Need help deciding on SLGS or TR!

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Kathryn & Nugget

Kathryn & Nugget

Member Since 2018
Good afternoon!

I am looking for some advice on the best protocol to use for Nugget.

She was diagnosed one month ago, and the vet prescribed 2 units of Lantus BID. She discouraged home testing and sold me repackaged Lantus... so scary all in itself.

I am on the last of the Lantus she gave me. We have an appointment tomorrow with a diabetic specialist and I will be asking about the SoloStar pens, or a prescription for a vial of Lantus as I know it will take time if I order the Solo Star pens from Canada (which I hope to do because I know the vial of Lantus here is over $300).

This is all pretty new to me, and I don't know the best method for me. I am having some trouble understanding the difference between the two methods and the terminology involved.

My daily schedule:
I wake up at 4:45-5AM and must be out the door by 6:15-6:30AM at the latest. I get home around 5:30 PM.
Originally I was testing at 5:00 AM, feeding at 5:30 and giving insulin at 6:00 AM. This was really difficult to keep up with on the weekends, so I shifted things around. Now because of the holidays things have shifted a lot. I am going on vacation for a few days, and my mom will be watching Nugget, so the schedule until 4/11 will be:
Test at 6:15AM, Feed at 6:30AM, give insulin at 7AM, repeat for the PM.
When I get back from vacation I have to go back to the earlier time.

What would you recommend as the best method? I am basically alone in testing and administering insulin (my SO has a severe phobia of needles). I want to give her the least amount of insulin she needs and I would love to get as close as remission as fast as possible.
 
Typically we test, feed and shoot all at once. Many shoot while the cat's head is in the bowl. It should all be doable within 10-15 minutes. If you test as soon as you get up, you can get a +10.5, which will provide some value in seeing how a dose is doing. And deciding if you need to leave higher carb food out for the day.

Do you have an autofeeder? You might want to look at the Sticky Note on doing TR with a full time job. Even if you decide on SLGS, there are useful tips in there.

One thing with both dosing methods, we increase by only 0.25 units at a time, especially since you are seeing blues on the AT. I would go back to 1.25 units.
 
I'm glad you're posting here. Lots of help from very experienced people. I suggest printing out the TR and SLGS guides and reading them over a few times. Jot notes about questions to ask here on the forum. :)
 
Wendy&Neko said:
Typically we test, feed and shoot all at once. Many shoot while the cat's head is in the bowl. It should all be doable within 10-15 minutes. If you test as soon as you get up, you can get a +10.5, which will provide some value in seeing how a dose is doing. And deciding if you need to leave higher carb food out for the day.

Do you have an autofeeder? You might want to look at the Sticky Note on doing TR with a full time job. Even if you decide on SLGS, there are useful tips in there.

One thing with both dosing methods, we increase by only 0.25 units at a time, especially since you are seeing blues on the AT. I would go back to 1.25 units.
Click to expand...
Blues are good, right? I was told by vet #2 that 100-199 is normal for cats, and that if she could stay 100-150 she didn't need insulin.

I will try testing as soon as I wake up tomorrow so I can get that +10.5, I am usually so tired at night that I can never stay up to test her so I have virtually no data for the evening and early morning hours.

We do not have an autofeeder. She has always been a grazer. She is quite the pest when she is hungry. Right now she does not have her softpaws caps on (she is a furniture wrecker and I just got a new-ish couch) so she stays in her room at night and when we are not home. What are the benefits of the auto feeder?
 
Kris & Teasel said:
I'm glad you're posting here. Lots of help from very experienced people. I suggest printing out the TR and SLGS guides and reading them over a few times. Jot notes about questions to ask here on the forum. :)
Click to expand...
Will do... going to print now so I can start writing notes. I will bring that with me to the vet tomorrow too. I want her to see that I am trying my best to understand and do the best thing possible for the Nug.
 
The normal range that the vet gave you is inaccurate. Normal BG is 50 - 120 (on a human meter -- it's a little higher on an AlphaTrack). The range the vet gave you is her comfort zone given that she's telling you that you don't need to home test. Although, I will say this is a closer to normal range than most vet's give. Vet's like to give themselves a margin so they are not risking a cat experiencing hypoglycemia. (Although, it's not a realistic margin of safety and they only way to lower the risk of a cat becoming hypoglycemic is if the caregiver is home testing.)

The benefit of an autofeeder, especially if you get one with a space for an ice pack, is that you can make sure food is available throughout the day. If you cat is used to grazing, it means there will be fresh food around if your kitty's numbers drop. It's a good insurance plan!

TR has been researched and published in a highly reputable veterinary journal. It is more aggressive in that dose changes are made more often and the points at which you make a dose reduction is lower than with SLGS. It is the approach which has an established performance for getting newly diagnosed cats into remission. You do have to test a bit more frequently (at least x4/day). SLGS involves holding doses for a week (vs 3 - 5 days with TR). Cats do go into remission with this approach. It is an approach to dosing that has been used here before TR was developed but it has nor research/science behind it -- just experience. It does allow for more flexibility. One of the biggest differences is that the people here with the most experience with Lantus dosing have all been users of TR. I find the guidelines for TR to be much clearer, but that's my opinion. I worked full time throughout Gabby's life and used TR -- in other words, I'm biased.



 
Sienne and Gabby (GA) said:
The normal range that the vet gave you is inaccurate. Normal BG is 50 - 120 (on a human meter -- it's a little higher on an AlphaTrack). The range the vet gave you is her comfort zone given that she's telling you that you don't need to home test. Although, I will say this is a closer to normal range than most vet's give. Vet's like to give themselves a margin so they are not risking a cat experiencing hypoglycemia. (Although, it's not a realistic margin of safety and they only way to lower the risk of a cat becoming hypoglycemic is if the caregiver is home testing.)

The benefit of an autofeeder, especially if you get one with a space for an ice pack, is that you can make sure food is available throughout the day. If you cat is used to grazing, it means there will be fresh food around if your kitty's numbers drop. It's a good insurance plan!

TR has been researched and published in a highly reputable veterinary journal. It is more aggressive in that dose changes are made more often and the points at which you make a dose reduction is lower than with SLGS. It is the approach which has an established performance for getting newly diagnosed cats into remission. You do have to test a bit more frequently (at least x4/day). SLGS involves holding doses for a week (vs 3 - 5 days with TR). Cats do go into remission with this approach. It is an approach to dosing that has been used here before TR was developed but it has nor research/science behind it -- just experience. It does allow for more flexibility. One of the biggest differences is that the people here with the most experience with Lantus dosing have all been users of TR. I find the guidelines for TR to be much clearer, but that's my opinion. I worked full time throughout Gabby's life and used TR -- in other words, I'm biased.


Click to expand...
I do use the AlphaTrak 2 for pets, so is the range of 100-199 normal on that meter?

To test 4x times a day would mean roughly every 6 hours- I can't do that with my work schedule (I commute over an hour each way and am out of the house for almost 12 hours Mon-Fri). So to make sure I am understanding correctly, please correct me if I am wrong- TR you adjust doses more often, based on the BG readings, in order to get the cat towards remission. Compare that with SLGS which is when you lower/raise the dose every week depending on the BG levels?

I'll look into the auto feeder. She is not the type of cat to gobble down all the food as soon as I put it out, and it seems to stay pretty fresh for at least 6-8 hours (I suppose from adding more water to it).
 
Testing 4 times a day doesn’t mean every 6 hours: the AM and PMPSs are two, a before bed is a third and one more somewhere else.
 
Hi there :cool:

How did you discover your kitty was diabetic?

Like Sienne, I too am biased (we used TR). Before you decide, do read the sticky about working full time and TR.

Keep in mind that whichever method you select, if it isn’t a good fit you can always try the other.

I will add that being newly diagnosed can be an advantage-the less time a kitty has lived with high BG, the better the chance of remission. Make the most of it.
 
Asia was a grazer and free feeder before FD, it’s not much different now, but I do use the auto feeder at night or when I go out. Let’s say you set the meal to every 2 hours, the portion that is current will be available until the next programmed time where it rotates, so she can still graze as she would have for 2 hours or whatever you decide to eat one portion before the next is available. This is the one I have and polled people here before buying it, this is the most popular auto feeder with current members:

https://www.amazon.com/PetSafe-5-Me...gital/dp/B000GEWHNS?tag=felinediabetesfdmb-20

The place to hold an ice pack is very small, and it’s a weird design flaw (IMO) that the ice pack sits under the currently available food slot. An unfortunately reality for most cats is that almost all of them end up with renal decline at some point, so even if kidney values are fine right now, it couldn’t hurt to add a little water to her food. I put raw food in the feeder and add 1-3 ice cubes to each portion (depending on how long it needs to sit out and stay fresh. The ice melts and it’s just extra water in the food, no harm done. You can also freeze their food and put it in the feeder that was so that it melts slowly over time.

I still have a full Lantus pen in my fridge from when I switched to Levemir, you are welcome to have it free of charge, just pm me and we can figure where to meet. I’m off the 1, C and B lines.

I agree with others, if you can swing it, I would try TR to improve remission odds and take advantage of the newly diagnosed window.
 
Sandy and Black Kitty said:
Hi there :cool:

How did you discover your kitty was diabetic?

Like Sienne, I too am biased (we used TR). Before you decide, do read the sticky about working full time and TR.

Keep in mind that whichever method you select, if it isn’t a good fit you can always try the other.

I will add that being newly diagnosed can be an advantage-the less time a kitty has lived with high BG, the better the chance of remission. Make the most of it.
Click to expand...
Hi Sandy. She was drinking an insane amount of water and urinating like crazy... and when she missed the litterbox and I went to clean it up, her urine was like syrup- so sticky and thick and had no scent. Ten days of that and I took her to the vet.

I just read the sticky. I worry about not being able to manage the timeline of TR. Being out of the house for 12+ hours a day is hard. I can rarely stay up past 9PM (I've got my own health issues and not getting enough sleep contributes to my not feeling well in a major way), which means I would be testing before I left for work, when I get home from work, and when I go to bed. Seems like that is not enough testing to follow TR.
 
You don't need to test every 6 hrs. Most people can't do that if they work outside of the house. Like I said, I work full time. Gabby's shot time was 5:00. I would leave the house at around 7:30. So, for the AM cycle, I was getting my tests in at +1 and +2. This made sense given that Gabby had an early nadir (usually at +3 or +4). There's a sticky on how to do TR if you work/go to school full time at the top of the board. As for testing in the PM cycle, if you have to get up to use the bathroom at night, grab a test! Some members will drink a lot of water in the evening so they do have to get up and can test or will they will set an alarm and get a "sleep test" (wake up, test, go back to sleep).

There's also a different feeder, a 2 compartment one, that is better able to accommodate an ice pack. Given Stacy's comment, you could always freeze cat food in an ice cube tray and make "catsickles" which would then defrost in a feeder while you're gone.

 
Stacy & Asia said:
Asia was a grazer and free feeder before FD, it’s not much different now, but I do use the auto feeder at night or when I go out. Let’s say you set the meal to every 2 hours, the portion that is current will be available until the next programmed time where it rotates, so she can still graze as she would have for 2 hours or whatever you decide to eat one portion before the next is available. This is the one I have and polled people here before buying it, this is the most popular auto feeder with current members:

https://www.amazon.com/PetSafe-5-Me...gital/dp/B000GEWHNS?tag=felinediabetesfdmb-20

The place to hold an ice pack is very small, and it’s a weird design flaw (IMO) that the ice pack sits under the currently available food slot. An unfortunately reality for most cats is that almost all of them end up with renal decline at some point, so even if kidney values are fine right now, it couldn’t hurt to add a little water to her food. I put raw food in the feeder and add 1-3 ice cubes to each portion (depending on how long it needs to sit out and stay fresh. The ice melts and it’s just extra water in the food, no harm done. You can also freeze their food and put it in the feeder that was so that it melts slowly over time.

I still have a full Lantus pen in my fridge from when I switched to Levemir, you are welcome to have it free of charge, just pm me and we can figure where to meet. I’m off the 1, C and B lines.

I agree with others, if you can swing it, I would try TR to improve remission odds and take advantage of the newly diagnosed window.
Click to expand...

Hi Stacy,
I am glad to hear that mixing her food with water can only be good for her! I only started doing that because I noticed she went from drinking a ton, to not drinking much at all. I know that part of that was due in part to the insulin, and also because of the switch from dry food to wet. I think that the auto feeder will be good to have during the summer when I am out for a good part of the day. I added the auto feeder to my amazon cart so I don't lose it!

When I get back from my trip I will pm you so we can find a good time/place to meet. That really is a generous offer and I do appreciate it!!!
 
Sienne and Gabby (GA) said:
You don't need to test every 6 hrs. Most people can't do that if they work outside of the house. Like I said, I work full time. Gabby's shot time was 5:00. I would leave the house at around 7:30. So, for the AM cycle, I was getting my tests in at +1 and +2. This made sense given that Gabby had an early nadir (usually at +3 or +4). There's a sticky on how to do TR if you work/go to school full time at the top of the board. As for testing in the PM cycle, if you have to get up to use the bathroom at night, grab a test! Some members will drink a lot of water in the evening so they do have to get up and can test or will they will set an alarm and get a "sleep test" (wake up, test, go back to sleep).

There's also a different feeder, a 2 compartment one, that is better able to accommodate an ice pack. Given Stacy's comment, you could always freeze cat food in an ice cube tray and make "catsickles" which would then defrost in a feeder while you're gone.
Click to expand...
Hmm. This is definitely going to take some planning and timing. I get home later on Monday and Tuesday than the rest of the week- if that wasn't the case I could totally push everything earlier and test/feed/shoot at 4:45 every day, which would give me more opportunities in the evening to test. Work really does get in the way of things!!!! I only have three more months before summer break, so I might just have to figure out how to make this work until the end of June. Then I'm home pretty much every day minus a long weekend trip (which I'm hoping we make it to remission by then). I am going to read all the stickies again.
 
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