2/19 Edward AMPS-325

SnowKat

SnowKat

Active Member
Yesterday

Well, we are back to pink after four lovely days spent under 300. Two steps forward, one step back, I guess. Hopefully he'll return back to cooler colors quickly.

I am considering going back up to 1u. I had dropped to .75u on 2/13 because I was *kind of* doing SLGS at the time, and that 76 on 2/8 warranted a reduction (admittedly, I caught it a bit late). But at this point, I am thinking I should go back to 1u and see what shakes loose.

I'm wishing everyone and their kitties a safe and sunny day!
 
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It looks like Edward gave you a 58 3 cycles ago. I would probably hold this dose a bit longer. JMO. We typically hold the dose for 3 days/6 cycles before an increase. One of the experienced folk should be around to advise you:)
Have a wonderful day Kat!
 
@Briere Fur Mom I'm not sure why a 58 would impact anything in TR? I was under the impression that a dose decrease was warranted for any reading below 50. I'm going to go review the protocol info...
 
SnowKat said:
@Briere Fur Mom I'm not sure why a 58 would impact anything in TR? I was under the impression that a dose decrease was warranted for any reading below 50. I'm going to go review the protocol info...
Click to expand...
Hopefully someone more experienced can give you some advice here. And like I said I could be totally wrong....just trying to help:)

Copied and pasted from the TR sticky dosing methods:

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.
 
From the TR 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."
To me, this suggests that I would be within the protocol guidelines to increase by .25u at this point, but if I'm wrong, I hope someone will chime in!
 
Until Sienne gets back and advises...we base our increases and decreases off of the lowest point in the cycle(nadir).
Using my cat Moey as an example(ECID....this is Moey only)...he got a dose reduction on the PM cycle of 2/11(went below 50). I thought the reduction wasn't going to hold. On 2/12, I started counting cycles(for a dosecrease) thinking his nadirs were going to start running higher. Surely enough, as soon as I would get through counting 2 cycles(1 day) Moey would give me an acceptable nadir, thus restarting the cycle counting. I'm very glad I haven't increased him because, his #s tell me that his depot has the potential to bring him down into some low #s....for now anyway; that is always subject to change. Hope that didn't confuse you more:facepalm::banghead:
At any rate someone experienced will advise you.:smuggrin:
 
@Briere Fur Mom - Thank you for your response... I have a couple follow-ups ??s... I am not familiar with the term "dosecrease" - is that an increase or a decrease? Also, why would an acceptable nadir (I'm assuming an acceptable nadir is anything over 50 in TR?) restart a cycle count? I thought only things like a dose change, skipped shot, etc. restarted the cycle count? Maybe I am misunderstanding? I'm sorry; I don't mean to be dense, I'm just trying to get things straight <3
 
At this point, I think it's debatable whether Edward is new to nadirs under 200. If you believe he's not new to those blue and green numbers, then his dose should have been increased after 3 days/6 cycles. If you consider him to be new to those numbers, the the dose is held for 5 days. It's sort of a moot point since it's been 6.5 days at 0.75u. You should increase the dose tonight.

Maybe I missed something, but I'm not sure why you decreased Edward's dose from 1.0u to 0.75u. With TR, remember that you decrease only if numbers drop below 50.

"Dosecrease" could mean either, hence your confusion. In the context that Briere was using it, I believe she meant increase. An "acceptable nadir" shouldn't restart the cycle count -- I'm not sure what she meant by that either. The cycle count restarts after any alteration in dose (increase or decrease), a skipped/fur shot, or even a one cycle decrease because you're nervous about shooting the entire dose. You're understanding the process correctly.
 
I apologize for no response...had to run an errand before the place closed and than the darn internet was having some issues. Come to find out the internet problem was due to the DH uploading a video:rolleyes::smuggrin:
It looks like Sienne corrected my thoughts on your increase and answered your dosecrease question. There's a ton of slang to be learned on this forum:)

I've def misinterpreted some things in the TR guidelines. So, pay no attention to me:rolleyes::p Goodness many apologies. I thought I was helping when none was needed:facepalm::banghead:
In my interpretation of TR...I thought nadir(s) in the 50s - 80s doesn't allow room for an increase. I have much to learn sensei!
I have many questions to add to my own post now...as not to hijack yours!
Have a wonderful evening Kat and again....sorry:(
 
@Sienne and Gabby (GA) - THANK YOU for the clarification. Edward is definitely not new to nadirs below 200... I suppose I should have increased dose earlier. I will increase to 1u tonight.

The whole reason I went to .75u and SLGS was because I had to go out of town and leave Ed in the care of sitters who couldn’t test, only a couple weeks after initially starting insulin. Then once I got back, things were just crazy with me catching up on work. I could barely keep my own head above water, let alone worry about increasing dose and switching back to TR. I was erring on the side of caution, and maybe also hoping a bit that I wouldn’t have to increase.

I’m just fumbling through this like the idiot that I am. I’m honestly having a hard time. I really appreciate your patience and help. Thank you, Sienne!!!
 
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