10/17 Angie pmps=322 +2=200

Hi LL,

I have only half an hour till I shot time - and I'm a bit confused about dose because we haven't followed the protocol with dose increases. We went from 1 unit to 1.1 units then 1.25 units. She earned a reduction at 1.25 units that should take her to 1 unit. Do I go down to 1 unit or do I go down to 1.1 units?

I shot 1 unit last night because I was too tired to think and wanted the easiest option.

Thanks,
Grace

Yesterday

Re: 10/17 Angie +11.3=288 What dose for amps?

Marje and Gracie said:

Because you are an experienced CG, I think you could tweak the dose a bit with a little fat on it. It might help a bit with the bouncing. She has gotten some green on this dose and has gotten close to it as recently as 10/8. If she doesn't continue down into green tonight, I'd increase a bit tomorrow. While normally increases would be 0.25u, I'm just thinking of fattening it so she doesn't go overboard on you if you are not feeling well. It might be better just to try and fine tune to see how she responds.

Click to expand...

I've been meaning to ask about this as well. I'm not really sure what you meant, Marje. Do you mean increase and decrease in smaller steps but still follow the protocol for when to increase or decrease? Or do you mean, that the dose can be fattened on days that she's bouncing a bit and then return to normal dose afterwards?

Thanks

Re: 10/17 Angie +11.3=288 What dose for amps?

Hi Grace, sorry no one got back to you in time. I see you went with 1U. That's fine. We'll see how she handles the reduction after the bounce clears. If she needs to, you can always increase up a little.

As for what Marje said, she doesn't mean to change the dose based on whether she's bouncing or not, but to follow the protocol on when to increase/decrease but to experiment with smaller changes. Some kitties are more sensitive to smaller changes than .25U. When kitties are newly diagnosed, following the protocol and increasing or decreasing by .25U is best. However, over time and once you've gathered the data, you may find you have a kitty that responds to smaller changes. With Neko for example, if she's getting the nadirs I want, I can often flatten out the height of her bounces by giving her a .125U increase. I use calipers to measure that. Also, if she goes below 50 but above 40, sometimes I'll give her just a .125U reduction. Below 40 is still the full .25U reduction. For Angie, it's a matter of you experimenting and seeing how she responds.

Re: 10/17 Angie +11.3=288 What dose for amps?

no advice to add, but just wanted to say it was nice to see Angie getting into better numbers yesterday, even if it meant that you had to drag her along in the car.

sending you well-wishes for your health issues.

Re: 10/17 Angie pmps=322

I'm having internet issues today. It doesn't stay connected long enough to post and I lost a couple.

Thanks everyone for the vines yesterday and today.

Wendy - thanks especially for that explanation. I think it makes sense. I've been using the dosing template for the BD Ultra-Fine needles. It goes up in 0.1 units or 0.25 units. I think maybe I'll go up and down in 0.1 units for a bit and see if that helps. I reckon Angie's dose is somewhere in between 1.1 and 1.25 units.

If you're adjusting on small amounts, do you still wait 5-7 days before increasing, if nadir is <200 but peak is >200? And, if she was to earn a reduction while I was doing micro adjustments, can I take her down 0.1? I suppose she can always earn another reduction if the dose is still too high.

Re: 10/17 Angie pmps=322 +2=200 more micro-dosing questions

Yup, even with micro-doses you hold the dose for 6-10 cycles to give her time to settle in, and likewise, you can adjust up or down in micro-increments as needed. Trix was very sensitive to dose adjustments, especially when I was close to a good dose for her, so I often "fattened" and "skinnied" her doses.

I hope your internet settles down...such a hassle when you get cut off from the outside world!

Thanks Amy

Re: 10/17 Angie pmps=322 +2=200 more micro-dosing questions

Hi Grace,
I do everything by drops. I use the Terumo syringes and the digital calipers. On the Terumo ThinPro 31-gauge syringe I figure that one "drop" is .11mm on the digital calipers. So if Rusty earns a dose reduction, I reduce by 1 drop. Similarly, if it seems that he needs more insulin, I increase by 1 drop. For reductions we follow the "3-numbers-under-50- on- the- current- dose rule" and the rule that calls for an "automatic reduction" for 1 number under 40. For increases I use "intuition", based on the nadir. I always give the new dose time to settle in and at this point in Rusty's FD adventure I only loosely follow the prescribed number of cycles when making changes in dose.

Good luck. The digital calipers are a great help in micro dosing because the lines on the syringes are often inaccurate. Have you seen Marje's discussions on dosing with calipers? Here's the link:
http://www.felinediabetes.com/FDMB/viewtopic.php?f=9&t=79851#p862835

Hugs and scritches,

Ella & Rusty