Re: 1/14 OliverTwist pmps 237 +3 218
I'm asking for advice on Ollie's dose. Do you think i should Increase or hold? I've put what i've tried to use to answer my own question below. But it goes on and on, doesn't come to any conclusion and and boils down to … Please advise me on if you think i should hold or increase Ollie's dose.
I've been so excited to see him in these numbers that I forgot i'm supposed to be thinking about his dose and giving him a chance to be OTJ. I've spent a lot of time reading the protocol and trying to figure out what I should do. Of course, i'm don't feel able to make a call by myself. I thought i'd write what i've come up with and then get the benefit of MUCH better brains than mine.
Ollie has been at a fat 3 for 10 days now.
20 cycles at fat 3
12 cycles his peak is over 200 and 8 cycles his peak is under 200 so I can fit him into this category
Increasing the dose
If nadir blood glucose concentration < 200mg/dL but peak is >200mg/dL (11 mmol/L)
Increase every 5-7 days by 0.25-0.5 IU depending on if cat on low or high dose of insulin
Some of those >200s I write off to bouncing off his low numbers in the previous cycle, but I don't see an exception for that in the protocol. So it would seem he would fit into having a dose increase.
I can also squeeze him into this category
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. Periodic slight adjustments are necessary in many cases.
But he doesn't fit into this definition of Phase 3
Phase 3: Holding the dose. Aim to keep blood glucose concentration within 50-200 mg/dL (2.8 – 11 mmol/L) throughout the day.
I look at his <100 numbers and it seems he's doing a fair amount of time there and that's a good thing even though he hasn't been able to produce them consistently during his am and pm cycles,. But he also seems to be leaving the blue amps and pmps behind and that's not a good thing. Although I wonder if some of them are bounces off his previous cycles and does that make any difference when considering the >200 amps and pmps
If someone else were asking this question, my answer would be... “I don't have any dose advice, but have a great day” If someone held a gun to my head and made me answer I would say “Hold that dose and wait for one of the experts to look at your SS and advise you”.
So after this litany that comes to no conclusion, could you please tell me what your opinions are? Thanks for all your time and advice.
sorry to be so wordy... i don't seem to be able to be concise. thanks very much mary and oliver
