8/5 Luna - AMPS 332, +6 68, +8 87, PMPS 203, +3 215

For_Luna

For_Luna

Member Since 2019
Yesterday
Luna's blue streak ended yesterday, so just waiting for her to come back down.

We're going away for a few days starting on Wednesday, so going to put Luna on .75u while we're gone. Really we would feel safe with 1u, but we want to make sure there's some wiggle room in case the sitter or the vet has a heavy hand one day.

When we get back, are we seeing good enough numbers to stay at 1.13 or is it time to try 1.25 again? I don't know what to think with all of the bouncing and the different numbers we're seeing in the AM & PM cycles.
 
carfurby said:
Is the sitter going to test? If so, that will help you know what dose to go to when you get back.
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No, Luna barely lets her get close enough to give the injection. That's why we have to decrease to .75 while we're gone.

"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."
"Increase by 0.25 unit after 3 days (6 consecutive cycles) if nadirs are greater than 200, but less than 300."

So this is the part that confuses me. 10 out of the last 14 AM nadirs have been under 200, with about half of those under 100. Do you have to increase after 5 days?
What's the cutoff for increasing? If everything isn't green?

If dose changes are based on nadirs, what do you do with a cat like Luna who has low afternoons but bounces at night?
 
Hi Dan. I'm sure someone with a lot of dosing experience will respond but if you look at
Post #17 by Libby and Lucy from Yellow Sticky "TR Protocols Myths Debunked" it may help you decide or at least give you info until someone gives an opinion :).

The thread is very helpful!
 
With a bouncy kitty you ignore the high numbers and focus on the nadir.

when your cat starts to see nadirs under 100, hold the dose for at least 10 cycles before increasing.

Since Luna is getting nadirs under 100, you would hold the dose for 10 cycles. Luna is due for a dose increase. When you get back from your trip you may want to increase to 1.25 units as long as you can monitor.
 
carfurby said:
With a bouncy kitty you ignore the high numbers and focus on the nadir.

when your cat starts to see nadirs under 100, hold the dose for at least 10 cycles before increasing.

Since Luna is getting nadirs under 100, you would hold the dose for 10 cycles. Luna is due for a dose increase. When you get back from your trip you may want to increase to 1.25 units as long as you can monitor.
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Yeah, that's the part that doesn't make sense. It never says when to stop increasing. When everything is green? That's not possible if you follow the other part of the protocol and decrease under 50.

So the myths sticky says, "Let's say your cat hits a nadir of 80 then he bounces. 80 isn't bad, let's see if he can do it again. Hold the dose until that bounce clears, usually 2-3 days. If the bounce clears and he hits a nadir of 80 again, great! That's a good nadir for now, let's see if he can do it again. I would hold the dose again and see what happens. If that bounce clears and his nadir is, for example, 110, then 110 is ok but could be better. There's really no reason to wait around (we are looking for Tight Regulation, after all). If this dose isn't getting him back to good nadirs after a total of 8-10 cycles, it's time for the next dose."

If you look at the nadirs for the last two weeks for Luna:
7/23 - 57
7/24 - 62
7/25 - High
7/26 - 63
7/27 - High
7/28 - High
7/29 - 58
7/30 - High
7/31 - 68
8/1 - High
8/2 - High
8/3 - 127 AM, 93 PM
8/4 - High
8/5 - High (so far)

So assuming these are in fact bounces, are we not doing what she said in the sticky? We're waiting 2-3 days and she's coming back down to green.

Edit: And I'm not opposed to increasing, I asked after all. Justing trying to make sense of all of this.
 
I didn't see that 93 when I looked at your SS. It was hidden off to the side. You should probably hold the dose when you get back. It is confusing. The idea is to keep increasing until you get into normal numbers and the cat starts earning reductions. Of course a bouncy kitty makes things more difficult. I think things may need to be customized a little for Luna with her bounciness.
 
Hope this answers your question. From the sticky:
  • 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.
That's when you stop increasing and attempt reductions. :)

Bouncing makes it really hard. Believe me, I know :woot::woot::woot::woot:
 
In my part of the world, it isn’t 8/15 yet. (See your title) ;)

With TR, you go back to the last good dose when you get back from being away and a pet sitter dose. Being on a lower dose for a few days may cause some glucose toxicity to set in.

I was always good with a dose giving me nadirs of 50-70’s, not so much the 80’s. It’s ECID, but unless Neko’s nadirs were 70’s or lower, her bounces we’re taking her above renal threshold. Since she had CKD, I wanted to limit the amount of time damaging her kidneys.

Are you feeding her to slow down those fast drops? In my experience, bounces from fast drops were worse that those from lower numbers.
 
I feed at AMPS, +4, and +8. If I catch the drop early, I'll split up some of those meals so she eats more often.

We were experimenting with higher carb food to slow down the drop, but I fed low carb today because she was so high this morning. That's my fault for thinking I could outsmart this cat.
 
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For_Luna said:
I feed at AMPS, +4, and +8
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Might be worth experimenting with an earlier feed, maybe +2, so she has fresh carbs on board before onset. I would also reconsider the +8 meal, or at least make it zero carb if possible. Feeding after nadir, when the insulin effect is starting to slow down, can shorten duration and give you higher preshots.
For_Luna said:
That's my fault for thinking I could outsmart this cat.
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Luna wins, again!
 
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