01/06 Willow PMPS 95,+1 113, +2 106,+3.5 104 +5.5 131,+9 115 Questions On Dose Increase :) edited

nslade001

nslade001

Member Since 2018
yesterday

Hi everyone! Hope you and your babies are doing well :)
Willow had a greener day and night yesterday, and we had another good night's sleep. Unfortunately, her greens are all in the 4's and 5's recently, thinking we may need to increase soon. Think we'll give it today and maybe increase to 1.5 U tomorrow if she doesn't drop a bit; she's been on 1.25 U since Dec 28 (pm).
With love, Nikki

Question on dose increase in comments, thanks so much!

AMPS 6.4 (115)
1.25 U Lantus
+3 4.1 (74)
+5 4.8 (86)
+9.25 4.6 (83)
PMPS 5.3 (95)
****STALL 25 MIN*****
2nd PMPS 5.4 (97)
1.25 U Lantus
+1 6.3 (113)
+2 5.9 (106)
+3.5 5.8 (104)
+5.5 7.3 (131)
+9 6.4 (115)
 
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Good luck with the increase tomorrow. Do monitor that cycle and the following cycle in case 1.5u ends up being too much. Some cats react strongly to the increase before working it properly.
 
I edited below to try and convert to US version, although it is hopefully more easily visible on my SS:

So, Willow had a beautiful surf today, and I'm interested to see what tonight brings. I do have a question (actually a few lol):

I'd been planning on increasing her dose to 1.5 U from 1.25 U tomorrow, since she's been on 1.25 U since the 28th of December. However, after obsessively analyzing her SS I'm sort of second-guessing myself.

Thing is, before the increase to 1.25 U she'd been usually running high 7s (hi 130s to low 140s) to low 10s (low 180s) in her PreShots; since the increase, she's usually mid 6s (115-120 ish) in the PreShots. Her BGs thru the day were mid 6s (115 to 120 ish) to mid 8s (150-157ish) before the increase, but are now running mostly in the 4s (72-88ish), with some 3s (60-70ish) (not a pile) and 5s (90-106 ish). It actually took her to the 9th cycle before she ran green pretty consistently and gained some real stability. We didn't see any 3, until one popped up in cycle 6 and cycle 10, then a whole night of 3s (60-70ish) in cycle 13.

Anyway, that all seems a pretty significant drop from just .25 U. If we increase the same and she has a similar response, she'll definitely earn a reduction but, more importantly, is pretty likely to go hypo. (I'm thinking the night of 3s could have been a slightly fat dose by error, since it never came close to repeating?)

So I'm wondering if I should just increase to a skinny 1.5 U trying not to do a full 0.25 U increase?

Or, if I just maintain the dose as it is, is she likely to drop down eventually to all greens (since she pops barely into the blues at the end of the cycles)? Are we just aiming for greens, or as low greens as she will go safely? (I understand the greens are the area where her pancreas/beta cells can recover, if they will do so?)

Is there a way we can finangle her blues down with feedings? Right now her last low carb feeding (1/8 can FF) is at +6 in the day and +4 at night (1/4 can FF), and she gets a small snack of chicken at +9 day and night.

Thanks so very much for any and all advice.

With love, Nikki
 
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I'm going to be brutally honest, to me, no way should you be increasing when you are seeing nadirs in mid 70s. And you saw low 60s only 5 cycles ago. Time for some patience IMHO. I don't see anything in your current SS that would call for an increase. Just my 2 cents.
 
Christie & Maverick said:
I'm going to be brutally honest, to me, no way should you be increasing when you are seeing nadirs in mid 70s. And you saw low 60s only 5 cycles ago. Time for some patience IMHO. I don't see anything in your current SS that would call for an increase. Just my 2 cents.
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Hi, thanks so much for your reply. I hope that is the case. However, from what I understand of the TR protocol I'm to hold the dose for at least 10 cycles for nadirs under 100 before increasing....I've held for longer, and just don't know what I should do next. How long should I actually wait? etc etc
With love, Nikki
 
Ah, ok I think I see where you are interpreting things maybe differently than I am. I believe the intent there is to allow caregivers the opportunity to evaluate when numbers start to come under 100, hold and see how low under 100, and how often, and increase if the dose isn't working well enough. If you consider that you are seeing many numbers under 100, and not just a little bit under, the idea of holding *at least* (note emphasis) 10 cycles would still apply. Let's say you only saw a little dip down once, maybe twice over a span of 5 days under 100, then yes, it would probably be time to consider an increase, since the dose doesn't seem to bring consistent greens....but I see consistent greens on you SS at the moment, I think he's looking really good, I'd hold the dose.

@Wendy&Neko , @Marje and Gracie , can either of you maybe weigh in based on your experience if you have a moment?
 
Christie & Maverick said:
Ah, ok I think I see where you are interpreting things maybe differently than I am. I believe the intent there is to allow caregivers the opportunity to evaluate when numbers start to come under 100, hold and see how low under 100, and how often, and increase if the dose isn't working well enough. If you consider that you are seeing many numbers under 100, and not just a little bit under, the idea of holding *at least* (note emphasis) 10 cycles would still apply. Let's say you only saw a little dip down once, maybe twice over a span of 5 days under 100, then yes, it would probably be time to consider an increase, since the dose doesn't seem to bring consistent greens....but I see consistent greens on you SS at the moment, I think he's looking really good, I'd hold the dose.

@Wendy&Neko , @Marje and Gracie , can either of you maybe weigh in based on your experience if you have a moment?
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Thank you. So I guess since her numbers are so good, I'll wait to see if she stalls here, or gets even better, or if she starts to consistently rise.

On another note...tonight may be interesting. Her +9.25 was 4.5, her PMPS was 5.3. I stalled 25 minutes, and it was 5.5, my lowest yet. I shot as normal but will check at +1 and +2. With love, Nikki
 
Oh I'm sorry, we have another member with a male kitty named Willow, my brain got stuck, your Willow is a she :rolleyes:. Well it seems all this talk of an increase has brought her into a nice little green preshot ;), I'll be around for a while yet if you need help or a little support :)
 
Lol that's just what I told Wayne, it was the threat of an increase. Thanks so much, I'll update BGs in title and post, and shout out if I need help :)
With love, Nikki
 
Any chance of updating your spreadsheet? Best to keep it up when asking dose advice,to date. For others on here, you might also want to drag the US 2019 tab to be the leftmost one, so it opens first.

Paws crossed for a lovely green surf tonight.:D
 
Wendy&Neko said:
Any chance of updating your spreadsheet? Best to keep it up when asking dose advice,to date. For others on here, you might also want to drag the US 2019 tab to be the leftmost one, so it opens first.
/QUOte
Click to expand...
 
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ugh I'm messing everything up here on the computer. And dropping things. It's going to be one of those nights.
Anyway, thanks so very much for the tip, @Wendy&Neko , I honestly thought I'd updated my SS (see? One of those nights) And I pulled my tab over, thanks for the tip. With love
 
Well, I have no idea what's going on here! lol Should I do a +5 or +6? Is she likely to drop? Sometimes her nadirs seem to be around +3, other times around +6. Sometimes I just don't see a nadir lol. My girl :rolleyes:
 
I don't know what to think. Did I miss? There was no wet spot that I noticed, and certainly no smell (I sniff the injection site each time, because I'm like that). I was 100% sure she got the shot, but the numbers certainly aren't saying that.
Think we'll go to bed and get up for a +9, unless someone suggests otherwise.
With love, Nikki
 
Willow could be bouncing a little bit from the green Preshot. Not unusual. I’m sure you didn’t give a fur shot if you can’t small it.
 
Bron and Sheba said:
Willow could be bouncing a little bit from the green Preshot. Not unusual. I’m sure you didn’t give a fur shot if you can’t small it.
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I never even thought of that, but I also guess I thought it would be more dramatic (a bounce). So that means she's still likely to dip. Do you think she's high enough to safely leave to sleep until a +9? Thanks!
 
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