1/31 Stu AMPS 405, +3 340, +6 279, +9 221, PMPS 329

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Ella & Rusty & Stu(GA)

Ella & Rusty & Stu(GA)

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yesterday: viewtopic.php?p=44421#p44421

Good morning everyone, We're in Phase 2 of the Tilly Protocol and beginning the second cycle on 2 units bid Lantus. Stu's numbers are still high, but I presume that it will take a few cycles to see how the numbers go and determine what to do next. Tilly protocol recommends holding the new dose for 5-7 days, but ". . . if the cat is producing continously high BGs (nadir always >=300 mg/dl), only hold the dose for 2-3 days before increasing it by 0.5 IU." I still don't know exactly when Stu reaches his nadir. He has been slightly higher at +6 than at +3, so he may hit his nadir at around +5 (??). I want to test at +6 for the sake of comparison with the previous days, but Stu's ears are pretty tattered, so I really don't want to do two tests an hour apart today unless it is absolutely necessary. Otherwise, things seem normal here. Thanks for all your help.

Ella
 
Re: 1/31 Stu AMPS 405

Ella, you need to hold the dose for 6 cycles--3 days to allow the dose to settle in Stu's body!! As a newbie, this is essential..As I know from Moonie, she responds to the new dose on the very last cycle of the 3 days, the very last second!! cat(2)_steam
Also, a new dose brings NDW-new dose wonkiness, which is a phenomema, where the body responds to more insulin initially, with higher numbers--
Please give the new dose & Stu a chance to see how this dose works.
None of us like high numbers, but they will come down...Promise nailbite_smile :thumbup
Have a great Sunday!
 
Re: 1/31 Stu AMPS 405

Morning...would you consider a +4 and a +8 then today? ECID but sometimes they show the start of a drop
4 hours after eating or so...
Looking good ! Hope you have a good day! :razz:
 
Re: 1/31 Stu AMPS 405, +3 340

Hi again. Thanks for the advice and words of encouragement. I already did a +3, so I don't think I'll do a +4 also. But this afternoon I have to go out after the +6 test and will probably not be back in time to do the +9. It may be a +10 instead. I am in no hurry to increase the dose until it is appropriate to do so! I am curious to see how Stu does on 2 units after a few days of settling in.
Many thanks!

Ella
 
Re: 1/31 Stu AMPS 405, +3 340

Sounds good Ella....with the high numbers, we need patience and ketone tests. :-D
It does take time to see the changes in the numbers....and the more testing we do through the cycle
as you are doing, gives us a better picture. Data, data, data!!!
You are doing very well and Stu is in good hands! :thumbup
 
Re: 1/31 Stu AMPS 405, +3 340

Tight Regulation/Tilly Protocol said:
However, if the cat is producing continuously high BGs (nadir always >=300 mg/dl), only hold the dose for 2-3 days before increasing it by 0.5 IU. Alternatively, if the cat is continuously producing moderately elevated BGs (nadir always >=200 mg/dl), increase the dose every 2-3 days by 0.25 IU ( if the cat is getting a low dose) or 0.5 IU (if the cat is getting a higher dose). From this point onward test for ketones once per week, or more often if the nadirs are still >=200 mg/dl.
Click to expand...

We use a modified version of the Tilly Protocol. Generally, only the first dose of Lantus is held for 5 - 7 days. Once a cat has already started Lantus, the dose is held for 3 days (6 cycles) as Ronnie suggested. You do not have to change the dose in 3 days - it's up to you. For many of us, it's hard to increase a dose if we are not going to be home to monitor so the real life constraints to following the protocol exactly and keeping our kitties safe are an important consideration.

You're right in that Stu's nadir is probably some time after +3 and before +6. Just keep in mind that nadirs can and do change. They may not be exactly the same each cycle.
 
Re: 1/31 Stu AMPS 405, +3 340, +6 279, +9 221

Hi again. I managed to get home in time to do the test at +9. The BG numbers have been going down steadily all day! Does anyone have an explanation or an opinion on how this is to be interpreted? Or is this just a type of leveling off after an increase in dose? Or, quoting from Tilly Protocol: "It is important to know that most cats do not have reproducibly-timed nadirs. It also is not uncommon for a nadir to occur at +12 hours after a shot." We'll see what the PMPS is! I can't tell you all how much I value your assistance. Many, many thanks!

Ella
 
Hi again everyone. PMPS is 329, so I guess I don't have to worry that Stu is on a slide! One thing I have noticed is that by testing (and treating) 6 times a day, he prefers the little bit of tuna and water that he gets for a treat to his EVO turkey & chicken wet food. He's not eating enough of the balanced food in my opinion (he used to clean his dish; now he "samples" it; he does come back to it eventually, but doesn't eat the whole meal). (I feed him an ounce of wet food 4 times a day.) A new quirk for a cat that likes to eat!

Thanks for everything.

Ella
 
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