? Cooper's making progress, but time for dose increase?

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Millie and Cooper

Millie and Cooper

Member Since 2015
Cooper had his best cycle yet yesterday during the day, getting down to 151 at +9 on our AT meter. But overnight, he steadily increased back to high 300's. We held the dose at 4.75 this morning (7th shot at this dose) to see if maybe it was a bounce that would clear. But at his +7 reading today, he's flat in the low 400's. :( We're making progress, but it's not enough.

So don't you think it's time to increase by 0.25 to 5 units at tonight's shot?
 
Here is the link to your previous post - we include those links so people can go back and see what happened previously.

Three cycles in a row with blue in them, that's awesome progress! :cool:

I am not sure if you are following TR, although it looks like it, but if you are I think I'd hold another cycle (for a total of 8) before increasing. He's getting a lot of mid blue nadirs. From the protocol:

Increasing the dose:
  • 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.
 
Thank you @Wendy&Neko . Yes, we have been following TR. I'm just worried that we'll lose momentum if we hold another cycle. You don't think so? So if we hold tonight and we get no blues, go up the in morning? But if we get blues, hold a little longer still? I am so scared that those yucky red and blacks are going to come back!
 
The goal is greens, or their equivalent on the Alphatrak. He's getting very close and when they start getting closer we slow down the increases a bit to see where he's going with that dose. If he doesn't go any lower tonight than what you've seen, I'd increase tomorrow.
 
I also think I'd give him tonight and see if he comes back down and how far. If he doesn't spend a little more time in lower numbers, I'd increase to 5u tomorrow. He's started to clear the bounces a little faster...which is great.

With Lantus and levemir, the effect of the shots are cumulative so one shot builds on the preceding. Some cats, Gracie for instance, can be "slow responders" so sometimes a little patience is required when they start to see good numbers. Do I think he will need more insulin? Personally, I do. But I do think it's wise to just give him tonight when he might be clearing the bounce and you are there to catch the nadirs so we can see how much he comes down.

I'm thinking with the AT 151 yesterday, he got close to green. :D
 
Thank you @Marje and Gracie. So basically you think a dose increase is in order for the morning unless he happens to hit some blues for a while tonight, right? Some yellows would still warrant an increase in the AM don't you think? I feel he is going to need more insulin too, but I'm happy to see some movement!
 
You're welcome!

If he's bouncing and he's yellow, we need to let the bounce clear and see where he is. So far, he's just gotten into blue and, as Wendy said, the goal is normal numbers.

If he's bouncing into yellow but then coming down to nadirs with normal numbers, then we need to give him more time. If he's just flat yellow then he needs an increase.

If you are worried about increasing tomorrow and leaving for work, then you could increase tomorrow night.
 
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