Dosage advice! PMPS 365/+2 369/ +5 146/ +9 160

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Re: Dosage advice! PM +9 160

No reduction for Rosy this morning, reductions are only earned if Rosy goes under 50 and since you got a mini curve last night we know that she didn't. Good job btw :-D

I think you should put the whole mini curve info into your subject line so the dosing experts can easily see that you did get a curve and they have something to base their decision on. If anything they may recommend a tiny increase. I think I would be in favour of holding this dose a little longer though, especially since you aren't always able to monitor her blood so well.
 
Re: Dosage advice! PM +9 160

i wouldn't change the dose at this point.

you want to see where the nadirs are on this dose when she's not bouncing, then look below at the protocol and assess the dose. now that she's gone through the bounce, watch the nadirs for the next 6 cycles and compare with the guidelines below. you only reduce the dose if she goes below 50.

Increasing the dose:
Hold the dose for 3 - 5 days (6 - 10 consecutive cycles) if nadirs are less than 200 before increasing the dose.
After 3 days (6 consecutive cycles)... if nadirs are greater than 200, but less than 300 increase the dose by 0.25 unit.
After 3 days (6 consecutive cycles)... if nadirs are greater than 300 increase the dose by 0.5 unit.

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.
Click to expand...
 
Tks Serryn & Julia!

Rosy has always stayed in the higher numbers, black, red, purple...I am seeing the pressure in dosing when she's in the blue & possibly green. :? What a shitty momma! :oops:
I should be feeling happy for her working for with us moving to the desired green land but man, tension des build up. I am constantly watching if there is any twitch in her eyes, hungry does not count because Rosy always clean up her dish after food. :lol:
I'll keep with the 1.25u but scared that she will go into hypo w/o my noticing. Yes, I did memmerise the handle low figures part, HC plus continuous testing, right?
 
Helen I was thinking just as I drifted off that we haven't quite settled on a protocol for you to follow SLGS or TR :oops: but either way no reduction, you only get a reduction under SLGS if Rosy goes under 90.

Yes for manging the low numbers just a couple of teaspoons of HC and retest in 20-30mins then we hope she will stay in the nice green healing numbers.

When you see how Rosy reacts to the tsps of HC it will be easier for you to make your own rules about it but my rules for Vyktor (and everyone seems to have their own slight variations) are to test in 20 mins if under 40 or test in 30 mins if between 40 and 50. If between 50 and 60 on the next test, test again in half an hour, if over 70 I now I can wait an hour but for the first time (until you see how Rosy reacts to the HC) you probably want to test again in 3o mins even if she's over 70, if under 50 more HC. I keep that up until 2 hours after the last HC was given and we have rising numbers.

Last night for Vyktor after 2 hours from being under 50 and the HC he was still only at 70 and that was down from 77 on the previous test so I gave him a couple more tsp of HC so I could go to sleep for a couple of hours.

Everybody feels the pressure in the beginning - if you didn't then you might be a shitty momma (or just one very cool customer :cool: ) as it is you are a great momma to Rosy - and all your 21 furbabies :smile:
 
hi helen!

i think it's really easy to feel like rosy's not doing well because you see some higher numbers. it helps to look at your facts, though, rather than relying on just how it seems to be. so i looked at rosy's spreadsheets for some facts for you.

in the last 20 days you've had 40 cycles. of that 40 cycles, rosy was

- green or blue on 10 cycles (25% of the time)
- no midcycle tests on 11 cycles (~25% of the month) so you don't know what those numbers would've been

so you can know FOR CERTAIN that 25% of the past 20 days has had her spending some time in BG numbers that are healing to the pancreas. there could possibly have been another 25% that she may have been in good numbers as well. the potential exists that she may have spent as much as 50% of the last 20 days' cycles hitting some decent numbers.

what we know is that rosy is a bouncy girl. the more time that she spends in lower numbers, the more her liver will get used to them and the less she will bounce. i would encourage you to get some tests in every cycle - you might see even more good numbers.

this is a long-haul project, not a quick thing. everyone gets discouraged and wishes there were some way to magically hurry our cats along. some of us spend years managing our cat's diabetes. i've now been doing this with punkin for 15 months. there is absolutely no way to hurry up the process - rosy will do what rosy does. the best thing you can do is to be committed to following the protocol, be patient on the bounces, and adjust her dose in accordance with those guidelines.

hang in there. you're doing a wonderful job at doing everything you can to help her. at this point it's up to her body to get with the program! maybe you can have a word with rosy about that! ;-) i'm just teasing you, of course.

we're all in the same boat with you - take comfort in knowing that you're not alone. one foot in front of the other gets a person a long ways! :YMHUG:
 
Hi Julie, Serryn & everybody here,
Thankyou so much for the great advice & support during the past 3 wks, I felt like months already :lol:
I am trying my best to do as much test as I think appropriate for Rosy but I still have to attend to my other 20 furry babies. Like Rosy most of them are getting old; over 10 yrs old. With the switching to canned food for them I hope they canbe stable for moments longer so that I can concentrate on Rosy during these days.
Yes, taking care of our sugar babies need a lot of committment. I tried not to think too much but concentrate on what I am doing here. Rosy's improvement & all your support & encouragement helped me to go on. I am not following a protocol :oops: But these few days I think I am on the TR :mrgreen:
Because of that near hypo of 31, I am so scared that I might loose her anytime she is in the blue zone. Caging Rosy with food available at all times is a solution & that will release me from those 3am "room service" for her ,but she's too sweet to be caged at night. I do have 8 "younger ones" going home (to their cages) during the night. They dont take it as a cage but as their private room as they are used to it. The remining "Oldies" are allowed to roam the house. They loved this private session w/o the young around.
As much as I want to go on with the TR, I just wish that my health will allow me to.
The Forum is the only place where I can get a confirmation on what I am doing, my friends, vets & everybody around me think I am crazy to be doing all this. Luckily I know from here, I am not alone. There are people who really care for their sugar kitty & doing their best to safeguard their safety.

helen
 
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