02/03 Boomer AMPS 151 +6 124 PMPS 202 +3 112, reducie, question about new dose

Judy and Boomer

Judy and Boomer

Member Since 2014
Yesterday
Good morning!
AMPS 151 shooting a reduced dose of 2.5u

Well once again Boomer and I had a pj party last night. He insisted on hanging around the 40s/50s despite bits of syrup and higher carb food. But he did earn his reducie last night by having a third number (with this dose) under 50.

When I reduced him this morning, I took him back to 2.5 from 2.5F. Should I be reducing a full .25u down to 2.25F (not even sure how on earth I would measure that!)?

Yesterday afternoon I got out for a walk by the river; saw a Bald Eagle a couple of times but no shots of it. Went to a second location after being told there was a Wood Duck in the (heated) pond but unfortunately it wasn't there when I got there. If I have a chance today I will revisit; depends on what weather is dumped on us today. It's mild here (well above freezing, barely) but is supposed to rain.
 
Judy and Boomer said:
When I reduced him this morning, I took him back to 2.5 from 2.5F. Should I be reducing a full .25u down to 2.25F (not even sure how on earth I would measure that!)
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That was always a dilemma when I was dosing "F" too. I would usually go to the 0.25 (reduction) increment for safety purposes because of work. If you will be able to monitor this week I would hold the 2.5U for 6 doses and see what he does.
 
Congrats on the reducie. I think if you had trouble getting him to come up it may be better to take the full 0.25 unit reduction. Nice on seeing the bald eagle yesterday.
 
Congrats on the reducie!

LizzieInTexas said:
If you will be able to monitor this week
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This is definitely a key component in this decision on how much to reduce. I am always afraid of that overfull depot rearing its ugly head, and tiny reductions don't leave a lot of wiggle room. The fact that he struggled to come up means you may need to be extra vigilant if you decide to do the trimmed dose.
 
YAY for Boomer! Hope he continues to do good on the lower dose :)
Happy Sunday.gif
 
The rain held off so I went out. I had tested at +2 191. DH didn't bother testing at +3 but tested close to +5 112

And +6 is 124

There are so very many birds out today! And the sun came out, the temperature is above freezing and it's beautiful out....and I really really need this! I got lots of shots this morning and am going out again this afternoon.
 
Hi Judy,
Srictly speaking as Boomer is a long term diabetic, it's a single drop below 40 that would earn him a full 0.25u reduction. The three drops below 50 is for kitties that bounce or don't hold reductions, having not been round I'm not sure what the reasoning has been for Boomer taking the 3 drops option???

from the TR sticky
  • 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, try to make sure kitty maintains numbers in the normal range of a non-diabetic cat (50 - 80mg/dL) for seven days overall before reducing the dose any fur
  • 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 few exceptions given to 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 an in-between the dose.
  • We've found many kitties benefit from 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) overall.
 
I think the 3 drops under 50 is useful and often used it when I thought that a full 0.25U would be too much. But Rusty was on a much lower dose than Boomer, so it just seemed prudent to do the 3-drops method and to sneak the dose down, rather than taking a full 0.25. In Boomer's case and since you are around to monitor, I think you would be ok to take the dose down to 2.25U and not bother with fattening or skinnying the dose. But if you don't want to go all the way from Fat 2.50 to straight 2.25. Perhaps you can stay with the straight 2.50U for 6 cycles and see what happens. If it is still a struggle to keep him from dropping, then go to the straight 2.25U.

We saw a Bald Eagle on our ski on Friday. It was very cold (high of 9 Fahrenheit) and windy. The eagle was gliding over the lake we were crossing.

OT: Gus went out in the deep snow today. He charged out the door when we were coming in. IMG_2679.jpg
 
Gill & George said:
Hi Judy,
Srictly speaking as Boomer is a long term diabetic, it's a single drop below 40 that would earn him a full 0.25u reduction. The three drops below 50 is for kitties that bounce or don't hold reductions, having not been round I'm not sure what the reasoning has been for Boomer taking the 3 drops option???

from the TR sticky
  • 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, try to make sure kitty maintains numbers in the normal range of a non-diabetic cat (50 - 80mg/dL) for seven days overall before reducing the dose any fur
  • 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 few exceptions given to 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 an in-between the dose.
  • We've found many kitties benefit from 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) overall.
Click to expand...
I don't know...it's something I've always followed so perhaps at one point it was in the sticky and has been taken out?
 
Ella & Rusty & Stu(GA) said:
I think the 3 drops under 50 is useful and often used it when I thought that a full 0.25U would be too much. But Rusty was on a much lower dose than Boomer, so it just seemed prudent to do the 3-drops method and to sneak the dose down, rather than taking a full 0.25. In Boomer's case and since you are around to monitor, I think you would be ok to take the dose down to 2.25U and not bother with fattening or skinnying the dose. But if you don't want to go all the way from Fat 2.50 to straight 2.25. Perhaps you can stay with the straight 2.50U for 6 cycles and see what happens. If it is still a struggle to keep him from dropping, then go to the straight 2.25U.

We saw a Bald Eagle on our ski on Friday. It was very cold (high of 9 Fahrenheit) and windy. The eagle was gliding over the lake we were crossing.

OT: Gus went out in the deep snow today. He charged out the door when we were coming in. View attachment 42314
Click to expand...

And what did Gus think of the deep snow?
 
Thanks everyone for your suggestions. I'm actually surprised by Boomer's numbers today but he's not bouncing much anymore so that's good.
He didn't do well on the 2.5u before but he also didn't do well on the 2.5F for quite a while (until I threatened a dosecrease). So I think I'll hold the 2.5u and see what he does. I do have to keep in mind that DH's treatments start on Tuesday and I plan to go with him (of course if Boomer needed me to stay home, I would and DH would understand). We know the Tuesday appt is later in the afternoon and we know the Friday appt will be in the afternoon. Wednesday and Thursday are unknown right now. The good thing is that the appts (except for Friday) are only about 15 minutes long so we should be home within an hour (we will be walking to/from the appts).
 
Judy and Boomer said:
I don't know...it's something I've always followed so perhaps at one point it was in the sticky and has been taken out?
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Wendy pointed it out to me the other day when I made a comment on another condo.
It's not in the protocol, but it is something people do, maybe it's one of those things that's spread on the board, if it had been on the sticky but taken out, I'm sure she would have said.
 
Wendy&Neko said:
The write up of the TR protocol on Tilley's page mentions 3 times between 40 and 50.
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That's interesting Wendy when you mentioned it the other day I looked there, I thought that might have been where I saw it, and I couldn't see it there, it looked like the page had changed a bit to me, of course I might have been having a brain fart.

Just to clarify, it mentions 3x but not specific to long-term diabetic cats.
 
Last edited:
@Gill & George
@Wendy&Neko

Gill & George said:
Just to clarify, it mentions 3x but not specific to long-term diabetic cats.
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Further clarification:
  • We added the drop below 40 for long term diabetics to the modified version of the TR Protocol described in the Dosing Methods sticky
  • Some time later the "Alternatively, if the nadir glucose concentration is 40 - <50 mg/dl at least three times on separate days, try lowering the dose. If the cat drops below 40 mg/dl once, reduce the dose immediately!" was then added on to the original German TR Protocol. They do not differentiate between long term and newly diagnosed diabetics.
  • the drop between 40 - 50 mg/dL at least 3 times on three separate days was never added to the 'modified version' of thee TR Protocol described in the Dosing Methods sticky
Since we had/have members following the German version, we suggested members see if their cats could earn reductions by dropping under 50 (newly diagnosed) or under 40 (long term) once before resorting to waiting for kitty to drop between 40 - 50 mg/dl three times on three separate days before taking a reduction. That's why we came up with the "who have shown they do not hold reductions well" part. The reasoning is simple. It's safer to reduce when kitty drops under 50 one time than it is to wait for it to happen three times. Note never have we nor the German Katzen Forum suggested dropping below 40 three times.

This is why the "earning reductions" Info post includes the 'drop below 50 three times in both the newly diagnosed and long term diabetics sections'.

REDUCTIONS:

Newly diagnosed diabetics - less than one year since diagnosis​
  • reduction *earned* after a single drop below 50 mg/dL and following TR, or
  • reduction *earned* after 3 drops between 40 - 50 mg/dL on three separate days for kitties who have shown they do not hold reductions well and following TR, or
  • reduction *earned* when the cat regularly has its lowest BGs in the normal range of a healthy cat (50 - 80 mg/dL) and stays under 100 mg/dl overall for at least one week and following TR.
  • reduction *earned* after a single drop below 90 mg/dL for those following SLGS
Long term diabetics - more than one year since diagnosis​
  • reduction *earned* after a single drop below 40 mg/dL for those following TR, or
  • reduction *earned* after 3 drops between 40 - 50 mg/dL on three separate days for kitties who have shown they do not hold reductions well and following TR, or
  • reduction *earned* when the cat regularly has its lowest BGs in the normal range of a healthy cat (50 - 80 mg/dL) and stays under 100 mg/dl overall for at least one week and following TR.
  • reduction *earned* after a single drop below 90 mg/dL for those following SLGS.
We highly suggest taking a reduction any time any kitty drops into the 30s or below. There are very few exceptions given for caregivers following TR who have collected years of data and KNOW their cat's response to the combination of insulin and food backwards, forwards, and inside out.​



Clear as mud? :)


BTW,
Gill & George said:
… it looked like the page had changed a bit to me, of course I might have been having a brain fart.
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No, you're not having a brain fart. The page has changed several times since I first saw it almost 13 years ago. So have the stickys in this group. We've all learned along the way and then make the appropriate changes.
 
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