Hi Maria,
I wanted to respond to your pm here in your post.
You were asking about following TR given your schedule. Let me think out loud for you.
- keep in mind that you are looking at AT test numbers. They run somewhere around 30-40% higher than the same blood sample run on a human glucometer. To give some rough equivalencies for you - 400AT = about 300 human; the 300 AT = 230ish human glucometer. So the numbers aren't as high as they seem when you're comparing them to other people's posts who are most likely using human glucometers.
As far as following Tight Regulation, this is from the
Tight Regulation Protocol.
PLEASE NOTE:
In the interest of keeping your kitty safe, the initial starting dose plus subsequent dosing guidelines suggested in the Lantus Tight Regulation Insulin Support Group are based on users following this Tight Regulation Protocol with Lantus or Levemir.
If the Tight Regulation Protocol isn't the right fit for you, the FDMB's Start Low, Go Slow Approach (SLGS) offers an alternative method in it's
"5 Steps to Regulating Your Diabetic Cat". The Relaxed Lantus Insulin Support Group has been set up by the Webmaster "for Lantus users who are not on the intensive protocol known as "Tight Regulation". If you are not using this protocol but do use Lantus, you will probably be happier in the "Relaxed" Lantus user group." However, you may post wherever you feel most comfortable.
The suggested "guidelines" in the Tight Regulation Protocol are just that... guidelines. Not hard and fast rules.
The Tight Regulation Protocol is a great place to start, but once you gain experience and knowledge of YOUR cat's response to insulin you may find yourself in need of tweaking and refining your approach to treating your cat's diabetes. "Every cat is different" is not just a slogan. Following suggested guidelines is a great place to start, but some kitties will force us to think outside the box. Bring up any concerns you may have. Chances are someone else has been there, done that and may be able to help.
In most cases, Lantus and Levemir are best used on a 12/12 schedule when following this protocol.. However, sometimes life does not afford the luxury of adhering to a strict 12/12 schedule every day of the week - every week of the year. Don't let fluctuations in your schedule deter you from using either one of these wonderful insulins. Shooting every 12 hours is best with this protocol, but many caregivers have worked around their limitations successfully.
REQUISITES WHEN FOLLOWING A TIGHT REGULATION PROTOCOL WITH LANTUS OR LEVEMIR:
Kitty should be monitored closely the first three days when starting Lantus or Levemir.
Blood glucose levels should at least be checked at pre-shot, +3, +6, and +9.
More monitoring may be needed.
It will be necessary to test kitty's blood glucose levels multiple times per day.
Learn the signs of and how to treat HYPOGLYCEMIA and prepare a HYPO TOOLBOX.
Test regularly for ketones and know about DIABETIC KETOACIDOSIS (DKA).
Use U-100 3/10cc syringes with half units marked on the barrel for fine dosing.
Feed a high quality low carb canned or raw food diet.
Feed small meals throughout the day. Some kitties adapt well to free feeding.
The premise of Tight Regulation is that if a cat is kept in normal blood sugar numbers (68-160ish AT) it gives their pancreas the opportunity to heal and begin producing insulin again. When that happens, a cat may be able to become diet-controlled and go off of insulin shots. The risk from doing that is that you are pushing a cat's BGs into the range just above hypoglycemia. If you are testing, you are able to keep your cat safe. If you aren't tesing, your cat will be at risk.
If you can't get least the preshot tests and a mid-cycle test each day, then tight regulation probably isn't the best choice for Keiko. There's nothing wrong with that - you have to work with life! The
Start Low Go Slow guidelines might be the best fit for your life. If you want to follow that, i'd put it in your signature line so that everyone can see it and people won't ask you to get more tests. You can post on TR, Relaxed or Main Health - whichever you want. The truth is that Lantus dosing is based upon how low the current dose is getting a cat, so before you adjust a dose, for his safety, you want to be able to say how low the current dose is taking keiko.
You're still fairly early into the diabetic dance - he's less than 4 months since diagnosis. Just looking at his spreadsheet, i can see why you are concerned. It's hard to know if he could be bouncing and having lower numbers in between the tests you are getting. Cats need such varying amounts of insulin - punkin got up to 15.5u before I had him treated for acromegaly.
Does any of that help? I'm not sure if i've fully answered your questions, so just ask more if it's muddy or incomplete.
Hang in there! this can be very frustrating, especially if you're not sure exactly what's going on. :YMHUG: julie
