4/21 Dimitri AMPS 212 PMPS 313

[ChEMom]

Yesterday's condo

Not a good day number-wise. Is it time to increase his dose by .25? I saw what Julie said before about not feeding him after his nadir, but he hardly
eats at all in the afternoon. It seems like he really likes to eat breakfast (right after his AM shot) and then comes back for "Second Breakfasts" about an hour
later and sometimes even a third breakfast 30-60 minutes later. But in the afternoon and evening, he's not very hungry. I was actually wondering if *making*
him eat dinner about an hour before his PM shot and reading might help? I mean, IF the bounce is the liver protesting, maybe having him a bit of food
would make the liver happy enough to leave him alone?

 

[Shelly & Jersey (GA)]

Hi Janet,

Is it possible for you to get some readings sometime around the +5 or +6 mark? Maybe you could set an alarm clock for around that time tonight? We make dosing decisions based on the nadir. How low does a dose take the kitty, in other words? Without getting some readings in between the shots, we don't know how well this current dose is working. It's very possible that the 1 unit takes Dimitri all the way down to 30 or 40. That might cause his liver to panic and then release extra sugar, which then causes the reading at the next shot time to be high. Without those "in between" tests, we simply don't know how well the dose is working.

I'm sure the more experienced users will be along soon to help answer specific dosing questions you have.

Have a great night!
Shelly

 

[ChEMom]

I had been getting some in between readings, but I wasn't home much today. I'll work on it. Thanks.

 

[Shelly & Jersey (GA)]

I know it's hard to get those in between checks. We have to do the best we can with our schedules. I couldn't get very many daytime checks at nadir because I was at work, and I was exhausted at night! Getting those night time tests can be really helpful, though, especially since a lot of kitties drop lower at night.

 

[Sandy and Black Kitty]

Hi there

Best to avoid feeding after +10 otherwise the PS BG reading may be falsely inflated due to the food.
Although dosing decisions are based mostly on nadir, PS is a consideration so you want to keep it clean.

Regarding an increase, being that he saw all that green on 04/19 and green again on 04/20 you should hold the dose.
From the protocol:

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.

After 3 days (6 consecutive cycles)... if nadirs are greater than 200, but less than 300 increase the dose by 0.25 unit.

After 3 days (6 consecutive cycles)... if nadirs are greater than 300 increase the dose by 0.5 unit.

I agree with Shelly - there is a strong possibility he is going lower than what you are catching.
More data is needed, it will keep him safe and help those who are willing to assist you with dosing decisions do so.

I'm sure someone has already mentioned the bare minimum BG testing required for safety is: right before you shoot and at least once during the cycle, both AM & PM.

The between shot tests don't all have to all be at +6; as a matter of fact it's more revealing if you stagger the times you do those tests.
To determine when in the cycle you should test, take a step back from the ss and look for the 'wide open spaces' that do not contain data.
Then try and place your next test in a +hour that has not seen a test in a while. In this way you are sprinkling tests throughout.

If you can manage to do this consistently, I'll bet in a week a clearer picture of what is going on with Dimitris BGs will emerge.


The TR protocol offers the best chance for remission, if it is in the cards.
Being a newly diagnosed (<1yr) diabetic is an advantage.
Make the most of it.

Hang in there - and hang in here. We have all been where you are.

 

[ChEMom]

Thanks so much Sandy! I'll work on the in betweens today.