7/28 Tibby PMPS 376: Am I ready for a curve?
- Thread starter Amy&Tibby
- Start date
Chris & China (GA)
Member Since 2013
Yes....Lantus usually takes 5-7 days for the depot to fill so you see how well the starting dose is working.
You're good to go for tomorrow!
Just an FYI....you're close to testing enough to do TR if you're interested. You'd just need to be sure to always get at least a "before bed" test on the PM cycle
If you can, it would be helpful to get some tests in a little earlier in the AM cycle too. Think of your spreadsheet like it's a puzzle....anyplace you see gaping white "holes", try to get a test in there to "fill in" that piece of the puzzle!
Chris & China (GA)
Member Since 2013
I think TR is actually easier to figure out because there are specific details telling you what to do and when to do them.
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.
The benefit of TR is that you can increase the dose as often as every 3 days if it's not getting Tibby where you want him instead of holding the dose for a full week.
It does require a little more testing than SLGS does but you're already testing enough (except for the every night "before bed" tests....which are just as important on SLGS as they are on TR!)
Amy&Tibby
Member Since 2020
I've been doing the SLGS for now. His numbers were so weird on Prozinc that I want to see if they are leveling or curving better overall. He seems to be getting more regular now that he's on Lantus. If you compare the spreadsheet numbers from Prozinc to his numbers now on Lantus, it looked like a random number generator was creating the data on Prozinc, but I'm able to see curves and patterns with Lantus.
I did a .25 increase after 9 days and a curve. His numbers look even better now. I think this is the insulin for him for sure.
I did a .25 increase after 9 days and a curve. His numbers look even better now. I think this is the insulin for him for sure.