New here. Looking to Tight Regulate Polly, maybe?

[Marilyn and Sheldon]

Diagnosed late March. Background on Health Forum:

Polly's Thread from Health Forum

Questions:

1. I'm out of the house for seven hours shortly after Polly's am shot. Work. If she tests low or goofy high requiring the wait-and-retest protocol, I'm stuck. Does this preclude TR? We're doing a 6:30, 6:30 schedule.

2. If she tests at 90 amps, she still gets her shot? I'd have to suck up my courage to do that. Courage seems to come with the condition, though. Could do that if experienced TR folks offer support!

3. Dose stays the same for 3 or more days. Even if she's off the meter high? My vet is an 8-5, M-F kind of guy. Nearest off hour vet service is 90 miles away. AKD a threat?

4. What about those days (or twice a year, week) when I'm out of town? My pet sitter has experience testing and shooting, but she can't stop at the house more than a couple times a day. Seems that won't work with TR. What do others here do?

Polly's ss is in my signature. Any advice? We've just started this journey. Any help anyone can offer...oh, my, I'd be so appreciative!

And thanks to Wendy who suggested I read the TR protocol. I'd love to try it. If it would work for our situation.

Thanks.

Marilyn and Polly

 

[Sienne and Gabby (GA)]

Hi Marilyn and welcome to Lantus Land.

I'm Gabby's sole caretaker and I work. In fact, I just moved part of the way across country to start a new job. I may have less of a commute than you but I basically get up way too early so I can get a couple of tests in before I leave the house. (I'm able to test up to about +2.5 -- maybe a bit later on some days but most of the days, I'm out of the house by +2.5.) I have a cat who has a well earned reputation for fast, early dives. I get home by her PMPS. I've been doing TR for quite a while.

One thing that can help is a timed feeder. Getting to have a handle on your cat's patterns is also a bonus.

As for travel, you're lucky. Polly will let your catsitter test. Gabby wants no part of anyone else but me poking her ear. I reduce her dose and my cat sitter comes twice a day for shots and feeding. It's possible to do TR when you travel.

You do hold the dose even if numbers are high. Often numbers can be high because of a bounce (a lower than usual number or a fast drop triggers a bounce) and you need to wait for the bounce to clear. Even if this isn't the case, because Lantus is a depot type of insulin, you need to give each dose a chance to stabilize and give yourself a chance to evaluate whether the dose is doing what it's supposed to do. Rapid dose increases can result in wonky numbers or put your kitty at risk for hypoglycemia.

The mantra here is shoot low to stay low. Once you have sufficient data, you'll be able to shoot any number above 50. And yes, we stick with you to help you get comfortable with shooting progressively lower numbers.

You asked about AKD. Did you mean DKA (diabetic ketoacidosis)? DKA isn't a threat unless you cat is either very prone to ketones which typically result from a cat having some sort of infection/inflammation, not eating, and not getting enough insulin. If you periodically test for ketones, this shouldn't be an issue.

 

[Wendy&Neko]

Hi Marilyn and Polly to Lantus Land. There are lots of other people here who are also away at work during the day. Developing a schedule where you can get a test after preshot will really help you, along with the timed feeder. Based on what you see for the test after preshot, you can leave low carb, medium carb, or high carb food for Polly to snack on to keep her safe while you are gone.

If you ever get a low test for a preshot and are unsure what to do, feel free to post here for advice.

Keep on with the questions, people here like to help.

 

[AZJenks]

Wishing you and Polly the best of luck!!! You have a wonderful community of people here to help.

 

[Shelly & Jersey (GA)]

Hi Marilyn,

Welcome to the TR forum! Just an introduction so you know who you're talking to - my name is Shelly, and my cat's name is Jersey. We started Lantus (after trying Humulin) in mid-February and Jersey went into remission in mid-April. She is now diet-controlled. I read your introductory post - it's great that testing has become part of the routine now. That's so hard to get started. I was in tears many times while learning how to home-test.

1. I'm out of the house for seven hours shortly after Polly's am shot. Work. If she tests low or goofy high requiring the wait-and-retest protocol, I'm stuck. Does this preclude TR? We're doing a 6:30, 6:30 schedule.

We were on a 5:30, 5:30 schedule, and I was out of the house for about 7 hours, too. I ended up buying a timed feeder to use while I was at work. It didn't get rid of all the worry, but it helped.

2. If she tests at 90 amps, she still gets her shot? I'd have to suck up my courage to do that. Courage seems to come with the condition, though. Could do that if experienced TR folks offer support!

Did I write that???? :lol: That sounds just like me! I was terrified of shooting low......but the people here held my hand the entire way. I did skip a few times when Jersey was low, and I knew I wouldn't be around to monitor.

3. Dose stays the same for 3 or more days. Even if she's off the meter high? My vet is an 8-5, M-F kind of guy. Nearest off hour vet service is 90 miles away. AKD a threat?

Dose changes are done slowly since it takes time for the depot to adjust to changes. When you're waiting, those high numbers are really hard to see. We saw a lot of them for probably 6 out of 8 weeks. Jersey was a bouncy kitty. When she finally got into a normal number, her liver panicked and started releasing more glucose. We would then have to wait out Mr. Liver. That was one of the most difficult aspects for me. Luckily, one day it just "clicked," and Jersey went barreling towards remissions.

One of the best things you can do is post Polly's numbers here every day. The dose advisors can then tell you - it's time to increase, time to decrease, etc. In the beginning, it was hard for me to put my trust in these complete strangers. I soon came to know them, watched them give advice to others (advice that worked), and watched the progress we were making with Jersey because of the advice they were giving us. They are amazing people, and we are in remission because of them.

My vet(s) - I consulted with two different ones - knew very little about FD. One vet was not supportive of Lantus or home-testing. The other vet wanted me to give 10 units of Lantus once a day. After finding this board, I didn't take Jersey back to either vet again. I simply let the people here guide me.

4. What about those days (or twice a year, week) when I'm out of town? My pet sitter has experience testing and shooting, but she can't stop at the house more than a couple times a day. Seems that won't work with TR. What do others here do?

We actually went against the advice of the members here and took Jersey with us when we went out of town for a night. They told us to just skip the shot and leave Jersey at home....but, no.....I had to be stubborn and take her with us. It didn't go well! :lol: I know several members here will skip shots a few times a year when they are traveling. As Sienne mentioned, others will have pet sitters give reduced doses while they're away.

If TR is the right protocol for you, that's fantastic. If it isn't the right protocol for you, that's okay, too. You have to make the decision that feels right to you. Just don't hesitate to ask whatever questions you have!

Have a great day!
Shelly

 

[julie & punkin (ga)]

i just want to add my welcome! everyone's given you lots of good info.

Only a couple of things I'd add:

the timed feeder we used (and loved) was the PetSafe 5 Compartment Feeder. The great thing about it is that you can set whatever times you want for the feeder to open. Food is the first tactic we use to deal with low numbers. I went back to work about a year after punkin was diagnosed. We got this feeder and if he measure lower we set the timed feeder to open when we predicted he'd need it. It really does give you peace of mind. The only criticism i saw for this feeder is that it doesn't fully open sometimes. What we found was that if you ALWAYS made sure the food tray was fully seated in the base, and pressed a button to do a test rotation, it was 100% successful at opening fully. The problems come if you don't have it down all the way. But we were in the habit of always doing that and never had trouble.

the other comment I'd make is to add a little more about the +2 test. What sienne is suggesting is that you might want to move your shot time earlier so that you can get a +2 before you leave for work. The +2 is an interesting test - for many cats (of course, not all because cats like to keep us on our toes!) the +2 can be a "pointer" on what will happen the rest of the cycle. If the +2 is higher than the preshot, that might tell you a bounce is starting and numbers may continue to rise.

if the +2 is about the same as the preshot, that signals the typical active Lantus cycle, which means that you could think that she'll have a typical lowering for the next few hours and then a rise back up until the next shot.

if the +2 is significantly lower than the preshot, you're getting a red flag that she needs extra attention. That's when you could know to put higher carb food in her timed feeder, set to go off every 30 minutes or so for a couple of hours.

The reason for all the "many cats" and "might" language is because we don't know yet what Polly's patterns are, but that's something that will become obvious fairly soon. We'll be able to see by all the evening cycle tests you do and the tests you do on the weekends.

Shelly's right - until you learn how she'll respond, if you're not going to be home, sometimes skipping shots is the safest strategy. As you gain confidence and learn her responses, you can progressively lower your "no-shoot" number until you see how she responds as you shoot those lower numbers. Whenever you shoot a lower number than you've shot before, you want to get a +1 and a +2 so that you can make sure she's not diving. What you'll learn is that as you shoot lower numbers, her numbers will flatten out and become more of a line than a curve, and the sooner you can safely get her under 120 the better.

There is a lot of traffic and experience on this forum, so you can feel free to post your questions and you'll likely get an answer fairly quickly. If you're faced with a preshot that you're not sure about shooting, post and ask for help in the subject line and someone will help you figure out the best option. We've had some issues with the board recently, so it would be a good idea if you printed out and posted the Shooting and Handling Low Numbers sticky, just in case the board is down.

ok, for not having much to say, i said a lot! :shock:

you don't have to absorb it all right away. Read other people's posts and browse through the yellow starred stickies at the top of this forum page. We've all been new and we get how overwhelming this beginning phase is. If you can post daily/often, we'll do our best to help you get Polly regulated and back to her healthy self!