? 5/8 Bijan AMPS 56 +3 38 +4 43 +5 47

bijer

bijer

Member Since 2022
Hello everyone! it has been a great past few weeks for bijan we have finally seen him stabilizing in greens and blues and am actually working on decreasing his doses now. We went away on vacation for 10 days and had bijan on 2.5 units while we were away and came back to a very happy and seemingly healthier stable non bouncy kitty.

My question is how long should I hold the reduction? He keeps dropping into the 40s and 30s so we have continued to decrease. And also when the preshot numbers are on the low end i figured a reduction was safer.

I am waiting for him to have nadirs around 50 to hold steady and I have been encouraging eating and snacks when I've noticed he's low. Other than the number being low on those occasions he seems happy and more playful than I've seen him in the past 6 months.


Link to older post
 
Since you are following SLGS, you reduce immediately if they go under 90, so reduce tonight. Also, you should not be shooting if preshots are under 90.

Also with SLGS, if nadirs are between 90 and 149, you stay with that dose. Until either another reduction is earned, or nadirs go above 150.

Do you have another test yet? With under 40, you need to test every 20-30 minutes.
 
@bijer
Hi your signature says SLGS, but your spreadsheet says TR up top, which one are you following? Can you correct which one you are following
If you are following TR like your spreadsheet says
This is what the sticky says about TR
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.
Your kitty is considered newly diagnosed because he was diagnosed on October 21, 2022, less than a year
Kitty's are considered long term is it's a year since being diagnosed
 
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Hi Wendy,

I tested him 2 more times and he went to 43, now 47. We have been reducing as I indicated on the chart.

Was following TR for reduction not SLGS as he was started very high by his vet he is averaging under 100 before his shots
 
bijer said:
Hi Diane thanks I didn't notice that until now. We are now follow TR since he is more stable. the bouncing before was too chaotic!
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No problem ,thanks for fixing your signature :cat:
Can you update your title with the rest of the BG numbers
Congrats on the reduction for tonight
 
You still reduce with a drop under 50 and following TR. The depot was in effect so waiting until +3 was too late for a second test. The depot will be in effect for as many as 4 or more cycles so if you can’t grab a test by +2 feed slightly higher carbs and even mc. Back to back reductions usually don’t work but with TR if it fails you won’t need to wait a week to up the dose.
 
tiffmaxee said:
You still reduce with a drop under 50 and following TR. The depot was in effect so waiting until +3 was too late for a second test. The depot will be in effect for as many as 4 or more cycles so if you can’t grab a test by +2 feed slightly higher carbs and even mc. Back to back reductions usually don’t work but with TR if it fails you won’t need to wait a week to up the dose.
Click to expand...

What is mc? Monitor closely? I have been with him for 24 hours and he is normal.

By depot do you mean the 2 units he was getting the past few cycles? How is this different from hour 2 to 3?
 
Just want to be sure you have your hypo kit in case Best ever drops too low and you need to bring his BG up to safe numbers
Such as

Fancy Feast Gravy Lovers Gourmet Beef Feast in Gravy 20% High Carbs

Fancy Feast Gravy Lovers Gourmet Chicken Feast in Gravy 15% Med Carbs

Fancy Feast Gravy Lovers Turkey Feast in Gravy 15% Med Carbs

Fancy Feast Gravy Lovers Chicken and Beef in Gravy 15% Med Carbs

Good idea to mark the cans with magic marker how many carbs

Or any on the food chart. Doesn't have to be Fancy Feast just an example about the med and high carb foods
And some honey in the house

https://felinediabetes.com/FDMB/threads/dr-pierson-new-food-
11% -15 is medium carbs.

16- 24 is high carb.
 
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With TR you still decrease, and always if under 40. He's been 5 hours below 50, he needs to come up now! He needs something higher carb than what you've been giving him. It's too dangerous to keep him so low for so long.

As for how long you hold the new dose - hold until any bounce is over and see where the nadirs land. Unless of course, he goes lower again. Or you see him trending higher. You can post here and help you with that decision.

Diane Tyler's Mom said:
Between 11% and 17% is medium carbs.

18% and over is high carb.
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Correction, from The Official Lantus, Levemir & Biosimilars Slang Dictionary MC = 11=15% and HC is usually 16-24%
 
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