05/26/2020: Switching Gideon to Tight Regulation

Shiloh567

Shiloh567

Member Since 2020
Hi All- Gideon is a fairly new diabetic. Since I am testing him more than just before his Lantus which is given at 7AM and 7PM, I guess I am now considered following TR protocol. His numbers are still all over the place. I lowered his dose to 0.75 units twice daily about 1 week ago. I previously was giving 1 unit twice daily, but he had a couple scary green moments. Vet was on board with lowering him. Anyways....how long do I let his numbers fluctuate and remain in the red a lot, before I consider increasing the dose to 1 unit twice daily? Do I just hang tight longer on the 0.75 units twice daily? I want the best chance for remission for him.
 
Because of the skipped shot you need 6 cycles to rebuild the depot. That means a decision would be made tomorrow night.
 
Thanks Elise. I will wait for sure. This morning, Gideon jumped up on the bathroom vanity (he is a tripod), which he had never done before. He was waiting for his treat, and it was ear testing time. So, though my husband is the "shooter", he was out for his early morning walk, so I did the ear stick a few minutes early, then gave Gideon his treat, then fed him. All went well, and hoping this will become the routine to him.
 
Just took Gideon's BG, and it is just 75. I will give him a bit high carb food. His insulin is not due for 4 hours, so he I am sure he will come up.
 
He might have reached his nadir if this is +8. His depot is building which is why he might not need an increase. (Anti-jinx). Max surprised me how quickly he adjusted to testing and injections. The treats helped. When he later needed fluids he hid the first time but again a special treat made that a breeze too.
 
Yes, this is +8. I just gave him a bit higher carb food (20%), and he is acting fine. I am not going to test again until his normal 7p. We also test around 10p before bed.
Thanks for your guidance & support.
 
You're looking good for TR...lots of testing, no dry food. Keep up the good work! It'll be good to see Gideon's progress as you can change doses every 6 cycles as needed. Best of luck :)
 
I think it’s timetable think about for an increase to 1.0 units now that you are following TR. You might need a few extra tests though and he might be bouncing from the 75 so before doing so I’d want some night tests to see if he’s dropping at night.
 
When you say night tests, what time are you suggesting? Is it the norm that even TR kitties need increases in Lantus?
Thanks.
 
Dosing has to be adjusted with TRYou want to bring the bg down to within normal numbers. The +3 is all you need but you need one every night so that you leave out food if you can’t monitor and the drop is too big or getting low. With TR you adjust their dose every 6-10 cycles depending on numbers. When you get a chance read the yellow sticky on TR again. You will hold the dose for 7-10 cycles with nadirs under 100 but you have only had one and he did have ketones. I’ll tag others to see what they advise.

@Wendy&Neko @Marje and Gracie @Marje and Gracie
 
Thanks Elise. My husband did get a +3 last night (291). I just posted it to the spreadsheet. I was working, so he did the last ear stick. We will keep up with 4 X day testing. So, for the mid-day, do you suggest a +6 test?
Unless a kitty eats exactly the same food, and exactly the same amounts, and has the same activity level, and also the same level of stress, numbers will always fluctuate some. It is just a mystery how Gideon's fluctuate "wildly". Perhaps it is because he is a new diabetic, and things will get smoother. Vet says to stick with 0.75 units BID for now, but I am not opposed to increasing back to 1 unit BID, when the time is right.
Gideon and I than you!
 
Can you start a new post for today after this? We ask that people do a new post each day, with a link to the previous one. Otherwise the posts get rather long.

It's better to mix up mid cycle testing in the +4 to +7 range. Cats don't always nadir at the "typical" nadir time of +6, mine never did, and it can vary somewhat from cycle to cycle. If it's possible to get a +2 most cycles, that can be a helpful predictor on how the cycle will go. If the +2 is about the same as the preshot number, it'll be a typical Lantus cycle with some downward movement. If there is a drop to +2, it'll be an active cycle needing closer monitoring. A higher +2 means a quiet cycle - probably a bounce. Speaking of bounces, I'd give Gideon a couple more cycles to see if he can resolve the bounce, before deciding whether to increase.
 
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