I’d like to preface my remarks by saying that we have alot of “lurkers” on the board. By that, I mean people who sign up because they have a diabetic cat but they aren’t ready to post yet. They read and try to learn just from that standpoint. That’s why it’s very important that experienced members make sure what they write is done so carefully, and, if it pertains solely to a specific cat, it is stated so others understand it’s advice for that specific cat and not to be used with another. Likewise, when we see someone post information that is not only incorrect but also borders on being dangerous, we have the responsibility to speak up. It is not my goal to argue but it is my goal, as always, to impart knowledge to keep your and others’ cats safe.
I read that you have a background in biology. I have a BS in biology & chem and an MS in biology and taught anatomy & physiology at the university level for several years. So, when our Gracie was dx, I thought that, as a scientist with a solid knowledge of A&P, this would not be a difficult journey. I was quickly reminded of an adage from graduate school to keep us humble: “you don’t know what you don’t know”. Thanks to some amazing members who stayed after their kitties had passed, I quickly learned that FD is more an art than science. However, it’s imperative that we remember that insulin is
a hormone and not a drug. Believing you can predict how it will always behave is a mistake.
My goal here is to pass on knowledge to keep you and your kitty, and those of others, safe.
I can assure my approach is very consistent with the SLGS guidelines
I truly believe you believe this but, looking at his SS, your approach is not nor has it been consistent with the SLGS guidelines. If you would like me to get the other two moderators on here to look at his SS and independently give you the same opinion, I’m happy to do so. While it is true that the SLGS method is a guideline and there is some room to modify, we would never suggest that be done for a newly diagnosed cat where there is so very little data on which to base a decision.
I feel I can "shoot" blindly if I am around to monitor him (and by now I have enough data points collected to know his reaction).
I am absolutely not being snarky when I tell you that this statement tells me you do not have any knowledge of how Lantus works and you don’t even have the data to explain his onset, nadir, and duration. You don’t have the data to know if he gets any carryover or overlap. Basically.....you don’t know what you don’t know. I am solely saying this because I am truly worried about the danger to which you are exposing Arancino. Pick your battles...yeah, I get that. I absolutely do but the battle you should pick is to test him before each and every shot and at least one other time during the cycle. At the bottom of this response, I have linked a video for how one of our other members learned to test her cat, Junior, who was a large cat and who drew blood even before she could attempt to test him. She was committed to winning that battle to keep him safe and, as it turns out, Junior decided testing wasn’t so bad.
I’ve heard so many people say what you’ve said that I can’t even begin to give you an estimate of the number but I’ll tell you that they find out quickly that it’s not a true statement that you can shoot blindly and tell by the cat’s reaction how he’s doing. There was a member who came on not long after us and she was able to get her kitty tightly regulated. But when it became evident he was not going into remission, she just settled for regulation in the 100-150 mg/dL range but his BG was so consistent and flat that she got complacent. For years. She tested, actually more than you do but not enough. She decided to run a curve one day and he was in mid-blue all day so they decided to give him insulin and go out for dinner. When they came home, he was non responsive in a pool of his own vomit and urine. They rubbed karo on his gums and rushed him to the ER where his BG would not register on a meter. Eventually, they got a 22. Sadly, he didn’t make it. She had years and years of data; she knew her cat’s patterns. She could tell you his onset, nadir, and duration.
I also knew my kitty very, very well. And I tested alot. One night, she was at 120 when I went to bed, I fed her 10% and got up two hours later, tested her and she was at 60. I fed her 10% food, retested in 30 minutes and she was at 25. Happy as a little clam....no symptoms, purring up a storm, not ravenous. As well as I knew her, and as many times as she had been in the 20s and 30s with no symptoms, I was shocked she was at 25. No vet would have been able to tell she was that low.
If you only take
one thing away from my posts to you, please let it be that you need to test him
before every single shot and once during the cycle.
The BG range in the spreadsheets seems to be reporting the values for fasting glucose, so not really applicable to "free-range" cats.
Not true and we don’t use the term “free-range” cats here so I’m not sure exactly what you are referencing. But, the ranges on the SS are not fasting glucose ranges. If you have any understanding as to how the pancreas works, then you would also understand that a diabetic cat that is eating can have normal glucose values. Look through SSs. There are many of them.
"Fasted blood glucose concentration in cats is ~3.0–6.5 mmol/L (117 mg/dL) when measured using a portable glucose meter calibrated for feline blood after overnight hospitalization and withholding food for 18–24 hours."
This statement is taken out of context (also, it is considered very helpful here when you quote
a document, that you link it so members don’t have to search for it). The authors were discussing screening of cats for FD in relation to vet stress. I did find it interesting they also stated (the bold is mine):
While there are no longitudinal studies looking at nondiabetic cats with increased blood glucose concentrations, cats in diabetic remission with mildly increased blood glucose concentration (>135 to <162 mg/dL; 7.5 to <9 mmol/L) are at increased risk of becoming diabetic within 9 months.
Your little buddy has often fallen in that range and so I’m very glad that you have restarted his insulin. And I hope that you will take to heart and start testing as I’ve suggested.
Raw diets for FIV+ cats are discouraged
I wasn’t suggesting that you transition him or any of your cats to a raw diet. I was just conveying the requirements for TR.
Here is the link to the video on testing a fractious cat:
Please let us know how we can help.
I was suggesting that if he could eat an all canned or even balanced raw diet, he could benefit from TR.
