3/3 Kloey AMPS 427 +4 264

trudy66 said:
How can I do the TR if I can't test during the days I'm at work?
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The idea is to test enough in the cycles that you can, so you can know what her nadir is on a dose. You can always feed higher carbs in the cycles that you cannot test to keep her from dropping too low. Since you have the Libre, you have the data even though you aren't home, so that's a big advantage.

trudy66 said:
How will I know it's a failed reduction?
I feel like she is bouncing with every shot?
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Right now she is bouncing in the day and dropping lower at night. You will know it's a failed reduction if she doesn't see greens at all and her numbers trend higher overall. She was seeing greens at 2U and 1.75U. Maybe she will at 1.5U too. Which is why I suggested giving it another couple of days to see if she can work this dose.
 
Bandit's Mom said:
The idea is to test enough in the cycles that you can, so you can know what her nadir is on a dose. You can always feed higher carbs in the cycles that you cannot test to keep her from dropping too low. Since you have the Libre, you have the data even though you aren't home, so that's a big advantage.


Right now she is bouncing in the day and dropping lower at night. You will know it's a failed reduction if she doesn't see greens at all and her numbers trend higher overall. She was seeing greens at 2U and 1.75U. Maybe she will at 1.5U too. Which is why I suggested giving it another couple of days to see if she can work this dose.
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I thought you don't get a number unless you scan it?
 
trudy66 said:
I have the libre 14 day. I don't think it records unless you scan.
If I can not do tests on those days. Can I still do the TR.
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I am trying to talk husband into pricking her ear if the libre goes out. He is not receptive but I'm still pressing him. If so, I could give shot at 520 at the latest and he could checked her at 7 before he leaves. He will scan her but is not ok pricking her ear.
And then it is a mad dash home to make it home to give PM shot,
I have a 45 min commute. Sometimes longer. I am going to talk to work and see if I. Could get off 15 to 30in early. But that is not a guarantee.
 
You have quite a bit of test data for the last week - except one PM cycle where there are no tests. How have you managed all that data? Husband scanned when you were at work?
 
Bandit's Mom said:
You have quite a bit of test data for the last week - except one PM cycle where there are no tests. How have you managed all that data? Husband scanned when you were at work?
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I work 2 days one week and 1 day the next. I was off for 9 days in between these last days. So I was here everyday with her.
I took her to vet to get new libre put on thinking I had a new sensor but it was one the er vet had used and just put back in the box. I thought the pharmacy gave me 2. So I went and got refilled. Think I may try to put on myself.
 
trudy66 said:
I work 2 days one week and 1 day the next. I was off for 9 days in between these last days. So I was here everyday with her.
I took her to vet to get new libre put on thinking I had a new sensor but it was one the er vet had used and just put back in the box. I thought the pharmacy gave me 2. So I went and got refilled. Think I may try to put on myself.
Click to expand...
How do I start TR?
 
Bandit's Mom said:
I think there are 2 versions of the Libre - one of them scans and stores data every 15 mins. Not sure which one you have?

@Katherine&Ruby knows more about it than I do.
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If you get the standalone Reader for the Libre, you can scan it with that. It's better because if you are using your smartphone to scan and you're not home, someone else who is can scan for you. The Libre takes a reading every 15 minutes, so if you have a PC, you can connect the reader to the computer with a micro USB cable and download raw data to add to the spreadsheet.

You can do TR even if you are not home for 12 hours during the day as long as you test at night. If you decide to start TR today, you would look to see when you had your last green or blue numbers and start counting cycles after that to figure out when to increase. Always reduce by .25 units if the cat goes below 50. Here's an excerpt from the TR dosing sticky at the top of the forum:

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.
  • Increase by 0.25 unit after 3 days (6 consecutive cycles) if nadirs are greater than 200, but less than 300.
  • Increase by 0.5 unit after 3 days (6 consecutive cycles) if nadirs are greater than 300.
Reducing the dose:

The TR Protocol is an aggressive method in itself. The modified version of the protocol is slightly more aggressive. Let's keep all our kitties in the Lantus, Levemir, & Biosimilars ISG safe by taking reductions when appropriate.
  • 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, attempt a reduction when the cat regularly has its lowest BGs in the normal range of a non-diabetic healthy cat (50 - 80 mg/dL) while staying under 100 mg/dl overall for at least one week.
  • Please do not let yourself become complacent or blasé about drops into the 20s or 30s. Please ask for advice immediately.
  • If your cat drops into the 30s, a full reduction of 0.25u is recommended. There are few exceptions given to caregivers who have collected years of data and KNOW their cat's response to the combination of insulin and food backwards, forwards, and inside out.
  • Caregivers whose kitties have "High Dose" conditions may find the need to reduce in whole units or more.
  • 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. Please use common sense in this situation. The "last good dose" is not the dose that just dropped kitty into the 20s or 30s. You want to resume momentum by finding an in-between the dose.
  • We've found many kitties benefit from reducing the dose from 0.25u to 0.1u before stopping insulin completely. During a two week OTJ trial, you want to see mostly green numbers (under 100) with only a few random blue numbers between 100 - 120 to help ensure a strong remission. Most kitties will be in the range of a healthy cat (50 - 80 mg/dL) overall.
 
trudy66 said:
If I do the tight regulation. How do I start?
Click to expand...
trudy66 said:
How do I start TR?
Click to expand...
You start by re-evaluating this dose after 6-8 cycles on it to see if it is a failed reduction and you need to go back up to 1.75U.
With that considerably lower +2 tonight, I'd try to get a +4 before bed.

trudy66 said:
I work 2 days one week and 1 day the next. I was off for 9 days in between these last days. So I was here everyday with her.
Click to expand...
That's not too bad. We can find some way to work around that.
 
Bandit's Mom said:
You start by re-evaluating this dose after 6-8 cycles on it to see if it is a failed reduction and you need to go back up to 1.75U.
With that considerably lower +2 tonight, I'd try to get a +4 before bed.


That's not too bad. We can find some way to work around that.
Click to expand...
 
Bandit's Mom said:
You start by re-evaluating this dose after 6-8 cycles on it to see if it is a failed reduction and you need to go back up to 1.75U.
With that considerably lower +2 tonight, I'd try to get a +4 before bed.


That's not too bad. We can find some way to work around that.
Click to expand...
My vet actually told me to go back to 1.75 today and stay there till we evaluate that dose. I did at 530. With her back in 400, just worried about ketones. I prob should have just stayed on 1.75. she didn't drop that low on the 1.75.
I need to get on TR to get her regulated. This bouncing all around is driving me crazy.
I need definite boundaries.
 
Hope going on TR will help! I know that when I switched from SLGS to TR early on in Ruby's journey, it was a total game changer. She went from pinks and yellows to all greens and blues and went down the dosing ladder quickly and then wound up staying on small doses of insulin until she had to start on steroids. It was the best thing I ever did for her. Good luck! :bighug:
 
Katherine&Ruby said:
If you get the standalone Reader for the Libre, you can scan it with that. It's better because if you are using your smartphone to scan and you're not home, someone else who is can scan for you. The Libre takes a reading every 15 minutes, so if you have a PC, you can connect the reader to the computer with a micro USB cable and download raw data to add to the spreadsheet.

You can do TR even if you are not home for 12 hours during the day as long as you test at night. If you decide to start TR today, you would look to see when you had your last green or blue numbers and start counting cycles after that to figure out when to increase. Always reduce by .25 units if the cat goes below 50. Here's an excerpt from the TR dosing sticky at the top of the forum:

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.
  • Increase by 0.25 unit after 3 days (6 consecutive cycles) if nadirs are greater than 200, but less than 300.
  • Increase by 0.5 unit after 3 days (6 consecutive cycles) if nadirs are greater than 300.
Reducing the dose:

The TR Protocol is an aggressive method in itself. The modified version of the protocol is slightly more aggressive. Let's keep all our kitties in the Lantus, Levemir, & Biosimilars ISG safe by taking reductions when appropriate.
  • 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, attempt a reduction when the cat regularly has its lowest BGs in the normal range of a non-diabetic healthy cat (50 - 80 mg/dL) while staying under 100 mg/dl overall for at least one week.
  • Please do not let yourself become complacent or blasé about drops into the 20s or 30s. Please ask for advice immediately.
  • If your cat drops into the 30s, a full reduction of 0.25u is recommended. There are few exceptions given to caregivers who have collected years of data and KNOW their cat's response to the combination of insulin and food backwards, forwards, and inside out.
  • Caregivers whose kitties have "High Dose" conditions may find the need to reduce in whole units or more.
  • 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. Please use common sense in this situation. The "last good dose" is not the dose that just dropped kitty into the 20s or 30s. You want to resume momentum by finding an in-between the dose.
  • We've found many kitties benefit from reducing the dose from 0.25u to 0.1u before stopping insulin completely. During a two week OTJ trial, you want to see mostly green numbers (under 100) with only a few random blue numbers between 100 - 120 to help ensure a strong remission. Most kitties will be in the range of a healthy cat (50 - 80 mg/dL) overall.
Click to expand...
Does the 14 day libre do that. I thought it was only when you scanned with the reader.
 
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