Hmm, I'm not sure exactly what you mean by:
With earning a reduction at 50 instead of 90, that means that she is closer to remission instead of just coasting along on insulin, right?
The way to get to remission, if it's possible for a particular cat, is to get their blood sugar back into normal range as quickly as possible after diagnosis. Having the blood sugar in normal range (called euglycemic) is the definition of tightly regulated. Time is of the essence in it, because the longer a cat has high numbers, the more damage is done to their pancreas' beta cells. If the cells aren't too damaged, they can heal and begin putting out insulin again. Not all cats are going to be able to get into remission, but even if a cat doesn't get there, getting them into normal range protects the rest of their body from the damages of high blood sugar.
I've seen a few cats become flat in blue numbers, but by far most seem to need to get into green numbers in order to stop bouncing. That means giving them enough insulin to get them into that range. The part below that I bolded and highlighted with blue says that most remission cats are able to stay 50-80 without insulin - to get them to stay there without insulin, you have to get them there WITH insulin first. Not sure if that makes sense, so if not, let me know.
I'm not well-versed on SLGS. It wasn't in regular use when I started and had mostly been replaced by Tight Reg. I have never figured out how a cat that gets reductions in dose at 90 can go into remission. I've heard that it did happen, but I haven't seen it. I'd assume that would only be on a very newly diagnosed cat. Perhaps someone with more experience with SLGS will help you on that question.
I just posted this part on remission from the Tight Reg page for someone else, so it's still ready to paste - here ya go:
- 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."
- Glycemic Status and Predictors of Relapse for Diabetic Cats in Remission
Does that help answer your questions?
