The Forum ... TR Protocol

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Christine & Onyx

Christine & Onyx

Member Since 2016
Hello, this is my first post ... My sugar baby, Onyx was diagnosed 3 months ago. I joined the Forum, I think it's wonderful that they have gotten many cats OTJ, but I don't think I can kept up with the Protocol. I also don't feel confident controlling my cats insulin by checking his blood several times a day, he hates it. I check his blood every few days, 6 hrs after his injection and he's been around 90-120 mg/dL and doing great, he's on Caninsulin 2 units, twice a day. He's on a wet diet only now, Fancy Feast (Pates) and he's back to being a kitten again. He's 8 years old. I keep a log and next time I go in to vet, he'll decide whether to give him less insulin or see if he is in remission. ... :cat:
 
We understand. There are many of us that do not follow the TR protocol. The important time to check is before every shot. The reason you test before each shot is to make sure it is safe to give the dose. If the BG level is too low and you give insulin, you risk Onyx becoming hypoglycemic, which can be very dangerous.
 
To Lisa, really, how did I miss that, I've been reading info till my eyes are red ... thank you. What level would be unsafe ??? So if it's low I skip the injection and test again before his next shot ??? My vet said to just check his blood once a week and keep a log. Before I bought a meter he told me to bring him in once a month for his blood test ... it's all so confusing. :nailbiting:
 
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Now does that mean check his blood after he eats and before his injection and how long in between ? I need to mention, I'm on disability, so money is tight. The strips are expensive, I can't afford to use 2 strips a day without it coming out of rent money. :(
 
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I would not recommend doing TR with an insulin like Caninsulin anyway--it has very fast drops and I think it would be dangerous to try. The TR protocol that you'll find on FDMB is very specifically for Lantus or Levemir.

Testing can be very hard at first (I was in tears the first week with Bandit), but once the cat gets used to it, they're fine! Bandit fought be tooth and claw in the beginning, but once I changed my attitude from "Oh, poor baby, I don't want to hurt you!" to "You're getting this test, cat, whether you like it or not because we need it to save your life!" it made a huge difference. Cats can sense your attitude, and if you're nervous and lacking confidence, they will not trust what you're doing. But if you reward every test with a treat, and stay calm and confident, eventually they'll let you test as much as you need a day without issues. I used to have to wrap Bandit in a blanket so he didn't claw me to shreds, and now he comes running when he hears the meter beep on, sits patiently, and purrs throughout the test.
 
Julia & Bandit said:
I would not recommend doing TR with an insulin like Caninsulin anyway - it has very fast drops and I think it would be dangerous to try.
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Agree 100%. I've used both Caninsulin and Lantus. I stopped Saoirse's Caninsulin treatment when she got into lower numbers because even on a small dose the drops were too steep. Thankfully she responded very well to Lantus when she was switched to it and I was able to continue her treatment safely.


@Christine & Onyx -

Fingers and paws crossed for you both that the testing will get easier. I had a similar experience to Julia; when I got more 'matter of fact' about the testing Saoirse became much more relaxed about it. She seemed to then have more confidence in me, even though I myself felt anything but confident.

Onyx is a beautiful boy, and I love his name. I'm very glad to hear his insulin treatment is helping him to feel much better. :)


Mogs
.
 
Aww thank you ... I'm lucky the Caninsulin is working, it's reasonably priced in Canada. I'm on disability, which means I'm on a tight budget. Even the strips up here are expensive, even though the meter for $4.99 ... it's been a tough go financially, but I so happy he seems to be doing great even though I've had to cut back on things. He comes first ...
 
Christine & Onyx said:
To Lisa, really, how did I miss that, I've been reading info till my eyes are red ... thank you. What level would be unsafe ??? So if it's low I skip the injection and test again before his next shot ??? My vet said to just check his blood once a week and keep a log. Before I bought a meter he told me to bring him in once a month for his blood test ... it's all so confusing. :nailbiting:
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For newbies, we recommend 200 as a "don't shoot" number. I have always used the longer acting insulins. Once you understand how Onyx's body normally responds to the dose, that number lowered a little. Just remember, ECID. Every cat is different. Also Every Dose is Different. If you have to skip a dose, that is ok. The next time the shot is due, the BG probably will be higher than normal, but that is expected. It is better to be high for a short while than too low for even a moment.
 
Julia & Bandit said:
Cats can sense your attitude, and if you're nervous and lacking confidence, they will not trust what you're doing. But if you reward every test with a treat, and stay calm and confident, eventually they'll let you test as much as you need a day without issues. I used to have to wrap Bandit in a blanket so he didn't claw me to shreds, and now he comes running when he hears the meter beep on, sits patiently, and purrs throughout the test.
Click to expand...

I agree. When I first adopted Spot I had to use the burrito method because she was scared and did not trust me. Once I stopped using the burrito and showed her that I trusted her, she began letting me test her with no issues.
 
Lisa and Witn (GA) said:
For newbies, we recommend 200 as a "don't shoot" number. I have always used the longer acting insulins. Once you understand how Onyx's body normally responds to the dose, that number lowered a little. Just remember, ECID. Every cat is different. Also Every Dose is Different. If you have to skip a dose, that is ok. The next time the shot is due, the BG probably will be higher than normal, but that is expected. It is better to be high for a short while than too low for even a moment.
Click to expand...

200 mg/dL ??? He has been in the 100 mg/dL range 6 hrs after his injection for a month now, but I guess that's why. Plus I was only checking every few days because the strips are so expensive. Another question, how long do I wait after his meal to check his blood before his injection time. Anyway, thanks everyone, time to seize the day, whats left of it ...
 
Lisa and Witn (GA) said:
For newbies, we recommend 200 as a "don't shoot" number. I have always used the longer acting insulins. Once you understand how Onyx's body normally responds to the dose, that number lowered a little. Just remember, ECID. Every cat is different. Also Every Dose is Different. If you have to skip a dose, that is ok. The next time the shot is due, the BG probably will be higher than normal, but that is expected. It is better to be high for a short while than too low for even a moment.
Click to expand...

Well, I tested him after his dinner before his injection and it was 300, so he still needed his insulin. Thank you though, I'm understanding more and more daily. At 6 hrs in he's around 100, so the insulin is doing it's job and that I am thankful.
 
Christine & Onyx said:
I'm on disability, which means I'm on a tight budget. [...] it's been a tough go financially, but I so happy he seems to be doing great even though I've had to cut back on things. He comes first ...
Click to expand...

I know what that feels like. Onyx is blessed to have such a loving and caring mom. :bighug:


Mogs
.
 
Christine & Onyx said:
200 mg/dL ??? He has been in the 100 mg/dL range 6 hrs after his injection for a month now, but I guess that's why. Plus I was only checking every few days because the strips are so expensive. Another question, how long do I wait after his meal to check his blood before his injection time. Anyway, thanks everyone, time to seize the day, whats left of it ...
Click to expand...
Hi Christine,

The '200mg/dL' is the initial 'no shot' threshold number; we recommend that newcomers to diabetes don't give the shot if the number immediately before the shot is below 200.

100mg/dL is just fine at the peak (lowest number) of the cycle. But, ideally, you wouldn't want to see him dropping any lower than that at this point.
And quite a few Caninsulin users have found that the peak happens earlier than 6 hours after the shot; 4 hours is quite common. So, it might be worth experimenting and trying some of your mid-cycle tests a bit earlier on?

Christine, which meter are you using?
And are you able to get test strips on Ebay? I don't know what the situation is in Canada, but here in the UK they can be a lot cheaper that way. I'm tagging a couple of sister Canadians, Mary Ann @Tuxedo Mom and Linda @MrWorfMen's Mom to see if they have any suggestions.

Welcome to FDMB! :bighug:

Eliz
 
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Welcome to FDMB Christine and sweet Onyx.

Testing is always important since response to insulin can change on a daily basis even with the same dose. Since insulin is a hormone the amount of absorption can vary and a kitties body can respond differently. With a harsher fast acting insulin like Caninsulin/Vetsulin it is very important to get a preshot reading as well as readings at +2, +4 and even +6 hours after the shot to see when the lowest point actually is and how fast the numbers drop. Because Caninsulin can drop the glucose numbers a lot in the first few hours after an injection it is important to know that the glucose number is safe before giving a shot and the other tests are to make sure the numbers do not drop too low.


I am in Winnipeg, Manitoba and I use both the Alpha Trak 2 pet meter and the Free Style Lite human meter. For myself I buy my Free Style Lite testing supplies at Shoppers Drug Mart. In Manitoba (and most likely BC) they have a seniors day every Thursday, where you can get 20% off regularly priced items, which includes the test strips. You need to be 55 and have a Shoppers Optimum card which is easy to register with. If you are not 55 then you can get someone who is to purchase the strips for you. About every 5 or 6 weeks they also have a "spend $50 get a $10 gift card" event on senior's day as well.. On these days I buy as many packs of strips as I can. You buy each one separately and get a $10 card which you use on the next box and so on and so on. Plus you get Shoppers Optimum points. Last year I was able to get $500 of product for free with the points.

Example: (Price check different Shoppers as here the prices can vary between different location)

Regular price $79.99/100
With seniors discount $63.99
With seniors discount and $10 gift card $53.99

We have another member in North Vancouver @Wendy&Neko who has said she gets the best price at Safeway. Here Safeway is more expensive, but in BC it may be that Safeway has better prices. At Safeway you would get Air Miles points which you can use for gas/groceries at various places. I don't know if Air Miles points can be used at the Safeway pharmacy?? Maybe Wendy will be able to tell you.

Also setting up a spreadsheet will be very helpful to get an idea on how well the Caninsulin is working for Onyx. Here is a link to setting up a spreadsheet:

http://www.felinediabetes.com/FDMB/threads/fdmb-spreadsheet-instructions.130337/

Being in Canada we are able to get human insulins at very good prices compared to what the US people pay. I don't know what you pay for Caninsulin or what size container you have, but if you need to change to a gentler, longer lasting insulin like Lantus or Levemir the prices are really not bad at all. I have two kitties on Levemir with a combined usage between them of 7 units (for 2 kitties) twice a day and my costs are about $25/month using the penfill cartridges.
 
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Christine & Onyx said:
200 mg/dL ??? He has been in the 100 mg/dL range 6 hrs after his injection for a month now, but I guess that's why. Plus I was only checking every few days because the strips are so expensive. Another question, how long do I wait after his meal to check his blood before his injection time. Anyway, thanks everyone, time to seize the day, whats left of it ...
Click to expand...
We recommend that you test, feed then shoot. Food can raise the BG levels significantly. By testing before you feed him, you will get a more accurate reading.
 
Tuxedo Mom said:
Welcome to FDMB Christine and sweet Onyx.

Testing is always important since response to insulin can change on a daily basis even with the same dose. Since insulin is a hormone the amount of absorption can vary and a kitties body can respond differently. With a harsher fast acting insulin like Caninsulin/Vetsulin it is very important to get a preshot reading as well as readings at +2, +4 and even +6 hours after the shot to see when the lowest point actually is and how fast the numbers drop. Because Caninsulin can drop the glucose numbers a lot in the first few hours after an injection it is important to know that the glucose number is safe before giving a shot and the other tests are to make sure the numbers do not drop too low.


I am in Winnipeg, Manitoba and I use both the Alpha Trak 2 pet meter and the Free Style Lite human meter. For myself I buy my Free Style Lite testing supplies at Shoppers Drug Mart. In Manitoba (and most likely BC) they have a seniors day every Thursday, where you can get 20% off regularly priced items, which includes the test strips. You need to be 55 and have a Shoppers Optimum card which is easy to register with. If you are not 55 then you can get someone who is to purchase the strips for you. About every 5 or 6 weeks they also have a "spend $50 get a $10 gift card" event on senior's day as well.. On these days I buy as many packs of strips as I can. You buy each one separately and get a $10 card which you use on the next box and so on and so on. Plus you get Shoppers Optimum points. Last year I was able to get $500 of product for free with the points.

Example: (Price check different Shoppers as here the prices can vary between different location)

Regular price $79.99/100
With seniors discount $63.99
With seniors discount and $10 gift card $53.99

We have another member in North Vancouver @Wendy&Neko who has said she gets the best price at Safeway. Here Safeway is more expensive, but in BC it may be that Safeway has better prices. At Safeway you would get Air Miles points which you can use for gas/groceries at various places. I don't know if Air Miles points can be used at the Safeway pharmacy?? Maybe Wendy will be able to tell you.

Also setting up a spreadsheet will be very helpful to get an idea on how well the Caninsulin is working for Onyx. Here is a link to setting up a spreadsheet:

http://www.felinediabetes.com/FDMB/threads/fdmb-spreadsheet-instructions.130337/

Being in Canada we are able to get human insulins at very good prices compared to what the US people pay. I don't know what you pay for Caninsulin or what size container you have, but if you need to change to a gentler, longer lasting insulin like Lantus or Levemir the prices are really not bad at all. I have two kitties on Levemir with a combined usage between them of 7 units (for 2 kitties) twice a day and my costs are about $25/month using the penfill cartridges.
Click to expand...

Thank you so much for all the information ...
 
Hi Christine - waving at you from across the water! :):)

I find that lancets, syringes and insulin are cheaper at Safeway now. You can't earn or use AirMiles at any pharmacy in BC. I don't buy test strips in Canada. I get them from the US online and get them sent to a US post office in Point Roberts. The cheapest online source for Canadian strips is the Bravo meter here. The other option is to buy strips for your current meter from EBay. My local Shoppers Drug Mart charges 10% more than anyone else, so I don't buy there. London Drugs occasionally has sales and Costco and Real Canadian Superstore can have good prices too.

I'm not sure what you are paying for Caninsulin now, but I found it cheaper to buy either Lantus or Levemir, because they lasted so much longer. If you keep them in the fridge, Lantus (and Levemir) vials last up to 6 months. If you buy the cartridges, you can use them up to the last drop. It depends on your dose, but I'll probably get at elast two months out of my current cartridge and with 5 in the pack, that's 10 months. I found with Caninsulin I was buying a new vial every month and I had to buy syringes from the vet so it turned out to be more expensive.
 
Hi Christine & Onyx! I didn't get a notification of the tag:blackeye: so I'm a bit late to the party. Mary Ann (Tuxedo Mom) has given you some great advice about discounts available on the strips. There is also the Bravo meter available HERE which has the most inexpensive strips available in Canada (approximately half of what the other brands cost....$39.99/100). The meter is free with the purchase of the strips. Perhaps this would be a good alternative if you would like to be able to test Onyx a little more often. The only caveat to this meter is that the strips are not available at local retailers and must be ordered online but if you can stock up, there is no delivery charge and you just need to ensure you re-order before your supply runs out. :)
 
Thank you everyone for your help. Onyx is doing great, I now check his blood every couple of days before his supper and injection. He glucose level is usually around 220-240 mg/dL, so he is still getting his insulin twice a day. I'm keeping a log and I'm understanding diabetes better. Right, now the insulin is doing it's job and that I am thankful. I will stay in touch. :cat:
 
Elizabeth and Bertie said:
Hi Christine,

The '200mg/dL' is the initial 'no shot' threshold number; we recommend that newcomers to diabetes don't give the shot if the number immediately before the shot is below 200.

100mg/dL is just fine at the peak (lowest number) of the cycle. But, ideally, you wouldn't want to see him dropping any lower than that at this point.
And quite a few Caninsulin users have found that the peak happens earlier than 6 hours after the shot; 4 hours is quite common. So, it might be worth experimenting and trying some of your mid-cycle tests a bit earlier on?

Christine, which meter are you using?
And are you able to get test strips on Ebay? I don't know what the situation is in Canada, but here in the UK they can be a lot cheaper that way. I'm tagging a couple of sister Canadians, Mary Ann @Tuxedo Mom and Linda @MrWorfMen's Mom to see if they have any suggestions.

Welcome to FDMB! :bighug:

Eliz
Click to expand...

I'm using a Accu-Chek Aviva and I bought my first batch of strips from Ebay.
 
Christine & Onyx said:
I'm using a Accu-Chek Aviva and I bought my first batch of strips from Ebay.
Click to expand...
You told me if his pre-shot reading is below 200 skip the shot. For the first time Onyx is at 195, feeling a little nervous about not giving him his shot. He gets 2 units of vetsulin twice a day, should I maybe give him just 1 unit ??? or skip all together.
 
We'd need to know how low he goes in order to give you feedback. Have you any test data for that?

When you know how much a dose will drop him, you can decide if it would be safe to give that dose in similar circumstances.
 
BJM said:
We'd need to know how low he goes in order to give you feedback. Have you any test data for that?

When you know how much a dose will drop him, you can decide if it would be safe to give that dose in similar circumstances.
Click to expand...

His peak times, he's been around 70-105. It seems to be lower as the days go by. Before his injection and food he's been around 210-250, yesterday was the lowest at 195. I see what you mean by knowing how much he drops at his peak time ... It's beginning to make sense to me now.
 
Christine & Onyx said:
His peak times, he's been around 70-105. It seems to be lower as the days go by. Before his injection and food he's been around 210-250, yesterday was the lowest at 195. I see what you mean by knowing how much he drops at his peak time ... It's beginning to make sense to me now.
Click to expand...

Yesterday he was 149 pre-shot, so it's been 3 days and I'm only giving him 1 unit instead of 2, twice a day and he's doing great !!! :)
 
Can we get you started using our grid to record your glucose tests? It will help us give you better feedback. Instructions are here.

Understanding the spreadsheet/grid:

The colored headings at the top are the ranges of glucose values. They are color-coded to clue you in as to meaning.

Each day is 1 row. Each column stores different data for the day.

From left to right, you enter
the Date in the first column
the AMPS (morning, pre-shot, test) in the 2nd column
the Units given (turquoise column)

Then, there are 11 columns labeled +1 through +11
If you test at +5 (5 hours after the shot), you enter the test number in the +5 column
If you test at +7 (7 hours after the shot), you enter the test number in the +7 column
and so on.

Halfway across the page is the column for PMPS (evening, pre-shot, test)
To the right is another turquoise column for Units given at the evening shot.

There is second set of columns labeled +1 through +11
If you snag a before bed test at +3, you enter the test number in the +3 column.

We separate day and night numbers like that because many cats go lower at night.

The nadir is the lowest glucose between shots. There is a general period when it will happen which is specific to the insulin being used and testing then helps make sure your cat doesn't go too low.

It is merely a grid for storing the info; no math required.
 
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