03/29 Shmee AMPS 390, + 6 88 (first green), photos

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Amanda & Shmee

Member Since 2018
Previous condo: http://www.felinediabetes.com/FDMB/...-dose-increase-new-blues.193252/#post-2159143

Last night he started to bounce from his blues yesterday, so I assumed I would see high numbers all day today but it looks like he may be surfing again today :cool: Since he is relatively new to blues I will be keeping him on this dose for 4-5 days.

Question: For TR, when exactly do you know when to hold and reduce the dose? This part of the reading has been a little confusing to me. I want to be sure I am dosing him correctly, so any advice would be appreciated.

Side note - I have been wanting to put up shelves in my kitchen for a while, so my Shmee can get on top of the cabinets. My brother started to put up them up last night and I can't wait for them to be done! He just needs to add one more little one to the side of the fridge, so he can get up there. I love the cat I decided to paint :D If the thread allows me to post a video I will have to do that on Friday when the shelves are ready and he can get up there!

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I hope all you beans have a great day, Friday is almost here :bighug:
 
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So. here's the info from the TR sticky note:

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.
  • After 3 days (6 consecutive cycles)... if nadirs are greater than 200, but less than 300 increase the dose by 0.25 unit.
  • After 3 days (6 consecutive cycles)... if nadirs are greater than 300 increase the dose by 0.5 unit.
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.
Notice that increases are based on several nadirs over the course of at least 6 cycles -- not based on just a single cycle. I generally look at the trend -- what range is the majority of the nadirs falling into. So far, you have only one cycle where the nadir is in the 100 - 200 range. Unless something changes, and the next several cycles have nadirs under 200, I would probably increase after 6 cycles.

Dose reductions are easier! If Shmee's numbers drop below 50 (on a human meter) or if Shmee is in normal numbers for a week, you reduce the dose.

 
Looks great, except for the Indians calendar! :p:p Go Twins! That is a pretty cool idea, I bet Shmee will love it!

Haha thank you Sean! My grandparents live in Minnesota so I am a secret Twins fan as well ;)


Notice that increases are based on several nadirs over the course of at least 6 cycles -- not based on just a single cycle. I generally look at the trend -- what range is the majority of the nadirs falling into. So far, you have only one cycle where the nadir is in the 100 - 200 range. Unless something changes, and the next several cycles have nadirs under 200, I would probably increase after 6 cycles.

Dose reductions are easier! If Shmee's numbers drop below 50 (on a human meter) or if Shmee is in normal numbers for a week, you reduce the dose.

Thank you Sienne! That is what I have been doing so I feel better about that. I have the stickys printed out / highlighted in a binder, I feel like I have read them so much but it's a lot of info so I appreciate you explaining it. I think the Tilly's Diabetes Homepage link confused me when it mentioned holding the dose ("phase 3"). But really that "hold" she I stalking about is only for a week or so once they are seeing normal numbers like you said, and then we start to reduce. Correct? I feel like I might just be overthinking it because him going hypo scares me so much.
 
So you have a catwalk across the kitchen from cupboard to cupboard? That's awesome!

Yes haha I cant believe I didn't think of "cat walk"! He used to jump from the countertop to the cabinets, but with his age (10) and weight now he hasn't done it for a while. But I know he loved it up there so I am hoping he will love the new addition! It should be done by tomorrow.


Way cool your cat walk. I would love to do something like that , but DH just rolls his eyes like this :rolleyes:

Haha!! Show him this YouTube video I fell in love with, he will REALLY do an eye roll then!
I think it is so awesome!
 
That was a huge drop from this morning!

Yes it was! I assumed this morning was the bounce from yesterday so I expected to keep seeing big numbers today from the bounce.

He is making me nervous going this low compared to this morning but I assume and hope it is ok??
 
Nice! Now feed a couple of teaspoons of LC. Hopefully it'll get him surfing in greens. Retest 30 minutes later.

30 minutes later (just now) at 101. :cool: I will try to make him eat some food too, he has had food out pretty much all day so I don't think he will be interested. I work at home so I usually just add more in his bowl at +3 and +6 if he needs more. But he hasn't had a big appetite today... :/ If he doesn't eat a full two cans of food by bedtime I think I am going to give him his appetite stimulant. Although I was thinking I want to go out tonight and try to get some more FF flavors and see if he is just being picky first before I give him the pill.
 
You know what to do. There is the possibility that he will pop up from those greens today. But, get a +1 and a +2 since this is the lowest you have ever shot. If you need help, just yell.
 
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