6/23 Fearless AMPS=139 +2.5(112) +4(70) +5(43) +6(61) +7.5(83) +10(159) PMPS=327

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That +5 43 earned Fearless a reduction:):cat:
I believe the 1 u is doing something. Look back at the cycles on 1u and see all the green.
ECID some cats hold reductions better if you hold the current dose for three drops below 50 on the human meter. You need to have enough supplies on hand to keep Fearless safe. If you do the three drops before reducing the dose.
If you are unable to monitor you should always stay with the safer dose.
Are you still on vacation?
I'd do 1u and monitor hopefully others will chime in
 
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REDUCING THE DOSE:
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 ISG safe by suggesting and taking appropriate reductions.
  • 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. See additional notes in the next paragraph about drops into the 20s and 30s. Alternatively, at each newly reduced dose... try to make sure kitty maintains numbers in the normal range for seven days before reducing the dose further.
  • Please do not let yourself become complacent or blasé about drops into the 20s or 30s. Please ask for advice immediately.
  • If your cat drops into the 30s, a full reduction of 0.25u is recommended. There are very few exceptions given for caregivers who have collected years of data and KNOW their cat's response to the combination of insulin and food backwards, forwards, and inside out.
  • Caregivers whose kitties have "High Dose" conditions may find the need to reduce in whole units or more.
  • If an attempted reduction fails, go right back up to the last good dose as soon as you see kitty's numbers trending upwards. You don't have to hold the reduced dose for a certain number of cycles before taking the dose right back up. The guidelines listed under the topic "Increasing the dose" do not apply to a failed reduction. Please use common sense in this situation. The "last good dose" is not the dose that just dropped kitty into the 20s or 30s. You want to resume momentum by finding a dose in-between the dose that dropped kitty too low and the reduced dose.
  • Since 2006 we've encouraged those practicing Tight Regulation to attempt reducing the dose from 0.25u to 0.1u before stopping insulin completely. During a two week OTJ trial, you want to see mostly green numbers (under 100) with only a few random blue numbers between 100 - 120 to help ensure a strong remission. Most kitties will be in the range of a healthy cat (50 - 80 mg/dL).
 
DebG said:
That +5 43 earned Fearless a reduction:):cat:
I believe the 1 u is doing something. Look back at the cycles on 1u and see all the green.
ECID some cats hold reductions better if you hold the current dose for three drops below 50 on the human meter. You need to have enough supplies on hand to keep Fearless safe. If you do the three drops before reducing the dose.
If you are unable to monitor you should always stay with the safer dose.
Are you still on vacation?
I'd do 1u and monitor hopefully others will chime in
Click to expand...
Back from vaca yesterday (when SS shows testing re-started) so increased the dose last night. Decided to do that before I left on the 20th but held the 1u because cat sitter wasn't testing. In actuality, on the most recent 1u dose, Fearless spent only 8 hrs in green during 22 cycles. He bounces off even high greens. If I reduce to 1u, I run the risk of seeing green as infrequently as during that period. But if I hold at 1.25u and wait for two more drops below 50 there's a good chance he will spend much of that time bouncing. Hence my uncertainty.
 
As you don't know what he got up to while you were out of town..... I think that in this instance I would take the reduction to 1u, if you find he trends up then call it a failed reduction, and bring him back to the 1.25u, you don't need wait 20 cycles to bring the dose back up if Fearless isn't getting nadirs in the desired range, then you can bring him back up.


Have you read this interesting thread about bouncing and strategies
http://www.felinediabetes.com/FDMB/threads/10-29-jetta-pmps-328-2-339.55306/
This is another one about shaving doses and 3 drops under 50
http://www.felinediabetes.com/FDMB/threads/3-27-mags-pmps-168-3-108-4-105-9-126-atrak.67264/
and I'm sure you have read this one on managing the curve with food, may be worth a revisit.
http://www.felinediabetes.com/FDMB/viewtopic.php?f=9&t=101989

I think that it would be possible for you to hold on to a dose a little longer by feeding strategically, slowing the drop and getting him to spend more time in green. eg this morning I would have probably fed some LC at +2.5, with that number being lower than amps, it was a signal that the cycle was going to be active. Staying ahead of the insulin with feeding often allows you to steer the numbers more effectively.
It seems to me that fearless drops early in the cycle and adopting a feeding strategy whereby you give snacks in the early part of the cycle, slowing him down, may help with the bouncing.
I eventually changed George's regular schedule t to give snacks at +1 +3 +5, (after some experimenting) , but there was some flexibility in this, if he was lower than PS at +2 I would proactively steer and he would get a snack at +2 as well (maybe even some MC or HC if he dropped fast/steeply into a low green), if he was the same or higher, I'd wait till +3 for his next snack, I believe that this helped me hold on to doses for longer which ultimately helped with the bouncing and holding on to reductions.

Waiting for three drops below 50 is a strategy we usually use for longterm diabetics and kitties that show they can't hold a reduction, Fearless hasn't held all his reductions, but he has held some, so not sure what I think about trying 3 drops below 50 for him, or the shaving the dose, both are more aggressive dosing approaches.
 
Gill & George said:
I would have probably fed some LC at +2.5, with that number being lower than amps, it was a signal that the cycle was going to be active. Staying ahead of the insulin with feeding often allows you to steer the numbers more effectively.
Click to expand...
I feed 1/2 his daily allotment of food evenly divided among the first 4 hours of the AM cycle and again in the PM. I used to do what you do (spread the food out further in the cycle), but found that the first 4 hrs works better for Fearless ... most of the time.
 
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