? 11/21 - Toro - reset the time machine because of the blues or consider them an accident ?

[Toro & Ovi]

Hi All, question for the experienced ones.....is Toro due to a reduction, based on more than 7 days under 100 or we'd better wait some more time?
From your experience, how is better to proceed with this reduction rule in order to minimize the possibility of a failure? Stay 7 days under 100? 14 days under 100? Ignore sporadic blues or reset the timing every time when we spot one?
Thank you.

 

[Gill & George]

I know you want to do TR.

I have some concerns, zero data

1) zero data in the am cycle, I know it's difficult with work, remission me are you out for the full 12hours in the morning? Are you not able perhaps to run a curve at least once a week? Get any spot checks in at any time?


2) Toro has hit low 50s on this dose on several occasions, that's. Close to a reduction point, yet you have not followed up with a check 30-60min later even though it's clear from the numbers he was dropping, and potentially could continue to drop, I'll say it again cats don't always nadir at the same time, assuming they do is a very risky strategy.

There's not really enough data to support a confident dosing decision on TR.
We don't know if your mid blues you've got are because he dropped to low and bounce up a little, or if his numbers were creeping up, impossible to say with the info at hand.

Are you able to step up the testing over the next couple of days? To try and figure things out?

If you are not, given some of the low numbers you have I feel the safer option, given the lack of data would be to try a reduction.

At the risk of sounding like a broken record, please try and get some tests in the am cycle, anywhere, it doesn't matter if it's +1 or +11, all data is useful at building a picture. Then on days off, or if you get home early, grab spot tests, run a curve, anything to build a picture of BG patterns, continuing on TR with such limited testing makes me worried for Toro.

 

[Doodles & Karen]

I agree with Gill and would advise to take a reduction to 1.5u.

 

[Wendy&Neko]

Ditto, I would reduce now.

 

[Toro & Ovi]

I know you want to do TR.

I have some concerns, zero data

1) zero data in the am cycle, I know it's difficult with work, remission me are you out for the full 12hours in the morning? Are you not able perhaps to run a curve at least once a week? Get any spot checks in at any time?


2) Toro has hit low 50s on this dose on several occasions, that's. Close to a reduction point, yet you have not followed up with a check 30-60min later even though it's clear from the numbers he was dropping, and potentially could continue to drop, I'll say it again cats don't always nadir at the same time, assuming they do is a very risky strategy.

There's not really enough data to support a confident dosing decision on TR.
We don't know if your mid blues you've got are because he dropped to low and bounce up a little, or if his numbers were creeping up, impossible to say with the info at hand.

Are you able to step up the testing over the next couple of days? To try and figure things out?

If you are not, given some of the low numbers you have I feel the safer option, given the lack of data would be to try a reduction.

At the risk of sounding like a broken record, please try and get some tests in the am cycle, anywhere, it doesn't matter if it's +1 or +11, all data is useful at building a picture. Then on days off, or if you get home early, grab spot tests, run a curve, anything to build a picture of BG patterns, continuing on TR with such limited testing makes me worried for Toro.

Ladies, we'll be able to give Toro some day tests during the weekend. If you take a look at the colours from the Toro's AT2 SS (which I've modified based on double tests with FL and AT2 and filled some blanks via math probabilities), you'll understand why I'm not too worried about the current numbers: the published TR protocol is more than safe designed and I can hardly believe something bad will happen to Toro as long as the numbers on human meters are over 35 - now that I know Toro was under 30 and he was acting perfectly fine (see October 20th, 2017). Right now he's surfing on 50's.
I believe this can't be considered a general rule, too - some kitties can get in trouble if they get into so low BG numbers.

 

[Gill & George]

The Weekend is a long way away in terms of insulin cycles, I would take the reduction, and aim to get those extra tests in.

Right now he's surfing on 50's.

Right now you have not got the data to assert this, you can see he is hitting 50's, but you have no way of knowing whether he is dropping further than this, I again remind you that he can continue to drop after +4, I could argue that it may even be likely.

TR protocol is more than safe designed

It is safe, but it is an aggressive protocol, the real issue is that you are not meeting the testing requirements to follow it.
This makes it much more risky, again, I would urge you not to assume that he will be OK as long as he doesn't drop below 35

I can hardly believe something bad will happen to Toro as long as the numbers on human meters are over 35

You are picking this number out of the air, and have not got the data to support that. By holding on to doses for too long, you will be letting the depot get over full, you risk the proverbial, hitting the fan, and facing plummeting BG, which in the best of circumstances would lead to you having to fight to keep him from a symptomatic hypo, but with your work schedule I fear the outcome would be much worse.

If we assume that the only blues he has seen are the ones you caught, he's been in good numbers for over a week now, only occasional blue, in line with the protocol.... Take the Reduction.