5/26 - Am I doing the proper dosage for TR on Lily's SS?

[Calicos are Best (GA)]

Hi Everyone,

I have been doing the TR method for about one month with Lily. I also have been busy cleaning her teeth multiple times this month. I was able to remove some tarter which was very exciting!

Right now Lily keeps going between 1.25 units of Lantus insulin and 1.125 units. It seems like 1.25 units is too much insulin as Lily gets very low nadirs. When I reduce to 1 unit it doesn't seem like enough insulin. So I have tried reducing to half of 1.25 units @ 1.125 units instead. I have even tried doing the 1.125 units does for 6 days instead of 3, but I wasn't able to stabilize and get the numbers I am looking for. I was curious if the 1.125 does was the perfect dose...and it was not, which I could see after the 6 day trial.

Does anyone have any advice from looking at Lily's SS? Am I doing the right things with TR and proper dosage?

 

[Bron and Sheba (GA)]

I think you mean after a 6 cycle trial not a 6 day trial.
1.25 is too much as it drops Lily into low numbers and you were correct to reduce the dose.
After the drop into low numbers a few days ago Lily bounced for 6 cycles. Then you increased the dose and it was too much again.
I think I would try keeping her a bit longer then 6 cycles on the 1.125 to see how she goes after she comes off the bounce.

 

[Calicos are Best (GA)]

I think you mean after a 6 cycle trial not a 6 day trial.

No, I did mean 6 days, you just have to look a little bit further back on the spreadsheet from May 14th - May 19th.

I think I would try keeping her a bit longer then 6 cycles on the 1.125 to see how she goes after she comes off the bounce.

I can try the 1.125 dosage again. I just wasn't sure if this was the best things to do, after comparing what happened from May 14th - May 19th. Would you try this dosage for 7 days? I didn't know if that changes the TR method as it goes against doing 3 days?

 

[Bron and Sheba (GA)]

Looking at the SS for 14 to 19 May you have a few cycles of lovely green numbers. I’m not sure why you increased the dose on 20 May. With TR you don’t increase the dose until you get 6 cycles without dropping into a green number. Then you increase.
I think it looks like 1.125 is the best dose at the moment.

 

[Sienne and Gabby (GA)]

I want to make sure you've picked up on one point with the TR protocol -- once you start seeing nadirs that are below 100, you want to hold the dose for 5 days/10 cycles.

From the Dosing Methods sticky:

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.

Another point for you to consider... What was a "good" dose last week, may not be a good dose this week. A cat's insulin requirements can change. It's hard to have a good handle on why this is the case but insulin isn't like an antibiotic where the dose is the dose. The variation may be due to it being hard to be completely consistent with measuring a dose, that it's allergy season (allergy is a form of inflammation), your cat is stressed from seeing another cat outside/in her territory, noise, constipation, or the moon is in a particular phase (and I'm really not kidding about the moon).

 

[Calicos are Best (GA)]

With TR you don’t increase the dose until you get 6 cycles without dropping into a green number.

Thank you @Bron and Sheba! I was not aware of the rule meaning "don't increase until you get 6 cycles without dropping into a green number"...I must have been doing it incorrectly.

I thought the rule was to finish 6 cycles (3 days) completely on the same dose. If your cat hits 50 or below in the 3 days, you decrease. Other wise you continue to increase the doses every 3 days if you don't hit the 50 or below. During May 22nd - May 24th, Lily finished 3 cycles at 1.125 units...She never hit any greens that I caught, however I suspect she may have hit a low on May 23rd that I wasn't able to catch. At +5 she was 201 and I wasn't home after that, when I checked her again at her PMPS she was was 425. I did give her a snack at +5 before I left, but maybe she needed more than her usual snack. Since I didn't catch her lowest point I increased. Instead of increasing or decreasing (because Lily never hit any greens for 3 days) I should have kept the dose 1.125 on May 25th, So is this correct thinking?

I want to make sure you've picked up on one point with the TR protocol -- once you start seeing nadirs that are below 100, you want to hold the dose for 5 days/10 cycles.

Thank you @Sienne and Gabby (GA)!!! I was definitely missing this factoid! I have only been doing a strict 3 days (6 cycles) and following it as a must do ONLY 3 days! I did not know about holding the dose for 5 days. I have been bouncing between doses every 3 days and I wasn't sure if I was doing it right.

the moon is in a particular phase (and I'm really not kidding about the moon).

lol, who knew the Moon could cause such problems!?!?