7/24 Billie PMPS 307 +2.5 222

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Deanna & Billie

Deanna & Billie

Member Since 2014
Hello everyone!!

Yesterday's condo: viewtopic.php?f=9&t=122233

I am reposting my question from yesterday - I know it was a busy day on here!

I'm wondering if a reduction from f1.00 to f0.75 is the right reduction after Billie hit 46/49 on Monday night.

I'm also generally curious about the trends with earned reductions. It's great to see Billie earning reductions, but with some other cats' spreadsheets that I have looked at, it seems like the numbers trend lower overall when reductions are earned. That was the case with Billie's first two reductions, but since then, it seems like her numbers are trending higher.

She earned 2 more reductions in the past 10 days, but her numbers have been higher overall than they were 3 or 4 weeks ago when she was seeing a lot of green. The past week had a lot of blue with yellow PS numbers, and just a few dips into green including the plunge to the 40s.

Any insight is much appreciated!! I hope everyone is having a lovely day.
 
Re: 7/24 Billie AMPS 281 +3.5 168 +6.5 182 dose question

sorry your question got missed yesterday! Wednesdays seem to be a day when many of us have other commitments at the moment.

the answer is yes, in a newly diagnosed cat, you want to take the 0.25u dose reductions every time the cat goes below 50, unless you have already tried this and learned that the cat doesn't hold dose reductions. Then you go to plan B. But Billie has successfully reduced and held the reduction already a couple of times. So I would still follow that plan for her.

However, the idea is that when you reduce the dose, you still want to be seeing the same good numbers, ie, green numbers. If you reduce and the cat bounces, as soon as the bounce clears if you're not back into green again, you'd call that a failed reduction and go back to the previous dose immediately.

There is some info about failed reductions here, and below:
Reducing the dose:
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. See additional notes in the next paragraph about drops into the 20s and 30s. Alternatively, at each newly reduced dose... try to make sure kitty maintains numbers in the normal range for seven days before reducing the dose further.

Please do not let yourself become complacent or blasé about drops into the 20s or 30s.
If kitty drops into the 20s, a full reduction of 0.25u (or 0.5u if kitty is on a higher dose) is strongly recommended.
If your cat drops into the 30s, a full reduction of 0.25u is recommended. There are very few exceptions given for caregivers who have collected years of data and KNOW their cat's response to the combination of insulin and food backwards, forwards, and inside out.
Caregivers whose kitties have "High Dose" conditions may find the need to reduce in whole units or more.
Please ask for advice.

If anyone suggests otherwise, they are putting your cat at risk! Our kitties are not just numbers. They are living beings who trust us to look out for them. The TR Protocol is an aggressive method in itself. The modified version of the protocol is slightly more aggressive.

If an attempted reduction fails, go right back up to the last good dose as soon as you see kitty's numbers trending upwards. You don't have to hold the reduced dose for a certain number of cycles before taking the dose right back up. The guidelines listed under the topic "Increasing the dose" do not apply to a failed reduction.

Please use common sense in this situation. The "last good dose" is not the dose that just dropped kitty into the 20s or 30s. You want to resume momentum by finding a dose in-between the dose that dropped kitty too low and the reduced dose.
Click to expand...

I think for Billie right now, I'd call it a failed reduction and go back up to 1.0u. I don't think she's in a bounce right now and it looks like her nadirs are in the mid-blues on the 0.75u.
 
Re: 7/24 Billie AMPS 281 +3.5 168 +6.5 182 dose question

Hi Julie! Thanks for all the information!

I agree that the fat 0.75 doesn't seem to be doing the trick. I'll try a regular 1u and see how that goes. I had been wondering about increasing the fat 1u because we only saw green in a few cycles on it, but then she took her trip into the 40s. I'll hold it for a while and see how it goes! Have a great night.
 
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