New to TR, numbers are crazy, opinions needed

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Skunky's Mom

Skunky's Mom

Member Since 2014
Hi all. Sorry I couldn’t figure out how to make this into a condo. And apologies in advance, it’s long. I should probably break it up.

I’m thinking about moving to tight regulation. I’ve been “relaxed” but really pretty close to tight regulation.

I’ve “shot low to stay low” twice. The first time I got a low PS, I reduced, and waited an hour. The second time I skinnied, out of an abundance of caution. The third time I thought - woot woot we’re making progress and gave full dose. And each time, that PS was the lowest she went that cycle.

What the?

I’d love for some of y’all to take a look at Skunky’s spreadsheet and give me some thoughts on what’s going on.

Numbers were really great the last two days. Lots of blues. And then. . blammo, 200s and a 314 PS today.

I don’t get it. On the good days, her food was 8% carbs, then we were eating a 9% variety. I’ve got to go shopping to get some more friskies SD turkey and giblets. I have several cans of the SD beef and chicken and she will not eat it. I’ll be interested to see if things change when we’re back at 5% carbs.

I did just switch to the Relion Prime. I did a paired test this morning and it was about 20 points lower than the Confirm. The Prime number was 243. I figure on the lower numbers, they will be closer. I’ll try to do more paired tests.

I’m trying to decide if it’s time to up the dose again. When I upped to 1 unit from .75, she dropped to 53, I freaked out, and reduced. I have a feeling her ideal dose is somewhere between .75 and 1.

I’m hoping to go on a 3 or 4 day beach trip the third weekend in September. I kinda hate to increase before then. I was thinking to have her given 1/2 unit while boarded (or have my ex watch her) just because .75 is hard to measure and I’d much rather her be too high than the alternative.

I also worry that my dosing is not consistent because it is so hard for me to estimate :-(

I’m also trying to decide if tight regulation is for me. It used to scare me. Now, not so much. But I am super freaking terrified of a hypo. On most days, I can test several times. I shoot at noon and her nadir is around 8, and I’m usually home by then. I have been getting up around +6 or 7 each morning and going back to bed. But I won’t be able to test like that EVERY day. Especially on a weekend day when I go somewhere. I don’t know whether to skinny a dose at a time like that or what.

I expect I’ll end up some where in the middle between tight regulation and relaxed. I’m middle of the road in almost every aspect of my life so it makes sense I would be here, too.

Any and all thoughts are appreciated!
Thanks much!
 
funky skunky is super fat, eh? :lol: that's about the best signature line i've seen!

well, welcome to both of you! We have lots of people who work and still follow Tight Reg. Typically they get more evening tests instead and use something like a timed feeder to make sure food can be available to their cat while they are at work. It might also mean that faced with a low preshot and having to go to work, you may need to skip a shot here and there.

The goal of TR is to get a cat's blood sugar into normal numbers (50-120) so that their pancreas can heal, and ideally the cat will go off of insulin and become diet-controlled. Even if they don't go OTJ, keeping them in normal numbers protects their body from the ravages of high blood sugar.

I agree that you could increase back to 1.0u. She was looking pretty good with that long green stretch on 8/22. That's the goal of TR - keep the cat in normal numbers for as long as possible. Don't be afraid of the 50's - they are great numbers and there is still safety in that range. When a cat drops below 50 into the 40's, then you take action to keep them over 50. As you get practice with bringing up low (below 50) numbers, you'll see you can steer FS's blood sugar with carbs. Once you realize you're in control, it gets infinitely more routine and less nerve-wracking.

Here is a recent post about shooting low. You can't do it and leave for work unless you know from repeated experience what FS will do with a low preshot, but when you're home, it's good to try it out and monitor the results.

Looking at her ss, i'm wondering what her feeding schedule is?
 
oh, and about your trip in September - typically people continue to follow TR until the day before they go, then re-evaluate the dose and if the cat won't be tested while you're gone, reduce the dose for the vacation.

With TR, we re-evaluate the dose every 6 cycles and decide if it needs to be held longer or increased. I wouldn't wait until after your trip to adjust the dose. Cat's bodies get used to higher numbers, and Glucose Toxicity sets in. Then you need even more insulin to move their blood sugar down.

Right now, this part of the protocol applies to Funky Skunky:
Tight Regulation Protocol
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.
After 3 days (6 consecutive cycles)... if nadirs are greater than 200, but less than 300 increase the dose by 0.25 unit.
Click to expand...

He's had 10 consecutive cycles at the 0.75u and a majority of his nadirs are under 200.
 
I agree that you need to work the juice now.... before your trip... ( adjust for the trip and then get back to it when you return)
good time to learn his patterns and maybe even get him surfing those greens all the time....
 
Wow, thanks ladies. This is very encouraging. And thanks for the link to the post about shooting low Julie. Though honestly, shooting green is something I hadn't even thought about. :shock:

I'm going to go ahead and increase tonight. I don't think we'll be going anywhere much this weekend - except for all the choice yard sales we have in my town this weekend every year.

I'm going to do a skinny 1unit. She's doing a lot better on .75 now than she did when she was on .75 before, so I figure that means she may go even lower on the 1u than she did then.

If I do go somewhere, or will be away around +6 to +9, or so - should I skinny?
What's the ideal time for the PM test? I was doing around +6 even though the nadir is later, because I figured I could tell where we will be going, and make sure she eats.

I forgot to mention - on the day she got so low, she had barely eaten at all, because she despises the Special Diet Beef and Chicken. I still have like 5 cans of it :-(

As for her feeding schedule Julie. . . um, is there supposed to be one? I always feed her when she gets her shots and at least once during the cycle, usually around +6, even though her nadir tends to run around +8. If I get up at the break of dawn to test her, I'll feed her then.

Do I need to be more strict about this? She's not eating as much as she used to - I figure that is a good sign.

I can also tell, in the past few days, she is feeling better. She's very snuggly. She spends a lot of time with me on the couch instead of upstairs (where her food is). It's warm up there and cold down here which might be why she likes it up there (I figure, like any old person, she doesn't like the cold!)

Her pee has been smelling better. I kept wondering why the bathroom where her litter box is smelled so awful and I realized it must be the sugar in her urine. A few days ago I noticed it didn't smell like that anymore. But today it did again a bit.

Thanks again y'all!
 
Re eating, it depends on how much she is eating. For some cats, if they eat late in the second half of the cycle it can drive up their blood sugar. Lantus wanes in the latter part. But if you're not feeding much past +8, it's probably ok. Cats who just graze can be fine too, it's the cats who eat a lot then that see more of an impact.

I didn't see anything while you had her on 1.0 that made it look too high. Sometimes skootching up in dose isn't as effective as increasing by 0.25u increments. But if you are more comfy with it, go for it.

It's great she's feeling better! As her blood sugar comes down overall, it's normal for her appetite to return to normal.

For testing, it helps to vary the times you check. You want to track how low a dose is getting her. If you need to leave, I'd check her before you go out, decide if you can just give her some food while you are gone. You want to keep her above 50. You can post here and ask to have someone help you decide, too.
 
Hi,

Welcome to the TR board! The wonderful people here helped me get my Jersey into remission back in April. I leave the dosing advice to the more experienced users here, so I'll let them answer your questions about the doses.

Your mention of the Friskies special diet caught my attention. I've been feeding my "kids" the Friskies turkey and beef/chicken. Over the past few weeks, they've absolutely refused to eat the beef/chicken. I don't know if the formula has changed, if there are some bad batches, or what.....but I did contact the company and provide the lot numbers for the food so they could perhaps research it. I told the pet store owner (where I purchased the food) about all of this. She told me to bring the food back in, and they would refund my money. Perhaps you could do the same? I wanted to mention it for whatever it's worth.

In terms of feeding schedules, several smaller meals is easier on the pancreas than a few larger meals. A lot of people here will feed at shot time, at +1, and at +2 (and at other times as needed based on the numbers). I generally fed Jersey about 8 times a day. I just gave her little amounts each time. I'm sure others here will offer suggestions about what type of feeding schedule might be best.

I'm glad you're considering TR. I was terrified at first, but I now know I couldn't have been in better hands.
Shelly
 
Thanks Shelly. So they were ok with the beef and chicken before? I might return it. It's only a few bucks but. . . I'm poor. Plus I hate having all this food she won't eat! I will have to go back to PetSmart today anyway, I'm pretty sure.

I'm about to post her condo today. AMPS was 78 just now. After one increased dose. Scary.
 
if you've got unopened cans, nearly all of the stores will let you make an exchange....
all you have to say is I have a diabetic cat.... and these aren't good for my cat....
 
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