3/16 Lincoln AMPS 238, +3 162, +5 36, +5.5 56, +6 72,+6.5 86, +9 144, PMPS 425, +2 342, +4 227

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Lincolns Mom

Member Since 2016
[url=http://www.felinediabetes.com/FDMB/threads/3-14-lincoln-amps-266-2-268-4-68-4-5-58-5-86-6-88-8-122-pmps-497.174811/]3/14

Well... he really likes to stop my heart some days... just tested at 31 and retested at 36.... HC with maples syrup and 4 temptations... retesting in 20 mins... so the question is do i take the reduction... i think i should for a few reasons... one its below 40... two the other two times he has been in the greens on the dose i have had to fed MC to encourage a surf... he was dropping if only fed LC.... but he has seen a lot of pinks and yellows on this dose... i am worried that he hasnt really earned the reduction and i am worried with the large depot what could happen if i dont take the reduction

thoughts???[/URL]
 
Yowza!!!!!!

I'd lean towards taking the reduction (reasoning: you've been on this dose a while so the depot is stable, the 31 isn't a borderline number, and you can always go back up if the reduction doesn't hold). But definitely wait for the more experienced hands to weigh in.
 
+5.5 56... fed some MC (12%) cause its his snack time and hoping that helps get a surf going when the HC wears off... i am leaning towards the reduction too.. the next question is if i take one do i take the .5 or the .25.... leaning towards the .5... given that i have fed him MC 2x to keep him above 50 and surfing... if i hadnt no doubt he would have gone below 50... so this is like the 3rd drop below 50 if i look at it that way... plus we have to wait the 6 cycles for the depot to drain...
 

I would refer you to the information in the Tight Regulation Protocol sticky. Unless your cat or the situation is an exception, dose reductions are taken in 0.25u amounts.


REDUCING THE DOSE:
The TR Protocol is an aggressive method in itself. The modified version of the protocol is slightly more aggressive. Let's keep all our kitties in the Lantus & Levemir ISG safe by suggesting and taking appropriate reductions.
  • 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. See additional notes in the next paragraph about drops into the 20s and 30s. Alternatively, at each newly reduced dose... try to make sure kitty maintains numbers in the normal range for seven days before reducing the dose further.
  • Please do not let yourself become complacent or blasé about drops into the 20s or 30s. Please ask for advice immediately.
  • If your cat drops into the 30s, a full reduction of 0.25u is recommended. There are very few exceptions given for caregivers who have collected years of data and KNOW their cat's response to the combination of insulin and food backwards, forwards, and inside out.
  • Caregivers whose kitties have "High Dose" conditions may find the need to reduce in whole units or more.
Larger reductions are sometimes taken if your cat has a high dose condition. I don't see anything in your signature that says Lincoln was diagnosed with acromegaly or insulin resistance.

It's not uncommon that numbers will wobble around. That's why it's important to test frequently when numbers drop below 50. (See the sticky on Shooting and Handling Low numbers.)
 
I would say definitely on the reduction! There are a couple of ways to go on the reduction size. With higher dose kitties I tend to be more cautious and do .5 unit decreases at this point. We don't know if Lincoln has a high dose condition, because he has not been tested for it. Since he's been well over 6 units, I suspect something is at play. Kitties with "high dose" conditions can suddenly need less insulin, hence my caution. FWIW, I once did just a 0.25 unit reduction at about the same dose size and was rewarded with a number in the 20's shortly after. :eek: Hence my cautious nature.

The second route to go is for kitties that aren't holding their reductions as well, though he just did a 0.5 unit reduction and held it. In the second option, you can take a slightly larger reduction tonight to drain the depot, and resume with a .25 unit reduction tomorrow. Low 30's and larger depots are not to be messed with. You need either a larger reduction or one time BCS to drain the depot.
 
going to take the .5u reduction and start it tonight... i know he is most likely going to bounce but once he needs a reduction he generally needs it... so new dose is 6.25u... excited he is earning reductions even if he likes to scare me to do it!
 
PMPS 425... no surprise he bounced... would have been surprised if he hadnt lol... still shot the reduction to start the depot drain tonight... here is praying he can hold onto another reduction :)
 
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