? Increase dosage during bounce?

[fearlessmom]

Fearless was doing pretty well the last couple weeks, hitting green for longer periods of time before bouncing, and bouncing for only 4 or 5 cycles each time, which is good for him. However, since sliding below 50 BG three days ago he's been bouncing unusually high. I want to take him back up to 1.25 units, where he was doing so well before. We're trying to stay on TR and the Sticky says to take him back up after 3 days. Am I on the right track to increase tomorrow AM? Or should I wait for this bounce to clear?

 

[Wendy&Neko]

There is no problem increasing during a bounce - read this post on increasing during a bounce. What you don't want to do is increase on the cycle they are clearing a bounce, because there is usually extra downward momentum on that cycle and the increase on top of it can make for lots of testing!

We're trying to stay on TR and the Sticky says to take him back up after 3 days.

Actually, the Sticky Note says "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. " The idea is to wait for the bounce to clear, and if you aren't seeing green, then you increase back up.

 

[fearlessmom]

What you don't want to do is increase on the cycle they are clearing a bounce,

How do I know when he's "clearing" the bounce?

 

[Chris/China (GA)/Garfield]

How do I know when he's "clearing" the bounce?

You know they're clearing a bounce when the numbers start coming down fast on the same cycle.....Like let's say kitty drops too low (below 50 on human meter) on Monday morning....by Monday PM, he's bouncing and in the 300's. The protocol says to reduce the dose.

On Tuesday he's in the 300's but drops into the 200's on the AM cycle and starts in the 200's on the PM cycle and drops to the mid-high 100's

On Wednesday AM (the 4th cycle since the "low") he starts in the 200's, but as the cycle goes on, he drops to 150, 130, 100, 95 and at PMPS is about the same 95 or lower....he's obviously "clearing the bounce" on that cycle.....you wouldn't want to increase on that cycle

Bounces can last up to 6 cycles and most cats will "wobble" during those 6....they won't just bounce high and then start coming down over the next 6 cycles....they may drop into the 200's and go back to the 300's....they may drop into the 100's and wobble back up to the 200's or more.

What you're looking for in those 6 cycles is for them to hopefully return to nadirs that are in the same general range they were before you reduced for them to hold the new reduced dose.....if they don't and get "stuck" (for example) in the mid 100's or higher, we'd say the reduction failed and return to the last good dose that got them where we want them to be.

 

[Chubba (GA)]

You know they're clearing a bounce when the numbers start coming down fast on the same cycle.....Like let's say kitty drops too low (below 50 on human meter) on Monday morning....by Monday PM, he's bouncing and in the 300's. The protocol says to reduce the dose.

On Tuesday he's in the 300's but drops into the 200's on the AM cycle and starts in the 200's on the PM cycle and drops to the mid-high 100's

On Wednesday AM (the 4th cycle since the "low") he starts in the 200's, but as the cycle goes on, he drops to 150, 130, 100, 95 and at PMPS is about the same 95 or lower....he's obviously "clearing the bounce" on that cycle.....you wouldn't want to increase on that cycle

Bounces can last up to 6 cycles and most cats will "wobble" during those 6....they won't just bounce high and then start coming down over the next 6 cycles....they may drop into the 200's and go back to the 300's....they may drop into the 100's and wobble back up to the 200's or more.

What you're looking for in those 6 cycles is for them to hopefully return to nadirs that are in the same general range they were before you reduced for them to hold the new reduced dose.....if they don't and get "stuck" (for example) in the mid 100's or higher, we'd say the reduction failed and return to the last good dose that got them where we want them to be.

Thanks for the good explanation. This helped me to understand what is happening with Gizmo right now.

 

[fearlessmom]

most cats will "wobble"

Fearless is the epitome of "wobble" this bounce. I'd almost call it a "delayed" bounce with that 500+ on Friday (a number he hasn't seen in 2 months!) That same day he dropped nearly 200 pts by +3 in the PM cycle so I thought he might be clearing early, but his nadir (or close to it -- it's usually +6 or +7 in the PM cycle) was above 150, so he wasn't clearing then. I'm thinking this evening's drop (also of nearly 200 pts) might yield the same results, but I'll stay up until +6 just in case.

I, too, appreciate the explanation. It's one I hadn't heard before.