Phobos - 3/2 - Dosing increase - how much?

[Raechel]

So, we were hopeful that Phobos would have some better numbers when we saw his first greens 10 days ago. However, it was just for the one day and his numbers have mostly been in the 400 range since. I was going to increase his dose by .25 this morning (to 2.5), but was wondering if we should just go ahead and increase by .5 since his numbers are so high?

Thanks for any insight!

 

[Raechel]

I went ahead with just a .25 increase, but if I don't see changes I only need to hold the dose for 3 days, right?

 

[Wendy&Neko]

A dose that got a green nadir and is still getting some yellow ones means only a .25U increase. Good luck with the increase.

Could you put a note in your signature line to show if you are following the TR protocol or the Start Low Go Slow method? I think you are holding doses too long. The TR protocol would have had you increase 10 cycles after that green. SLGS has you hold a week, perform a curve, then adjust the dose.

If you are following Tight Regulation, then you can increase after 6 cycles if you see nothing lower than 200.

 

[Raechel]

Ahhh. Thank you for your reply, @Wendy&Neko . This wording of "cycles" vs. "days" keeps messing with me. Re-reading the protocol, I see my mistake. I'm trying to follow the TR protocol.

So, increases are based off of the lowest number, not the average low? Meaning, I don't need to pay attention to all of those 400's?

 

[Angela & Blackie & 3 Others]

Here's the information with regards to General Guidelines and Increasing the Dose:


"General" Guidelines:

• Hold the initial starting dose for 5 - 7 days (10 - 14 consecutive cycles) unless the numbers tell you otherwise. Kitties experiencing high flat curves or prone to ketones may want to increase the starting dose after 3 days (6 consecutive cycles).

• Each subsequent dose is held for a minimum of 3 days (6 consecutive cycles) unless kitty earns a reduction (See: Reducing the dose...).

• Adjustments to dose are based on nadirs with only some consideration given to preshot numbers.

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

• 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.

You may want to check Phobos for ketones since his/her #s are still quite high. I hope the above helps you, and good luck!

 

[Wendy&Neko]

So, increases are based off of the lowest number, not the average low? Meaning, I don't need to pay attention to all of those 400's?

Yes, you want to determine the next dose based on how low the current dose can get her. The 400's are likely bounces.