? 11/30 Freckles AMPS 274 - When life gives you lemons

Judy and Freckles

Judy and Freckles

Member Since 2019
Freckles has been staying in an orchard of lemons - very flat BG numbers. I'm wondering if I'm testing enough to try TR to get things moving along more as I recently read that TR sees more cats go in remission than SLGS method.

Here is my schedule and I am really looking for feedback to see if TR is a possibility.

4:45 am - wake up and do animal chores
5:30 am- AMPS Freckles
5:45 am- feed and shoot insulin
6:00 am - leave for work

5:30 pm - home from work, PMPS Freckles
5:45pm - feed and shoot insulin
8:00pm- test Freckles
10:00 pm - test Freckles and go to bed

I have an hour commute to work in the city and to the nearest 24 hour vet. If necessary, I can bring Freckles into the city with me on workdays and sometimes can go and test her over my lunch hour. She gets slightly stressed over the car ride, but nothing over the top (I think it's more that she needs to use the LB by the time we get to the city).

She has a slow feeder that is set to provide 1/4 can of FF @ 8:00, 10:00, 12:00 and then FD chicken at 2:00 (4 feedings in a 12 hour cycle).

Typically I am testing 4x/day and doing a curve on the weekend. Is this enough to go TR? Maybe someone on this board can see something I am doing that can be improved upon to start lowering her numbers more quickly but safely?

Would love members' thoughts on this.

Thanks in advance!
 
Judy -

I think TR is feasible with a full time job. Have you seen this post on the subject? I worked thought out Gabby's FD journey. The big difference was that my commute time was shorter. It's looking like you're testing enough. At the very least, you can give it a try and see if you feel like TR is working for you and Freckles.
 
Sienne and Gabby (GA) said:
Have you seen this post on the subject?
Click to expand...
Thanks Sienne. Yes, I've read the post before- thank you for the link again though. My commute is long which also means the nearest 24 hour vet is 1 hour away should I need them - but that's the same whether I go SLGS or TR.

I am picking up new vial of Lantus today to see if that makes a difference. Freckles is due for a dose increase tomorrow.
 
I posted this in another member's condo a few days ago regarding Lantus but still don't know if Lantus loses it's potency gradually or completely>

"The pharmacist told me that Lantus should be kept at room temperature, so that is what I did until I found this forum. The vet tech told me to roll the Lantus bottle not shake it - so that is what I did... until I found this forum. Thanks GOODNESS for the people and info on this forum!!

My bottle is about 1/2 done and it was started at the end of September. The insulin is still clear, is now being refrigerated and not rolled or shaken but maybe the damage to the insulin has already been done? When Lantus is mishandled, does it lose it's potency on a gradual basis or is it an "all or nothing" kind of deal?"
 
I agree, I think you test enough to be able to follow TR. A couple of things that you might consider if you switch to TR. To me, Freckles doesn't seem to be a super bouncer, which is a good thing. I also like that you have mini meals organized at good times during the day when you are gone. Should you ever see a lower am preshot, you can always give him a little higher LC before you leave for work, then maybe even leave some higher LC for the 8:00 a.m. to prop the numbers up before onset. Technically not terrible numbers given you are using an AT2, but yes, depending on your goals for Freckles, being able to increase sooner may just be what you need at this point.

ETA: oops, sorry, I see you have a separate line when you switched to human meter, my bad.
 
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I never used a vial. I always used pens. In the long run, the pens end up being cheaper and I liked that they are protected in a plastic sleeve.

Generally, the Lantus is fine providing you don't see any crystalline "floats." That said, I had one pen in a box that was bad after a pharmacy tech kept slamming the box of pens into the counter as he was trying to get the paper bag the box was in to drop into a plastic bag. I was screaming at him to stop what he was doing. (Fortunately, the pharmacy manager replaced the pen.) I've really not seen a gradual loss of potency. But, since I used a pen, there was less insulin in one pen vs a vial. Others that have used vials, have noted they've been able to use them to the last drop but how the insulin is maintained can make a difference.
 
Judy and Freckles said:
I posted this in another member's condo a few days ago regarding Lantus but still don't know if Lantus loses it's potency gradually or completely>

"The pharmacist told me that Lantus should be kept at room temperature, so that is what I did until I found this forum. The vet tech told me to roll the Lantus bottle not shake it - so that is what I did... until I found this forum. Thanks GOODNESS for the people and info on this forum!!

My bottle is about 1/2 done and it was started at the end of September. The insulin is still clear, is now being refrigerated and not rolled or shaken but maybe the damage to the insulin has already been done? When Lantus is mishandled, does it lose it's potency on a gradual basis or is it an "all or nothing" kind of deal?"
Click to expand...

I've never had Lantus go bad or lose it's potency. I've used a vial of Lantus for nearly a year and it was good to the last drop. I often seem members here that would like to think the Lantus is the reason for less than stellar numbers - however I tend to believe that it's more likely the cat and not the Lantus that's at fault for not meeting your expectations about improvement.

Although Lantus doesn't need to be rolled, shaked, etc. human patients on Lantus typically carry it in their purses or in a pocket - yep, every day - jostling and jiggling all the time - the only difference is that they only keep it for a month -and most use it all up by then if not before. I believe Lantus is a very stable compound these days and since it's already in solution it doesn't react to a little bit of jostling or even a day or two on the counter.

The only time I've ever heard of Lantus going bad was when it was frozen - definitely that would be the end of it. I also wouldn't want to use it if it had been left in an extremely hot place - like the dashboard of the car to heat up...both of those extreme situations could cause the product to lose potency.

That's my take on the whole 'is the Lantus to blame' or 'has it gone bad' topic. I hope this is helpful.
 
Christie & Maverick said:
Should you ever see a lower am preshot, you can always give him a little higher LC before you leave for work, then maybe even leave some higher LC for the 8:00 a.m. to prop the numbers up before onset.
Click to expand...
Thanks Christie. I thought I read somewhere on this forum or Dr. Lisa's website that zero LC wet food could very well likely be equivalent to the 8 LC as when you get into the lower carbohydrate numbers they % of carbohydrates is difficult to differentiate (but always stay below 10 % carb on wet). Has anyone else read this?

Currently I am using FF and according to the Cat Food Database the flavours I'm using are under 4 carbs.
 
I think moreso it is that there isn't much difference between let's say 1-2% and 4% or 5% since even between batches the numbers can be off. But really it is an every cat is different (ECID) thing as well. If you have a carb sensitive cat, yes, the variance may be noticeable. For me, higher LC used to be 8-9%, but Mav is fairly carb sensitive, so I find I can use 6% food to keep him flatter. I've seen some kitties not budge much with higher MC food at lower numbers, which is strange to me, if Mav even smelled 14-15% food, he'd be high :p
 
Christie & Maverick said:
I think moreso it is that there isn't much difference between let's say 1-2% and 4% or 5% since even between batches the numbers can be off. But really it is an every cat is different (ECID) thing as well. If you have a carb sensitive cat, yes, the variance may be noticeable. For me, higher LC used to be 8-9%, but Mav is fairly carb sensitive, so I find I can use 6% food to keep him flatter. I've seen some kitties not budge much with higher MC food at lower numbers, which is strange to me, if Mav even smelled 14-15% food, he'd be high :p
Click to expand...
Yeah. That makes sense. Never thought of it that way before! Thanks for the insight!:facepalm:
 
@Judy and Freckles

I don’t see a condo for today so I’ll post here.

Has anyone ever mentioned IAA to you? IAA or Insulin Auto Antibodies is where the immune system sees the insulin as a foreign substance and so attempts to destroy it as it would a virus. That means it’s likely that most of the insulin given isn’t available for the body to use so numbers stay high and flat even as the dose rises. I’m not saying she has IAA but she has “some” insulin resistance.

The only way to know if a kitty has IAA is to test for it which we recommend doing, along with the test for acromegaly when the dose gets to 6u bid. The good thing about IAA is it’s self limiting after a year but there are also other ways to break through it.

My hope is that she’s just developed a little insulin resistance, not IAA, because SLGS has meant she stayed at higher numbers longer. That’s just the nature of the beast quite often. It is what it is. Switching to TR will let you raise the dose faster.

Paws crossed.
 
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