? 11/30 Zhoom Boy PMPS 504 (a bounce) - curve day - dosing advice needed
- Thread starter CRL
- Start date
Yup -- you are correct. A dose increase is the way to go unless something dramatic happened during the PM cycle today.
Bobbie And Bubba
Member Since 2015
Hi there! You gave the reduction enough time. I think giving him an increase to 1.5 is a good idea.
You test enough to follow TR which would allow you to not reduce until he goes under 68. As you can see , he barely made it into the greens 9 days ago and you had to reduce following SLGS.
What do think? It would give him more time in safe green numbers to help the pancreas heal.
You test enough to follow TR which would allow you to not reduce until he goes under 68. As you can see , he barely made it into the greens 9 days ago and you had to reduce following SLGS.
What do think? It would give him more time in safe green numbers to help the pancreas heal.
CRL
Member Since 2019
I have finally gotten used to the SLGS method and feel like I kind of understand what I am doing. I just read over the TR method and it seems so confusing to me, like I won't know what to do from day to day. I want to get him feeling good, so the TR method seems appealing to me because it seems that it could potentially get his numbers down where I have not had too much success with that as of yet. I would just need so much help, probably every day, until I felt like I knew what I was doing. And I am a real nervous nelly! But I might be willing to try. It seems too that a human meter is better for this method?
Chris & China (GA)
Member Since 2013
You can use whichever meter you're comfortable with, but on TR, we do tend to test a lot and the price of the AlphaTrak strips becomes cost prohibitive for a lot of us.
The main difference is in the point where you'd reduce. On the pet meter it's under 68, on the human meter, it's under 50.
It's actually fairly clear....and we are always here to help you make decisions!
From the TR protocol:
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.
- 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.
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, Basaglar, & Levemir 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.
After 3 days (6 cycles), you re-evaluate the dose based on how low he's gone in the previous 3 days. If he's not where you want him, you increase by .25
AT FIRST, if he's not spent much time in blue/green numbers, we might suggest you hold the dose up to 10 cycles.
If you post daily, you'll get help with not only dosing advice, but you'll also start to learn more about how to make those decisions on your own. Reading other people's threads and looking at their spreadsheets will also help.