I think you CAN but with it just going to 49 you aren't OBLIGATED to. It's up to you. I've been really liking the interpretation of this "holding the dose" phase as it's articulated on the
Tilly's Diabetes Page. Same protocol, some different interpretations.
Phase 3: Holding the dose
Try to keep the cat at a dose where the BGs are in the 50 to 200 mg/dl range for as much of the day as possible. The majority of cats are actually able to achieve consistent BGs in the 50 to <100 mg/dl range with consistent dosing. A well regulated cat looks like
this.
Don't let the cat go below 50 mg/dl (N.B. there are some cats that do well with BGs >=40 mg/dl and are difficult to regulate unless the dose is held at BGs in this range, but a cautious approach should be used until you are sure your cat reacts this way). 200 to 220 mg/dl is approximately the renal threshold for glucose and important for renal health and general recovery. This phase may last a long time (many months). Periodic slight adjustments are necessary in many cases.
If your cat remains in this range, testing for ketones is no longer necessary. But if your cat should, for example, develop an infection and suddenly have higher BGs as a result, start testing for ketones immediately and adjust the dose appropriately.
If he were mine, I think i'd wait a little bit longer at the 2.5u dose and see if some of those higher numbers would come down some. It's up to you, though. If you'd spent 3 hours with him under 50 today, and had to keep carbing him, that would be a clear signal that he needed a dose reduction. But since he barely blipped for a moment to 49 and he still has higher numbers in the day cycles until today (which i think says today shows great progress!) i think it's optional. You're aiming for nice long green cycles.
The goal with tight regulation is to get their blood sugar mostly under 120 all the time, rather than to go down in dose. Once the BGs are all regulated, you won't be able to stop him from having dose decreases.
Anyway, that's my 2 cents worth. It's ok to reduce, as everyone has suggested. It's also ok to hold the dose a little longer and see if those other cycles will come down. If you do decide to reduce the dose, if you see him stop having green cycles, I'd call it a
failed reduction and not hesitate to go back up. More on
failed reductions from the TRP page.
