? 4/5 Ember AMPS 301 Reduction questions

[Elaine and Ember]

Good morning! Ember was down in the green for the second night in a row last night! I’m brand new at this reduction thing, so I have a couple questions. I reduced again but was I supposed to if it’s back-to-back greens? She still has her prior higher dose in her depot, so she was probably still dropping from that, not yesterday’s reduction. I assume there’s no dose-holding during reductions because safety first, but I just wanted to double check. Also, I started increasing in .5u increments on the way up at 5u, so now that we’re back under 5u, should I go back to adjusting in .25 increments? I decided on .5 since I’m at work today and can’t monitor, but can adjust tonight to 4.75u if I should have taken a smaller reduction. Thank you! And safe surfing, everyone.
? - 4/4 Ember AMPS 342, +3 314, +4 274 Reduction amount?

 

[Mary & Jude]

Hi Elaine! The guidance in taking back-to-back reductions with SLGS appears sometimes to be (as the discussion I'm about to post states) more "art that science." Here is the discussion: Oregano 3/30. Pmps 183, +1 184, +2 139, +82.

She's still seeing higher numbers that you want to get down, but she did drop to 62 last night, which is not super low, but lower. Of course the 5.5 depot was still in play last night, so that could be driving the lower numbers.

BTW, I went back through your posts to look for food information and an answer to why you're following SLGS instead of TR. Is it a food issue--is she stuck on eating dry food??? I ask because if you can lower her reduction point (by switching to TR or by lowering the SLGS reduction point--which some folks do), you might be able to hold her at a dose long enough (and not take an earned reduction) and get those higher numbers down (notice she has been coming down--along with doing some bouncing).

Also, did you ever consider getting her tested for Acro/IAA?

Let's tag some folks with more experience in dosing @Bandit's Mom @tiffmaxee to see what they say.

 

[Elaine and Ember]

Hi Elaine! The guidance in taking back-to-back reductions with SLGS appears sometimes to be (as the discussion I'm about to post states) more "art that science." Here is the discussion: Oregano 3/30. Pmps 183, +1 184, +2 139, +82.

She's still seeing higher numbers that you want to get down, but she did drop to 62 last night, which is not super low, but lower. Of course the 5.5 depot was still in play last night, so that could be driving the lower numbers.

BTW, I went back through your posts to look for food information and an answer to why you're following SLGS instead of TR. Is it a food issue--is she stuck on eating dry food??? I ask because if you can lower her reduction point (by switching to TR or by lowering the SLGS reduction point--which some folks do), you might be able to hold her at a dose long enough (and not take an earned reduction) and get those higher numbers down (notice she has been coming down--along with doing some bouncing).

Also, did you ever consider getting her tested for Acro/IAA?

Let's tag some folks with more experience in dosing @Bandit's Mom @tiffmaxee to see what they say.

That post is very informative. Thanks for sharing! My gut is telling me to stick to 5u for a while and give her a chance to respond to that and not lose all the progress we’ve made recently, but I’ll see what the experts say.
As for not switching to TR, it’s more my job than the food. I usually get home about +10.5, which means I can’t monitor her AM cycle 4-5 days a week so I’m worried I can’t safely do TR. I’ve been thinking about getting a libre (I had a chat with my vet about it yesterday, in fact) but the logistics seem pretty overwhelming. I had been planning to test for IAA/acro but then this recent string of good numbers happened, so I didn’t schedule it.

 

[Mary & Jude]

Elaine,

I agree with your inclination to take her back to 5u; we'll see what others say.

Is there any way you could grab a second test in the a.m. cycle (on those days you must work) at +2? That's what I do with Jude; that test sort of lets me know what direction he is moving in and how fast, and I can make a decision to leave MC food out when I go to work if I see that he might be going in a direction that concerns me. Bottom line, safety is key, and I know that's what you're trying to do with Ember, keep her safe.

If you decide to do the Libre, you know that there are several very helpful people on the forum that I know will be happy to guide you.

I seem to remember that Ember is a foster? Is that correct?

 

[Wendy&Neko]

With a higher dose kitty, knowing if they have IAA or acromegaly as part of the picture can help us when determining what to dose and whether reductions should be made. I tend to be more cautious and take reductions with kitties with IAA and/or acro, because there can be changes related to those secondary endocrine conditions that can contribute to the need for more or less insulin, such as antibodies dying or acro tumour pulsing/ebbing. Just because a cat reduces down from 6 units, doesn't mean any IAA or acro has gone away. We've seen kitties on lower doses with those conditions.

Some differences between Oregano and Ember examples. Oregano was on less than half the size of dose (and depot) of Ember, the dip to green happened on the first cycle of the reduction and was a "blink and you'll miss it" type of green instead of several hours worth. Also, Ember got down to at least 62, possibly lower if you'd tested earlier in the cycle.

Speaking of those fast drops, any chance you could get some +2 tests at night? Ember seems to be dropping really fast at night when she goes green. The that drop seems to be causing a bounce during the day (good for you when you work). However, bounce break cycles have extra downward momentum and sometimes those types of cycles earn reductions they might not otherwise. If you see a fast drop at +2, you might be able to slow down the drop with some extra food or slightly higher carbs.

 

[Elaine and Ember]

With a higher dose kitty, knowing if they have IAA or acromegaly as part of the picture can help us when determining what to dose and whether reductions should be made. I tend to be more cautious and take reductions with kitties with IAA and/or acro, because there can be changes related to those secondary endocrine conditions that can contribute to the need for more or less insulin, such as antibodies dying or acro tumour pulsing/ebbing. Just because a cat reduces down from 6 units, doesn't mean any IAA or acro has gone away. We've seen kitties on lower doses with those conditions.

Some differences between Oregano and Ember examples. Oregano was on less than half the size of dose (and depot) of Ember, the dip to green happened on the first cycle of the reduction and was a "blink and you'll miss it" type of green instead of several hours worth. Also, Ember got down to at least 62, possibly lower if you'd tested earlier in the cycle.

Speaking of those fast drops, any chance you could get some +2 tests at night? Ember seems to be dropping really fast at night when she goes green. The that drop seems to be causing a bounce during the day (good for you when you work). However, bounce break cycles have extra downward momentum and sometimes those types of cycles earn reductions they might not otherwise. If you see a fast drop at +2, you might be able to slow down the drop with some extra food or slightly higher carbs.

Lots of really good info. Thanks so much. I’ll call the vet this week about scheduling the blood tests. I thought we dodged a bullet since we didn’t stay at 6u. Bummer! So do you think I should keep my 4.5u reduction since her status is uncertain?
Yes, I can get tests at PM +2 some nights, so I’ll definitely start getting those on the nights I’m home. Thanks!