Elementary question...

So how do you actually know when your cat is regulated? I know OTJ is when you get two straight weeks of green numbers.

But I am still a little unclear on what it means to be "regulated."

Is that your numbers stay pretty even through out the day? Or is more about being in the blues and greens?

Sorry, I am still struggling with what I should be looking/hoping for.

Lucy's BG seemed to stay about the same for most of yesterday (mid-yellows and only a PMPS pink).

Today her AMPS was pink but her +6 is blue.

How do you guys interpret these numbers. Does it mean that we might be getting close to finding the right dose/food balance for her?
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Previous post.

kalyv said:

So how do you actually know when your cat is regulated? I know OTJ is when you get two straight weeks of green numbers.
But I am still a little unclear on what it means to be "regulated."
Is that your numbers stay pretty even through out the day? Or is more about being in the blues and greens?

Click to expand...

A regulated diabetic is on a consistent level of insulin which does not take the cat into a hypo and does keep the cat in normal or close to normal numbers the majority of the day. Urination would be decreased to perhaps 2-3 times a day without there being lakes of wet litter. Appetite should not be ravenous; reasonable hunger at mealtimes. Behavior should be similar to that prior to becoming ill. Cat should be 'normal' - activity level and behavior should not seem unusual for the cat.

Thanks BJM. I think we are getting there, then. :RAHCAT

kalyv said:

So how do you actually know when your cat is regulated? I know OTJ is when you get two straight weeks of green numbers.

But I am still a little unclear on what it means to be "regulated."

Is that your numbers stay pretty even through out the day? Or is more about being in the blues and greens?

Sorry, I am still struggling with what I should be looking/hoping for.

Lucy's BG seemed to stay about the same for most of yesterday (mid-yellows and only a PMPS pink).

Today her AMPS was pink but her +6 is blue.

How do you guys interpret these numbers. Does it mean that we might be getting close to finding the right dose/food balance for her?
________

Previous post.

Click to expand...

OK I'll give it a go with an answer.

I think my two are pretty much 'regulated' for a couple of acros. I try to keep them above 100 or 5.6 to you.

Ollie's been around 60 to 200 now for weeks, and that's great. His dose today was 21.5u and was up to 37u a few weeks ago, but I kept his numbers as close to a normal non-diabetic as I could.

Shadoe's been not as low with her numbers but she has curves not as flat. With her, the dose has been rising, from 17u and up to 19u but is coming down, so her dose is dictated by her lows.

If you have a cat not diabetic,their numbers should be green or even up to maybe 110 or 120 (6.1-6.6) maybe from foods or stress or meds or a bit sick, and your goal is to try your best to use insulin to get your cat into that range, under the 11/5.6 as much as you can.

I bet if you tested yr non diabetic cat, you would see fluctuating numbers. I have tested Booboo a few times and she's mostly around 42 - 58, but other cats could have a higher decent range.

If you are giving a dose that can get numbers into some good stretches of greens and blues, I would say you are doing pretty well. If you can adjust the dose to fit the needs, then you are OK.

If you are standing on the solid ground, things are pretty stable, yes? Now, what if you were standing in a boat? When there are no waves, it's pretty easy to redistribute your weight and stay upright, but if the waves get a bit bigger, it's a little harder but doable.

That's what you are doing, you are helping your cat stay balanced. Sometimes it's a little iffy, but you know how to adjust the dose to get back on balance. You know how to keep your cat regulated.

In the beginning, a cat is started on a dose, and you wait and test to see if it's too much, enough or not enough and you adjust. As you go along, you learn how YOUR cat reacts to foods and to insulin and to dose changes, up or down. You learn how long it takes for a dose to settle, and many other things. Eventually you reach a dose where you are getting pretty nice numbers mid cycle. You could say if you can keep nadir between 50 and 200, you are doing a bang up job.

Keep in mind the general guidelines from the Lantus/Lev protocol as it still applies when thinking about regulated.
"General" Guidelines:
--- Hold the initial starting dose for 5 - 7 days (10 - 14 cycles) unless the numbers tell you otherwise. Kitties experiencing high flat curves or prone to ketones may want to increase the starting dose after 3 days (6 cycles).
--- Each subsequent dose is held for a minimum of 3 days (6 cycles) unless kitty earns a reduction (See: Reducing the dose...).
--- Adjustments to dose are based on nadirs with only some consideration given to preshot numbers.

Increasing the dose...
--- Hold the dose for 3 - 5 days (6 - 10 cycles) if nadirs are less than 200 before increasing the dose.
--- After 3 consecutive days (6 cycles)... if nadirs are greater than 200, but less than 300 increase the dose by 0.25 unit.
--- After 3 consecutive days (6 cycles)... if nadirs are greater than 300 increase the dose by 0.5 unit.

Reducing the dose...
--- If kitty drops below 40 (long term diabetic) or 50 (newly diagnosed diabetic) reduce the dose by 0.25 unit. If kitty has a history of not holding reductions well or if reductions are close together... sneak the dose down by shaving the dose rather than reducing by a full quarter unit. Alternatively, at each newly reduced dose... try to make sure kitty maintains numbers in the normal range for seven days before reducing the dose further.

--- If an attempted reduction fails, go right back up to the last good dose.
--- Try to go from 0.25u to 0.1u before stopping insulin completely.

Sure you may have the odd spikes, so just focus on the nadir in the cycles, keep between 50 and 200.

Thanks Gayle. So based on Lucy's spreadsheet - which do you think is better for her - 2.5 or 2.75? She has never dipped below 40 on 2.75 but that could be because I was there to feed her out of it.

And also, if I keep her at the lower dose where she is less likely to go into green, will that make the possibility of OTJ less likely? I mean, will slightly higher numbers retard the healing of her pancreas?

kalyv said:

Thanks Gayle. So based on Lucy's spreadsheet - which do you think is better for her? She has never dipped below 40 on 2.75 but that could be because I was there to feed her out of it.

And also, if I keep her at the lower dose where she is less likely to go into green, will that make the possibility of OTJ less likely? I mean, will slightly higher numbers retard the healing of her pancreas?

Click to expand...

Your goal is to 'help' her pancreas so that it can heal and, if possible, get to the point that it's 100% functional. I don't feel that you have to push her to get right down there; you are doing just too much manipulation and it could explode in your face if she goes low while you are out or does not come up how you like.

If you are forcing her to go too low, the result is that she may just resist and bounce, so that's not good at all.
If she is hitting 40 but you catch it in time to feed and pull her up, maybe try to shave a bit off the dose.

Always side with safety and if it does not feel good to you, then just back off a bit to see if she will settle and level off a bit. She may have some mid range blues, but I think that's alot better than mid-greens that bounce up to pink. Level is better, even if it's a bit higher.

OK that makes sense. I think I will keep her on the 2.5 for a bit and see if she levels out. She is rather bouncy so, as you say, pushing her too much may do more harm than good. Thanks G.

yes, for sure stick to the 2.5 because if you look at just the colors on the ss, with 2.75, she goes low and then bounces, hit's black, and bounces can take a couple days to settle.... imagine tossing a huge boulder into some water, massive waves and it will take longer to settle than if you had tossed a little pebble.

With your being away working, it's better that you don't have to worry if she's going low while you're out.

Thanks Gayle. She went into the pink again PMPS, but ate less than normal today. Strange.

kalyv said:

Thanks Gayle. She went into the pink again PMPS, but ate less than normal today. Strange.

Click to expand...

I hope she is not getting sick but just not as hungry.... you know, as they get closer to regulated, they don't seem to eat as much, so maybe that's part of it.

Make a note on your ss in the comments if you notice any changes like eating less; it may add up to something as days go on.

Well I have been giving her the "soup" so that might be making the difference. Usually she is asking for for food by about 5:30 or 6 so I feed her and then give her shot when it is scheduled. But today she didn't ask for food at the usual time so I just waited until she did so her PMPS was actually not food-affected for a change. But she chowed down after her shot so total volume is about the same over the course of the day.