8/11 Tomcat PMPS 158, +2=67, +3=47, +6.5=47

viewtopic.php?f=9&t=101806

Evening all

Well I have a few observations and questions regarding reductions. Tomcat "earned" a reduction tonight.....even though his cycles have been slowly getting a little higher.....I am not too sure I should decrease though....here are my thoughts:


This is how I look at the entire diabetic situation (no animal science knowledge at all!!): in a perfect world to help a cat go into remission ...the cat's pancreas should be "suppressed" ....not have to work at all.....until it has totally...TOTALLY...healed itself.

I don't understand why a cat earns a reduction because it drops below 50 ONCE even though their numbers just aren't that grand. The only reason I can find on the board is solely for the CG. Marje posted a great Sticky about reductions with her example of how it was difficult for her to stay ahead of Gracie's dropping numbers all day......as Marje did not take a reduction and the depot was just too full. okay, I get that. here is my point:

MY POINT IS FOR THOSE OF US LUCKY ENOUGH NOT TO WORK: I test and feed Tomcat all day anyway........I will test him just as often regardless of his numbers .......so why not make it worth my time and stress with lower numbers......and BETTER HEALING?

can someone tell me the ADVANTAGE TO THE CAT to take reductions? not for the CG. (obviously, I realize the hypo reasons for keeping a dose for too long)

****Is it "helpful" for the pancreas to actually have to work a little? Will "suppressing" the pancreas too much cause it to become lazy?

or is it just too risky not to take a reduction ...just in case that next cycle is so low/super full depot that all the syrup in the world won't do the trick?

In conclusion: why does a newly DX kitty have an easier road for reductions vs. a long term DX kitty? I feel that the protocol for long term diabetic kittys earning a reduction should be the same for all.........because then you truly KNOW they earned it......and it wasn't because the cat didn't eat good that day, or the cat exercised too hard and burned up all his sugar .....or because the moon was full!


Kelly
okay having said all that: would you give Tom his reduction? ha

 

Re: 8/11 Tomcat PMPS 158, +2=67, +3=47 hold or decrease?

Yes, I would give Tomcat his deduction. He's been on this dose 8 cycles and has earned it. I don't know why you say his cycles aren't looking good. His highest number on this dose was 158, and that's because of a delay. I think he's looking GREAT! And what's the reason to reduce for a cat? If you don't reduce and he goes low a lot, it can be dangerous and hard on him. Think safety. I have seen a CG with a cat in the 30's for several hours. That isn't good for either of you. Also, Tom has a track record of holding his reductions well.

 

Re: 8/11 Tomcat PMPS 158, +2=67, +3=47 hold or decrease?

I'm not sure, but I think "glucose toxicity and insulin resistance" has something to do with that?

The protocol does have a built in "exception" to the "one time under 50" rule. And I think that is the "history of failed reductions" clause :lol:
When people have given reductions, then had to turn around and raise right back up to the last good dose, they get that history of failed reductions. And even if the cat might not be a long-term diabetic yet, the data is there to show that prior reductions haven't worked. And they might go with the three times under 50 route.

The way I think about it, if it were my cat, I'd take the reduction for one time under 50 regardless. Until I see something fail, I'm going to assume "success" is going to happen. If there is going to be a "line in the sand" for reductions, then I'd be giving Bob a reduction every time he stepped over the line. I wouldn't take a reduction based on "well, I think he must have gone below 50 at +6 because I got a 52 at +7". No, I'd have to catch it on the meter myself. But if he "earns it", I'm giving it to him. With PZI, it was really actually much harder. There wasn't a magic number for reductions. It was all following my gut with doses. I said in somebody's condo last night that I believe that's the huge benefit to TR. There are rules, guidelines, lines in the sand, whatever you want to call them. But there are definite indications that tell you when to adjust a dose. And I'd follow them until I saw them fail definitively.

Just my 3 cents. ;-)

 

Re: 8/11 Tomcat PMPS 158, +2=67, +3=47 hold or decrease?

I think there is a balance between providing support to the pancreas and allowing it to function. The insulin dose should reflect what the cat needs. Numbers below 50 indicate that the cat is getting too much insulin and the dose needs to be reduced. This may be because the pancreas is healing and beginning to work.

FWIW, the TR protocol used by the German Lantus forum uses a slightly different approach.

 

Re: 8/11 Tomcat PMPS 158, +2=67, +3=47 hold or decrease?

Looking good there Tomcat, congrats on the reduction, work that juice.
Your doing good, relax :smile:

 

thanks all for your responses and advice!! I don't know why I am so resistant to reductions..... :?: but,

I also have to listen to Tom, who has been telling me ALL NIGHT long that it is indeed time for a reduction!

He must have read my post..... ;-) .

I am about 30 mins away from opening up a can of HC GRAVY and calling it a night!!!.....but I won't. And will regret it come AMPS! :shock:

 

You did feed the 47 you just got though, right? LC at least?

 

Well, I am not that hard core yet Carl!!

yes, I fed him some 10% ............

see I do have a heart for the poor ole/old fellow.....don't I? it isn't "unkind" to let him surf this low is it?


nice job with Karen and Poe..... Carl

 

Unkind? No, not at all, I don't think. He's acting like he feels great right? Right now, his BG is the low end of normal for a cat. I'm guessing he's feeling pretty good. The more time he spends in normal, the more likely it is he'll eventually learn to live there for good. ;-)