? 1/2 Des PMPS 151, +2 176, +4 209 - Dosing advice

Prikitiw

Prikitiw

Member Since 2024
Hi all, I'm new here and would appreciate your advice.

When you see nadir from PMPS to +2, is this a sign that the dose is too much and needs to be reduced?

Thanks!

Reina
 
Looking at the PMPS numbers you posted above your +2 is higher than the Pre Shot nunber, so I don't think the dose is to high ,whatever dose you are shooting
Hi Reina, when I tap on your spreadsheet nothing comes up.
Maybe this will help

* At the top right of the spreadsheet screen click on Share.

* In the pop-up dialog box click on the Get Link section.

* Change link access from 'Restricted' to 'Anyone with the link' and make sure that the permission on the right hand side is set to 'Viewer'.

* Click Done to save the changes.

Can you also add the name of the meter you are using to your signature

Then the members can take a look at it and give you advice

Have you read the 2 dosing methods for lantus ?
They will let you know when an increase or decrease is needed, you can pick one when you decide and then add it to your signature and SS
https://felinediabetes.com/FDMB/thr...-low-go-slow-slgs-tight-regulation-tr.210110/
 
Last edited:
Diane Tyler's Mom said:
Looking at the PMPS numbers you posted above your +2 is higher than the Pre Shot nunber, so I don't think the dose is to high ,whatever dose you are shooting
Hi Reina, when I tap on your spreadsheet nothing comes up.
Maybe this will help

* At the top right of the spreadsheet screen click on Share.

* In the pop-up dialog box click on the Get Link section.

* Change link access from 'Restricted' to 'Anyone with the link' and make sure that the permission on the right hand side is set to 'Viewer'.

* Click Done to save the changes.

Can you also add the name of the meter you are using to your signature

Then the members can take a look at it and give you advice

Have you read the 2 dosing methods for lantus ?
They will let you know when an increase or decrease is needed, you can pick one when you decide and then add it to your signature and SS
https://felinediabetes.com/FDMB/thr...-low-go-slow-slgs-tight-regulation-tr.210110/
Click to expand...


Hi Diane, thank you for flagging, sorry about that. I've changed the permission as you suggested.

Link to spreadsheet
 
Welcome. We ask new members to post an intro on main. Since you are following TR, reductions are earned if the bg falls under 50 which has not happened so a reduction has not been earned. The nadir is the lowest bg in the cycle and can move around so I dint understand your question. Please rephrase it.
 
tiffmaxee said:
Welcome. We ask new members to post an intro on main. Since you are following TR, reductions are earned if the bg falls under 50 which has not happened so a reduction has not been earned. The nadir is the lowest bg in the cycle and can move around so I dint understand your question. Please rephrase it.
Click to expand...

Thank you and will do the intro on main!

I will wait until BG falls under 50 then before reducing.
 
This is from the dosing sticky.
General Guidelines:
  • Hold the initial starting dose for 5 - 7 days (10 - 14 consecutive cycles) unless the numbers tell you otherwise. Kitties experiencing high flat curves or prone to ketones may want to increase the starting dose after 3 days (6 consecutive cycles).
  • Each subsequent dose is held for a minimum of 3 days (6 consecutive cycles) unless kitty earns a reduction (See: Reducing the dose...).
  • Adjustments to dose are based on nadirs with only some consideration given to preshot numbers.
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.
  • Increase by 0.25 unit after 3 days (6 consecutive cycles) if nadirs are greater than 200, but less than 300.
  • Increase by 0.5 unit after 3 days (6 consecutive cycles) if nadirs are greater than 300.
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, & Biosimilars ISG safe by taking reductions when appropriate.
  • 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, attempt a reduction when the cat regularly has its lowest BGs in the normal range of a non-diabetic healthy cat (50 - 80 mg/dL) while staying under 100 mg/dl overall for at least one week.
  • 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.
Since you are set up with a signature and spreadsheet one of the moderators will move this if they feel it’s necessary.

It’s a good idea to post a condo if you have any questions including about dosing. Many post a daily condo at least at first. I did. We just ask you post one thread a day here. If you have more questions you can add a question mark prefix or change your subject thread. The bg is going up so your cat might be bouncing from the lower pmps last night. That often happens until kitties get used to more normal bg.
 
There’s one other way to earn a reduction. If the bg is almost all green for 7 days and most nadirs under 90 a reduction is earned.
 
tiffmaxee said:
There’s one other way to earn a reduction. If the bg is almost all green for 7 days and most nadirs under 90 a reduction is earned.
Click to expand...

Thank you, Tiff, this is all super helpful. I had read the dosing sticky, but I was not aware that nadirs can move around.

I thought that nadirs are always around +6 or +7, and if that's not the case (e.g., the nadir is late, such as PMPS), then there's an issue (e.g., dose should be reduced).

Since the bg is going up and Des seems to be bouncing from the lower PMPS last night, I will hold the 2.25 dose until the bouncing clears.

I had read that a bounce cycle can last up to 3 days (6 cycles) until it clears and I start seeing a curve (or a semblance of a curve) again.
 
Keep in mind that lantus is known for giving fiat cycles especially as bg gets into normal numbers. I don’t think he’s bouncing any more. I’d increase tomorrow to 2.5. It’s true bounces can last up to 3 days but many clear much sooner.
 
tiffmaxee said:
Keep in mind that lantus is known for giving fiat cycles especially as bg gets into normal numbers. I don’t think he’s bouncing any more. I’d increase tomorrow to 2.5. It’s true bounces can last up to 3 days but many clear much sooner.
Click to expand...

Thank you, Tiff! I've increased to 2.5.

How can you tell if a bounce has cleared (e.g., sooner than 3 days)?
 
When a bounce clears the bg comes back down. It’s not always easy to spot. The string of blues today was good.
 
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