? 9/11 Henri; PMPS 152, +2 200, +4 145, +5 131, +6 119, +7 118, +8 130, +9 160 TR dosing

These are Henri's numbers for today. Sometimes she gets pretty low before her PMPS and I had been using food in the afternoon to bring them back up so I can dose her...I'm not sure that was the right thing to do?

I've been reading up a bit and I want to follow the TR protocol but I think I may be confusing what I'm reading.

My take on it so far is to stall and wait a half hour to see if her numbers are going up, and if they are it's safe to dose bc youre dosing for the future numbers bc of the time it takes to kick in? So what is the safe low number for me to dose in this circumstance? Also, does that mean I can still use food to manipulate her numbers...say up to 2 hrs before PMPS? I should also note that I was doing it with low carb food only.

My other question is if I am stalling...how long do you stall for? 30 min, 60 min etc? and then if I did stall that dose of insulin would be longer than 12 hours from the last dose. What do I do with the next dose? Keep my original dosing time or is the stalled time the new official dose time for insuin.

I have some links to read through still but if there's anything else you think I should know please feel free. I am literally starting from scratch, running on fumes as you can see from her spreadsheet lol

https://docs.google.com/spreadsheets/d/1OG2DE6K4Qn7i8E1vlvwgISq4hp_Pv9_8b-80OdX7zts/edit?usp=sharing

 

Is your SS up to date? It's 4 hours until PMPS - these are excellent numbers.

I see no need at this time to do any food manipulation...

 

It is! OK...that good to know bc I had just offered her food and she literally took like 5 licks and was done. She was following me around like a little lost puppy cat though so I though she might be hungry lol

What range would I be in when considering food to manipulate the number up?

 

If she drops 100 points from the 160 to 60, then you would want to feed her some MC - to slow the drop.

Looks like she's in a very good spot right now...test for your peace of mind and to know where she's headed.

 

her

Just tested her
+10 138
at what number would I stall and what number is it safe to dose her with insulin

 

At what low number is it safe to dose her with insulin for her PMPS?

 

On TR we do not recommend shooting below 50. You may get to shoot your first green tonight - let's see if she keeps moving in that direction.

@Butters & Lyla - I know you've been dealing with a lot of low PMPS numbers lately, care to chime in?

 

138 @+10 gives her room to come down more and still have a shootable number.
You can shoot anything 50 and above with TR. It would be so amazing if you get to shoot your first green! Many would be envious. "Shoot low to stay low" is what we are all going for here.
This looks like it may be a cycle where she is breaking a bounce, as she's slid down all day. When was the last time you fed her? +10 is your last chance to give her any food before PMPS, so if you want to give her something, you can give her a little bit of LC right now and then no more food til PMPS.

 

Exciting and nerve-wracking at the same time!

 

I'm excited! I didnt realize she was doing so well!
She last ate at a few bites at +8 but her last meal was at +5-+6

 

That's great!
Will keep an eye out for your numbers!

 

A suggestion: can you please add "TR" into your signature? See mine says "Lantus, TR"...that's pretty standard. We always look in your signature for key bits of information, then your spreadsheet. Is it a recent switch from SLGS to TR? If so, you can add the date started in there, too.

 

Will do

I think i hadnt decided yet...so not a switch from one to the other but a switch from the vets recommendations to TR? lol

 

+11 is 152 so I guess shes on her way up. Wonder if we'll make it into green numbers tonight.

If she gets below 50 is that when I start a high carb food or a medium carb food maybe?

 

LOL! Right! I've gotten kinda used to people here starting on SLGS and many switching to TR.

So you have not yet decided if you're going to follow TR, then? But you want to shoot according to the numbers that TR allows for? Very different from SLGS.

 

So on TR, you want to keep kitty above 50. If kitty goes below 50, say into the 40s then you would need to use H/MC to bring them back up. But people use M/HC food at other times to keep their kitty surfing in green numbers, for example.

 

I recommend you read and then re-read all of the sticky threads that are posted at the top of the forum. There is one on how to deal with low numbers. And of course, the TR dosing method sticky. I still read them all of the time. You cannot read through them enough. And go back and read other people's condos so you can see how they handled low numbers for their kitty, look at their kitties' spreadsheets, too.
The more you read up front, the more prepared you will feel when Henri does get into lower numbers.

Looks like Henri may decide to bounce again....maybe.

 

will do

It seems like TR is tougher but more effective? and I do have the ability to teat a minimum of 5 or 6 times a day on the days I work 10 hour days. I'll have to look for those stickys. I'm a little technologically illiterate so I might have to have my husband help me find them lol

I wonder if I can help regulate the bounce with food? Like instead of feeding her a large dinner...to space it out a bit more or feed a little later after the insulin starts to kick in? I hope she doesn't bounce again :/

 

are those numbers you mentioned..the 40's and 50's based on a human meter?

 

Yes they are. I see you are using Relion.

 

If you can test 5-6 times per day that is enough to do TR. You also need to get some nightime tests in. I like to do a +2.5 and then a before bed test, which gives me a good indication if I have to set an alarm for further testing.

https://www.felinediabetes.com/FDMB...-low-go-slow-slgs-tight-regulation-tr.210110/

https://www.felinediabetes.com/FDMB/threads/dont-panic-or-how-to-handle-low-numbers.210109/

They are all at the top of the list of everyone's condos.

 

I can definitely do some night time testing too. I'll always be able to do a +2 to a +4 and I can set alarms for whenever I need. I have recently realized I can work a 10 hour day on very little sleep lol

 

sorry...this may be a stupid question but what is a condo?

 

No stupid questions! The "condos" are the threads that everyone has going for their cats. We are writing back and forth in your "condo" for today for Henri.

 

Lol Thank you! Ive never done the forum thing so I'm still trying to figure all this out lol

Ive noticed I sometimes miss messages if there are multiple responses so now I just scroll back to the top and read each one all the way down

I'm reading through the links you posted...I think I may print them out and make a 1 page version of what to do with low numbers and add it to my hypo kit I still have to find some high carb foods. It seems the food I picked that I thought were high carb are only medium lol

 

It's all a learning curve. Nice catch recognizing your HC food is actually MC before you actually need it.
Do you have the link for the food chart: https://catinfo.org/docs/CatFoodProteinFatCarbPhosphorusChart.pdf
I selected all of my foods for Butters based on the % carbs in this chart. Lots of options.

 

Did you end up shooting? What was PMPS? DOn't see it yet in your SS.

You can spread out her food over the course of a cycle into more equal portions. It's better to have smaller meals throughout than two large ones.
I use an autofeeder with four compartments on timers. I give butters a bit more food with insulin and then four to six small snacks during the rest of the cycle. Some people split the food into exact equal portions to be fed throughout the day.
Track what you feed and when so you can see how the food influences her BG numbers. It is a bit of trial and error. You want to "feed her curve". When she gets into lower numbers, you use food to steer her numbers or to keep her surfing along.

And here, in this sticky, for your reading pleasure it tells you how insulin works (learn and understand the terms "duration", "onset", "nadir") and gives and example of an active (not necessarily typical) Lantus cycle:

https://www.felinediabetes.com/FDMB/threads/the-basics-new-to-the-group-start-here.18139/

 

I did. I'll update now
He PMPS was 152 so I dosed her .75 unite. her +2 was 200 and in another 45 min i'll test her +4

 

Thank you! I have an automatic feeder with ice packs but we are currently having a fly problem and I cant leave any food out. I found them swarming in my other girls bowl this morning I'm always home to make sure she gets a good breakfast in (7 am/7pm) my husband can always feed her lunch between 12 & 1 but she usually only eats about 20 calories (give or take) and then I often give her some more of how ever much shell eat from about 9-10 pm. Ideally I would leave food out for her but until I get this fly problem under control it's not an option. I do keep track of how many calories she eats when bc she isnt being that great of an eater since coming home from the hospital and switching her to wet. She ha been a kibble kitty her whole life...never really interested in wet. I get a total of 180-250 calories into her daily depending on her mood I guess lol. I find if she eats too much after 10 I have a hard time getting breakfast in to her. I'm going to have to print out her curves and jot down the food in relation to it so I can visualize it.

 

Her +4 is 145
So if she drops into the green...as long as it's not below 50, I should wait to see what happens? and then if she drops below 50, I should give MC/HC food to bring her back up?

If I catch it in the 60's would giving her some low carb food help to bring her up more slowly and maybe we would avoid another bounce? or are we still bouncing from before lol Would that be something that's OK to do with TR?

 

Here is a general guide:
50-70 BG
Give 1-2 tsp LC, retest 20-30 minutes
If dropping, little more LC and repeat process
If holding, no more food but retest in 30 min
If rising, no more food and take a "poke break" once above 70 (check 1 hr later)

If you're earlier in the cycle though you might want to intervene with M/HC. Otherwise, use M/HC if she drops below 50.

 

Yes, especially when you haven't experienced lower numbers yet. See my previous post. This is "feeding her curve".
Remember that with your MC & HC, and you have your hypo kit with karo, you are in control of Henri's numbers. You can use these things to bring her up if she gets too low.

 

I normally feed Butters LC snacks (these are part of her daily food intake) at +2.5, +5, +6.5, +7, and +9 of both AM and PM cycles. Every cat is different. Mine nadirs late and also gets acid tummy if she goes too long without food, so she gets late cycle snacks.

Have you fed her a snack since her dinner? Do the best you can with her food, given your constraints. The autofeeder is covered, no? It probably makes a noise when it turns. Butters runs to it when she hears it, so if Henri learns the same you may be able to leave it in spite of the flies?

 

Thanks for the detailed explanation! I'll be up monitoring for quite awhile. Meanwhile she is snoring away lol

 

It does but these flies are little and can get it. We had an empty can upside down on a plate of cat food (it was covering the food) bc my husband wanted to show me what she ate when I was at work. They were in the can. They got between the can and the plate :-(

She ate 19 calories at 8 (+1)
14 calories at 9 (+2)
and another 14 calories at 10:30 (+3.5)

 

Looks like you are up monitoring every night! Tests every two hours, even through the night! That's amazing. You're doing great with monitoring already. You'll be fine tonight.
If you ever run into a situation that you need immediate help in handling, post for help. And keep your condo title updated with Henri's numbers. People are often keeping watch for low numbers in condo titles.
Clearly Henri is having a great night already. I'm looking to get some sleep myself. Butters has decided she's going to rise, and now I'm taking the MC out of her autofeeder.

 

Excellent. Add this in the "remarks" column of your spreadsheet so that you can see any impact it has on her BG numbers.

ETA: And the flies....ew. Sorry. That is not fun to deal with.

 

Thanks! Will do... and you get some rest too

I'll be sure to add it to the comments. I have pretty good details for most days when it comes to her food. I even made a spreadsheet of her favorite flavors and brand of foods lol

 

Okay. I see a few people on the west coast who are still around, if you need anything. I'll check out your condo later to make sure all is well, but if I miss any action, just post for help.

 

Will do

Thanks!

 

+6 119
Her numbers keep dropping. Is this OK. I know between 50-70 I should try feeding small amounts of LC food and testing every 20-30 min. Will I have to worry about a bounce...or is this still part of her bounce from a couple weeks ago. What earns her a dose reduction? Or is she too all over the place for that still

 

Yes, it is okay.
Remember now that you are on TR, a dose reduction is if she gets a number below 50.
I'm gonna have a look at your spreadsheet....hang on.

 

I don't see in your ss when you fed her? Did you give her any food at +4, +5 or +6? And if so, was it before or after testing?
But don't worry, she is doing a nice, slow slide. These numbers are really good.
This is not a bounce right now. A bounce is when they shoot up after lower numbers. She will likely bounce because she seems to be a cat who bounces.
Dose reductions are taken based on the TR protocol. Remember the links I posted in your condo earlier? When you have time, read them. Taking reductions is explained in the TR/SLGS dosing methods one in detail.

How much longer til your +7?

 

She just had her +7 and it was 118.

She ate her dinner at her PMPS. Then
19 calories at +1
14 calories at +2 and
8 calories at + 3.5

I'll add the food to my spreadsheet in the morning...err in a few hours lol

I'm exhausted... dosing off for 30-45 min in between testing lol

 

Yes I caught the +7 in your spreadsheet. She's holding steady.

 

Remember, you have food you can use to move her upwards if you need to. But these are great numbers and no need to worry. If you want to feed her a snack, you can. Feeding between 70-50 doesn't mean you have to withhold food at all other times.

When a cat slides down, that is not the bounce. That is the insulin doing its job. You will get more comfortable with lower numbers the more you experience them. I'm guessing you went back to sleep, so I'm going to do the same.

 

+8 130

It seems shes gping back up! Ill trst again in an hour and then maybe I can get a couple solid hours before work tomorrow

 

+9 160

I think its safe to sleep now lol