10/18 Willow AMPS: 412 / +3: 271 / +6: 112 (YAY!) / +7: 103 / +9: 186

Willow had her first big drop today at her 8.5 unit dose! @Wendy&Neko advised me to increase by 0.5 with nadirs in the 200s, past the 5-unit dose. Now that she's gone into the 100s, should I hold her current dose for longer than 6 cycles, or increase by 0.25 after 6 cycles? And is there a record of high-dose TR steps written somewhere that I've missed?

 

That's awesome news! How is Willow liking those low blues?

Definitely hold the dose a little longer with those blues. You can hold doses 6-10 cycles for nadirs under 200 and I would hold at least 8 cycles. With high dose kitties, as long as you are following TR, you basically follow what it says. The difference for higher dose cats is the sizes of increases. You want that increase to be proportional to the size of increase in smaller doses. So 0.5 units over 5 units total dose, 1 unit increases over 10 units. And if she doesn't get below 100, you can do a 0.5 unit increase again. If she does go below 100, sneak it up by 0.25 units.

Here's the link to your last post here, for continuity: https://felinediabetes.com/FDMB/threads/9-30-willow-amps-289-3-287-6-380.236182/

 

Yes Willow is doing well, chilling out!

Got it, thanks! Is there a logic to how to decide between 8-10 cycles of holding the dose? Like if she doesn't go this low again in cycles 4/5/6/7/8, I'll increase after 8 cycles?

And if I get past 10 units, I'll use this same logic except 0.5 -> 1 unit, 0.25 -> 0.5 units?

Thanks!

 

A couple things to consider on how long to hold the dose. First, whether upper or lower blues. I tended to hold longer for lower blues. I'd also try to see where she headed after the resulting bounce broke. That could mean I'd have to hold a couple extra cycles for the bounce to break.

You've got the logic for dose increases. With one caveat. Some higher dose cats are more sensitive to smaller changes. But what you've stated is a good place to start, until you gather data and see what works for Willow.

 

Thanks. She is definitely bouncing today, and threw up most of her AM food. I am kind of surprised she made it until today without throwing up, although she did have diarrhea yesterday. Will try to test her ketones today.