Re: 4/18 Ruby (AT) AMPS 169 - dosing question
arozeboom said:
1) At what number do I start shooting again?
when thinking about resuming insulin, we don't look for a single number. what we watch for is an upwards trend. if she's trending upwards we'd suggest resuming insulin.
please be aware that kitties will often bobble up and down during an OTJ trial. it happens. some kitties do it more than others. don't let it concern you. i can look for ss examples later if you're interested.
2) She's basically her own timed feeder. I put out 1 can of FF at shot time and she will generally eat 1/3 to 1/2 of it then. She will normally go back every couple of hours for a snack. (If I need her to eat more, like she starts dropping, all I have to do is put the bowl in front of her and she'll eat.) She''s not the lick the bowl clean type unless there is gravy involved. Most of the time there is a bit of food left when we pull the bowls at +10. Is it ok to keep with that schedule?
sounds good to me.
3) The instructions say this..."If your cat is green at your normal test times, no need to test further until the next "PS" time, just feed small meals and go about your day. If he is blue, feed a small meal and test again after about 3 hours." With using an AlphaTrak, what number do I consider "green" and "blue". Based on my comparisons, pretty much everything under 145 or so fall into double digits on our Relion Micro. Should I go with counting under 130 as green and over 130 as blue?
that will have to be your call. you've done quite a few comparisons between your two meters. go with what you're comfortable with.
4) Wait, does that mean that once we start the trial I can sleep a whole 8 hours in a row if I want?
sleeping 8 hours is a requirement of every OTJ trial! :mrgreen:
I'm guessing it might be a little while before she has a 130 PS, but I want to be ready.
what we're looking for is overall time spent in normal numbers. the only reason i suggested 130 to marje is because of Rand's notation regarding the AT meter running 30 points higher than human meters. we usually suggest starting OTJ trials on green preshot numbers for those using human meters. all we want to do is provide a good start to the trial.
as marje mentioned, not every newly diagnosed kitty heads off the juice with a solid green spreadsheet. it's ok. the tiniest amounts of insulin have been dropping ruby too low. there comes a time when we have to evaluate what's going on. i think we're at that point with ruby. AT meter numbers sometimes present a lopsided view of a kitty's progress for those of us who think in terms of the data collected from human meters. the "test sheet" you created puts the data into a perspective most of us are used to dealing with. she's looking pretty darn good!
in our quest for green numbers we often overlook a single word in the protocol when taking reductions. the word is "
overall":
"When the cat regularly has its lowest BGs in the normal range of a healthy cat and stays under 100 mg/dl overall for at least one week, attempt to reduce the dose. Alternatively, if the nadir glucose concentration is 40 - <50 mg/dl at least three times on separate days, try lowering the dose. If the cat drops below 40 mg/dl once, reduce the dose immediately!"
overall, ruby is maintaining numbers in the normal range on what most would consider the smallest amount of insulin one could possibly draw into a syringe. again, according to Rand... that 67 last night would be considered a 37 on a human meter. given the discrepancies and margin for error between meters, i don't know if it actually equates to a 37, but in any case... it's low enough to warrant a reduction.
something else to take into account...
there's more leeway involved when we're talking about an OTJ trial for a newly diagnosed kitty versus a kitty who has been on insulin for quite some time. newly diagnosed kitty's spreadsheets don't have to look quite as pretty as spreadsheets of kitties who have been on the juice for a long time because *usually* the longer a kitty has required insulin the less chance of remission.
imho, ruby's drops combined with the
overall time spent below 100 (human meter) and the minute dose make her a candidate for an OTJ trial. frankly, i don't know how much more you could possibly reduce her dose. if the trial should fail, no big deal. it just means she'll need a little more support for a bit longer. ruby's on a mission. there's no stopping her.
good luck!!!
