I heard back from Marje/Gracie, Sandy/BK and Wendy/Neko - the consensus was that you test often enough that if you WANT to go to 0.1u as a final step before doing an OTJ trial, you could. When FDMB first started and everyone used the SLGS with Lantus, people did go from 0.25u to OTJ. In more recent years with the Tight Regulation Protocol, people were encouraged to decrease the dose to 0.1u in order to support the pancreas as long as possible before taking the cat off of insulin.
It's a little more confusing because you're using AT and we don't have any "official" documents that give AT/human glucometer conversions. The Tight Regulation Protocol doc by Rand/Roomp uses AT 68 as the rough equivalent to a human glucometer 50, which is 30% more (50 + 30% = 65), so we've made guesses that the normal range on an AT *might* be 68-160ish. But it's just a guess. The decision on what constitutes normal in an AT is going to be up to you. All of these documents below are using human glucometer numbers.
From the SLGS sticky on remission:
Remission:
Remission is reached when kitty can go 14 days without insulin while maintaining normal blood glucose values in the 50 - 120 mg/dL (2.7 - 6.6 mmol/L) range. Most will remain in the 50 - 80mg/dL (2.7 - 4.4 mmol/L) range. However, some will experience infrequent BG numbers higher than the norm. Continue feeding low carb food. Test the cat's BGs once per month. If BG numbers begin to trend upwards, it's time to bring kitty in to see your vet for a check-up. Common reasons for kitty falling out of remission include dental issues, infection, inflammation, pancreatitis, etc. Just about any illness or disease can do it.
From the Tight Regulation Protocol sticky on remission:
- Since 2006 we've encouraged those practicing Tight Regulation to attempt reducing the dose from 0.25u to 0.1u before stopping insulin completely. During a two week OTJ trial, you want to see mostly green numbers (under 100) with only a few random blue numbers between 100 - 120 to help ensure a strong remission.
Remission:
- From Tilly's Diabetes Homepage:
Phase 5: Remission
"14 days without insulin and normal blood glucose values. Most remission cats are able to stay in the normal range all of the time (50 to 80 mg/dl), although there are a few cases of sporadic higher and lower BGs. Don't stop feeding low-carb and try to avoid cortisone if possible. Test the cat's BGs once per month.
Approximately 25% cats that achieved remission using this protocol relapsed and required insulin again (frequent causes are hyperthyroidism or bouts of pancreatitis). Therefore, it is important to keep your diabetes kit up-to-date. Then you can react immediately by giving insulin and home testing. Importantly, the sooner you react to a relapse (i.e. preventing hyperglycemia and initiating other necessary veterinary treatment), the more likely a second remission will become.
The longer a cat has had diabetes, the less likely it will go into remission. Many long-term diabetics get stuck in Phase 3 or 4. Yet there is a benefit of using this method for such a cat as well: keeping the cat's BG levels as normal as possible is much healthier for it long term. Insulin requirements will often decrease to very low levels too."
What direction do you think you'd like to go with Princess?
