1/12 Tibby AMPS 253 flat numbers yesterday. increase dose?

Well, his numbers just kind of stayed flat all day yesterday. Don't know if that means anything.

Overall, he hit some blues, but no greens. Today is his 5th day on this dose.

Should I be upping his dose tomorrow?

https://felinediabetes.com/FDMB/threads/1-11-tibby-amps-271-pmps-211.241316/#post-2717434

 

If he doesn't see any green today, it's time to increase.

This is the 6th cycle of the bounce. You should see some action today - either AM or PM.

 

I agree with Bhooma...not reaching any great numbers in 6 cycles on TR, I'd go ahead with an increase...just searching for that green lagoon...give Tibby some help to get there

Have a great day Amy!

 

Best with today & the dose increase if needed !!

 

OK, I think I'm increasing. Do I need to wait until tomorrow, or should I do it today? And it's now going to be 5.5 instead of 5?

 

Some cats respond to the increase in the very first cycle - like Tibby did on 1/8. If you can monitor, you can increase, but I would suggest you increase tomorrow AM so that you can test through the cycle.

 

I was actually maybe going to work in-person tomorrow, so I might increase tonight and set alarms. Hmm, I need to think on that.

 

The only reservation I would have with an increase tonight & being away tomorrow, is that it looks like Tibbys trend is to have more active cycles during the day vs evening? In looking at the SS from 2020 & now, there were a few active cycles in the evenings (9/10/20; 11/25/20; 11/27/20) but otherwise, it looks like it is during the day that Tibbys body gets down to business!!

Given that the recommendation at this point is to increase by 0.5 units vs 0.25 units because Tibby is at a higher dose now, maybe it would be best to hold the dose one more day until you are around to monitor during the day----if you will be home Thursday? Just an observation & thought . It would be nice to see what happens the very first cycle with the dose change......and more important, to get some sleep before having to go into work in person . But hey, there is always concealer .

Again, just a thought...wishing the best with whatever decision you make .

 

Good point. I almost just fell asleep, so maybe I'll go to bed early and work from home tomorrow.

A bigger problem is that I will be going back in-person Friday and for the foreseeable future. I may have to switch back to SLGS. How do I modify that to be a bit more TR-like? Is there a middle ground?

 

There isn't really a middle ground between TR and SLGS. Each method has it's own safety mechanisms built into it and there isn't a dosing method that's been tested that lies between the two. You can do a bit of customization to SLGS, once you have the data to do so. And I hope the last couple weeks has given you more of that data. Going up by 0.5 units will also help you get there a little faster.

 

This is what we discussed early on....customize with the help of experienced members vs following the outline provided for SLGS like she would need to if she were managing it on her own. @Marje and Gracie was tagged early on about it because I recalled seeing her do this with a few others along the way .

I just wanted to chime in so there wasn’t confusion since this was mentioned early on as a possibility if at any point TR became an issue

 

Thanks. That's what I was thinking of. I may be able to figure out how to do TR and work, so I'll give that a shot. At least it's just Friday that I'll be at work, then a three day weekend, and THEN I'll have to figure out how to do TR and work.

 

Plenty of time to figure it out & you will have more info by then as well with the increase
It will all work out.....

 

Thanks for the tag, Amy (@Tomlin)

As Wendy said, if Amy continues TR, she can increase by 0.5u now that Tibby is over 5u bid. That can help.

But, if she does SLGS, the work I’ve done with others is fast-tracking when nadirs are 300 and above and most are +400. Also this works if the dose has been dropped back too much at some point in time due to a rebound check and the kitty is at risk for glucose toxicity. When the dose can only be increased by 0.25u a week, fast-tracking can help clip the glucose toxicity resulting if kitty is left in high numbers while the depot refills. Tibby, under SLGS, does not need fast-tracking but also to do that, Amy would need to be home to monitor as its aggressive.

If Amy sticks with SLGS, we can try making the reduction point 70 instead of 90.

 

I'll keep up the TR through the long weekend at least and try to get enough data next week when working, but that reduction point alteration sounds good if I have to switch back to SLGS.

The good thing with this five-day wait we just did, I'm now on a schedule where I could do three days of a cycle and then be home if I increase it during the work week. I can usually work at home on Wednesdays now.