Morning! I just finished lunch and was looking at Chippy's SS, I figured you had decided to split the difference when I saw you shot 1.5.
Skipping the shot with lantus drains the depot so it may take a few cycles (up to six, before you see the full effect of the dose) Try not to worry if his numbers remain in the yellow and pinks for a little while, apart from the depot having to restabilise, he may also be bouncing, which is normal to see in unregulated diabetic cats, the bounce can also take 6 cycles to clear,(though in Chippy's case, if he is bouncing, based on the data you have, he probably will not be bouncing long, I think the pink start is more due to a lack of insulin than a bounce)
As you know we have the two dosing methods we follow, TR is the one that is backed by a published veterinary study , the more 'aggressive' of the two methods.
http://www.felinediabetes.com/FDMB/attachments/management-of-diabetic-cats-pdf.11641/
From the Dosing sticky history of TR
TIGHT REGULATION (TR)
Tight Regulation with Lantus or Levemir for Diabetic Cats
Management of Diabetic Cats with Long-acting Insulin - summary published in 2013
The Tight Regulation Protocol with Lantus or Levemir for Diabetic Cats was developed by laypersons from the German Diabetes-Katzen Forum. The protocol was eventually published in the Journal of Feline Medicine and Surgery. Note: Basaglar is a new brand of insulin glargine developed and made available since the TR protocol was written.
The tight regulation protocol was tested in 55 diabetic cats for Lantus/glargine and in 18 diabetic cats for Levemir/detemir from the German Diabetes-Katzen Forum. Owners measured blood glucose an average of 5 times daily and adjusted insulin dose based on the protocol. An overall remission rate of 64% was achieved in the cohort. Significantly higher remission rates were observed if good glycaemic control was achieved soon after diagnosis: 84% for cats started on the protocol within 6 months of diagnosis went into remission, and only 35% for cats that began more than 6 months after diagnosis.
Highlights from the Tight Regulation Protocol with Lantus or Levemir (full list found on website):
SLGS takes the increases more slowly than TR, requires less testing, but is also often slower at getting a cat regulated.
Both methods are safe, perhaps she may be more likely to take on board a published method? No harm in sharing both, she could see then that initially at least you would be following a more conservative approach??
The Start Low, Go Slow Method (SLGS) with Lantus, Basaglar, or Levemir for Diabetic Cats has been adapted from the FDMB's original 5 Steps to Regulating Your Diabetic Cat. Adaptations were necessary to accommodate the action, nuances, and exceptions of the newer Lantus, Basaglar, and Levemir insulins.
From the
Basics sticky, an explanation of some of the terms I have used above.
A full understanding of the following concepts will go a long way in helping you regulate your kitty's blood glucose when using Lantus/Basaglar or Levemir:
- Carryover - insulin effects lasting past the insulin's official duration
- Overlap - the period of time when the effect of one insulin shot is diminishing and the next insulin shot is taking effect
- Insulin Depot - a "spare tank" of insulin, which has yet to be used by the body
- Bouncing - Bouncing is simply a natural reaction to what the cat's system perceives as a BG value that is "too low". "Too low" is relative. If a cat is used to BGs in the 200's, 300's, or higher for a long time, then even a BG that drops to 150 can trigger a "bounce". Bouncing can also be triggered if the blood glucose drops too low and/or too fast.The pancreas, then the liver, release glucogon, glycogen and counter-regulatory hormones. The end result is a dumping of "sugar" into the bloodstream to save the cat from going hypoglycemic from a perceived low. The action is often referred to as "liver panic" or "panicky liver". *Usually*, a bounce will clear kitty's system within 3 days (6 cycles).
