? Need help! Mimi 12/1 Should I wait to increase?

Discussion in 'Lantus / Basaglar (glargine) and Levemir (detemir)' started by Mimis mom, Dec 1, 2019.

  1. Mimis mom

    Mimis mom Member

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  2. Mimis mom

    Mimis mom Member

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  3. AmandaE

    AmandaE Well-Known Member

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    I think it might be best to follow the protocol and increase tonight since you're so close to the 6 cycle mark. It is up to you though, if you decide to increase this morning just make sure that you will be able to monitor all day and that you have all of the things needed in case of a hypo situation. :)
     
  4. Sienne and Gabby (GA)

    Sienne and Gabby (GA) Senior Member Moderator

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    First, numbers in the 200s are not "high". High numbers are 400s and above -- for some cats, maybe 300s and above.

    If you are following TR, then follow the protocol. TR is aggressive. If you increase prematurely, you are courting problems.
     
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  5. Mimis mom

    Mimis mom Member

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    Oh ok.. I was just going off what the bottle of test strips said was high

    Thanks!
     
    Last edited: Dec 1, 2019
  6. Mimis mom

    Mimis mom Member

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    She's reading still high but I am now interested in this "error of margin" thing that could be happening but wonder if its common for higher numbers?
    for example I got 292, then tested right after and got 359, and 348? Am I going to have to test 3 times now and go with the one I got the best number with or is the difference in 292 to 350 something not the same as say if she tested 75 and then 120? I thought I read somewhere that the readings in the higher numbers have more error than the ones in the lower numbers and having one read 50 or so points off isn't as concerning as one that is that far off when the numbers are below 100.. hope that made sense, its hard to put into words (also my brain is tired today)
     
  7. Gill & George

    Gill & George Well-Known Member

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    Try not to get caught up in the margin of error.
    Basically who cares if it is 293 359 or 348, there's not much in it really, they are within 20% of each other give or take.
    I would only repeat a test if you have a number that doesn't fit in with how the cycle is panning out, so a surprise high or a surprise low. Otherwise you are going to drive yourself doolally.

    What does the TR protocol say regarding an increase? Mimi spent a nice bit of time in blue/below 200
    From the Sticky
    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.
    • Increase by 0.25 unit after 3 days (6 consecutive cycles) if nadirs are greater than 200, but less than 300.
    • Increase by 0.5 unit after 3 days (6 consecutive cycles) if nadirs are greater than 300.
    Does that help?
     
  8. Mimis mom

    Mimis mom Member

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    what about when the 50 point difference is important- say when Im trying to decide to hold a dose or increase? she has a couple of numbers below 200 but in the high 100s. so according to TR you will always hold a dose for at least 6 cycles- and if its below 200 6-10?
    I should be increasing tonight?
     
  9. Mimis mom

    Mimis mom Member

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    also, off topic- do cats ever get type 1 diabetes? and why does Dr Pierson say in her food chart to feed diabetic cats at least 15% carb over her feeding recommended 10 % and below
     
  10. Gill & George

    Gill & George Well-Known Member

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    Oct 27, 2015
    8 to 10
    Today is cycle 6 tonight 7 and tomorrow morning 8.

    So you should continue to hold.
    Tonight and tomorrow day at least. Revisit during tomorrow morning what to do with the dose.
     
  11. Gill & George

    Gill & George Well-Known Member

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    I'm heading to bed Rosa it's late for me.
     
  12. Marje and Gracie

    Marje and Gracie Senior Member Moderator

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    Mimis mom said:
    She's reading still high but I am now interested in this "error of margin" thing that could be happening but wonder if its common for higher numbers?
    for example I got 292, then tested right after and got 359, and 348? Am I going to have to test 3 times now and go with the one I got the best number with or is the difference in 292 to 350 something not the same as say if she tested 75 and then 120? I thought I read somewhere that the readings in the higher numbers have more error than the ones in the lower numbers and having one read 50 or so points off isn't as concerning as one that is that far off when the numbers are below 100.. hope that made sense, its hard to put into words (also my brain is tired today)
    Don’t retest unless you get a wacky number that doesn’t fit in. Don’t worry about meter variance. And yes, the meter variance will be much larger when numbers are high.

    Example:

    400 x 0.8 = 320 so a difference of 80 vs 100 x 0.8 = 80 so a difference of 20.

    If you have a 50 mg/dL difference, than the BG is high enough that you will not have to worry about whether you should be giving an increase or not. In other words, if she’s at 220 and you retest and get 176, and that’s her only blue number, she needs an increase. Again, don’t retest to find out what the meter variance number is.

    No, they don’t. And I don’t know where you are talking about on Dr. Lisa’s chart. You’ll have to be more specific. I don’t really understand the question.
     
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  13. Mimis mom

    Mimis mom Member

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    Attached Files:

  14. Mimis mom

    Mimis mom Member

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    but she's not new to numbers below 200? Does that mean in the history of her diabetes?
     
  15. Mimis mom

    Mimis mom Member

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    not sure if that is clear- it says
    Carbohydrates: Choosing diets with 10% or less carb calories is a good goal but, unless the cat is diabetic, sticking with less than 15% is also reasonable.
     
  16. Mimis mom

    Mimis mom Member

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    thanks for your input! good night!
     
  17. Marje and Gracie

    Marje and Gracie Senior Member Moderator

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    She is saying if you have a non diabetic cat, it’s ok to feed foods that are less than 15% calories from carbs. She’s also saying diabetic cats should be fed less than 10% calories from carbs which is what the TR protocol also says.
     
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  18. Mimis mom

    Mimis mom Member

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    Drrrr I read that wrong...

    So my question about sticking 8-10 cycles if nadirs below 200 are new but she’s not new to them and she hasn’t seen nadirs below 200? Are we sure I shouldn’t increase?
     
  19. Krystina & Nelli

    Krystina & Nelli Well-Known Member

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    I agree with @Gill & George.
    Hold ;) tonight and tomorrow day at least...
     
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  20. Mimis mom

    Mimis mom Member

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    Ok. I guess I’m confused about the “if they are new to numbers under 200 in the nadir hold for 8” but she’s not new to numbers that low- or am I understanding it incorrectly?

    i held it 1.25
     
  21. Krystina & Nelli

    Krystina & Nelli Well-Known Member

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    It will all start making sense... trust me?! :bighug:
    YOU are doing good darlin!
     
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  22. Marje and Gracie

    Marje and Gracie Senior Member Moderator

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    The TR protocol states to hold the dose 6-10 cycles if the nadirs are below 200. The section which refers to “if your cat is new to numbers below 200” means that once the cat starts seeing nadirs below 200, if they haven’t been there before, hold the dose 8-10 consecutive cycles after the blue numbers.

    For cats that have seen nadirs below 200, if you see blue numbers, hold the dose 6-10 consecutive cycles total.

    In addition, Mimi is bouncing from the blues so I’d give her eight cycles and see if she’s cleared the bounce and where she’s landed.
     
  23. Mimis mom

    Mimis mom Member

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    The only thing is it’s been almost 2 weeks since she’s seen any green and the blues were mid to high.
     
  24. Marje and Gracie

    Marje and Gracie Senior Member Moderator

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    Rosa

    Either you trust us or you don’t.
     
  25. Mimis mom

    Mimis mom Member

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    Of course I trust you- I’m also trying to learn and understand.
     
  26. Marje and Gracie

    Marje and Gracie Senior Member Moderator

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    May 30, 2010
    As you should. But TR is already more aggressive than other methods and it specifically states how often doses can be raised. Even if she hasn’t seen green in a bit, you still have to be patient and increase according to the protocol.
     
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  27. Krystina & Nelli

    Krystina & Nelli Well-Known Member

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    Two post going on here?
     

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