Considering a change for Queenie

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Chris & Queenie

Chris & Queenie

Member Since 2015
I have been following the TRP for about three weeks and I'm pondering if the GS method might be better for Q and for me. How much harm would I do by just slowing things down a bit? I am concerned about my ability to keep up with all the testing and have times when it would simply be impossible to monitor a kitty bouncing around in the 50's, 60's etc.

I am interested in what others have gone through when switching back and forth between these methods. If the goal of the TRP is to hopefully get OTJ then would you not see that happen within a reasonable amount of time? perhaps 6 months (just throwing that out), not many years? Q is 12 and she's spry, but I can't say she's not well past her mid point in life. If she were significantly younger I could see putting her through testing for the TRP for a year or two at the most. I know ECID and I am betting none of you have a crystal ball, but I would want to give her the best quality of life for the years she has left.I can't help but ask how much shorter would it be if my plan was to manage her (with less stress onus both) but not strive for the lowest possible number all the time?
 
I think it depends on what you consider a "reasonable amount of time." It's rare for a cat to go OTJ in a few weeks. The kitty of one of the members who isn't posting regularly these days took 2 years to decide to go OTJ. Check Amy's kitty -- it took even longer although the probability of remission decreases over time.

There are plenty of kitties who went OTJ using SLGS prior to TR's existence.

I'm at work and will try to post more when I have a chance.
 
Chris & Queenie said:
If the goal of the TRP is to hopefully get OTJ then would you not see that happen within a reasonable amount of time?
Click to expand...

Generally, yes...we see most of our OTJ kitties within the first 6-12 months BUT we've also had kitties go OTJ after 3 years (and I think even more!)

12 yrs really isn't all that old...more like middle aged (I'd compare it to about mid-upper 50's in a human) Queenie could have many more years of life and love to share with you...unfortunately, she may not....there's no way any of us can know

You don't have to test as often as you do...as long as you can test before each shot and once mid-cycle during the AM and before bed on the PM you can continue to do TR....but of course when she does go into those 50's, you're going to need to test more often...at least until you have enough data to really know your cat. With China, I know her well enough by now that I know when it's safe to leave her for awhile when she's in the 50's and 60's and when it's not. What part of the cycle she gets those numbers in factors in, as well as how long I have to be gone and unable to test. You always have the option of "aborting the cycle" if you really need to rest or can't be there to test for any reason...just carb her up really well

The good thing about having her spend all that time in those numbers is that her pancreas is healing...which increases her chances of going OTJ

Which protocol to use really has to be your decision though.....the main differences are that on TR we do dose increases more often and we wait until they drop below 50 to decrease. On SLGS, they only get increased once a week and decreases are made when they drop below 90.

Whatever you decide to do, we'll be here to help you though!! Queenie sure is looking a LOT better than she was just 1 month ago!!
 
Queenie has made significant progress towards remission in the month that she has been on insulin. You just never know for sure how long or how short a time the kitty will be on insulin, but based on the progress so far I might think Queenie's time will be shorter rather than longer. Again, one never knows, but she has made good progress.

I agree with Chris that you could stick with TRP and just not test quite as often. For me I wanted as much data as possible so testing often didn't bother me, but for others it just doesn't work for them. As Chris suggested you could get PS, and one mid cycle, and then on the weekend or on a day off you could get a curve to better understand how Queenie is responding to food and insulin.

But no matter what, you have to choose the protocol that works best for you. I choose TRP because I wanted to get Sammy's number back to normal as quickly as possible, but for others the stress of dealing with the quick increase and the potential for LOWs is just too great and they would prefer a slower approach. Only you can decide which is better for you. Honestly I have no idea if one protocol over the other produces a better chance of remission.
 
Thanks Chris, Don't get me wrong, I don't write off a 12 year old cat by any means. Like I said, she's probably past the mid point, but who knows. The first two we ever had lived to be twenty and we lost one two years ago a few months shy of 22. I always feel at 14 or even 15 they "owe" me a few more miles :)


And before I go on, yes I can be anxious about things, but no I did not expect remission by now by any means. I jut don't feel I see a clear pattern, or any real pattern for that matter and I feel like it is being rushed and I would rather slow down just a little... I also think a reasonable amount of time for remission is going to be different for everyone but honestly 3 years seems like a really long time to hope for that, especially in a cat of her age.

I am only testing this much because I have been really surprised from time to time at what I'm getting and because I'm not really feeling comfortable I can predict anything yet. Her days have been so vastly different from time to time - mistakes aside, though I do think her bounces are shorter and not as high anymore. She does respond to food well and typically will eat for me, and so far she does seem to handle the lower numbers without problems. But just the other night as I was reading over the sticky about shooting at low numbers and the info about Hypo and all the possible ways things could suddenly take a bad turn ~ I had to ask myself why I would go there repeatedly....in the middle of the night.... or the middle of a work day.... So I think slowing things down a bit will do a few things for us. It will relieve some of my anxiety, it will give her ears a break, it will allow me to get through my next huge project and hopefully it will allow me to see a little more of a pattern even if it means her numbers are more in the yellows and blues than the blues and the greens. If I can relax a little and feel comfortable testing right before I shoot along with occasional spot checks (as long as she's otherwise doing fine), then I feel that's the right approach for now, for us and all the things that factor in here.

And please understand I am enormously grateful to everyone and don't plan to jump ship. I have learned a ton. It is empowering to see that what I am doing is having such an obvious and in many ways swift impact on her overall condition. When I brought he home from the vet her feet were like little cement boots, she was pawing in the water getting in the litter pan and then getting out and pawing at the water and then back into the litter. It was very sad. Now the water bowl is clean and the litter pan looks like a normal healthy cat is using it. She's gained weight, started to get more satiated with food and as shown signs she really wants to hang out with me. All great things that give me immense hope.

And I am very thankful to you especially for that, you suggested I come to this forum. Had Queenie gone home with my mom I have no doubt she's be uncontrolled and not a whole lot better than when she went in.

thank you!
 
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You have to do what works for you. Just to offer a different perspective for you to consider . . . the thing i'm noticing is that she is really doing extremely well. In the past 10 cycles, you've reduced the dose twice (as of tonight), had 4 skipped shots and yet she is STILL in green tonight. That says huge progress. It says that even with the dose reduction, and the depot being interrupted, she is still doing well enough to recover almost immediately from the interruptions and "get back to business."

What I would suggest is that you stick with the TR protocol for another 2 weeks and see what happens. Sometimes when things get to the point where the cat is doing well, they can go down the dosing scale very quickly. It's almost like you can't prevent them from earning dose reductions because their pancreas is sputtering back to life and putting out some insulin. That's what it looks like is beginning to happen with Queenie. You've reduced her dose and skipped her shots, but STILL, she got to 34 tonight.

As you said, we have no crystal balls. But I see a spreadsheet that looks very optimistic to me. I could be wrong, but if she were my cat i'd give it a little longer and see if she continues down the dosing scale.

After that 34 you would reduce her dose in the morning to 1.5u. that's 25% less insulin than she needed 4 days ago. :D
 
By no means am I an expert at ANY of this and I may be completely misunderstanding a few of your points, but it looks like part of the reason that you are wanting to switch protocols is because it is difficult to test so much when Queenie is going low. And that it is sometimes difficult to be able to monitor a kitty that is bouncing in the 50s and 60s.

Using the GS method does not guarantee that Queenie will NOT go into the 50s and 60s, it just means that you may not be as aware of it. You would be relying on the secondary signs of a possible hypo, as stated in the handling low numbers (or wherever it is listed) and probably if seeing some of those signs, testing anyways.

From what I am reading/understanding from your post and concerns, you are thinking/hoping the GS method will calm some anxiety and fears regarding the lower numbers. The GS method is not going to relieve any anxiety that you have regarding the numbers you are seeing, you just wouldn't be seeing them. Skooter and I have been doing this dance for almost a year (diagnosed in April, insulin started in May of 2014) and I will be honest, I still have no idea what his spreadsheet reads. I do know that he typically nadirs early and that is about the only pattern I have noticed. HOWEVER, there are amazing ladies on this web site who DO know how to interpret the spreadsheet and find those patterns. I rely on them to point out those patterns and help me to start looking for some myself.

After collecting all the data I have, as I said before, I have learned that Skooter nadirs early. So on nights where I really need some sleep, even if he does a pretty big drop at +2 or +3, I know that he is gonna nadir by usually +4 or +5, so I can still comfortably get sleep that I need. The other thing I have learned is that when Skooter is dipping into lower numbers (32 being his lowest), he showed no signs at all of being that low. The only way I knew that was from just a random test that I did. So while it is great to have the signs of a hypo, Skooter didn't bother to read them so that he knew how to tell me he was going super low.

Right now, with my work schedule you will see that I am rarely able to come home during the work week to test him and tend to do a lot of night tests and weekend tests. While not ideal, it is what I can do with my schedule right now. When work permits, I absolutely come home to test him because for me, the more data I collect, the more I will understand SKOOTER'S sugar dance. As we all know ECID and they each dance to the beat of a different drummer.

From my perspective, TR protocol is not about getting the lowest number possible, but keeping our cats under renal threshold and added bonus of the normal range of 50-120 as long as possible as that is when the pancreas will do the most healing.

I get the stress of this sugar dance, you can ask anyone here, there were many a night where I cried and every person here took turns letting me use their shoulder, once I got one super wet with tears, the next person was there :P

Again, I may be misinterpreting your statements, but you remind me a lot of me and I know that I need to get as much information as possible. I have a feeling that if you were to try the GS method, you would end up testing at the minimum needed for TR anyways.

The insulin and your cat have no idea what protocol you are following, and neither really cares. They are going to work how they are going to work regardless of what protocol you use or how often you are testing. For me, as exhausting as this dance can be sometimes, I would not do anything differently. The other thing to keep in mind, this could possible be a short term thing in the grand scheme of things with the ending result that you are no longer giving insulin and testing weekly or monthly if she gets OTJ.

If I am completely off and misunderstanding your concerns, feel free to disregard my entire post :) Also, for any of those "wise timers" (didn't want to say old timers :P) reading this, if I am completely off on my interpretation of the different protocols, please let me know.

In the end, you must do what is right for you and Queenie, but wanted to throw this out there
 
We do get a lot more remissions with TR than happens with SLGS... And then the stress is completely gone... I would hang in a bit longer if I were you. Vyktor took 3 1/2 months to get there but has now been off insulin for three years - well worth the effort.
 
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