Thinking of switching to TR method - need advice

AngelaMiao

AngelaMiao

Member Since 2019
Hello!

Currently doing the SLGS method with my cat but I'm not finding it easy to get him regulated. He's down from 0.75 to 0.25 units from the few times he went down below 90 but I don't think it's enough insulin for him since he usually stays pretty high on the days hes not bouncing.

I have two main questions:

If I were to switch to the TR protocol would I change his dose to the 0.25u per kg of ideal weight?

Do I need to check him at +3, +6 and +9 at night?

The night time testing is what I have the hardest time with since I have a 6 month old at home who doesn't sleep his nights, so sometimes I get so tired that I sleep through a alarm. I currently test his BG about 5 times a day.

Please see his spreadsheet in my signature.

Thank you!
 
Hi Angela! Here's the link to your last thread (we like to have it so people can quickly go back and see what's been going on)

The main difference between SLGS and TR is the point at which you reduce the dose. On TR you don't reduce until they drop below 50 instead of the 90 on SLGS.

If Jack were my cat, I'd go back to the .5 unit dose for now and see how he does. He wasn't dropping into "dangerous" numbers on the .5 dose and was starting to get some nice healing green numbers!

You don't necessarily need to get tests all night long. If you can grab a "before bed" test (like at +2 or +3) that can give you an idea of if you might need to test later in the cycle.

In a lot of cats, a +2 can act kind of like a crystal ball in predicting where they're going later in the cyc
If the +2 is about the same as the PS, it's usually going to be a pretty normal lantus cycle...gradually down to nadir then gradually back up to the next PS.

If the +2 is a lot higher than the PS, it usually signals the beginning of a bounce and those are the cycles where you can usually take a "pokey break" and get some sleep!

If the +2 is lower than the PS (by more than just meter variance) that's your "early warning" that he may be going a lot lower later in the cycle. At night, those are the cycles where you might want to set an alarm to be sure to get a few more tests in.

On TR, you gradually learn to shoot lower Pre-shot numbers too....Once I had enough data and experience with China, I'd shoot anything over 50, but at first, if you get a Pre-shot under 150, you'd want to Stall, don't feed and post for help. Re-test in 20-30 minutes to see if the number comes up without the influence of food.

If someone comes on to help you when you first shoot a lower number than you're comfortable with, they won't leave you unless they can find someone else with experience to stay and watch to make sure everything goes well.

I think going to TR will help Jack …..yes, it's more aggressive than SLGS, but it also has a better record at achieving remission.
 
If you change from SLGS to TR, the main changes are the criteria for decreases (now below 50), how long you hold a dose before evaluating it (3 + days), and getting a test at each preshot, plus at least one other each cycle. With SLGS you hold a dose with nadirs between 90 and 149, with TR you would increase with nadirs in that range. You test enough already for TR. You don't change the dose. That formula is only for kitties brand new to starting insulin and Lantus.
 
Thank you! Will go back to 0.5 tonight.

I got worried when I read the 0.25u per kg because my cat weighs 18 pounds, ideal weight is about 12-13.
 
How often do I do curves? It says to increase or decrease based on nadirs but I haven't been able to find his with all the volatility (I did one full curve but it was pretty flat and ended up being the one "good" day he had).
 
You really don't need to do an "official" curve.....you just test at random times to get a good picture of what's going on.

Think of your spreadsheet like it's a puzzle.....the more "pieces" (test results) you have sprinkled around, the easier it is to see the whole picture.

If you see a big white "hole" in your spreadsheet, try to get a test in to fill it up!
 
@Wendy&Neko you mentioned that with a nadir of 90-149 you would increase a dose on TR. Where can I find that information? I can't find it on the TR sticky.
 
AngelaMiao said:
with a nadir of 90-149 you would increase a dose on TR. Where can I find that information? I can't find it on the TR sticky.
Click to expand...

It's not in the sticky but with TR, we are trying to get the nadir down into better numbers so if they're only getting down to 90, we might want to increase a little to bring the number down even more. Remember, eventually we want them to stay in normal numbers as much time as possible....that's between 50-120 with most of the numbers under 100

AngelaMiao said:
Also what do I do when I have random pre-shots under 100? Do I give the full dose on TR?
Click to expand...

At first, if you get a Pre-shot under 150, you'd want to Stall, don't feed and post for help. Re-test in 20-30 minutes to see if the number comes up without the influence of food. Gradually, you'll learn to shoot lower and lower numbers until you're eventually able to give the full dose if they're above 50
 
AngelaMiao said:
Also what do I do when I have random pre-shots under 100? Do I give the full dose on TR?
Click to expand...
I see you have already have some data on what happens when you shot as low as 127. If you are comfy shooting that low already, you don't have to post for help when you see lower than 150. However, feel free to post for help if you want to. Take a read of the Sticky Note on Tight Regulation: Becoming Data Ready to Handle/Shoot Low Preshots. I printed it off, along with the Handling Low Numbers sticky note, just in case of power outage when I needed them.
 
I don't know where you see the 127, but the lowest I've shot was 142. He was in a bounce cycle so I didn't really get a chance to see a result.

I just put him back up to 0.5 tonight but he's bouncing again (+3 was higher) so we'll see how this goes once we level out.
 
Oh wow, yeah you're right. Sorry, I'm tired. I'm not super worried about shooting low numbers since sometimes I feel like his numbers come from the shot prior to his last
 
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