Confused by conflicting information

[Bree]

Hi all,

I was encouraged to post on this forum following these two other posts:
http://www.felinediabetes.com/FDMB/...able-to-give-proper-care.169833/#post-1848744
http://www.felinediabetes.com/FDMB/threads/kai-updates.170274/

To spare you from having to go back through and read this all, I will give a brief summary. Kai was diagnosed in the fall. Her vet encouraged a month or so of a diet change (to Hills m/d wet and dry combo...wish I knew then what I know now!). In early December, new blood tests revealed that the diet change did not work (no surprise there!). Long story short, I was fortunate to get some invaluable help in this whole process by a very kind and knowledgable woman in Seattle. Since then, I have started insulin under her guidance. I have been taking BS and reported to her twice a day, after which she tells me how much Lantus to give. But, based on some responses in my posts above, there has been some concern about our approach. I trust this women, she is an RN and has helped over 25 cats into remission. She fosters diabetics cats and is passionate about this issue. I'm so confused!

Kai seems to be doing fine. In fact, her energy has increased; she's playing more than she has in a long time. Her urine volume and drinking frequency has decreased noticeably. However, her appetite has definitely increased over the past three days or so.

Thoughts?

Thank you!

 

[Kris & Teasel]

Hi all,

I was encouraged to post on this forum following these two other posts:
http://www.felinediabetes.com/FDMB/...able-to-give-proper-care.169833/#post-1848744
http://www.felinediabetes.com/FDMB/threads/kai-updates.170274/

To spare you from having to go back through and read this all, I will give a brief summary. Kai was diagnosed in the fall. Her vet encouraged a month or so of a diet change (to Hills m/d wet and dry combo...wish I knew then what I know now!). In early December, new blood tests revealed that the diet change did not work (no surprise there!). Long story short, I was fortunate to get some invaluable help in this whole process by a very kind and knowledgable woman in Seattle. Since then, I have started insulin under her guidance. I have been taking BS and reported to her twice a day, after which she tells me how much Lantus to give. But, based on some responses in my posts above, there has been some concern about our approach. I trust this women, she is an RN and has helped over 25 cats into remission. She fosters diabetics cats and is passionate about this issue. I'm so confused!

Kai seems to be doing fine. In fact, her energy has increased; she's playing more than she has in a long time. Her urine volume and drinking frequency has decreased noticeably. However, her appetite has definitely increased over the past three days or so.

Thoughts?

Thank you!

Bree, I'm very glad that you've reposted here. I was one of the people that gave you the conflicting information and I felt bad about any upset I might have caused. I assume that you're continuing to work with your diabetes mentor. Has she explained her thinking/methods to you? I think it's best to understand the rationale for any approach we take in treating our FD kitties. Would you be able to make dosing decisions yourself using her methods if for some reason you couldn't contact her?

All we can do here is assess an owner's dosing and BG data according to the protocols that are promoted here. When we see something that doesn't fit we comment accordingly. That's what happened in your case. I hope you didn't feel attacked in any way.

 

[Bree]

I absolutely did not feel attacked, so don't give that another thought. I just feel very concerned about what I should be doing. Everyone on here is so kind with their help and advice, but so is this other lady! I'm just not sure how to proceed. I have talked to her a bit about her approach and she stands by it. She says it's what she has used successfully for over 10 years and is able to get cats into remission in an average time of three weeks. I am certain that she (and all of you!) only have Kai's best interest in mind, so it's hard to know what to do.

 

[Kris & Teasel]

I absolutely did not feel attacked, so don't give that another thought. I just feel very concerned about what I should be doing. Everyone on here is so kind with their help and advice, but so is this other lady! I'm just not sure how to proceed. I have talked to her a bit about her approach and she stands by it. She says it's what she has used successfully for over 10 years and is able to get cats into remission in an average time of three weeks. I am certain that she (and all of you!) only have Kai's best interest in mind, so it's hard to know what to do.

Whew! Very glad to read this. I know that your kitty is your primary concern and I'd be as confused as you are if I was in the same position. Maybe you can find a compromise: work with your mentor but keep a line of communication open here in case you run into an issue that stumps you. We're always willing to help.

 

[Jill & Alex (GA)]

I might be able to offer an explanation which may shed a little light on what I think may be happening...
or at least I'll try.

Most caregivers on the FDMB follow one of two Lantus/Levemir dosing protocols when attempting to regulate their diabetic kitties (TR or SLGS). Both of these protocols call for consistent dosing carried out in a methodical and systematic manner. In many cases, these two dosing methods are the only methods individual members are aware of or are familiar with.

However, as explained in the Tight Regulation Protocol sticky:

"As of this writing, the Tight Regulation Protocol with Lantus or Levemir for Diabetic Cats is the only published protocol we know of for use with Lantus or Levemir. However, the guidelines are not intended to portray the ONLY way you can use Lantus and Levemir insulins. The guidelines listed are how to best use Lantus or Levemir when following this protocol. Please be aware there are other feline diabetes message boards on the web using different dosing methods/protocols successfully."
(emphasis mine)

We often hear, "Lantus likes consistent dosing" on the FDMB. Unfortunately, the sentence is rarely, if ever, finished with, "... when using one of the two methods described in the Lantus & Levemir Insulin Support Group."

There is more than one way to regulate a diabetic cat on Lantus or Levemir besides what we follow here on the FDMB. And yes, some methods implement the use of a sliding scale. Obviously, your mentor follows a different method than the methods we've used for years with great success on the FDMB. However, choosing a method/protocol is a matter of personal preference as well as finding the right fit for the individual caregiver.

We have a saying around here: Every cat is different (ECID)! The "best method/protocol" and the "best insulin" is the one that works for you and YOUR cat!

That said, I did look at Kai's spreadsheet. I do think consistent dosing could help her.
Let us know if or how we can help...

 

[Bobbie And Bubba]

Hey there and welcome to L & L. I can understand your confusion with using a different method or protocol then reading advice here . I think Jill hit the nail on the head for you and what ever method or protocol you decide to follow is the right one for you and your cat at that time . Sometimes, I think people can get themselves more confused by trying to merge different methods or start to doubt the one they are using. Just like when people here are using both a human meter and a cat meter and getting different numbers and getting more and more confused as to how to interpret or merge the two meters which doesn't work as the protocol here is written for people using human meters .

Let us know if we can help you in any way .

 

[DebG]

Bree I think the protocol she is having you follow is the sliding scale or something similar.

When Fritz was first DX with FD in Feb 2016 I came across the sliding scale approach. I had not found this forum and it all made sense to me. You can look at Fritz SS back in April I was following that method.

Without trying to tell you what to do for your kitty. I can share with you that either the SLGS or TR on this forum is a (safe) approach to managing and having the possibility of Kai going into remission.

Having said that there very well could and can be a different methods. My BIGGEST concern was keeping Fritz (my kitty ) safe.

Please keep coming back and asking questions. This forum has some of the best most caring experienced people that know FD, and how to safely care for our kitties.

IMHO the best advice I can give you is to research and do your homework.

This forum saved my kitties life. I was terrified when Fritz was DX as the several vet clinics I took him to all seemed to lack knowledge and desire to stick with me and Fritz and follow this through long term. I can tell you from experience you can go to 100 or more vet clinics and everyone of them will tell you something different, most times the treatment care could and will be harmful to the kitty. All the ones I went to told me not to test except for once a month (a curve) which had to be done in their clinic that is crazy even with my having no knowledge I knew not to inject that in his little body and not know what it was doing to his BG. Humans don't blindly take insulin and not test so why would they tell me that, plain and simple they get 5 to 8 total hours of school on diabetes and that is for every animal.

I do see this isn't your experience and that the lady in Seattle is having success my guess is that those kitties are either food or steroid induced and once you change food or take them off steroids.

I think that is great that you are reaching out and questing and researching what will be best for Kai.

Good luck!!!! Please come back we are here to help

 

[Jill & Alex (GA)]

I trust this women, she is an RN and has helped over 25 cats into remission.

I have talked to her a bit about her approach and she stands by it. She says it's what she has used successfully for over 10 years and is able to get cats into remission in an average time of three weeks.

Treating feline diabetes with Lantus/Levemir has undergone many changes since I joined the FDMB in 2006. We went from fumbling around on our own... trying to figure out how to best use Lantus... to now having several different dosing options on the net to choose from.

I'm very curious and I've always been open to learning about other methods of regulation. Getting 25+ cats into remission over the course of 10 years isn't especially impressive on it's own simply because our track record here is better, but having the ability to get cats into remission on an average of 3 weeks on insulin therapy does intrigue me. We have seen cats who have gone into remission that quickly with a diet change to low carb wet food... with or without a short stint on insulin, but those cases are few and far between. IMHO, those are the cats who will go into remission pretty much no matter what the caregiver does or doesn't do. Under normal circumstances, the quickest I've been able to get my own cat into remission was 3 months the first time (with Lantus) and then at 8 weeks with Levemir (after an almost 3 year remission), but the second time around I knew what I was doing, understood the nuances of the insulin as well as my cat's response to both food and insulin. This knowledge allowed me to be extremely aggressive the second time around (2009 Lev Spreadsheet).

Treating feline diabetes is ever changing. I'm curious, open, and love to learn about successful methods being used by others! Heck, learning and my being open to "other" dosing methods was the first step in establishing use of the TR Protocol seen on the FDMB today!