Re: 11/11 Remi AMPS 111, +1 88, +2 57
good morning!
I see that Remi has you on your toes today, but I'll go ahead and reply to your questions from earlier. They will probably become relevant again soon. And in the meantime, yep, I totally agree with carbing him up if you have to leave. I've had to do that many times.
phlika29 said:
I gave the 0.75 dose this morning before reading your post but although I know I need to be patient as Sienne said I really want to keep remi in the normal numbers and so am inclined the fatten the dose as you suggest.
Patience has its place in this sugar dance, but IMHO this isn't it. I'll explain what I mean:
On the way UP the dosing scale using the Tight Regulation Protocol, you do need to give the doses time to work before changing dose. I do think a lot of people hold doses much longer than necessary. The protocol's recommendations (3 days in most cases, 4-5 days when a cat first starts hitting blue and when they first start hitting green) already have most of the "what-ifs" built in - they are already accounting for New Dose Wonkiness and possible bouncing from blue/green. In most cases there is simply no need to wait longer than that. There are a few cats that need more time, but for most of us, holding a dose too long just allows for glucose toxicity to set in. So patience, sure, but not TOO much. LOL!
BUT - those are the steps to
attain tight regulation. Once you HAVE tight regulation, then your goal is to keep it. Take all that you have learned about Remi, and do what you need to do to keep him in range. That's a lot easier than losing the regulation and trying to get it back. So I would absolutely tweak the dose if I saw my all-green cat start to trend upward and I wouldn't wait any particular number of cycles to do it. I would do it as soon as I thought it was an upward trend and I would tweak by whatever amount I thought would get the job done. Just know that if you tweak it up, most of the time you'll have to come back down again fairly quickly. Sometimes they were not quite ready for a reduction, but they might just need another day or two before they WILL be ready. You might be seeing that today, or it might just be that Remi is feeling better today.
My reasoning is that I can monitor remi quite a lot and he wasn't on the 1 unit for all that long before he went below fifty. When he went below fifty he hadn't eaten as he was unwell and so although I know he still earned his reduction I knew he might struggle with it.
I agree, and it's why I suggested an increase. Also, because Remi is in a fairly flat stage right now, the likelihood of him really plunging into danger is very small. Obviously you need to keep on top of the numbers, but you don't need to panic about them.
Having said all that this morning his AMPS 6.2 / 111 so that is in the normal range isn't it? Under the 120.
The ideal is to be pretty much all green. Occasional blips over 100 (up to 120-ish) can be overlooked, but we have seen significantly better results with cats that stay green versus those who spend a lot of time in blue. Once the cat is all green 24/7, we will start recommending reductions after a week of being in solid green. Many (probably most) cats get ahead of us and start insisting on reductions even sooner than that. Many all-green cats will start to really run down the dosing scale in a big hurry. You can almost SEE the pancreas healing taking place. They may or may not race all the way down to 0.0 units, but they almost always will land on a lower dose than the one they spent most of their diabetic days on. Just something for you to look forward to. ;-)
Questions?
they are very lucky kitties.
