5/8 Nellie AMPS 114 +3 107 +6 79 - Q about TR/dose

[Skyynett]

5/6 - https://felinediabetes.com/FDMB/threads/5-6-nellie-amps-86-1-100-2-88-3-91-4-76.262961/#post-2946645

Hi all! have a question about TR. On the sticky it mentions:

• 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.

On http://www.tillydiabetes.net/en_6_protocol2.htm it says "Try to keep the cat at a dose where the BGs are in the 50 to 200 mg/dl range for as much of the day as possible."

I guess I'm wondering per the sticky rules, are you trying to increase until you earn a reduction? Or are you trying to do as Tilly's protocol says and keep them in the normal range as much as possible?

Just trying to decide what the next best move is for Nellie. At 3 units, her appetite is for sure returning back to pre-diabetes days (which at times can be unnerving), she isn't showing any excessive thirst or peeing anymore, and she is holding her ideal weight. Her pre-shot numbers are still mostly blues however her nadir's are typically in the high 70's and 80's. Just wondering if she needs an increase to get her to be mostly under 100 or keep plugging along at this dose and see if she starts seeing even more greens. To be honest I would prefer the latter given that she is now at her normal/pre diabetic appetite which is more grazing/not as predictable and I worry with an increase I'd need her to keep reliably eating from getting too low, but ultimately just want to do what is best for her. Thank you for any and all advice!

 

[Wendy&Neko]

Maybe this post will help: Reminder: *earning* reductions and starting OTJ trials

The goal really is to try to keep them safely in healing green as much as possible, not to force a reduction. Forced reduction fail more often and provide less healing time for the pancreas. But you don't want to be giving them higher carb foods all the time to keep them safe. Having said that, and if you are able to monitor, I'd be tempted to increase to see if you can get rid of those numbers above 200. You've seen mid/upper nadirs in the 70's, which does leave you a little bit of room for an increase. And this is cycle 13 on this dose. However, you do have to be comfortable with the amount of food you can get in her when she needs it and your ability to monitor.

 

[Skyynett]

Thanks @Wendy&Neko that is helpful. I’m going to see where is at for tonight’s pm shot but she seems hungry this evening so going to attempt to go up to 3.25 since I can monitor her closely tonight and this week in general.

edit: she just threw up a tiny bit of brown liquid so I’m going to keep at 3 and see how she does and possibly increase tomorrow am.