Scooter keeps earning a decrease and then not holding it

[Ry & Scooter]

This is frustrating now. Twice Scooter has earned a decrease from 1.25 down to 1.00, but then he sits in pinks-yellows for 4 days until I increase it again to rinse-repeat... this is silly and I'm upset because we were so close to regulation and now we are right back where we started. Should I just keep him at 1.25 or try something new?

 

[Marje and Gracie]

Hi Ry

From the protocol:

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.

Even though he is newly diagnosed, he's not holding his reductions well. I would start to shave his reductions and see if that helps. FWIW, sometimes you have to go up and down on the dose before they hold a lower one. Once he clears this bounce, as long as he doesn't come down into green, I'd raise his dose and then next time around, shave his reduction. If he comes into green on this dose, the only way to get more insulin in him is to first raise the %carbs you are giving him and when the numbers go up, increase him back to 1.25u. But you will have to closely monitor him to do that....which it appears you are doing anyway. Does that make sense?

 

[Sienne and Gabby (GA)]

Of course, you ask the question and Scooter has a green nadir today!!

Shaving the dose, like Marje described, is one option. The other option is to allow Scooter to drop below 50 on three separate occasions and then reduce by 0.25u.
This is from the Tight Regulation Protocol:

Alternatively, if the nadir glucose concentration is 40 - <50 mg/dl at least three times on separate days, try lowering the dose. If the cat drops below 40 mg/dl once, reduce the dose immediately! The reduction is done very slowly in a step-by-step manner. At each newly reduced dose, try to make sure the cat is still stable in the normal range before reducing the dose further.

 

[Ry & Scooter]

Yup... LOL :roll: and then he had a big yellow bounce and another late green nadir this evening... why is he so bouncy again? ohmygod_smile

I'll keep it at 1 for a while longer and fatten it up if I need to... when he earns decreases its usually with a number like 47 or 49 and sometimes I'm hesitant to do it, but... I seem to have missed that part about 3 consecutive in the TR protocol. That sounds like it might work better for him.

 

[Sienne and Gabby (GA)]

The 3 drops then decrease is from the Tilly website where there's a copy of the TR protocol. Just so you're aware, don't combine shaving the dose with the 3 drops below 50. It would be too aggressive and potentially unsafe. Choose one or the other as a strategy.