One of my other kitties is probably going into remission, but the Sticky advises that you reduce by .25 per week until zero insulin. But if the pre shot numbers are 130 or below, how do you give ANY insulin without it being dangerous? How do you get a solid remission if you have to actually stop insulin because of low Pre shot numbers? I don't understand.....
If cat is going into remission, PS 105, then how do you still give insulin?
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Chris & China (GA)
Member Since 2013
You have to gradually learn to shoot lower and lower numbers. Most of us (once we have the data) that are doing Tight Regulation will shoot anything over 50
At first, you don't shoot under 150....but as time goes on and you test and learn about your cat, you gradually lower that number until you're shooting lower and lower numbers
At first, you don't shoot under 150....but as time goes on and you test and learn about your cat, you gradually lower that number until you're shooting lower and lower numbers
Tuxedo Mom
Member Since 2014
According to MsBliss's signature she is using the Alpha Trak 2 meter. Any reading under 68 on the AT meter is considered too low.
Thank you Chris, but how do you know you are precipitating a hypo episode? There can be so little warning with my cats. One of mine never had any symptoms and he was "LO" on the alphatrak which means anything below 20! It scared the h out of me. When you shoot lower and lower, how do you know they won't crisis? Even with tests and a curve, if they are off their food that day, the insulin can be too much.
But my one cat who is probably going into remission, I hope, is reading between under 100 to 160 while on less than one unit. Here the instructions are to reduce by .25 units per week, I guess until it's zero, then monitor for 2 weeks to judge remission. But if his number is so low, I don't feel safe giving him ANY lantus. Aren't we not supposed to shoot if it's under a certain number?
Chris & China (GA)
Member Since 2013
you avoid hypos by frequent testing and learning how your cat responds....but even then, there are occasions when they might go too low (under 68 on the AT)....by testing often though, you see that they're going too low and can intervene to bring them back up with high carb food or Karo/honey/syrup
Yes there are occasions when you wouldn't shoot...if your cat isn't eating at all or they're lower than you're used to and you can't be home to test
What we do is withhold food for the 2 hours immediately before shot time so we get a test that's not influenced by food....then we test/feed/shoot
Test to make sure they're high enough to give insulin (this number will vary depending on the protocol you use, your ability to test and your comfort level), Feed to make sure they're at least willing to eat and Shoot
Each time they drop below 68 (on the AT) they earn a reduction in dose.....the hope is that they keep earning reductions until they "earn" their way off insulin completely
If you want to see the benefits of learning to shoot low, please take a look at China's spreadsheet in our signature.
It would really help if we could see the numbers you're getting on our spreadsheet program. We could give you much better advise then. Here are instructions on getting the FDMB spreadsheet
Yes there are occasions when you wouldn't shoot...if your cat isn't eating at all or they're lower than you're used to and you can't be home to test
What we do is withhold food for the 2 hours immediately before shot time so we get a test that's not influenced by food....then we test/feed/shoot
Test to make sure they're high enough to give insulin (this number will vary depending on the protocol you use, your ability to test and your comfort level), Feed to make sure they're at least willing to eat and Shoot
Each time they drop below 68 (on the AT) they earn a reduction in dose.....the hope is that they keep earning reductions until they "earn" their way off insulin completely
If you want to see the benefits of learning to shoot low, please take a look at China's spreadsheet in our signature.
It would really help if we could see the numbers you're getting on our spreadsheet program. We could give you much better advise then. Here are instructions on getting the FDMB spreadsheet
Critter Mom
Member Since 2014
When I did Saoirse's first OTJ trial I followed the published TR protocol to the letter. I learned how to manage dosing when she was 'in the greens'. In the latter stages of her Lantus treatment (first time round) I reduced Saoirse's dose from 0.25 IU BID Lantus to zero insulin when her BG response met the published criteria but her numbers started to trend upward after only a couple of days without any insulin. Subsequently I learned here that other caregivers had better success when, instead of going from 0.25 IU Lantus to no insulin at all, they gave microdoses of Lantus to taper their cats off insulin. I reinstated Saoirse's insulin treatment and gave her microdoses (zero or less on a BD 0.3ml U100 demi syringe). Because I'm disabled I'm at home all the time (agoraphobic among other problems) I was able to closely monitor Saoirse so I knew where she was headed on a cycle and if there were times when her pancreas really started 'helping out' unexpectedly I was able to steer her BG with food to keep her safe. I'm not sure what I'd have done if I wasn't in the position to be able to monitor her that closely. The benefit of using the microdoses was that Saoirse's second OTJ trial was a success and her remission held for nearly a year until pancreatitis knocked her back into diabetic numbers.
Mogs
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Andy & Pimp
Member Since 2015
TR protocol actually states to reduce the dose when kitty is "mostly under 100" on a human meter. There's no published numbers for the AT meter. I think you might be in good shape to try a reduction if he can hold under 130-140 for a week.
ETA: when a cat's doing well on Lantus, with a proper dose and no bouncing, numbers tend to be pretty flat (unless Mr. P decides to suddenly join the party).
manxcat419
Member Since 2015
Like Mogs, I had Rosa on micro-dosing with Lantus for a while - her smallest dose was 0.05. That time coincided with me having a full time work contract and there were many mornings when I had to skip the AM shot because I couldn't monitor - in total I skipped 10 doses between 3/16/15 and 4/7/15. So for a while, Rosa was actually on 0.05 once a day a lot of days rather than twice a day. But it worked...so far (anti-jinx). 
Critter Mom
Member Since 2014
Similarly to April with Rosa, toward the end of Saoirse's first round of Lantus treatment I would only give her an AM dose and skip the PM cycle. I took advantage of Saoirse's natural tendency to run lower at night. It was a way through for us and got us over the major problem I have with erratic sleep and perhaps not be able to stay awake to test her. Without the PM dose Saoirse would be safe even when I did pass out without warning.
Mogs
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Mogs
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This was very helpful toward my understanding, thank you. I will try and set up that sheet and post my results asap, and see China's spreadsheet as soon as I have time to sit and focus (without too much interruption).
So, it's necessary to do a really gentle weaning I guess? Makes sense. I'm hoping to get one of my cats weaned, but that might not be realistic. I'm ever hopeful though.
Do you think there is any validity to YA's claim that their food can help maintain a remission and help with pancreatitis?
The one cat that is looking possible remission was up higher than I would have guessed during part of his curve this afternoon: 204, then 170, food, 190, then back to 146, today. I think I was a little too hopeful as it turns out.
manxcat419
Member Since 2015
It is really, especially if you're aiming for a really strong remission. The longer you can give the pancreas some support with even the very tiniest doses, the more chance there is of the remission being strong.
That's really a very hotly contested subject to be honest. It doesn't appear to have hurt Rosa's numbers at all, but of course it is a dry food which we're recommended to avoid. And I've seen it said that even though it's low carb, it isn't low on the glycemic index - I'm not quite sure how that works because as far as I know the glycemic index is based on carb content and how quickly those carbs are metabolized...hopefully someone here can explain it to you.
Never say never - let him earn those reductions until he's hopefully ready for micro-dosing and then see what happens. I would never have thought Rosa was a candidate for remission after being diagnosed with a BG of 680, yet somehow she pretty much followed the textbook for the TR protocol all the way down!
Chris & China (GA)
Member Since 2013
If we weren't all hopeful, we wouldn't all be here!! We all hope for that special day when we can say our kitty is OTJ!!
Critter Mom
Member Since 2014
I've no experience of feeding YA and also I don't recall anyone posting here specifically about YA and pancreatitis so I've no idea whether it's a help or a hindrance to cats with pancreatitis. Sorry I'm not any help to you about this.
Mogs
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Julia & Bandit (GA)
Member Since 2009
YA is high in fat. I would not recommend it for pancreatitis, unless you're sure the cat can handle high fat foods (some can, many can't).
The glycemic index measures how much the carbs in a food affect blood sugar--because of the way dry food is manufactured (it must have some sort of starch to bind it, otherwise it would remain a powder), it can cause a greater effect on BG than a canned food with the same carb count. For example, Bandit can typically eat a canned food at 8-10% carbs with no noticeable effect on his BG, but if he eats a dry food at 8% carbs it will shoot his BG up over 100 points. Not every cat will see this effect on their BG from the lower carb dry foods, but many will, and in my opinion, it's just not worth the risk unless the cat refuses to eat canned food. And there is more to the diet than just carbs--dry food is dehydrating, and dehydration will put added strain on the kidneys, which is important to not do with uncontrolled diabetics or CKD cats.
The glycemic index measures how much the carbs in a food affect blood sugar--because of the way dry food is manufactured (it must have some sort of starch to bind it, otherwise it would remain a powder), it can cause a greater effect on BG than a canned food with the same carb count. For example, Bandit can typically eat a canned food at 8-10% carbs with no noticeable effect on his BG, but if he eats a dry food at 8% carbs it will shoot his BG up over 100 points. Not every cat will see this effect on their BG from the lower carb dry foods, but many will, and in my opinion, it's just not worth the risk unless the cat refuses to eat canned food. And there is more to the diet than just carbs--dry food is dehydrating, and dehydration will put added strain on the kidneys, which is important to not do with uncontrolled diabetics or CKD cats.
manxcat419
Member Since 2015
Thank you for the explanation @Julia & Bandit. I do agree in principle that wet food is better of course, but for Rosa's particular eating issues at the moment I haven't had a lot of choice but to offer some YA along with the wet food - nothing I can do treatment-wise will count for anything if she starves herself to death by inches. She still eats some wet (more some days than others), but nowhere near enough to maintain her weight - she was losing about 0.3 lb per month. The days she eats enough wet food, we don't give the dry but it is an option for the days she really won't eat wet food or only picks at it. That said, we have increased her fluids to offset the dehydrating effect of dry food - fortunately that's an option we do have as she was already on sub-q.
She still eats some wet (more some days than others), but nowhere near enough to maintain her weight - she was losing about 0.3 lb per month. The days she eats enough wet food, we don't give the dry but it is an option for the days she really won't eat wet food or only picks at it. That said, we have increased her fluids to offset the dehydrating effect of dry food - fortunately that's an option we do have as she was already on sub-q.
Julia & Bandit (GA)
Member Since 2009
Thank you for the explanation @Julia & Bandit. I do agree in principle that wet food is better of course, but for Rosa's particular eating issues at the moment I haven't had a lot of choice but to offer some YA along with the wet food - nothing I can do treatment-wise will count for anything if she starves herself to death by inches.
A cat has to eat--and if you can't find a canned food she'll eat to get her required daily amount of calories, then you do the best you can with the dry and try to mitigate the ill effects of it, as you've been doing. Eating is priority 1. That's why I said I don't recommend it unless the cat refuses to eat canned food (or not enough canned food to survive certainly counts).
However, this doesn't appear to be the case for the OP--if the cats will readily eat canned food (as they seem to in the OPs case), then I wouldn't recommend adding the YA.
Thank you for the explanation @Julia & Bandit. I do agree in principle that wet food is better of course, but for Rosa's particular eating issues at the moment I haven't had a lot of choice but to offer some YA along with the wet food - nothing I can do treatment-wise will count for anything if she starves herself to death by inches.
One of my kitties is hot and cold on wet food--the other will eat wet food. I've been feeding FF Classic and am now learning it is high in phosphorus, which is bad for CKD. YA is low in phosphorus, and can help with the pancreatitis because it balances protein to fat, even though it is higher in fat. They have to eat, but balancing diabetes against CKD is so difficult. I give subq fluids for hydration, so I'm going ahead with my YA experiment since I've already bought it.
I'm on the second day now with this experiment, so I'm giving FF with a few bits of YA on top and FortiFlora sprinkled on top of that. So far, it has helped with the constipation, which helps with the pancreatitis because it helps reduce any vomiting. It's all madness and incredibly anxiety provoking because I can't tell which end is up.
I'll post later with more results.
manxcat419
Member Since 2015
I'll be interested to hear how you get on with the YA. Rosa seems to be doing really very well with it as a part of her diet - she gave me her lowest number in several weeks yesterday. It is all a balancing act, especially with CKD (and the way CKD cats can be overly picky with food) as well as diabetes in the mix. But as you already give subq, you could speak with your vet about doing the same thing we do with Rosa - if she seems like she could be a little better hydrated and she's absorbing her fluids fairly quickly, then our vet suggested we simply add a small amount of extra fluid. I would never suggest doing that without getting your vet's opinion as overhydration comes with it's own problems, but maybe your vet could offer some guidance on whether or not that would be an option for you.
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