8/8 Figaro AMPS=482 :| Question re TR increase frequency

[Figaro's Liz]

http://www.felinediabetes.com/FDMB/threads/8-6-figaro-amps-257-6-346-pmps-432-4-463.217829/

Still in the reds... wondering if he may be bouncing from the yellow a couple days ago. If so, could break tonight.

However, if these highs continue... I notice in the TR protocol on Tilly's page that increases can be done in increments of .5U (as was pointed out to me recently) AND every two to three days when nadirs >300 (0.25U every 2-3 days when nadirs >200, which they certainly have been, we will see if 2U makes a dent). I'm interested in the frequency in particular since it varies from the TR method sticky. Is two days simply considered too fast around here, or could it be appropriate in this case?

ETA is there any added risk when varying the approach to suit a work schedule--i.e., being more aggressive with increases on a Friday/Saturday because I'll be home to monitor?
I increased by only .25u yesterday because there was one yellow at the previous dose and I'm working 9-5 M-F. But I am wondering if I could increase again tomorrow, since I will be home to monitor over the weekend (assuming I see no blues/greens today).

Wish I had understood enough to try TR from the get-go, but oh well, here we are

 

[tiffmaxee]

I think most that give .5 increases are high dose. I would increase by .25 so you don’t miss a good dose. Let’s see what happens today and tonight before deciding on when to increase. Let the depot build. Just my two cents.

 

[Penelope and Mačka]

Yes, I know these reds look ugly, but you just started with the new dose and you want to keep him safe. I am very conservative and also a newbie so let's see what others think.

 

[Sienne and Gabby (GA)]

You can certainly increase by 0.5u if the majority of nadirs are above 300. I would not do both -- increasing after 2 days and increasing by 0.5u -- at the same time. I would suggest picking one strategy and see how it works with Figaro so you have some idea how he responds vs doing both at the same time and not knowing if one method is better that the other. I don't think I've seen very many people increase after 2 days unless we had a very solid reason for fast tracking the dose (e.g., a cat that is a recent DKA survivor). I've seem more people raise the dose by 0.5u.

 

[Jill & Alex (GA)]

I would suggest picking one strategy and see how it works with Figaro so you have some idea how he responds vs doing both at the same time and not knowing if one method is better that the other.

I agree with Sienne. Data gathering can become very cloudy when one more than one variable is changed at a time.

You can certainly increase by 0.5u if the majority of nadirs are above 300.

I'd like to clarify...
You can certainly increase the dose by 0.5u if the dose is not dropping kitty any lower than 300.

That said, please be aware: these guidelines are given for those using meters calibrated for humans. I'm not saying you can't use a meter calibrated for pets. However, note the protocol itself requires a human meter because it was written for use with human meters.

My point in mentioning this is if you're thinking about accelerating an already accelerated dosing method in this manner, you might want to pay attention to and follow the guidelines. One being: "you will need a brand-name glucometer made for human diabetics which uses 0.6 µL of blood per test or less." A full list of guidelines for the TR protocol can be found here: http://www.tillydiabetes.net/en_6_protocol2.htm.

 

[Figaro's Liz]

I think most that give .5 increases are high dose. I would increase by .25 so you don’t miss a good dose. Let’s see what happens today and tonight before deciding on when to increase. Let the depot build. Just my two cents.

Thank you for your two cents! Yes, still need to see what happens. I am always trying to prepare for the what-ifs, not always successfully...

I would suggest picking one strategy and see how it works with Figaro so you have some idea how he responds vs doing both at the same time and not knowing if one method is better that the other.

That makes perfect sense. I don't think I would be comfortable doing both at once in any case, but I wondered if the shorter dose duration is ever used by members on the board, what circumstances might warrant that approach rather than the .5u increase, and/or if it is expressly discouraged because practical experience on the board has shown it to be either dangerous or less effective. Sounds like it is not commonly used on the board, at least, and that is helpful to know.

I'd like to clarify...
You can certainly increase the dose by 0.5u if the dose is not dropping kitty any lower than 300.

Okay. This means increasing only by .25 last time was a good decision, since I did have a ~260 reading once among otherwise 300+ numbers. So that is helpful.

My point in mentioning this is if you're thinking about accelerating an already accelerated dosing method in this manner, you might want to pay attention to and follow the guidelines.

Very good point about the meter. I think a lot about the low-end lack of translation between human/pet meters, but not so much in the higher numbers. I've become accustomed to thinking of red-pink-yellow-blue-green numbers with the daily SS inputs, even though I know logically the numbers I have are not equivalent to human meter readings. So thank you very much for the reminder to consider that.

I seriously appreciate your input and help in keeping Fig safe and better. @Penelope and Mačka and all, thanks.