Need advice - skipped both shots yesterday. +11 this morning is 117 — OTJ trial or shot?

Toonces has been in blue and green numbers for some time and it seems over the last week that on each reduced dose I give him he just keeps going too low. I’m not in a position with my job currently to be able to test him during the day so I’m concerned about shooting this morning with an AMPS of 70. Am I supposed to just continue reducing by .25-.5 under these circumstances? I’m considering skipping this shot. Any advise appreciated. Thanks!

 

Since you can’t monitor and are using a pet meter I would skip insulin this morning and drain the depot.

 

Thanks. That’s what I decided to do. In general, with the TR protocol, are you supposed to just keep reducing every day when they keep going low?
And what am I supposed to do under the TR protocol re the next shot tonight having skipped a dose? Thanks- I’m so confused! I’ll be able to closely monitor him all weekend so am hoping I can get a better picture.

 

It's difficult to say what you should do tonight given there is little data to see what he's been doing overnight. Many cats go lower overnight so he may have earned more reductions than you have given.

Toonces is doing great and looks like he is on a mission. The numbers you are getting are wonderful. It will be interesting to see what his PMPS is tonight after the missed shot this morning. I'd wait to see what his PMPS is before making a final decision re: tonight's dose . A test at +11 would be helpful as you would then have time to post to get some suggestions.

 

Toonces +11 is 117. Not sure what to do regarding his shot tonight.

 

Without more data, especially at night, I think I'd skip.

Try testing tonight at about +3 and see if the number comes down. If it does, his pancreas might be trying to work again!

On your spreadsheet, when you skip a shot on purpose (not a furshot ), put N.S. in the "U" column for "no shot"

 

Thank you!

 

Toonces is 117 this morning after skipping both shots yesterday. Is it crazy to get an OTJ trial? It didn’t seem like the TR protocol contemplates this but rather steady dose decreases until nothing. I’m so nervous about setting him back when he’s been doing so good - acting like a kitten again!

 

If you are able to monitor today, I would not skip. Ideally, with TR, you get the dose down to the tiniest amount that you can measure. You want to give Toonces' pancreas as much support as you can for as long as you can before you attempt an OTJ trial. Take a look at TinySole's spreadsheet as an example of a kitty that's on an OTJ trial and also using an AT meter and where the dose has been reduced to a tiny amount.

There's likely one concept that hasn't been well explained. If you recall, when changing a dose, you need to give the depot time to stabilize. This may mean waiting at least 3 days with increases, for example. This applies to both dose increases and reductions. When Toonces' numbers drop into dose reduction territory, especially if you have just reduced the dose (e.g., between 12/6 - 12/8), you need to give the depot time to catch up with the dose reduction. Taking what amounts to back-to-back reductions may mean that the reduction won't hold. I suspect that members here were coaching you to reduce the dose for safety reasons given your very limited testing at night.

I would strongly encourage you, especially given how well Toonces is doing, to see if you can get those PM cycle tests. It really looks like the PM testing will be time limited given where Toonces' numbers are.

 

Thanks so much. I’ll try a small dosage today and monitor him as I’m better able to do that on the weekend.