Tight Regulation protocol question

[MélanieW]

So I'm almost afraid to ask, because each time I ask a question Noah does the complete opposite of what I think he is going to do.

But here it goes. Noah's numbers are starting to look REALLY good. Almost like a regulated cat!!! I've been reading about the tight protocol and had a question about the following:

When the cat regularly has its lowest BGs in the normal range of a healthy cat and stays under 100 mg/dl overall for at least one week, attempt to reduce the dose. 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 (0.25 or 0.5 IU increments). At each newly reduced dose, try to make sure the cat is still stable in the normal range before reducing the dose further.

If the cat will not stay in the normal range after a reduction, immediately increase the dose again to the last good dose. Sometimes, a cat can even manage to keep its BGs low for a day or two, but then the BGs begin to rise again because the beta-cells haven't recovered enough yet. Try to go from 0.25 IU to a drop before stopping the insulin completely. Reducing the dose too quickly generally does not work: most cats do not go into remission with fast reductions.

So from what I'm reading even if Noah doesn't go under 50, I can try reducing his dose after a week of normal numbers. But would I wait a week (7 days or 14 cycles) every time before reducing the dose again?

 

[Wendy&Neko]

Spreadsheets speak better than words. Here's an example of another Ontario kitty, Davidson and his SS, that did just that. Most of his reductions down the dosing scale were done one week at a time, in normal numbers.

Noah is starting to look really good! He'll tell you when he's done with a dose by either going under 50, or spending 7 days in normal numbers.

 

[Jill & Alex (GA)]

So from what I'm reading even if Noah doesn't go under 50, I can try reducing his dose after a week of normal numbers.

Yes, you'd want to see numbers in the range of a healthy cat (50 - 80 mg/dL) and staying under 100 overall for a week prior to taking a reduction.

But would I wait a week (7 days or 14 cycles) every time before reducing the dose again?

Yes, wait a week to reduce again (applying the same criteria)... unless he were to drop below 50. Dropping below 50 earns a dose reduction.

 

[MélanieW]

Thank you! Looking at a spreadsheet does make things easier. I'm very visual, so this is really helpful. I'm cautiously optimistic about Noah's numbers.

 

[MélanieW]

Yes, you'd want to see numbers in the range of a healthy cat (50 - 80 mg/dL) and staying under 100 overall for a week prior to taking a reduction.

Yes, wait a week to reduce again (applying the same criteria)... unless he were to drop below 50. Dropping below 50 earns a dose reduction.

Thank you! Will wait a week if numbers are below 100 unless we drop below 50 before taking a reduction. If numbers are higher than 100, we'll keep the dose the same! I'm just happy about not seeing yellow or pink so it makes it easier to be more patient.

 

[Lincolns Mom]

keep up the good numbers Noah... would be great to earn reductions without the scary trips to the sharks... hope you have a great day Melanie