8/26, Tango AMPS 71 Dosing help for this morning

Lori C & Tango

Lori C & Tango

Member Since 2022
@tiffmaxee @Bandit's Mom @Christie & Maverick @Diane Tyler's Mom

From 8/25

https://felinediabetes.com/FDMB/thr...27-1-122-4-5-94-8-119-10-138-pmps-168.267573/

Starting 8th day dosing at 2.5.

I entered 71 as AMPS for today, but it's actually +11. Last night and this morning's schedule was a little different. After +2 BG reading last night @97 gave Tango a tlbs of Friskies. At +6 BG reading BG @ 89 and gave another tlbs of Friskies. At 5:00am did not test, but he was meowing for food so I gave him about a tbls of Almo Nature. He threw up at 7:00am - I'm sure it was from Friskies and/or mixing foods as he hasn't barfed in a long time. Now it's 45 minutes to shot time - do we shoot 2.5 or is it time to reduce?

TIA
 
We're using Alpha Trak so isn't it 68?

How long do we have to keep testing throughout the day other than pre-shot?

I understand that with TR you stick to a dose for 3-5 days. What determines, other than a drop below 68, when you reduce dosage and when you don't need to test all day?
 
Lori Callagy said:
We're using Alfa Trak so isn't it 68?

How long do we have to keep testing throughout the day other than pre-shot?

I understand that with TR you stick to a dose for 3-5 days. What determines, other than a drop below 68, when you reduce dosage and when you don't need to test all day?
Click to expand...
Yes. You are correct about the AT. Sorry. I thought you were ReliOn and I am wrong since you are using AT.
 
Suzanne. No. He has not had a 68 since we reduced to 2.5.

I know that with TR you hold dose for 3-5 days.

1) If BG doesn't drop below 68 how long do you stay with that dose?
2) If yes, does that mean you could continue TR for several more days or weeks and need to test throughout the day?

Trying to figure out the whole process to trying to get your cat regulated.
 
The requirement for following TR is that you need to get at least one mid-cycle test during both the day and evening cycles. You don't "need" to test all day necessarily. It's a good idea, if you are at home with Tango, to get a +2 or even a +3 in Tango's case (you can do a 2.5) to see if he's dropped much from the AMPS/PMPS number. I think a +2 might be too early for Tango, but that depends a little bit on his preshot number, too. If you are able though, it would be very good to try to get another test or two in the early part of the cycle before his typical nadir. I would try for maybe a +4 and +6 and then stop testing for the rest of the day when he usually starts going back up a bit. Or a +5 and a +7 and then stop. It all sort of depends upon what numbers you are seeing. Obviously if you get a really low number then you will need to keep monitoring. Since you just gave the Friskies Pates yesterday (I'm assuming they're the LC Friskies pates so correct me if I am wrong) you didn't have to use anything HC to bring him up or anything like that.
 
Lori Callagy said:
I understand that with TR you stick to a dose for 3-5 days. What determines, other than a drop below 68, when you reduce dosage and when you don't need to test all day?
Click to expand...
The rule for a reduction is a drop below 68 on a pet meter or a week in largely normal numbers. I'm on my phone so can't link the sticky on earning reductions.

With time Tango will flatten out and see more predictable cycles requiring less testing. When a cat's pancreas suddenly wakes up and the cat decides to head down the dosing ladder, it can be an "exciting" ride for the caregiver. Hang in there. All the stress and sleepless nights will pay off.

Getting an autofeeder and ensuring he has access to food when you are not at home or asleep can make it easier.

How much time for his shot? 30 mins? And he ate at +11?
 
Suzanne & Darcy said:
But I am not actually seeing a 68 on your spreadsheet for yesterday? Am I missing it?
Click to expand...
@Suzanne & Darcy
Hi Suzanne I have a question on 8-19 her cats BG was 54 @+4 AM cycle
Shouldn't she have reduced or since the day before on 8-18 night cycle she reduced because he earned a reduction during the AM cycle @ 65+8 and you don't want to do back to back reductions?
@Suzanne & Darcy
 
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Some people following TR have a dose that is working for their cat and they are on the same dose for a long time. There is no requirement to change the dose just because it's been 3 days (6 cycles) or longer. It's all based on what's going on with the kitty and what his nadir is (for the most part it's the nadir). Other considerations for reducing (other than the 68 we've already discussed) would be if the cat spends a week in "normal" numbers and things like ... well, kitty has not dropped below 68 but in order to prevent that you've had to use a lot of HC and honey to prevent it -- and sometimes if this has happened multiple times and it's clear that you are having to prop up the numbers with way too much HC and honey/karo -- then it becomes clear that the cat needs a reduction.
 
Suzzane - the Friskies I gave him was higher carb. I guess I shouldn't have, but I panicked as he went from 97 to 89.

Bhooma - 15 minutes to shot time. He hasn't eaten. I'm going to feed him now then shoot 2.5

Hubby and I (and Tango) are getting stressed with all this testing and thinking it's not going to end.
 
Here's the section on reductions from the TR dosing guide -- you've probably seen it before, but since we are talking about it, I copied and pasted below.
-------------------------------------

"Reducing the dose:

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, Levemir, & Biosimilars 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.
 
Lori Callagy said:
I panicked as he went from 97 to 89.
Click to expand...
I understand that panic! The greens seem scary at first. Do you happen to know what percentage of carbs the Friskies was? Anything 10% or less is still considered low carb. Medium carbs is higher - up to 19 percent -- and high carb is 20 percent and over.
 
Suzanne & Darcy said:
Here's the section on reductions from the TR dosing guide -- you've probably seen it before, but since we are talking about it, I copied and pasted below.
-------------------------------------

"Reducing the dose:

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, Levemir, & Biosimilars 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.
Click to expand...
Do these pertain to Pet Meters also? I thought they were just for human meters
 
Suzanne. To clarify numbers are for the Relion? For AT it would be 68 for newly diagnosed diabetic and range is 80 - 150?
 
Diane Tyler's Mom said:
Hi Suzanne I have a question on 8-19 her cats BG was 54 @+4 AM cycle
Shouldn't she have reduced or since the day before on 8-18 night cycle she reduced because he earned a reduction during the AM cycle @ 65+8 and you don't want to do back to back reductions?
@Suzanne & Darcy
Click to expand...
I noticed that on Tango's spreadsheet yesterday. The August 19 54 at +4 of the morning cycle. I noticed that there had just been a reduction the previous day (Aug 18) and I assumed that she was advised to not do another reduction on Aug 19 because she had just reduced and "back to back" reductions rarely are successful. Tango needed a little time to let the depot reduce a bit in order to see what the new 2.5 unit dose would do. You're an eagle eye on the spreadsheets, Diane. You never miss a thing. :cat:
 
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Diane Tyler's Mom said:
Do these pertain to Pet Meters also? I thought they were just for human meters
Click to expand...
Well, yes -- as you know, all the protocols for dosing on this forum were written for human meters -- as we are always telling people and we are trying to pursuade them to switch to human meters (also much less expensive for test strips.) So modifications are made for the alpha trak. That's why we said to reduce at 68. I don't know of a document on the site that has any kind of "conversion chart" for an Alpha Trak to a human meter and I don't think it exists (prove me wrong because I would like to see it and save it if there is one!) :)
 
Suzanne & Darcy said:
I noticed that on Tango's spreadsheet yesterday. The August 19 54 at +4 of the morning cycle. I noticed that there had just been a reduction the previous day (Aug 18) and that she was advised to not do another reduction on Aug 19 because she had just reduced and "back to back" reductions rarely are successful. Tango needed a little time to let the depot reduce a bit in order to see what the new 2.5 unit dose would do. You're an eagle eye on the spreadsheets, Diane. You never miss a thing. :cat:
Click to expand...
Thanks for the information ,maybe I should be in charge of catching things :p
since I don't know how to give advice on dosing :cat:
 
Suzanne & Darcy said:
I noticed that on Tango's spreadsheet yesterday. The August 19 54 at +4 of the morning cycle. I noticed that there had just been a reduction the previous day (Aug 18) and that she was advised to not do another reduction on Aug 19 because she had just reduced and "back to back" reductions rarely are successful. Tango needed a little time to let the depot reduce a bit in order to see what the new 2.5 unit dose would do. You're an eagle eye on the spreadsheets, Diane. You never miss a thing. :cat:
Click to expand...

Now I'm getting all screwed up. What I remeber is on the 18th an official reduction to 2.5 was earned due to the 65 at +6. I know we were going back and forth on doses and that token doses were given. I would need to go back and read through all the threads or I think the correct term is condos?
 
Lori Callagy said:
Suzanne. To clarify numbers are for the Relion? For AT it would be 68 for newly diagnosed diabetic and range is 80 - 150?
Click to expand...
With AT if the cat falls below 68 a reduction is earned, but the "normal" range on an alpha trak meter is 68-150. That would be the range where a cat would have to spend a majority of its time for a week in order to earn a reduction that way (with the AT meter).
 
Suzanne & Darcy said:
Here's the link to the thread where Bhooma explained about not taking a second reduction one day after the previous reduction. You've done everything correctly. Don't worry!!
https://felinediabetes.com/FDMB/thr...-95-4-54-4-1-2-79-6-84-9-279-pmps-557.267330/
Click to expand...

Got it. Thank you!
Bandit's Mom said:
The rule for a reduction is a drop below 68 on a pet meter or a week in largely normal numbers. I'm on my phone so can't link the sticky on earning reductions.

With time Tango will flatten out and see more predictable cycles requiring less testing. When a cat's pancreas suddenly wakes up and the cat decides to head down the dosing ladder, it can be an "exciting" ride for the caregiver. Hang in there. All the stress and sleepless nights will pay off.

Getting an autofeeder and ensuring he has access to food when you are not at home or asleep can make it easier.

How much time for his shot? 30 mins? And he ate at +11?
Click to expand...

We did get the Pet Safe 5 auto feeder and it's working great:)
 
Suzanne & Darcy said:
The requirement for following TR is that you need to get at least one mid-cycle test during both the day and evening cycles. You don't "need" to test all day necessarily. It's a good idea, if you are at home with Tango, to get a +2 or even a +3 in Tango's case (you can do a 2.5) to see if he's dropped much from the AMPS/PMPS number. I think a +2 might be too early for Tango, but that depends a little bit on his preshot number, too. If you are able though, it would be very good to try to get another test or two in the early part of the cycle before his typical nadir. I would try for maybe a +4 and +6 and then stop testing for the rest of the day when he usually starts going back up a bit. Or a +5 and a +7 and then stop. It all sort of depends upon what numbers you are seeing. Obviously if you get a really low number then you will need to keep monitoring. Since you just gave the Friskies Pates yesterday (I'm assuming they're the LC Friskies pates so correct me if I am wrong) you didn't have to use anything HC to bring him up or anything like that.
Click to expand...

Friskies Shreds with chicken in gravy i what I gave Tango. On the BalanceIt calculator it's 16.5% carbs
 
Bandit's Mom said:
You weren't able to get any tests in the day today?
Click to expand...

We just did pre-shot tests yesterday. Yesterday was probably our most stressful day. We decided to take a break on other testings. We were home and watched Tango for any physical changes.

This morning he tested at 482. I know, if we had done a couple other tests yesterday, we could've seen when he started to climb. Don't know if amount of food he ate has anything to do with the climb, but yesterday he ate less than last couple of days because we were feeding him more due to the low numbers.
 
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