4/24 Dimi - AMPS 315, +1 393, +3 330, +6 308, +8 235, +9 141, +11 163

Bobbi Kraham

Bobbi Kraham

Member Since 2022
A bit of progress with a couple blues today, but Dimi's blood sugar also got really high at around +.5 he was at 450. I didn't scan him at that time, but I see it on his libre graph. He tends towards really steep climbs and drops, which makes me think I'll never get him regulated. Also, his nadir seems to be pre-shot. I know most cats on Lantus have nadirs around +6, so not sure why his is so late. Any thoughts on that? Thanks.

Previous thread: https://www.felinediabetes.com/FDMB/threads/4-23-dimi-amps-318-1-331-3-330-6-302-7-262-9-236.262395/
 
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Neko's Lantus nadir was anywhere from +3.5 to +13, but most commonly +7 to +9. Other cats I've seen have nadirs around +2. The +6 as nadir is what is "typical", but a lot of cats like to be different. :rolleyes: Not sure the majority are at +6. Cycles where kitty breaks a bounce tends to have later nadirs, and that seems to be what is happening when you saw those later nadirs.

It can take a few cycles after the increase to start seeing what the new dose can do. Hopefully you'll get some idea of that tonight.

Is Dimi over his lethargy now?
 
Wendy&Neko said:
Neko's Lantus nadir was anywhere from +3.5 to +13, but most commonly +7 to +9. Other cats I've seen have nadirs around +2. The +6 as nadir is what is "typical", but a lot of cats like to be different. :rolleyes: Not sure the majority are at +6. Cycles where kitty breaks a bounce tends to have later nadirs, and that seems to be what is happening when you saw those later nadirs.

It can take a few cycles after the increase to start seeing what the new dose can do. Hopefully you'll get some idea of that tonight.

Is Dimi over his lethargy now?
Click to expand...
Thanks, good to know that he's not the only one with unpredictable nadirs. Yes, lethargy is gone, he's back to himself - whew. Negative for ketones. I'm going to give tight regulation a shot. Is my understanding correct that I should hold this dose for 3-5 days? Thanks!
 
Bobbi Kraham said:
. Is my understanding correct that I should hold this dose for 3-5 days? Thanks!
Click to expand...
Yes but you can always ask for help if needed

Can you please add TR to your signature and SS up top so members won't keep asking you :cat: Dimi is such a gorgeous kitty

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.
  • Increase by 0.25 unit after 3 days (6 consecutive cycles) if nadirs are greater than 200, but less than 300.
  • Increase by 0.5 unit after 3 days (6 consecutive cycles) if nadirs are greater than 300.
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, & Biosimilars ISG safe by taking reductions when appropriate.
  • 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.
 
Diane Tyler's Mom said:
Yes but you can always ask for help if needed

Can you please add TR to your signature and SS up top so members won't keep asking you :cat: Dimi is such a gorgeous kitty

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.
  • Increase by 0.25 unit after 3 days (6 consecutive cycles) if nadirs are greater than 200, but less than 300.
  • Increase by 0.5 unit after 3 days (6 consecutive cycles) if nadirs are greater than 300.
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, & Biosimilars ISG safe by taking reductions when appropriate.
  • 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...
SS and Signature updated. Thank you! Fingers crossed!
 
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