12/27 Tibby PMPS 116. What to do?

Discussion in 'Lantus / Levemir / Biosimilars' started by Amy&Tibby, Dec 27, 2020.

  1. Amy&Tibby

    Amy&Tibby Member

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    Feb 22, 2020
  2. Sienne and Gabby (GA)

    Sienne and Gabby (GA) Senior Member Moderator

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    Dec 28, 2009
    If I can offer a suggestion...

    With TR, you want to be sure to get at least one test during both the AM and PM cycles. It's particularly important since many cats experience lower numbers during the PM cycle. Can you make it a habit to always get a before bed test? For example, there's no way to know if Tibby's cycle stayed in the yellows between PMPS and PM +9 or if numbers dropped and what you're seeing at AMPS is a bounce. You may want to consider routinely getting a +2 or +3 during the AM and PM cycles if that's at all possible. If the early test is lower than your pre-shot number, there's a good chance that it will be a cycle where Tibby's numbers are dropping.
     
  3. Amy&Tibby

    Amy&Tibby Member

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    Feb 22, 2020
    I can do that much easier than the +9 at night. But overall, what tests should I be doing? Right now I have AMPS, +3, +6, +9 PMPS, and then a +9 at night. I'll add a +2 or 3 at night. Should there be any more?

    Also, I should be doing a weekly curve tomorrow. I'm still planning on doing that, though I'm not sure if I'll do an AM or PM curve.
     
  4. Amy&Tibby

    Amy&Tibby Member

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    Feb 22, 2020
    I just did his +9, and it's 149. What should I do?
     
  5. Amy&Tibby

    Amy&Tibby Member

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    Feb 22, 2020
  6. Amy&Tibby

    Amy&Tibby Member

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    Feb 22, 2020
    And he did eat some chicken and some of his FF pate as usual. I'm about to get him to eat some more. He usually eats in stages.
     
  7. JaxBenji

    JaxBenji Well-Known Member

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    Jul 10, 2020
    Hi Amy! Did you have a specific question? The major differences between TR and SLGS are (1) the reduction point (<50 on TR and <90 on SLGS) and (2) no dry food on TR. Of course more info is in the dosing method sticky.

    Actually - I think this is your second post of the day - here's your first post - https://felinediabetes.com/FDMB/threads/12-27-tibby-amps-344-day-2-of-tr-trial-9-is-146.240592/ - perhaps a mod will combine them @Wendy&Neko @Sienne and Gabby (GA)

    For this board, it's best to have one post per day - you just update your daily thread (& title) with questions. The Posting Guidelines sticky is helpful as is the New to Group sticky (I see you aren't necessarily "new" but it has lots of good info nonetheless :bighug:)

    Nice to see those blues :cool::cool::cool:
     
  8. Amy&Tibby

    Amy&Tibby Member

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    Feb 22, 2020
    I wasn't sure about one or two posts. It seemed like the situation was changing, so I did the second post. Good to know.

    I don't really understand why there is a difference between TR and SLGS. Also, since I'll be going back to work next week, I'm wondering if I really should be trying out TR for just one week. But I need to get more data no matter what, day and night, so I'm giving it a shot. I've read the dosing sticky several times, but I don't get it.

    I was going to do a curve tomorrow from when I changed his dose last on the SLGS method. Do I still do that?
     
  9. Wendy&Neko

    Wendy&Neko Senior Member Moderator

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    Feb 28, 2012
    Nice PMPS and shot tonight.:cool:

    I merged your two posts of the day. If you have a new update or new question, just go ahead and edit the subject line for your existing post of the day to reflect what's new.

    Tight Regulation protocol is a dosing method that has been scientifically studied, peer reviewed and published in veterinary journals. SLGS is a method developed on the message board, prior to TR being developed. Both have had many cats on the two methods. TR is more aggressive - faster increases and lower reduction point. And for that reason requires more testing than SLGS. You need to do at least the preshots and one additional test each cycle. If you are off for a week, you could do two increases via TR, but only one with SLGS.

    The other difference between SLGS and TR is when you'd increase. With SLGS, your goal is to get nadirs between 90 and 149. With Tight Regulation, you'd like nadirs more in the 50-100 range, which is the pancreas healing zone. So, if you are following SLGS now, with that 114 today, you would stay at this dose. With TR, you would increase by 0.25 units because your nadirs are not in the goal range.

    You could do a curve if you want, but if you have enough spot checks, a curve is not necessarily. Your goal with the curve is to gather more data on how low the dose is taking the cat, and when onset and nadir times are.
     
  10. Amy&Tibby

    Amy&Tibby Member

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    Feb 22, 2020
    With SLGS, I was doing curves weekly, but with TR it's every 3 days? Yesterday was just the 2nd day doing TR and being completely off kibble, so that's my worry od adjusting a dose too soon.

    Also, he seems so bouncy. I'm not sure I have reliable nadirs yet.
     
  11. Wendy&Neko

    Wendy&Neko Senior Member Moderator

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    Feb 28, 2012
    No, with TR you want to get at least 4 tests per day, two per cycle, so not a full curve, unless you want to.

    In order to slow down the bouncing, he has to get used to normal numbers. The only way to do that is to get to a dose where he's seeing greens. Which he isn't doing at 4.0 units.
     
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  12. Amy&Tibby

    Amy&Tibby Member

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    Feb 22, 2020
    OK, I'll check for his nadir today, which is day 3 on TR without any kibble in his diet, and change his dose accordingly, depending on what people say today.
     
  13. Amy&Tibby

    Amy&Tibby Member

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    Feb 22, 2020
    Is the two tests per cycle in addition to the pre-shot tests? So that's 6 tests per day, at least?
     
  14. Bandit's Mom

    Bandit's Mom Well-Known Member

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    Oct 18, 2019
    1 test per cycle in addition to the PS ones. Active cycles would require more tests, though.
     
  15. Amy&Tibby

    Amy&Tibby Member

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    Feb 22, 2020
    Oh, that's more manageable. And I get home from work early enough to get close to those lower late numbers. He will miss his Dr Elsey's chicken kibble, though. :)
     
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  16. Bandit's Mom

    Bandit's Mom Well-Known Member

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    Oct 18, 2019
    That's great! And which of us doesn't miss junk food! Even the healthy kind!
     

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