? 4/25 Pia. Undeserved reduction?

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GinnyBarr

GinnyBarr

Member Since 2017
Idk if this is how it goes, but her numbers seem to be hanging in blue since her reduction. Should I keep it? Increase it? Help.
 
Hmmm.... Looking at Pia's spreadsheet, I see what you are saying about the 0.25 taking her down less than the 0.5, but she has hit green in 3 of the 4 cycles since the reduction, so I don't know that I'd call it a failed reduction just yet. She's a bit higher so far today, but you're only partway through the AM cycle.

If it were me I'd hold this dose a bit longer, just to make sure you've seen all that it is going to do.
 
I would not call it an "undeserved" reduction. A BG in the 30s ALWAYS calls for an immediate dose reduction. Her numbers at this dose so far aren't bad. I would definitely give it at least through tonight's cycle, and possibly a couple more days. From the TR sticky:
  • when your cat starts to see nadirs under 100, hold the dose for at least 10 cycles before increasing.
Click to expand...

I think that applies here. I'd hold it eight cycles, unless she starts to really trend up.
 
Nan & Amber said:
Hmmm.... Looking at Pia's spreadsheet, I see what you are saying about the 0.25 taking her down less than the 0.5, but she has hit green in 3 of the 4 cycles since the reduction, so I don't know that I'd call it a failed reduction just yet. She's a bit higher so far today, but you're only partway through the AM cycle.

If it were me I'd hold this dose a bit longer, just to make sure you've seen all that it is going to do.
Click to expand...
Ok. I will hold it. Ty.
 
Tricia Cinco(GA) & Harvey said:
I would not call it an "undeserved" reduction. A BG in the 30s ALWAYS calls for an immediate dose reduction. Her numbers at this dose so far aren't bad. I would definitely give it at least through tonight's cycle, and possibly a couple more days. From the TR sticky:


I think that applies here. I'd hold it eight cycles, unless she starts to really trend up.
Click to expand...
Cool. Hopefully she she's some green soon. 8 cycles, that's 4 days, right?
 
Try not to look at 1 cycle but rather a good 3-5 days. I'd also not be in a hurry to go back to the dose where she dropped to 30. She might have a wee off cycle here and there but otherwise she's looking great.
 
She's looking good Ginny. Is she pooping okay? Constipated or dry poops can elevate the numbers a bit. But I agree that she is seeing greens on this dose so I would hold it for now according to the TR protocol.
 
Bobbie And Bubba said:
She's looking good Ginny. Is she pooping okay? Constipated or dry poops can elevate the numbers a bit. But I agree that she is seeing greens on this dose so I would hold it for now according to the TR protocol.
Click to expand...
Poops seem pretty normal. A little wetter today, but still solid. Definitely not dry.
 
Tricia Cinco(GA) & Harvey said:
From the TR sticky:
Click to expand...
Tricia Cinco(GA) & Harvey said:
  • "when your cat starts to see nadirs under 100, hold the dose for at least 10 cycles before increasing."
I think that applies here. I'd hold it eight cycles, unless she starts to really trend up.
Click to expand...

I'm sorry, I have to disagree with @Tricia Cinco(GA) & Harvey 's analysis. That particular suggestion from the TR sticky specifically applies to dose increases... not dose reductions. Pia got to where she's at today as a result of a dose reduction.

We want to look at the TR section pertaining to reductions.
Specifically, in this case, these guidelines:
  • 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.
  • If an attempted reduction fails, go right back up to the last good dose as soon as you see kitty's numbers trending upwards. You don't have to hold the reduced dose for a certain number of cycles before taking the dose right back up. The guidelines listed under the topic "Increasing the dose" do not apply to a failed reduction. Please use common sense in this situation. The "last good dose" is not the dose that just dropped kitty into the 20s or 30s. You want to resume momentum by finding a dose in-between the dose that dropped kitty too low and the reduced dose.
You took the 0.25u reduction as suggested. Now the question is whether we're seeing a failed reduction or not. This is the 5th cycle after the reduction. The 5th cycle is *often* when you'll see the depot from the higher dose deplete.

If I were in your shoes, I would see how the rest of the cycle goes. If Pia shows a substantial rise by PMPS time, I'd take the dose up to something a little less than 0.5u, but a little more than 0.25u since 0.5u caused her to bottom out just a few days ago. We have to remember, "The "last good dose" is not the dose that just dropped kitty into the 20s or 30s. You want to resume momentum by finding a dose in-between the dose that dropped kitty too low and the reduced dose."

If Pia stays pretty flat til shot time, you might want to stick with the 0.25u dose and then re-evaluate in the morning. From what I can see on her spreadsheet at the moment, her numbers are beginning to trend upwards. Watch carefully. You don't want to lose momentum if you don't have to...
 
Jill & Alex (GA) said:
I'm sorry, I have to disagree with @Tricia Cinco(GA) & Harvey 's analysis. That particular suggestion from the TR sticky specifically applies to dose increases... not dose reductions. Pia got to where she's at today as a result of a dose reduction.

We want to look at the TR section pertaining to reductions.
Specifically, in this case, these guidelines:
  • 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.
  • If an attempted reduction fails, go right back up to the last good dose as soon as you see kitty's numbers trending upwards. You don't have to hold the reduced dose for a certain number of cycles before taking the dose right back up. The guidelines listed under the topic "Increasing the dose" do not apply to a failed reduction. Please use common sense in this situation. The "last good dose" is not the dose that just dropped kitty into the 20s or 30s. You want to resume momentum by finding a dose in-between the dose that dropped kitty too low and the reduced dose.
You took the 0.25u reduction as suggested. Now the question is whether we're seeing a failed reduction or not. This is the 5th cycle after the reduction. The 5th cycle is *often* when you'll see the depot from the higher dose deplete.

If I were in your shoes, I would see how the rest of the cycle goes. If Pia shows a substantial rise by PMPS time, I'd take the dose up to something a little less than 0.5u, but a little more than 0.25u since 0.5u caused her to bottom out just a few days ago. We have to remember, "The "last good dose" is not the dose that just dropped kitty into the 20s or 30s. You want to resume momentum by finding a dose in-between the dose that dropped kitty too low and the reduced dose."

If Pia stays pretty flat til shot time, you might want to stick with the 0.25u dose and then re-evaluate in the morning. From what I can see on her spreadsheet at the moment, her numbers are beginning to trend upwards. Watch carefully. You don't want to lose momentum if you don't have to...
Click to expand...
So she was a nice 125 @ pmps. So I'm gonna stick with the .25. This is the lowest she's been on this dose, so I'm hoping she keeps decreasing. Ty for the extra information. There's never too much to learn and know. Especially all.the differences between TR and SLGS.
 
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