8/3 Charms AMPS 276,+2 289,+4 146,+5 93,+6 80,+7 79 PMPS 118

[Sam and Charms]

Yesterdays' Condo

I knew I was going to be out for a few hours this afternoon so I did not want to chance a dose increase knowing Charms is capable of a big drop, and then the lower numbers and the lower PMPS made me hesitate again. Please take a look at these new numbers and let me know what you think.

Two questions - I read in a post that a cat can get a dose decrease if they stay in the greens for a week or they go below 50. To achieve remission which method is better? If Charms is getting a lot of greens why do you increase the dose? Just curious, helps to know how things work.

Also if a dose increase is suggested, how do I get a .25 increase using needles with only half marks. I can barely see the half mark as it is, how the heck would I measure .25! I have been dealing with only .5 increases so far. - Sam

 

[mtncat58]

Re: 8/3 Charms AMPS 276,+2 289,+4 146,+5 93,+6 80,+7 79 PMPS

:lol: .25 are so much fun, you go to the half mark and counter clockwise take off 4 drops. At least that is what I do and was told don't quote me. But yes I think it was 5 days or get a 40 and get a decrease, not sure why you would go up? But hey that PM is a great number. your doing good :smile:

 

[Deb & Wink]

Re: 8/3 Charms AMPS 276,+2 289,+4 146,+5 93,+6 80,+7 79 PMPS

Two questions - I read in a post that a cat can get a dose decrease if they stay in the greens for a week or they go below 50. To achieve remission which method is better?

Which method is better? Whichever works for your cat. Sometimes it will be one method. Other times it will be the second method. Lucky (mtncat58) earned reductions with both methods at different times in this sugardance.

Yes, a cat can earn a dose reduction 2 ways.
1. If a newly diagnosed cat drops below 50 for a newly diagnosed cat like Charms, it's an automatic reduction, 0.25U less. You do not want to do reductions too close together, because the depot has not had time to adjust and drain so you do not know if the reduction will hold.

2. If they are in all normal numbers 50-130 for 7 days or 14 cycles. Less common way to earn a reduction.

Here is the section of protocol that discusses these two ways.

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. 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.
•If an attempted reduction fails, go right back up to the last good dose.
•Try to go from 0.25u to 0.1u before stopping insulin completely.

If Charms is getting a lot of greens why do you increase the dose? Just curious, helps to know how things work.

If the dose he is on is not keeping him under the renal threshold, roughly BG of 220, then a little more juice may be warranted. Sam is also getting high green numbers and has some room to move downward a bit on the BG's.

Also if a dose increase is suggested, how do I get a .25 increase using needles with only half marks. I can barely see the half mark as it is, how the heck would I measure .25! I have been dealing with only .5 increases so far. - Sam

You do your best to get consistency in where you place the plunger with those 0.25U increments. Here is a picture of a 0.25U dose in a syringe with 1/2 unit markings.

 

[Wendy&Neko]

Re: 8/3 Charms AMPS 276,+2 289,+4 146,+5 93,+6 80,+7 79 PMPS

Although it's great to see these greens on Charms, as Deb says, there is a bit of room for improvement. A little more juice could help flatten out the cycle and lower those yellows. If Charms was getting into 50's or 60's, I'd hold the dose but he's in upper greens now. I've also seen a saying here, sometimes you have to go up to go down, meaning that you do want to start getting reductions. Sometimes that first reduction seems to trigger more of them.

You might want to look at getting a cheap magnifying glass if you don't have one already. I found that useful for the .25 and .75 unit doses. I also use a pair of digital calipers to help keep doses consistent. Not something I used when we were up around 8+ units, but it also helps find those .25 unit spots.

 

[Sienne and Gabby (GA)]

Re: 8/3 Charms AMPS 276,+2 289,+4 146,+5 93,+6 80,+7 79 PMPS

Just to clarify, it's not that the nadir is green. The dose is reduced if the numbers are largely below 100 for a week. This aspect of dose reduction is based on the TR protocol used on the German counterpart of this board.

Phase 4: Reducing the dose

When the cat regularly has its lowest BGs in the normal range of a healthy cat and stays under 100 mg/dl overall for at least one week, attempt to reduce the dose. Alternatively, if the nadir glucose concentration is 40 - <50 mg/dl at least three times on separate days, try lowering the dose. If the cat drops below 40 mg/dl once, reduce the dose immediately! The reduction is done very slowly in a step-by-step manner (0.25 or 0.5 IU increments). At each newly reduced dose, try to make sure the cat is still stable in the normal range before reducing the dose further.

There are times when a kitty is in higher green numbers. Often the pre-shot numbers may be blue. In a situation like this, it may be useful to fatten a dose as a means of lowering the overall level.

Just wait. You'll probably get to shoot doses like a fat 0.75u. Many people use a magnifying lens or whatever works to allow you to see the syringe up close and personal.

 

[Sam and Charms]

Re: 8/3 Charms AMPS 276,+2 289,+4 146,+5 93,+6 80,+7 79 PMPS

Thank you everyone, those were all really , really helpful answers. I really appreciate all the time you have put into helping Charms and me. I am trying to wrap my head around all this information, and you all are great about explaining things. Helps so much when you understand why you are doing something, makes the effort to get that extra .25 in that tiny little needle worth it! - Sam