4/1/15 Oz ? Not holding the dose?

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Ian & Oz

Ian & Oz

Member Since 2014
Hello,
I reduced Oz's dose from 2.75 to 2.5 on the 26th of March, the 2.75 dose was very aggressively pushing him into low numbers. I had to constantly monitor him to keep him out of the 40's. He reached 48 on the 26th, which earned him a reduction. Strange thing is, he started on a new bottle of Lantus on the 2nd of march & he didn't start to really take off & head downward until 24 days later. Just prior to Oz's levels really dropping into the green, his schedule had been thrown off by 2 hours & I had to work back to his usual time of 9:30 AM & PM. When I got him back on time, the next day is when he dropped into the green. I'm hoping someone may have some experience with this particular situation or have some ideas as to why this happened. I'm not sure what to do now if 2.75 is too strong & 2.5 isn't strong enough. I've read on here somewhere awhile back, that there are some that use calipers or other measuring devices to get "in between" doses, which sounds a bit complicated.
Any help would be greatly appreciated.

Ian
 
Hi Ian!

The post you're referring to is at the bottom of the "Where Can I Find?" post, look under "dosing with calipers."

I think you have a failed reduction. He had green cycles only for a few cycles after you reduced to 2.5u, which likely was still being affected by the depot of the 2.75u. A previously larger dose can influence as many as 4-6 cycles after the dose is reduced. I would go ahead and go back up to 2.75u and try to get control asap, and perhaps when he earns the next dose reduction, you may want to use calipers to shave the dose instead of reducing by the whole 0.25u. I've noticed that people using calipers with cats similar to Oz seem to have great success at getting control. Max is one that really fell into line when Elise was able to hold his dose long enough to flatten him out in green, then when she reduces she just shaves a tiny amount off.
 
Thank you Julie.
Is there another way to shave a dose without using a caliper?
The 2.75 dose is going to drop him very low again, I would imagine. So you're saying I should raise the dose back up & then shave it down, not quite .25u, would that be half of .25? Do you know which specific caliper (Brand etc.) is used?
 
I'm saying to increase his dose back up to 2.75u for several cycles until you've got control of his BGs again - basically mostly green. Then when he needs a dose reduction, you have the option of just taking a hair off the dose - some cats don't seem to be able to handle 0.25u reductions. The goal with Tight Regulation is to get everything under 120, and often it seems like you have to have a higher dose and hold up the nadirs by feeding, in order to get the high numbers in the cycle to come down. So in other words, while the 2.75u dose might be able to bring him into the 40's at nadir, you can prevent that from happening for a little while by feeding him to keep him over 50.

There is a good post on "Feeding the Curve" on that same "where can I find?" post that more fully explains what I've just touched on here.

I never used calipers so can't really speak to them, but I do know from people's comments that at least some folks order them from Harbor Freight, and that they have options for less than $10.
 
My DH got me a pair of digital calipers at his favorite metal machine tool shop. Neko notices differences in dose of .125 units and my BD syringes are horribly inconsistent on placement of the zero line so I find calipers essential.
 
Are cats that can't hold a reduction able to go into remission? Does not being able to hold a reduction mean he's less likely to go into remission?
 
Some cats just go down the scale more slowly than others. Take a look at Eddie's SS as one example of a bouncy cat that flattened out more with smaller decreases down the scale. He's now down to .1U. There have been lots of other examples. Then there are cats that just need to go back up by .25U, spend enough time in green to heal, then start going back down again in .25U amounts. It's not unusual for a cat to go up and down a few times around a good dose.
 
Hi Wendy, thanks for your reply.
I'm trying to decide which way to go, I'm thinking about using the caliper method to measure the "shaved' doses, but I like what you're saying as well, that maybe going up & down a few times might work in .25 increments. I've been through the ringer lately with Oz dropping really low & staying there, I barely slept at all & I'm still feeling it. Trying to keep my spirits up about all of it.
 
The calipers aren't difficult to use. I did get mine from Harbor Freight. I ordered on line. Have you watched Marje's video on how to use them? It makes it easier to be sure you are giving the same dose each time. Some fill a syringe with colored water and use it as a sample. Others have made paper calipers.
 
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