Was the reduction in dose a right way to go?

Would you please offer your opinions on my deciding to drop Bailey's dosage from 2U to 1.5U?

thanks

 

Others will have to advise as I am too new to this. But just looking @ the 90 and below, Bailey clearly earned that reduction. It is my understanding on SLGS it would have been .25 instead of .50. On tight regulation may be different. But, can understand the concern to keep an eye on Bailey. I was shown how they do not drop as much when their numbers come down....otherwise it is scarier than need be. Will see what others say. And, bounces come with reductions temporarily.

 

The 38 definitely earned a reduction, but we generally only do reductions and increases in .25 unit increments, so we would have suggested doing 1.75

Since you've already shot the 1.5, you could stay there for a total of at least 6 cycles...if he doesn't come back down into good numbers by then, we'd just call it a failed reduction and go up to 1.75

 

Thanks everyone!

 

I'd encourage you to look over the sticky notes that describe the two dosing strategies -- the Tight Regulation Protocol and Start Low Go Slow. They differ with regard to how long you hold doses and how aggressive you are with where the cut off is for dose reductions. It will help us when it comes to offering feedback if we know which approach you're following,

 

I was aiming at Tight Regulation and judging by the last couple of cycles I am ready to call it "failed reduction"... I am hesitant to wait for 6 cycles to bump up his dose. What you all think?

 

I think I'd hold the 1.5 and there are a couple of reasons

It looks like on the 11/21 AM cycle he might very well have gone lower before you got the 118 at +7. I say this because of how fast he "bounced" back up...he was at 359 only 5 hours later.

Bounces can take up to 6 cycles to clear, so when they are bouncing, we want to be careful about increasing

ALSO, since you didn't shoot on the morning of the 20th, the "shot clock" starts over. Any time you miss a shot, do a furshot, shoot a reduced dose for some reason (other than an earned reduction) the 6 cycles starts over

Have you got ketone test strips? It is important to check for ketones when they're running high like he is. Ketone test strips are available at any pharmacy that carries diabetic supplies

 

Checked for ketones today, was negative. I am just discouraged a bit that we were getting somewhere with 2U it seemed and then I had to go away for a day and miss his shot

 

Don't beat up on yourself. Think of it like a fur shot -- and we've all done that!

FWIW, even with the skipped shot, Bailey got back on track in a day. Right now, you're seeing a bounce. Bounces are supremely annoying but a normal part of the process.

For future reference, when you reduce, unless it's unusual circumstances, the amount of the reduction is 0.25u. I suspect you're going to need to raise the dose soon.

 

How's Bailey feeling otherwise??

Remember, our kitties are more than their numbers, so if he's feeling good, that's very important too!

 

In answer to the question in your subject line, in my opinion you were absolutely right to reduce the dose after you got a test in the 30's. Per the Tight Reg guidelines, I'd have reduced by 0.25u.

I would also call it a failed reduction and go back to 1.75u if he were mine. However, I think one could also make an argument for holding the 1.5u and seeing what he gets to when he clears this bounce. He only got to blue numbers yesterday, but it also was after a skipped shot. So . . . in my opinion, you could go either way.

 

Bailey was more tired than usual yesterday and today. Just comes up to eat, otherwise either lays next to us or sleeps. Hopefully it is just because of high numbers for a couple of days... Will keep checking for ketones. Did any of you ever detected raised ketones with the test strips? (I have the Relion Walmart ones)

 

A lot of people have detected ketones using the test strips...that's why we suggest you test Bailey to make sure he doesn't start producing them

If you ever get a result more than "trace", it's a medical emergency and he needs to go to the vet immediately....if you get "trace", you should post with a 911 here....there are some things you can do from home to help clear them

 

Yes, you can detect ketones with either urine test strips or blood ketone test strips. The NovaMax blood ketone meter measures both glucose and ketones from the same strips.

One thing you can do to help prevent ketones is to add water to Bailey's food - as soupy as he'll tolerate.

 

Thanks,
I 'll keep an eye on ketones especially since Bailey already have a history of DKA. I do add water to his food already and he also gets 100ml of sub-q fluids every day.