1/17 mocha pmps 253 +3 276

Discussion in 'Lantus / Levemir / Biosimilars' started by PeterDevonMocha, Jan 17, 2010.

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  1. PeterDevonMocha

    PeterDevonMocha Well-Known Member

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    http://felinediabetes.com/FDMB/viewtopic.php?f=9&t=2791

    PM +6 52

    WCR: seems to be in a good mood despite being poked all night. Not sure if she went any lower then the 52 after her +6. Can't imagine she would of went much lower. Between putting her in our room at 11:30 and testing her at 12, she ate 3/4 of a can of food at her nadir so our thought is, she was going to start going up anyways and she was also going to start having food spikes to deal with.

    Shot her usual 3.25u this morning to shoot through rebound. I know she earned a dose reduction according to the old tilly protocol, but I also know libby mentioned a new tighter protocol on mocha and holding her on the dose longer, but wanted to hear in from others, but they never responded, at least not in mochas condo. Was just wondering what the verdict on that was going to be?
     
  2. Greg and Carmelita (GA)

    Greg and Carmelita (GA) Member

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    Dec 29, 2009
    Re: 1/17 mocha amps 291, till protocol question?

    Looking at your spreadsheet, it seems like maybe reductions from nadir below 50 aren't holding, but those by 40 are working out. In your place, I would probably hold out. Other opinions are surely forthcoming.
     
  3. Lynn and Angel

    Lynn and Angel Member

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    Dec 28, 2009
    Re: 1/17 mocha amps 291, till protocol question?

    Hey, Angel was at 53 last night at +6 so we were right there with you poking! They also have almost the same ps this am so they bounced the same amount. I'm not sure what you should do about the decrease but I know back a couple of months ago someone (Libby?) decided Ang needs to follow the below 40 cut off for a decrease. Those are way harder to come by I've learned. He also has to go down in skinny's not .25 increments also making it slower, but I think you're already doing that. Anyway, I think these techniques are working for him, but he's been diabetic longer than Mocha -just over a year now. Good luck and hopefully you'll get a definite answer.
     
  4. Helene & Tizon

    Helene & Tizon Well-Known Member

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    Dec 29, 2009
    Re: 1/17 mocha amps 291, till protocol question?

    IMO, I second Greg.... and would even put Mocha in the shave-a-dose fanclub too.
    But, that's just my opinion.
     
  5. Sienne and Gabby (GA)

    Sienne and Gabby (GA) Senior Member Moderator

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    Dec 28, 2009
    Re: 1/17 mocha amps 291, till protocol question?

    I'm lining up behind Greg and Helene. I think whatever you can do to get Mocha used to lower numbers that give her pancreas time to heal will help. Mocha seems to spend very little time in the blues. I think if you can tinker with micro-dosing so that Mocha is in the blues more and you shave the dose when reductions are earned, I suspect Mocha will have a better chance of the reduction holding.
     
  6. PeterDevonMocha

    PeterDevonMocha Well-Known Member

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    Dec 28, 2009
    Re: 1/17 mocha amps 291 +2 324 +6 266

    Ok well thank you for the replies. I guess I was hoping libby would drop by today and figure out if we should try out the new protocol with mocha. Something about she would have to go below 50 on three different occasions on the same dose before changing it up. Yes, we already do shave doses with mocha, not full dose increments so we are good on that aspect.

    So I guess as it stands right now we should shave her back down to a (F)3.0? Right now we are at a solid 3.25u. She seems to be sitting in rebound city today.
     
  7. Cassandra and Sasha

    Cassandra and Sasha Well-Known Member

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    Dec 28, 2009
    Re: 1/17 mocha amps 291 +2 324 +6 266

    I agree that maybe a new approach should be taken with her, and Tilly was updated a couple of weeks ago so that it matched Rand. Here is the new section:

    When the cat regularly has its lowest BGs in the normal range of a healthy cat and stays under 100 mg/dl overall for at least one week, attempt to reduce the dose. Alternatively, if the nadir glucose concentration is 40 - <50 mg/dl at least three times on separate days, try lowering the dose. If the cat drops below 40 mg/dl once, reduce the dose immediately! The reduction is done very slowly in a step-by-step manner (0.25 or 0.5 IU increments). At each newly reduced dose, try to make sure the cat is still stable in the normal range before reducing the dose further.

    It's worth a shot as she doesn't usually hold just below 50 reductions well and you monitor like champ. :smile:
     
  8. PeterDevonMocha

    PeterDevonMocha Well-Known Member

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    Dec 28, 2009
    Re: 1/17 mocha amps 291 +2 324 +6 266

    Ok, we will try the new protocol with mocha. Since she went below 50 yesterday, we will count that as one. Tomorrow she starts her new lantus cartridge so I'm not sure what to expect out of that one. Hopefully some good things!
     
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