? 2/6 Henry AMPS 62 +1 104 +2 111 +6 80 +7 61 PMPS was 114 +1 77 and +3 58

Hello there! I was wondering if anyone could take a look at Henry’s SS and if I am following the reduction correctly? I re-read the TR protocol and think I am just confusing myself.

Got a bit worried as Henry hasn’t been in the greens this consistently ever so it is new for us. I also do not want to mess up any progress now that he went into the blues and greens. Thank you for your insight!

 

Hi Kay I'm going to tag a few members for you, reading TR it looks like you shouldn't have reduced on 2-5 during the PMPS cycle because Henry didn't drop under 50 and he's newly diagnosed. He would be considered a long tern diabetic if over a year from diagnosis

I could be wrong because I see @Bandit's Mom told you to stick with the 2 units for a few days in your previous post


Here is the sticky
The TR Protocol is an aggressive method in itself. The modified version of the protocol is slightly more aggressive. Let's keep all our kitties in the Lantus, Levemir, & Biosimilars ISG safe by taking reductions when appropriate.

• If kitty drops below 40 (long term diabetic) or 50 (newly diagnosed diabetic) reduce the dose by 0.25 unit. If kitty has a history of not holding reductions well or if reductions are close together... sneak the dose down by shaving the dose rather than reducing by a full quarter unit.
• Alternatively, attempt a reduction when the cat regularly has its lowest BGs in the normal range of a non-diabetic healthy cat (50 - 80 mg/dL) while staying under 100 mg/dl overall for at least one week.

@Bandit's Mom

 

@tiffmaxee

@Bandit's Mom

@Suzanne & Darcy

@Wendy&Neko

Her previous post
https://felinediabetes.com/FDMB/thr...256-8-246-pmps-233-2-284.273713/#post-3041435

 

That change to greens and the odd blues is lovely to see.

The 2.0 unit dose was held long enough, the increase to 2.25 was warranted. However, there is no data for the nights of the 3rd and the 4th. Is it possibly you just didn't enter the data those nights? It could be it's the 2.25 unit dose that is the magic one giving you greens, and the depot from that dose kept on giving you greens. The larger depot can influence lower doses for 4-6 cycles after a reduction.

With TR, we reduce when we see a number under 50, or a week in solid greens. We don't go by what might have been, because it also might not have been.

 

Thank you so much. I really confused myself - I was previously following SLGS, think I am mushing all the info together.

 

Thank you very much. I am going back to the meter’s memory to see what I have. I know there was one night I definitely did not check as I fell asleep early…ok so 50 is my number to watch out for…now that I’ve reduced, should I maintain this dose or go back to the last “good” dose? Sorry for my confusion. And yes I agree I am so happy with the blues and greens but got concerned since Henry’s never been here before lol. Thank you

 

I would go back to the 2.25 units. It's possible he will give you an indication soon that she wants a reduction.

 

I gave Henry 2.25U tonight. Henry’s PMPS was 114 +1 77 and +3 58 — really dumb question, the 58 does not count as a “50” right? I’m paranoid about him dipping too low. I’m going to check him one more time before bed.

 

Give him a little LC and get another test in 30 mins? Did he get food between PMPS and +3?

 

Hi Bhooma! Yes he had dinner after the PMPS and before the +1. I’ll give him a little LC now.

 

Under 50 means the 40's. I know it's scary, but you have the tools (BG monitor and high carb food) to keep him safe as needed. If it helps any, cats not on insulin can test in the 40's, we just don't want cats on insulin there because it leaves no margin for error.

 

Lol thank you — noted re: under 50’s lol. Yes we have his kit ready that we hope to never use. Another silly question for anyone who reads this and no urgent response needed…does Henry’s sugars show any patterns? I was reading in one of the stickies how some cats do not necessarily experience nadir at mid-cycle, and sometimes it happens PS or after even…in looking at his recent patterns, I don’t see any so I am still having a hard time predicting where he’ll be based on PS #s… and thank you!!!

 

As cats numbers turn more to green, their numbers become very flat. I personally loved shooting when Neko's had a PS in the 80's, cause that was her sweet spot, typically didn't move more than 10 points the entire cycle. When you consider that BG monitors have some variance allowed between tests, it's really hard to say when exactly the nadir is in such cycles.

It's true that some cats don't nadir mid cycle, again Neko as an example. It was even more noticeable when she moved to Levemir. I spotted nadirs as late as +15, ie. 3 hours after the following shot. Though typically it was more like +9 to +12.

As for Henry, you might find his patterns change as he becomes a regulated and green. Which means you'll need more than just a couple days of data to see patterns in his new numbers. Bounce breaking cycles tend to have later nadirs, but he doesn't seem to be doing that much anymore. Or at least he's only bouncing to blues. Flat green cycles also seem to nadir earlier.

 

Thank you so much for sharing — this is very helpful. I (and Henry!) really appreciate all your guidance today.

 

Have you gotten another test yet?

 

Yep! Just got his +4 and it is 87

 

You're good for the night

 

Yay!!! Thank you again