a strong remission. Most kitties will be in the range of a healthy cat (50 - 80 mg/dL).

 

Haha, so should I do the 6.75 iu tonight? I did bump it back up to 7.0 iu this morning... As I said, not sure I should have ...perhaps I should have done the 6.75 iu again and see where the day took me?

...Emmett ALWAYS has other plans.

R

 

Please remember that with Lantus or Lev, you evaluate how low a particular dose brings your cat. The 7.0u dose brought Emmett to the 40s. What you were likely seeing at AMPS was a bounce. I'd suggest dropping the dose back to 6.75u. The other point to keep in mind is that Lantus is a lousy insulin when it comes to "shooting down" numbers. You need a short acting insulin for that purpose. The more you change the dose in rapid succession with Lantus, the more you tend to see wonky numbers.

 

I would.

 

K, will do. I wasn't to sure, I will do the 6.75 iu tonight.

Thanks!

R