5/8 Dumdum AMPS~439 +6~383 PMPS~427

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akilo

Member Since 2013
AMPS 439
+3 363
+4 388
+6 383
PMPS 427
+2 343
+4 199

yesterday
AMPS 421
+2 465
+4 422
+6 442
PMPS 402
+2 308
+4 77
+5 43
+6 60
+7 72

These two days were busy and tired days. Thanks that I can do my work at home, so that I can care Dumdum at the same time. :lol:
Few days ago, Dumdum's BG went to 44 , and our vet told us he ate too less and suggested that we add more food for him. we reduce dose and add about 30% food for him at the same time. He was really happy about that, but also his BG higher and higher than before. We decides that first we have to do is making his BG stable. Look back his curve, his nadir showed good at AMPS before, but too low at PMPS curve. Since we can't change dose as his BG number, we do some change at his food. His AMPS food is the same as before, and add extra 30% food at PMPS.
I am not sure will this work, but I hope it will. The vet said too less food makes his body can't recover his small inflammation inside, and that will makes his BG number unstable, so providing more food will be necessary.
His weight is little less than before, and that makes being patient really difficult... :-|
 
Hi guys .. well, no food advice from me .. numbers last night looked nice .. :mrgreen: is always a welcome sight .. I hope you see more of it soon! Have a great night guys!
 
I feel so happy now. I just test +4 and whisper to Dumdum "I am so much want to see blue again, not pink or green." and it's 199. :lol:
 
I'm a little unclear looking at your spreadsheet.

You earned a reduction with that 43 yesterday on 5/7.
But I don't see that you took the reduction.

I would say that Dumdum's bg is going to be unstable. He will get there on his own ( more stable) but it is a process. It takes patience.
You can manipulate it with food, that's what we do here. We steer with feeding different carbs to "steer" them.
But you won't really have control.
Dumdum is in the driver's seat.

More frequent small meals are helpful especially as he needs to add a little weight.

Since you didn't take that reduction yet, you might want to monitor as he could be on his way down....
 
No we didn't took the reduction because when I read the page again and it says if reduction fail, go back up to the last good dose. The other page says if the nadir glucose concentration is 40 - <50 mg/dl at least three times on separate days, try lowering the dose.
So we think so far looks like 4/30~5/1 was the last good dose, and it doesn't shows 40-50 three times on separate days ,that's why we still shot 0.75u and I will monitor at least until +5.
we used to provide him small meals at night. He always has his small meals at +4, +5 and +6 after he finished his meal, but it's really a good idea to provide him more small meals to add weight :-D
The only reason I don't provide him small meal at day time is because he is always at high number in day time. I'm afraid small meal will makes his BG higher.
In fact I'm not sure that when his BG is high, can he absorb nutrients. Can he?
 
Akilo:

You're reading two different modifications of the Tight Regulation Protocol. The one here, is (obviously) the one most of us use. The other page is the version used by the Lantus forum in Germany. Here's the central difference. With both protocols, any drop below 30 gets an immediate dose reduction of 0.25u. With the German/Tilly protocol, three drops between 40 - 50 warrants a dose reduction of 0.25u. You do NOT shave the dose. This approach is aggressive and requires close monitoring. The version we use here will allow you to reduce the dose after one drop between 40 - 50 and will allow you to shave or fatten a dose (i.e., make micro-dose adjustments).

It doesn't matter which version you use. You just want to stick with that version.

It looks to me like you "shot through the bounce" after Dumdum was in the 40s on 5/2. You then reduced the dose and, I agree, I don't think the reduction held. So, you were correct and increased back to 0.75u.

You now have a choice. If you want to hold the dose until Dumdum's numbers drop between 40 - 50 two more times, that's fine.

I'm not sure I completely agree with your vet. If an animal has been ill, protein is important. If Dumdum is underweight, more food is fine. I wouldn't want you to be feeding more than is necessary. No one wants Dumdum to be overweight which can make it harder to manage his diabetes.
 
Thank you Sienne. I didn't realize that they are different Tight Regulation Protocol. I use google translation change the web into Chinese, and that will become an article which is combined by some not so fluent sentence. Only when I'm not sure in some situation, I will go back to read original article again and again and try to conform what it means for sure. So that I should choose one and just do what it says?
The other question is that I've bring my glucose meters to the vet, and compare with the number that vet's test. Our home-testing meter's number will lower than vet's number about 25 when the number is <100. But when number is >100, it will be almost the same as vet's number. Which means when I use our meter to test, the 40 might means 65 actually. Should I consider this tolerance when deciding reducing dose immediately or not?

About food, Dumdum is about 12.1lb before when he was health and in good glu control. In March, he was about 11lb, and 10.56 in April. We usually give him only 220 kcal per day, but after the vet said so, I found standard of AFFCO, and it looks like he should have about 300 kcal per day. He is always in good shape, I think that's why our vet want us to give him more to help him recover his inflammation problem. Now due to his unstable glu, I think I'll discuss this problem with vet again.
I'm still searching the good way to give him more food without making his glu goes up, but in fact there is no so much Chinese articles that talk about how digestion system work at diabetic cats. Yesterday Rhiannon suggested that give him more small meal, and I do give him more small meal when his BG is at normal numbers, but I am not sure should I give him more small meal when his BG is high. So far I haven't find any information in Chinese is talk about this, just some articles are talking about diabetic human should separate their meal into small meals, and doesn't distinguish high or low BG number. I'm not sure is that meaning distinguish high or low BG number isn't important. That's what I am still working on searching and trying to find out. If any of you could give me some information about food control at diabetic cats, I will be very very greatful. confused_cat
 
Hi Akilo. I think this is the modified version of the protocol that most of us here follow http://www.tillydiabetes.net/en_6_protocol2.htm.

It sounds like your vet is pretty smart.

I would try to feed his regular amount of food even if Dumdum's BG is high, as he still needs the food. I would just try to stay with a low carb food especially when he is in the higher range.

As far as comparing the vet's meter to your meter, I thought it was usually the other way around. That the vet's meters are pretty comparible to ours at the lower numbers and often off by a little bit when compared when the cat is in the higher numbers.

I'm not totally sure I understand your reasoning why you did not reduce after that 43 on Tuesday. He went higher the next cycle because he was bouncing from the lower number because he is not used to those lower numbers yet.
Please keep watching him, as Sienne said, since you did not take the reduction.

I hope you have a good evening :)
 
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