New to TR, Looking for help stabilizing, Any Suggestions?

Hi everyone,

I recently started switching my cat Lily's insulin dosage method from SLGS to TR. I started the TR method on 4/20/19. I also have to mention that on 4/26/19 I was not able to give Lily her PM insulin shot at the usual +12 time. I didn't have anyone else to give her the shot so I opted to give the shot 5 hrs later. I did this because Lily has a history of DKA from January of 2019 and October of 2018.

I am not as familiar with working with the TR method, but I wanted to try it to see if Lily's numbers would get better. Right now Lily seems to be bouncing quite a bit. Does anyone have any advice from looking at Lily's spreadsheet?

I really worry about Lily with the numbers in the 500s. When the meter reads HIGH, the manual says the numbers are as high as the 600s. I definitely need some help and have been struggling to regulate Lily for some time. I am not sure how to get the better numbers consistently. Any tips would be greatly appreciated!!!

 

I am glad you went back to 1.25 units. With TR, you only increase after six full cycles, longer if you are seeing green, which you did on 4/30. The ugly numbers after that were from however low she went that night. I would have gotten another test after the 75, to make sure her numbers weren’t still dropping. You didn’t hold the 1.25 unit dose long enough, it was only five cycles beforenyou increased.

Following TR also means getting a second test each cycle, in addition to the preshots. I only see two tests today. High preshots are not a reason to relax. I have seen cats earn reductions starting the cycle in black, Neko earned reductions from high reds.

On the 26th, you gave her shot 5 hours later, or at +17. Does that mean the shot on the morning of the 27th was 12 hours after the evening shot?

 

Thank you for your reply Wendy!!!! I really appreciate you looking at Lily's SS!

Ohhhhh, ok. I thought the TR said you could do increases 2-3 days...I will take your advice and hold for 3 days / 6 cycles. I can definitely test more. Yes, I didn't realize that the high numbers could still earn reductions. I just figured if Lily was that high, she would be staying high for the entire day. Thank you for those tips! Extremely helpful!

Correct, on the 26th of April I did give Lily her PM shot 5 hrs later at 1AM on the 27th, instead of between 7pm - 8pm earlier when it was still the 26th. The following shot I gave to Lily at 12:23 PM on April 27th. I tried to work back to Lily's normal schedule. I know you are supposed to only move it back 15-30 mins a cycle, but I was having a difficult time doing that, so I did try to move it back by an hour or so each time. That could also be having an effect on Lily's numbers too. Maybe those doses acted as dose increases?

I will continue to hold the 1.25 dose. I just tested Lily at 3.5 hrs and she was 340. I can test her again before I go to bed.

 

With TR, there is provision for increasing sooner if high and flat, which means solidly high blood sugars, not temporarily high numbers from bounces. Bounces usually resolve in six cycles or less.

High numbers don’t earn reductions, but the low numbers that cause the bounces and resulting high numbers can. We determine the dose based on how low the dose takes the cat.

Shooting early can ac5 like a dose increase, so shooting early as you did could indeed have impacted her numbers. I hope you are back on schedule now. That’ll be once less variable to consider.

 

My Gabby was notorious for for starting a cycle in the 400s, dropping to the 40s by nadir, and shooting back into the 400s by the next shot. If I hadn't been testing, I would have ended up increasing her dose when I should have been decreasing.

 

So far so good today! I fit in Lily's tests this morning.

Her AMPS = 96
+2 = 114
+3 = 73

I fed her+5 snack at +3 instead of +5. I'll have to check again to see if she needs another reduction. I am sure her BG will continue dropping as it is only at +3. Wow @Sienne and Gabby (GA) , that is crazy! From 400 - 40!!! A couple days ago Lily did that to me too. She went so high the meter said HIGH = 600ish? or so. (according to the manual) Who knows the exact # really because the meter said HIGH. It took her to +15 to get all the way down to 44. And I was shocked!

 

I am lucky she didn't bounce again this morning! The tricky part will be trying to make sure she doesn't bounce again. Feels like yo-yo-ing all the time like a roller coaster. I am going to try to cut out chicken & turkey flavors and just feed Lily Tuna & Salmon flavors from now on. Maybe that can help too. I feel like when I switch the flavors of canned food all the time that also makes it much more difficult to manage her numbers. I suspect the chicken & tuna make the BG #s higher.

 

Have you checked out the Food Chart by Dr. Pierson? It lists the carbs for a whole bunch of different cat foods. Some of us mark the bottom of the cans with the % of carbs.
It's better not to feed fish too often. "fish is considered by vets to be one of the most allergy-inducing food sources around." by Dr. Pierson "cat foods tend to be high in fish, there may be a causal link between hyperthyroidism and fish consumption. This is one of several reasons why I recommend against feeding fish-based diets to cats."

There's a lot to learn ,but the more you read, the more you learn ,the easier it will be to help your kitty Lily

Here's a very informative article by Dr. Pierson. https://catinfo.org/

Best of Luck to you & kitty Lily

 

Yup - Gabby was a diving diva.

It looks like Lily is clearing bounces quickly! One additional thought that I took good advantage of. If numbers seem out of sync to you (either higher or lower than expected), it may help to re-test. Even though you get a reading on the meter, it may be a bad test.

 

@JoyBee&Ravan Thank you for the advice & Good Luck vibes! Oh dear, really seafood diets are bad? I have checked out the Food Chart from Dr. Lisa Pearson before. You guys on FD have introduced me to it before. I use the Dr. Lisa's chart and the Database where you can filter by brand. She only lists the nutrition label for 2 of the flavors Lily eats (turkey & tuna). I feed Lily kitten fancy feast. I was doing (chicken, salmon, turkey, & tuna). I didn't like the idea of only feeding Lily 1 flavor of food like all of the prescription diets. Same flavor everyday, I thought that would be boring for her.

I think the most challenging thing is the portions of food, what times of day, and the amount of insulin. I feel like I just need the right combination to unlock the door to have Lily under control. I am happy for the most part with the kind of diet Lily is on. Maybe I will consider rotating all 4 of the flavors of chicken, salmon, turkey, & tuna. I was very close to just doing tuna & salmon only. I will continue to think on it.

I will keep this in mind!!! I was thinking this today as Lily's numbers have been lower today. I have been trying to keep a close eye on her numbers. I had to step out for a little bit.

Today Lily has been:

AMPS = 96
+2 = 114
+3 = 73
+4 = 65
+7 = 61
+8 = 63


My fingers are crossed I can keep this going! These are numbers Lily & I dream about each day!!!

 

I was looking at Lilly's SS. Why were you giving her Karo & gravy lovers cat food from Feb10th thru March? Her BG was very High at times from all the High carbs?

Unless her BG drops Low you should be giving her Low carbs 4%.

 

Clearly I was still learning and very hopeful that I could make the better numbers happen. Which I still am, lol. I have been struggling for some time to stabilize Lily. If you notice on her SS she has many colors like a rainbow.

During this time, (February - March) I was not as informed about the rule that you shouldn't use higher carb foods as a tool unless Lily hits 50 or under. I probably was trying everything i could to prevent bouncing and was not as aware about that 50 rule. (I think someone else mentioned that I should not have been doing that during this time also)

March 18-20th on Lily's SS, I was trying so hard to keep those green and blue numbers to stay. She was bouncing a lot and I thought I could prevent it with the gravy lovers. Again, I just wasn't using the high carb food properly.