? 4/21 oregano amps 400, +1 364, +2 322, +3 324

wade

wade

Member
Anyone have experience with this? Oregano was at 2.75 2x daily doing well, getting blues and some yellows, then at +5 (pm) on her 4th day went below 90 and stayed there for a couple hours. So earned reduction. Yay, I thought. Improvement. So backed her down to 2.5 following the SLGS protocol, and we are on day three of that now and it’s purples and reds am and pm. It’s incredibly deflating. We were improving and now I feel like I’ve set her back because we reduced, but the instructions are really clear that you have to reduce .25 if you go below 90.

this normal?

Thanks and apologies for the whiny tone. Just really discouraged after the progress we made at 2.75 to see so many high 300s again now that we are back at 2.5.

Wade and oregano
 
Here is some information from one of the sticky’s that talks about bouncing.
  • Bouncing - Bouncing is simply a natural reaction to what the cat's system perceives as a BG value that is "too low". "Too low" is relative. If a cat is used to BGs in the 200's, 300's, or higher for a long time, then even a BG that drops to 150 can trigger a "bounce". Bouncing can also be triggered if the blood glucose drops too low and/or too fast.The pancreas, then the liver, release glucogon, glycogen and counter-regulatory hormones. The end result is a dumping of "sugar" into the bloodstream to save the cat from going hypoglycemic from a perceived low. The action is often referred to as "liver panic" or "panicky liver". *Usually*, a bounce will clear kitty's system within 3 days (6 cycles
 
Hi Wade! I agree with Kat--she's bouncing. And I hope some senior members weigh in here with some advice.

I'm not a senior member on this forum, and I will not offer dosing advice, but I will tell you that, personally, the decision to lower her dose (on 4/19), which perfectly follows SLGS protocol, is the exact reason I decided to switch to TR. I kept needing to reduce Jude because we fell below 90, instead of holding him at a dose that eventually began to effectively lower his numbers. You can look at my sheet (and others' sheets) to see how this works. It's just something for you to consider. You're certainly testing enough to switch to TR. And if you were following TR, you would not have had to lower on 4/19. My experience has shown that senior members will not try to persuade you to follow one dosing method over another--it's a decision each person needs to make based on their own personal situation. I'm just speaking from my own experience. I'm glad I made the decision because it helped me to get Jude out of the blacks, pinks, yellows and into the blues and greens, and into a tightly regulated state.
 
Kat & Trixie said:
Hi Wade, bumping this back up to get some more experienced eyes on your post.

Oregano may be bouncing from those lower numbers. It can take a couple days for the numbers to stabilize again. Don’t despair.
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Thank you for the bump. I’m still endeavoring to learn how to do that. And I appreciate the encouragement. The hard part for me is the guilt that comes from feeling like I’m failing my kitty. I know I’m not—she and this awful disease have become the central aspect to my life since she was diagnosed—but it’s tough. As I know many folks on this forum know. I have this fantasy that I’m going to ride this slgs protocol up to whatever her perfect dose is and then she’ll be fine, regulated, etc. and it’s not gone that way. Been a dog fight every step of the way. I’d be lost without this forum.
 
Kat & Trixie said:
Here is some information from one of the sticky’s that talks about bouncing.
  • Bouncing - Bouncing is simply a natural reaction to what the cat's system perceives as a BG value that is "too low". "Too low" is relative. If a cat is used to BGs in the 200's, 300's, or higher for a long time, then even a BG that drops to 150 can trigger a "bounce". Bouncing can also be triggered if the blood glucose drops too low and/or too fast.The pancreas, then the liver, release glucogon, glycogen and counter-regulatory hormones. The end result is a dumping of "sugar" into the bloodstream to save the cat from going hypoglycemic from a perceived low. The action is often referred to as "liver panic" or "panicky liver". *Usually*, a bounce will clear kitty's system within 3 days (6 cycles
Click to expand...

ah. Well this makes sense. So if that’s the case then in the next day or so we should see some leveling off. That’s encouraging. And we are still negative for ketones so a. It of good news there.

thank you for the advice and information. It is comforting and helpful.
 
Marielle said:
Hi Wade! I agree with Kat--she's bouncing. And I hope some senior members weigh in here with some advice.

I'm not a senior member on this forum, and I will not offer dosing advice, but I will tell you that, personally, the decision to lower her dose (on 4/19), which perfectly follows SLGS protocol, is the exact reason I decided to switch to TR. I kept needing to reduce Jude because we fell below 90, instead of holding him at a dose that eventually began to effectively lower his numbers. You can look at my sheet (and others' sheets) to see how this works. It's just something for you to consider. You're certainly testing enough to switch to TR. And if you were following TR, you would not have had to lower on 4/19. My experience has shown that senior members will not try to persuade you to follow one dosing method over another--it's a decision each person needs to make based on their own personal situation. I'm just speaking from my own experience. I'm glad I made the decision because it helped me to get Jude out of the blacks, pinks, yellows and into the blues and greens, and into a tightly regulated state.
Click to expand...

Ok so maybe I need to learn more about TR. I do test a ton—probably 45-60 scans a day and I work from home so have her in my office during the day. And if I am out of the house my wife is here so we have full and comprehensive coverage. But something about TR terrifies me. I have looked at SS’s that shoot at 90 or less which I can’t fathom. I think I genuinely don’t understand the system because I don’t understand how those kitties aren’t going into hypo states. I also need to get my mind right about the greens—when I see them I get incredibly anxious. I think it is probably because when oregano was first diagnosed the vet put her on vetsulin which was brutal. Multiple hypo events per week, spiking and dropping 300+ points in a two hour period… I got where I was having ptsd from greens. Lantus has been a game changer for us on that point (I can sleep again) but it has been tough finding the right dose to get her into the 100-199 range (the blues). I’m going to go back through the TR stickies and see what that might entail. I appreciate the suggestion. Diving into Jude’s
SS now.
 
Marielle said:
Hi Wade! I agree with Kat--she's bouncing. And I hope some senior members weigh in here with some advice.

I'm not a senior member on this forum, and I will not offer dosing advice, but I will tell you that, personally, the decision to lower her dose (on 4/19), which perfectly follows SLGS protocol, is the exact reason I decided to switch to TR. I kept needing to reduce Jude because we fell below 90, instead of holding him at a dose that eventually began to effectively lower his numbers. You can look at my sheet (and others' sheets) to see how this works. It's just something for you to consider. You're certainly testing enough to switch to TR. And if you were following TR, you would not have had to lower on 4/19. My experience has shown that senior members will not try to persuade you to follow one dosing method over another--it's a decision each person needs to make based on their own personal situation. I'm just speaking from my own experience. I'm glad I made the decision because it helped me to get Jude out of the blacks, pinks, yellows and into the blues and greens, and into a tightly regulated state.
Click to expand...

wow. It’s like you just flipped a switch in late January. That is simply switching to TR?
 
Hang in there, Wade. You’re doing a great job and it’s admirable how much effort you’re putting into her care.

TR was a huge help for us too. You’d have to ditch the dry food though… I think it has to do with how Lantus works, it’s been said here Lantus is better at keeping numbers low than it is bringing high numbers down. The fear of greens is real too - but you test and have the means to keep her safe now.
 
If you look at Noogi's sheet you will see I have also had a great deal of success with TR. It was not immediate, but our situation was made a little more complicated by changing to a low carb diet in Feb. This resulted in a rapid decrease in dosage under SLGS. Once I switched over to TR I needed to increase dose again. But then we also had a switch-flip moment where things just started to work for us. There was a bit of a dose dive once we got into pancreas-healing greens but as you can see have settled on 1u for now and doing very well on it.

TR does require that you get comfortable with green numbers and even shooting greens. Completely understand that you are anxious about it from previous bad experiences. It takes a while to understand and more importantly *trust* that Lantus works in a different way, with long gentle cycles in the lower numbers. You will need to build up your confidence about managing drops into the 60s and 50s again, and brush up on your carb manipulation skills should she drop into a lime again.

I needed a lot of guidance and support when I switched to TR. And not going to lie, it was a lot of work - lots of learning by rereading sticky notes over and over, monitoring often late into the night, saying no to social events to stay home and watch the cat, and also coping with my own nerves around the whole process of carb manipulation to bring Noogi up from lows and keep him safe. But I did it and have got to a place where my cat is well regulated and I feel good about managing him, which just six weeks ago felt like an impossibility. Seeing how how much better Noogi feels now has made all the work of getting to grips with TR worth it. And of course I am still doing it, but with much less anxiety and a lot more sleep!

Wade, I encourage you to give TR some thought. But don't feel pressured - no one will judge you if your feel TR is not for you. And if you do try and it and find it too much you can always change back. But if you decide to go for it this community will help and support you through it.
 
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Tim & Pookey said:
Hang in there, Wade. You’re doing a great job and it’s admirable how much effort you’re putting into her care.

TR was a huge help for us too. You’d have to ditch the dry food though… I think it has to do with how Lantus works, it’s been said here Lantus is better at keeping numbers low than it is bringing high numbers down. The fear of greens is real too - but you test and have the means to keep her safe now.
Click to expand...

how do you get their numbers down that low on TR to start with? Is it just a matter of more insulin?
 
Helen + Noogi said:
If you look at Noogi's sheet you will see I have also had a great deal of success with TR. It was not immediate, but our situation was made a little more complicated by changing to a low carb diet in Feb. This resulted in a rapid decrease in dosage under SLGS. Once I switched over to TR I needed to increase dose again. But then we also had a switch-flip moment where things just started to work for us. There was a bit of a dose dive once we got into pancreas-healing greens but as you can see have settled on 1u for now and doing very well on it.

TR does require that you get comfortable with green numbers and even shooting greens. Completely understand that you are anxious about it from previous bad experiences. It takes a while to understand and more importantly *trust* that Lantus works in a different way, with long gentle cycles in the lower numbers. You will need to build up your confidence about managing drops into the 60s and 50s again, and brush up on your carb manipulation skills should she drop into a lime again.

I needed a lot of guidance and support when I switched to TR. And not going to lie, it was a lot of work - lots of learning by rereading sticky notes over and over, monitoring often late into the night, saying no to social events to stay home and watch the cat, and also coping with my own nerves around the whole process of carb manipulation to bring Noogi up from lows and keep him safe. But I did it and have got to a place where my cat is well regulated and I feel good about managing him, which just six weeks ago felt like an impossibility. Seeing how how much better Noogi feels now has made all the work of getting to grips with TR worth it. And of course I am still doing it, but with much less anxiety and a lot more sleep!

Wade, I encourage you to give TR some thought. But don't feel pressured - no one will judge you if your feel TR is not for you. And if you do try and it and find it too much you can always change back. But if you decide to go for it this community will help and support you through it.
Click to expand...


Is it the general consensus of the more experienced folks on this site that TR is better for the cat? It seemed so risky to me but after today (4th day) if oregano being 400 literally all night last night and all day today, I am reconsidering. She seems to feel fine but I k ow these high numbers can’t be great for her.

I am going to spend some time learning about TR. I honestly know nothing about it other than there are a lot of lower numbers. How to get there, what makes it different from slgs, etc. lots to learn and I’m going to really start tonight.
 
Hi Wade. TR is an aggressive method towards regulation. Doses are increased every 3-5 days and decreased when a newly diagnosed cat falls under 50. Because it is an aggressive approach to regulation, it requires not feeding any dry food. The cat must be on an all wet food or raw food diet. TR also requires at least 4 tests a day (which you're getting).

I see that you're feeding some crunchies which means following SLGS for safety. Do you think that Oregano will take freeze dried or air dried in place of the Dr. Elseys? If so, then look into switching to TR.

Oregano is just bouncing from the greens the other night. Bounces can take up to 6 cycles to clear. Tonight will be the sixth cycle since greens so you may see some action tonight or tomorrow. Paws crossed.

While you contemplate whether TR is right for you and Oregano, I think that you can lower your "no shoot" or "token dose" number. You saw that a token dose on 4/16 with an amps of 172 didn't help move the numbers. I think that you should be able to shoot the full dose any number over 150 as long as you can monitor as you have been doing :cat:. And of course if nervous or anxious, just post and include something like "help with lower numbers" or something that makes sense o_O.

PS there is nothing wrong with your tone! You sound like an eager to learn CG who just wants what's best for his fur baby :bighug:
 
Hi Wade, Sorry I haven't responded until now--busy day. I think you've heard some good feedback from others. I really wish @Angela & Cleo and/or @Bandit's Mom would weigh in here as well. Jude did sort of flip a switch (we also call that hitting a break-through dose), and he began racing down the dosing ladder, which was a wild ride, but the outcome was that he is now tightly regulated. The consideration for you with TR is this: your reductions are earned at a lower bg number (50 for newly diagnosed cats/40 for long term diabetics) than slgs (reductions earned if kitty falls below 90--though you could opt to lower that, and some do, to, like 80 or so). By holding doses that bring kitty lower for longer periods, the numbers get better, but, as others have mentioned, when numbers get better, that means you are going to be shooting in the greens. As Tim mentioned, Lantus is designed to create flat cycles. Look at Tim's sugar sheet--he shot in the greens daily until Pookey finally went into remission. When you read about TR, you'll get more scientific detail on this. It's a dosing protocol that is backed by research and can help get kitties into remission (though I must mention that Jude went into remission on slgs--following a food change--and he was likely a steriod-induced diabetic). As others have said, no one is going to judge you for choosing one dosing method over another; we're just sharing our experience and doing so in light of your concerns that Oregano is still experiencing high numbers. We all hope that you can get Oregano's numbers regulated, whatever method of dosing you choose.

ETA: I'm so glad @Angela & Cleo weighed in while I was typing this!

ETA#2: I also wanted to mention that what CGs do when kitties go too low during a cycle is carb manipulate with food. You'll learn how to test at the beginning of a cycle, shoot, and then test again to determine how Oregano is handing the insulin. If she is going down too fast, you'll use MC or HC food to help keep her up and surfing through a cycle.
 
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Wade,

I just wanted to chime in with my experience as I’m someone who is also super nervous about lower numbers and hypos. I think it’s great that you’re going to start reading up on TR vs SLGS tonight. And please don't hesitate to ask questions here. Everyone here is incredibly supportive, patient, and caring. As Helen said, if you do decide to try out TR, this community will help you along the way. They’ve helped me SO much. Even when I've been a huge pain in the butt.

Remember that you can switch back to SLGS if you find TR isn’t for you. A while back, Wendy had mentioned to me that some people in the past have done TR to get their cat under control, then switched to SLGS once their numbers were better. That comforted me and it stuck with me, and so that’s exactly what I did. If you look at Charlie's spreadsheet, you’ll see that he was stuck in high numbers for several weeks. I’m glad I was using TR at that time, because he really needed the rapid dose increases that TR provides to catch up with the glucose toxicity and break through. With SLGS, the dose increases are a little further apart (hence the “go slow”). If he was on SLGS at that time, I think he would’ve stayed one step behind the glucose toxicity for too long.

You’ll also see on his sheet that I recently switched back to SLGS. For one, I’m comfortable with where his numbers are now and I would also like to avoid shooting green (he’s on a bit of a high-ish dose so it’s extra scary to me). That said, you might find that by the time you get to lower numbers, you’ll have a much better idea of how Oregano uses the insulin and what her patterns are. That plus building more trust in the way lantus works, as Helen so perfectly said, will help you feel more confident.

One last thing I will say is if you do decide to switch to TR, it might be helpful to try and post on here every day if you can. That will help us stay up to date on the goings-on with Oregano so we can help you guys better, plus it will help YOU feel more supported and confident. There are a lot of things I would have missed or wouldn't have learned if I wasn't posting on here every day asking questions and being a nuisance to everyone (jk on that last part).

I know how much you love Oregano, and I'm confident you'll make whatever decision is best for both of you. We're here for you either way!
 
Angela & Cleo said:
Hi Wade. TR is an aggressive method towards regulation. Doses are increased every 3-5 days and decreased when a newly diagnosed cat falls under 50. Because it is an aggressive approach to regulation, it requires not feeding any dry food. The cat must be on an all wet food or raw food diet. TR also requires at least 4 tests a day (which you're getting).

I see that you're feeding some crunchies which means following SLGS for safety. Do you think that Oregano will take freeze dried or air dried in place of the Dr. Elseys? If so, then look into switching to TR.

Oregano is just bouncing from the greens the other night. Bounces can take up to 6 cycles to clear. Tonight will be the sixth cycle since greens so you may see some action tonight or tomorrow. Paws crossed.

While you contemplate whether TR is right for you and Oregano, I think that you can lower your "no shoot" or "token dose" number. You saw that a token dose on 4/16 with an amps of 172 didn't help move the numbers. I think that you should be able to shoot the full dose any number over 150 as long as you can monitor as you have been doing :cat:. And of course if nervous or anxious, just post and include something like "help with lower numbers" or something that makes sense o_O.

PS there is nothing wrong with your tone! You sound like an eager to learn CG who just wants what's best for his fur baby :bighug:
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we have not tried raw food diet but I suspect she’ll love it. I have her on about 90% soft food now with some crunchies as snacks in between (high protein crunchies but still crunchies so not ok for TR I understand). The raw replaced for the Fri chows may be the ticket there.

I am going to be switching to TR if I can’t get her regulated on slgs in the next couple weeks. We will likely be bumping up .25 to 2.75 (again, heavy sigh) in another day or two once we have finished this week at 2.5, and if that or 3 units twice daily don’t do it I’m probably going to just bite the bullet and go TR. I worry about the nights in TR but we’ll figure it out I guess. I just really need to get her regulated.
 
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