Advice on changing dosing protocols

I am getting a lot of great advice about how to proceed with dosing Tigger.
I was trying to do the SLGS protocol faithfully but it's been suggested Tigger's
BG is still too high and dangerous since he's had DKA. I too wanted to speed things
up after the numbers indicated 0.25 did nothing, but 0.5 lookedpromising at first.
The vet is no help and doesn't want to discuss "tiny increments ahead of schedule"
- just wants to wait the full 14 days on 0.5 (they didn't know I had already started
0.25 on my own). It has been suggested I try TR instead but I don't think that will
completely work for us in the long run. However, I have made the decision to
increase to 0.75 units BID as I will be home to monitor the next 6-10 cycles pretty
closely. Thoughts? I've updated his SS with today's #'s so far, but I know we may
not see much change until I have info on 6 cycles or so. Just looking for opinions
on skipping the last few cycles at 0.5.

 

I personally think you made the right decision, those numbers need to come on down

 

I suggest you try to wrestle a version of TR into your schedule to get his numbers down.

 

If it’s your job that stops u fro doing the TR, I work during the day and it does work out well, I just test, feed and shoot early so I can do a +2 before I leave

 

I can't seem to make it work - if i tried to shoot a lot earlier - I won't be home from work in time for PM shot. We leave for work at 730 and don't get home until 615ish. . . . if I shoot at 530 am I will always be almost an hour later in PM . . . and thats if I get out normal time. On Mondays I don't get home until 630 or later . . . So I think I could shoot at 630am and get a +1 but not a +2 . . . it just doesn't seem to work unless he doesn't have a 12/12 schedule and I gather thats very important too.

I could try shooting at 6am, get a +1.5 and rush home to test/shoot only 15 min late or so, but again, not on [most] Mondays.. . . . . . .

 

If you're within 30 min. of shot time you will be close enough. I think a lot depends on whether you're comfortable not getting a test in after AMPS. Would a 7:00 shot time work? Since you said "we", are both you and your significant other on the same schedule?

You might want to take a look at the sticky note on doing TR if you work or go to school full time. There are some helpful suggestions there.

 

Here’s the post Sienne was referencing on doing TR and working.

 

My wife and I basically have the same schedule (out of house from 730-615) but she is off one weekday. I am off all weekend and can always do curves. We basically shoot at 7 already. but that gives me 30 min just to watch him, not really test again. so four days a week he wont get any test during the day beside AMPS. Obviously we can and do more at night. If I tried to shoot earlier like 530am, I could get a +2 in am - but I don't think that will tell us much right now - his numbers never go lower until +4 or more. Then, like I said, we'd be ATLEAST 45 min late with PM shot. On average. Sometimes 1 hour 15 min late. We could do a 630 and a +1 but again, his BG's dont or havent seemed to budge yet at that point, we need alot more data first.

The vet emailed back and thinks we should just switch from 0.5 to 1 unit. We have already done 2 cycles at 0.75 though . . . any suggestions? A few more cycles here or jump to 1 unit? His nadir has only been under 300 once.

 

ECID so if you shoot early and get a +1 and can predict what Tigger will do with his numbers, then that would work. You can leave FROZEN food out as it takes a while to defrost and they lick away at it when hungry. Since you're not there to monitor if you change to TR, I would increase in .25 increments for a few days and as Sienne mentioned, testing or shooting within 30 min is okay..........

 

I'm a big fan of letting the data guide your decisions. I shot early (5:00) because Gabby had an early onset and nadir and this allowed me to get a +1 and +2 (and sometimes a +3) before I left for work. I could also be home by 5:00. Tigger sounds more typical with regard to where you're seeing onset.

Based on your work schedule, I would not dramatically increase Tigger's dose unless you're going to be around to see the effect. Increasing on a Thursday or Friday (or whatever works best given your schedules) so you have a day before you expect to see much of a change in numbers would seem to make sense -- at least to me.

Since you're gone all day, if you've not already started using a timed feeder, you may want to see about getting Tigger acclimated to using one. A timed feeder will likely give you some peace of mind once his numbers start moving so you're not worrying about his having access to food.

 

He and his brother have those feeders that only open for the correct cat. Blu is a piggie and Tigger only wanted his brothers "normal" food - solved both problems! Ive had a lot of people say their cat would never use one with the moving door and having to put their heads under a bar. Believe me, if my skittish siamese can be trained in less than a week - almost any cat can!

I happen to be off this whole week which is why I felt okay skipping the last few doses of 0.5 and going to 0.75. Now I'm wondering if I should have just gone for the 1 whole unit. I'm sure changing too much is bad/potentially missing the better (lower) dose but his numbers arent close to being good. The vet felt an increment of 0.5 was in order with his high nadirs, but now that we've given a few doses at 0.75, will that be dangerous? I can monitor very closely for 4 days before I go back to work. I feel like we havent even seen his real response to 0.75 yet, so i dont want to wait if we are going to increase more. (I like the idea of 6 solid cycles done before we have to leave him alone all day).

 

At the minimum, I would give this dose 4 cycles and if numbers haven't budged, consider a 0.25u increase.

 

ok, I think thats sound advice

 

Love mine! I have 4 of them. Saved me a lot of headaches.

Wish you luck with that dose increase and big kudos for making this work for you.

 

so todays numbers - a bounce? that pmps surprised me after Tigger went into the yellow and blue for once!