? 04/03 Max 333@ AMPS; 212@6; 133@PMPS; 189@2

My cat Max seems to have a very hard time regulating. His nadir is almost always his PM preshot now. He will often spike quite high as well. I have had to miss several doses in the last couple of weeks because of his low preshot number. I have him on the same diet now for some time and haven't changed the dose in a while either trying to get him to regulate better. Any ideas?

 

Since you are following SLGS for dosing, you should be reducing the dose by 0.25 units when you see a number below 90, which you have several times now. Hopefully with 3.25 units, you won't be getting those preshot numbers that are too low to shoot.

Another couple suggestions - you should be doing a curve every week with SLGS, to help you get a better idea how low the dose is taking him. It's also a good idea to get spot checks in the night time cycle, as many cats go lower at night. We determine the dose based on how low it takes the cat. A test just before bed is a good one.

 

Thanks Wendy. I understood shot reductions were based off nadirs below 5. That's whats throwing me off cause it's his preshot number thats usually low. I have been trying to reduce the number of tests lately because his ears are getting sore. That's why I haven't done as many full curves. His low point is almost always about +4 so I didn't think the other readings were quite as important. Just trying to give his ears a break.

 

A cat's nadir can and does move around. Think about the question "how low does this dose take my cat" and reduce if the answer is below 90. The last three times he's given you numbers below 90 at PMPS, there were no other tests that day, so we don't know if he was even lower earlier in the cycle. So, best to reduce for safety.

 

Something else I was struggling with was when I reduce his dose he generally goes super high, over 20, yes this may be bounce but he has usually stabilized at readings around 20 throughout the day hence why he has ended up at the dose he's been on lately. This was another reason I was hoping he would regulate better with a more normal curve but he is usually flat with the odd reading out of place. He isn't fitting normal patterns at all. I will watch for the next low reading and adjust accordingly. I've also uploaded more readings from yesturday. Again very flat.

 

A very flat yellow cycle, like today, is often a sign of downward motion to come. Make sure you get a test before bed in tonight.

We change the dose based on how low it takes the cat. We don't want him to be on a dose that is taking him dangerously low.