? 9/30 Sulls AMPS 226 (need help deciding to up the dose or hold for a few more days)

Aliona

Member Since 2020
Hi guys,
Please let me know what you think. We stated with 1.5u but 2 cycles later Sulls tested 50 AMPS so we skipped that shot and reduced the dose to 1u.

Now he's been on 1 unit for 6.5 cycles and stays mainly in yellow (with some exceptions to blue).
According to TR protocol we suppose to monitor the starting doze for 3 days and then adjust depending on numbers. But in "increasing the dose" stage we suppose to hold the doze for 5-7 days.

So the question is, since we had to quickly reduce the starting dose, should we now hold this dose for 5-7 days or up it by 0.25 after 6 cycles.

Thank you!

https://www.felinediabetes.com/FDMB/threads/9-29-sulls-amsp-138-1-196-2-233.236111/
 
Did you give a shot last night? The spreadsheet show an empty cell for the PMPS shot.

With TR, reductions are by 0.25 units, not 0.5 units. So you decreased by too much to start.

Also with TR, it's the initial dose that is to be held for 5-7 days (unless they earn a reduction), and subsequent doses in the increasing the dose phase, are held 6-10 cycles. So the other way round from what you stated. Since you have seen low half of blues on this dose, I would be inclined to hold it a couple more days before deciding if you need to increase again. That will also give the depot time to build.
 
Did you give a shot last night? The spreadsheet show an empty cell for the PMPS shot.

With TR, reductions are by 0.25 units, not 0.5 units. So you decreased by too much to start.

Also with TR, it's the initial dose that is to be held for 5-7 days (unless they earn a reduction), and subsequent doses in the increasing the dose phase, are held 6-10 cycles. So the other way round from what you stated. Since you have seen low half of blues on this dose, I would be inclined to hold it a couple more days before deciding if you need to increase again. That will also give the depot time to build.

Thank you @Wendy&Neko! Yes, we did 1u last night but didn't record it :facepalm:(thanks for pointing it out, i just fixes it).

People here advised to decrease to 1u probably because he got 50 AMPS after only 2 cycles and they thought that the starting dose might've been too high.

Regarding the timing of increases/reductions. I was looking here http://www.tillydiabetes.net/en_6_protocol2.htm For phase one "starting dose" it says "Generally the starting dose is kept for 3 days." And for phase two "increasing dose" it says "Hold each dose for 5-7 days ..... 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"

So in our situation, we should be holding for maybe 2-3 more days to see what happens and if he will start getting more blues on this dose (fingers crossed)?
 
You don't need to look that far away to find the description of TR, it's here in our dosing methods Sticky Note. We find it best to hold that initial dose a couple days longer to build the depot.

So yes, hold the dose 2 more days, unless a reduction is earned by going under 50.
 
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