Reduce dosage?

Fedya and Izzy

Fedya and Izzy

Member Since 2019
Hello everyone, Fedya seems to be doing super well on his insulin right now. He's consistently been in the blues for the past few days and we've been seeing some green numbers too which is great! I was just wondering at what point should we start reducing Fedya's dosage? He's getting green numbers more often now and I was thinking what I should do if he's in the green PMPS. I'm kinda warry of giving him 2.25 U if he's in the green and was thinking that perhaps if that does occur we should decrease his dose to 2U instead. What do you guys think? I'm just worried that if we keep it at 2.25 at green he's at risk of becoming hypo. Again, thanks for the help and advice everyone!
 
Hi there,

Yes, he is looking good!

Looks like he earned reduction on 7/21 when he had that 41, which you took. Not sure why you went back up the next day again unless there was something else going on I am not aware of. Normally the new dose would be held for several days on TR. since I don’t know all the backstory I am tagging a few more experienced people to advise...

@Bobbie And Bubba @Bron and Sheba
 
Hey there. Yes, he earned a reduction with that 41 on 7/21. That reduction down to 2 units should have been held. The higher numbers after that 41 were due to bouncing which could take 6 cycles or 3 days to clear.

It’s looking like he is all ready clearing it. What time do you shoot tonight? If he continues to drop lower you might have to stall without feeding unless he is up over 50 and even then, I would reduce the dose back to 2 units because he earned it in 7/21.
 
Looking at the SS I see (as Julie points out) that Fedya earned a reduction when he dropped to 41 a couple of days ago. You took the reduction but went back up the following dose to 2.25 units.
When you take a reduction, you stay with the new dose until you either earn another reduction, or you need to raise the dose because the numbers are telling you it was a failed reduction.
The depot drained a bit when you reduced the dose for one cycle but I think it is filling up again.
I would drop back to the 2 units next dose.
 
Yeah we were just sorta worried because when he had that reduction, on that day, he just didn't really feel like eating much so we were worried that his numbers were so low to due to the fact that he just didn't eat much. But, I think you guys are right its time to take it to 2 units. His next dose is at 8PM so that's pretty soon. Thanks guys!
 
Bron and Sheba said:
Looking at the SS I see (as Julie points out) that Fedya earned a reduction when he dropped to 41 a couple of days ago. You took the reduction but went back up the following dose to 2.25 units.
When you take a reduction, you stay with the new dose until you either earn another reduction, or you need to raise the dose because the numbers are telling you it was a failed reduction.
The depot drained a bit when you reduced the dose for one cycle but I think it is filling up again.
I would drop back to the 2 units next dose.
Click to expand...
Thanks for the better explanation about holding the dose. I spent the day in Philadelphia with my son for his birthday and I’m a bit fried!
 
Bron and Sheba said:
Looking at the SS I see (as Julie points out) that Fedya earned a reduction when he dropped to 41 a couple of days ago. You took the reduction but went back up the following dose to 2.25 units.
When you take a reduction, you stay with the new dose until you either earn another reduction, or you need to raise the dose because the numbers are telling you it was a failed reduction.
The depot drained a bit when you reduced the dose for one cycle but I think it is filling up again.
I would drop back to the 2 units next dose.
Click to expand...
After switching Fedya to 2 units his numbers are looking higher than they were before. I don't know if we have waited long enough but maybe we should switch Fedya back to 2.25 units. Thoughts?
 
The dose is perfect right now. Yesterday AM yielded lots of greens. Towards the end of that cycle a bounce started. Remember, it can take up to 6 cycles for a bounce to clear. And today you were back in the greens at + 6. The dose is perfect right now.
 
If you are going to follow TR, you base your dose upon the lowest number in the cycle. If you've reduced the dose, you do not increase based on a bounce that may occur in the next cycle or two. Rather, doses are held for 3 days/6 cycles. This allows the depot to stabilize and adjust to the new dose Any change in dose requires that you hold the dose for the indicated amount of time. So, if you change the dose, skip, shoot a reduced dose, etc., the cycle count starts over. You've been at 2.0u for 4 cycles. Barring numbers dropping below 50 which would signal a dose reduction, you want to hold the dose for 2 more cycles. From the TR Protocol:

Increasing the dose:
  • Hold the dose for 3 - 5 days (6 - 10 consecutive cycles) if nadirs are less than 200 before increasing the dose by 0.25 unit.
    • if your cat is new to numbers under 200, it is recommended to hold the dose for at least 8-10 cycles before increasing.
    • when your cat starts to see nadirs under 100, hold the dose for at least 10 cycles before increasing.
  • Increase by 0.25 unit after 3 days (6 consecutive cycles) if nadirs are greater than 200, but less than 300.
  • Increase by 0.5 unit after 3 days (6 consecutive cycles) if nadirs are greater than 300.
 
Alrighty, I see. Thank you! I was also wondering if anyone can explain why does lowering the dose temporarily diminish the depot? I just want to be able to understand it thoroughly. Thanks again in advance!
 
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