4/4 Bud AMPS 455, +3 341, +5 299 increase?

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Blamethecats and Hannah said:
Yep, me too! Bud and Hannah seem to be in cahoots on this! I upped her dose a bit this AM... probably the wrong decision, as it usually is. This is making me nuts. o_O Hang in there, Stacy!
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I'd say they are most definitely in cahoots! What's in it for them? They like making their beans crazy? Lol. Maybe they think we wouldn't give them as much attention if they threw us good numbers all the time.... Thanks for checking in on me over here! I'm going to get advice about a possible increase for tonight.
 
@julie & punkin (ga) This morning was the 7th cycle after that decreased dose I gave. Time to increase to 1 or hang out at 0.75 a while longer? I've been getting a curve today. So far:
AMPS 455
+3 341
+5 299

So not heading down anywhere fast.
 
According to SLGS, you would stay on a dose for one week, which you've now got at the 0.75u (i don't think the one reduced dose 4 days ago is recent enough to be a factor to change anything), then do a curve for 12 or 18 hrs as described below, and based upon the results of that, adjust the dose. He's dropping fairly quickly today (I'm looking at the +3/374 and +5/299, a drop of 75 points in 2 hrs). He might be clearing the bounce right now. I'd see where he is between now and pmps and make the decision based upon the guidelines below.

By the way, if you're using this thread for today, would you go ahead and update the subject line to reflect it? I had to look twice between the subject line (thinking it was today) and the spreadsheet!


After 1 week at a given dose perform a 12 hour curve, testing every 2 hours OR perform an 18 hour curve, testing every 3 hours
Note: Random spot checks are often helpful to "fill in the blanks" on kitty's spreadsheet.

  • If nadirs are more than 150 mg/dl (8.3 mmol/L), increase the dose by 0.25 unit
  • If nadirs are between 90 (5 mmol/L) and 149 mg/dl (8.2 mmol/L), maintain the same dose
  • If nadirs are below 90 mg/dl (5mmol/L), decrease the dose by 0.25 unit
  • As your cat's blood glucose begins to fall mostly in the desired range [lowest point of the curve approaching 100 mg/dl (5.5 mmol/L) and pre-shot value around or below 300 mg/dl (16.6 mmol/L)], do lengthen the waiting time between dose increases. If you decide to change another factor (e.g., diet or other medications), don't increase the insulin dose until the other change is complete (but do decrease the dose if your cat's glucose numbers consistently fall below 90 mg/dl (5.0 mmol/L) as a result of the change). Don't be tempted to rush the process along by increasing the dose more quickly or in larger increments-- no matter how high your cat's blood glucose is! Rushing towards regulation will cost you time in the long run, because you may shoot past the right dose.
Lather, Rinse, and Repeat!​
 
julie & punkin (ga) said:
According to SLGS, you would stay on a dose for one week, which you've now got at the 0.75u (i don't think the one reduced dose 4 days ago is recent enough to be a factor to change anything), then do a curve for 12 or 18 hrs as described below, and based upon the results of that, adjust the dose. He's dropping fairly quickly today (I'm looking at the +3/374 and +5/299, a drop of 75 points in 2 hrs). He might be clearing the bounce right now. I'd see where he is between now and pmps and make the decision based upon the guidelines below.

By the way, if you're using this thread for today, would you go ahead and update the subject line to reflect it? I had to look twice between the subject line (thinking it was today) and the spreadsheet!
Click to expand...

Sorry I didn't start a new post, was being lazy... lol. I've updated my title. I've been thinking of switching to tight regulation. I know I can't test during the day but if you're only changing doses if he goes below 50, that just might mean staying at a dose a little longer if I'm not catching The nadirs, correct?
 
TR needs 3 tests per day - at least one mid-cycle test. People who can't get it done during the day usually get a before bed test at night, say maybe a +4 or so, to help point out the nadirs.

I think the biggest thing is to have enough nadirs that you feel pretty confident about how low the dose is taking a cat. So you might want to do a more relaxed version of TR, like you're describing, where you stay a little longer on the dose. TR pushes a cat into normal numbers fairly rapidly, based upon the protocol's study that showed that cats who get their blood sugar back into normal numbers as soon as possible after diagnosis, have a good chance of having their pancreas heal and be able to produce insulin again. If that all works, the cat becomes diet-controlled. So it's got a lot of positives behind it. Doses are increased every 3-5 days until the cat gets into normal numbers. But the testing is the safety net - you don't want to push a cat into normal numbers (50-120) if just below that is the potential for a hypo and the cat is unattended, unless you've set things up to protect the cat.

There are lots of people who work all day and still do TR, making modifications based upon life and the cat's responses. A timed feeder is one helper that can make a huge difference. When a cat goes into low numbers you give them carbs to bring them up. The timed feeder can be a substitute for you if you can make sure that your cat can get to it and will eat. I know you've got a bunch of other kitties, so you might have to isolate Bud in a bedroom with a litter box and timed feeder during the workdays if you want to be more aggressive with dosing. One member bought 2 timed feeders - which i thought was rather brilliant - and if needed, she had them set to go off every 1/2 hr for 4 hours between the 2 of them. She had the Petsafe 5 Compartment Feeder, which is what we also used, and which has 4 covered compartments. People can put a variety of things in there, from regular canned cat food to high carb, or you can freeze cat food mixed with water into "catsickles" and put them out - either in a feeder or if the cat will graze and leave them alone til they thaw, just in a dish.

Take a look at the top sticking on working full-time while following TR and see if there are some ideas there that help.
 
I realized after I hit post that my post did sound like I wasn't ever going to be testing nadirs... My normal testing routine now is AMPS, PMPS, and a before bed which is anywhere between +3 and +4 during the week and then I try and snag as many tests as I can on the weekends. So yeah, I think I can make tight regulation work. So yes on the increase to 1.0 unit tonight?

I think I will spend some time reviewing the timed feeders tonight. As it is now, I leave food out that they graze on most of the day. Turkey and Giblets seems to last a while as it is not their favorite. :) but ideally I'd like to find what is best for Bud as far as feeding during the cycle goes.
 
There's a link on the Where Can I Find? post at the bottom under feeders where some people have talked about pros/cons of feeders.

I think i'd go to 1.0u tonight unless he gets into green numbers between now and pmps. Kinda doubt that will happen, but just in case.
 
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