3/11 PMPS 106 +2 80. ADVICE. new to TR protocol

Kjensoc

Kjensoc

Member Since 2019
Hi, just looking for some support and encouragement. I think Simba's numbers look really good. Just started the tight regulation protocol on Saturday. My vet put him on three units of Lantus back on February 7th when diagnosed. When I got the blood glucose monitor he had numbers down in the 50s. I recently had him boarded at the vet for 2 weeks and unfortunately they did not drop the dosage despite the results I showed them. And were not able to get blood glucose readings because they said he was too difficult. (Does he look difficult :) )! when I got him back Friday his first number was 84 at PMPS so I dropped him to 2 units and that's what I've been testing him on. I've just ordered syringes with the half unit measurements because right now I just have the pen needles. Based on the post on the tight regulation protocol it looks like I need to wait for a full week of numbers below 100 or a drop to below 50. I'm not sure I've caught his nadir so he may or may not have hit below that at this point. Would anyone drop him .25 yet or keep testing? Thanks in advance! Any advice appreciated!
 
Simba had a bit of a drop to +2 tonight. Can you get a +3 or +4 to make sure he's not dropping further? The 3.0 unit depot should be gone now, so you are seeing what 2.0 units can do. With TR, you would continue to hold the dose for that drop below 50 or a week in normal numbers. Today is day 3. :D
 
Would you mind looking at Simbas spreadsheet again? Today will be seven days of getting numbers and they've been very consistent. It doesn't strictly fit what I was reading on the tight regulation protocol. He's mostly under 100 and has had a few times over. Would you reduce him by .25 tonight? Thanks!!
 
Simba is looking REALLY awesome! With that said, according to TR, because of those numbers that are over 100, he technically hasn't earned a reduction at this point. Personally, I would continue to hold his current dose. We'll see if others chime in, too. Great job!!
 
I agree with Amy he's looking very good, but with the amps in 120's so recently I'd continue to hold for now unless you catch a drop below 50 of course.

Did you shoot without getting a pmps last night?

I wouldn't be surprised if he were to drop below 50 before too long, grabbing a test at +2 especially when you are shooting green may give you a heads up to a reduction earning cycle, if you were to catch a sharp drop at +2 from PS, that would be your signal to monitor and figure out if he's going to drop further or if he's going to surf for the rest of the cycle.
 
Thank you, Amy and Gill. Yeah I did miss his PMPS test last night. I will continue to check those + 2 and see what happens and be patient before reducing his dose. He did sneak his sister's medium carb food tonight when I wasn't looking so he probably won't have a big drop tonight! We're a carb loving family!
 
Given the way Simba's numbers have been trending, I would encourage you to try to get a curve (testing every 2 hours). From the data you have, it's hard to see where your kitty's nadir is. With so much green, I'd want you to not miss a dose reduction so having a better sense of where nadir generally falls may be helpful.

Also, I want to bring your attention to the two ways a kitty that's following TR gets a reduction:
  • 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.
Click to expand...
I'd draw your attention to the second bullet. If Simba stays within a normal range for a week, a dose reduction is indicated.

 
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