At what BG level a cat needs insulin to treat diabetes?

[Evey]

Hi~ I got some different information about when a cat needs insulin today and I would like to know what your opinions are.

So I was talking to a moderator of a local Diabetic Cats Support Group today. The moderator has lots of experience of helping cats successfully getting remission. The moderator suggests that Evey could try OTJ now since it's low enough and giving a cat insulin for too time would make a cat rely on the insulin and can never get out of it. With 0.5U of insulin, she is currently with the normal range 71-159mg/dL (This is the range provided by the vet. but according to TR, it's not within the normal range yet). I understand that different protocal has its own mechanism. But is it true that a cat can be rely on insulin and can never get rid of it?

Also, another question about OTJ. The local moderator suggests that during OTJ, if the cat's BG is not above 270mg/dL, the cat doesn't need any insulin because the pancrease can adjust the BG level. Just wait 24 hours to see if the BG goes down or not. If the BG still stays above 270, the insulin is necessary. The 270 number seems quite high since when Evey was diagnosed she was about 270. I mentioned about Evey's test results when she was diagnosed (GLU:274mg/dL, FRU 397umol/L, UGLU: 1000mg/dL). The moderator said that based on those results, Evey could have get to remission by just changing her diet into wet food and she didn't really need insulin to treat diabetes. Is it true? I'm wondering at what BG level a cat needs insulin to treat diabetes and when a cat can get to remission just simply by changing diet.

I would love to know what your opinions are~

 

[Bron and Sheba (GA)]

Hi,
I’m very glad you have posted here for more information.
I will answer your questions.

The moderator suggests that Evey could try OTJ now since it's low enough and giving a cat insulin for too time would make a cat rely on the insulin and can never get out of it

I totally disagree with this statement. A cat needs insulin for as long as he/she needs it, and saying if a cat relies on it will never get out of it is just a complete load of rubbish. I have looked at your spreadsheet and while your kitty is doing well, she is not ready to come off insulin.
If you are following TR which is what your SS says, you would need to reduce the dose of insulin down to 0.25 units, and see how that dose goes. Then when Evey drops under 50 next time, you would reduce to 0.1 units. I would recommend you post daily and and for help moving forward. I would also suggest you start posting on the Lantus forum where you will get a lot of help.
Here is the link HERE
I will tag @tiffmaxee and @Bandit's Mom to keep an eye out for you to post in the Lantus forum.

Also, another question about OTJ. The local moderator suggests that during OTJ, if the cat's BG is not above 270mg/dL, the cat doesn't need any insulin because the pancrease can adjust the BG level. Just wait 24 hours to see if the BG goes down or not. If the BG still stays above 270, the insulin is necessary. The 270 number seems quite high since when Evey was diagnosed she was about 270. I mentioned about Evey's test results when she was diagnosed (GLU:274mg/dL, FRU 397umol/L, UGLU: 1000mg/dL). The moderator said that based on those results, Evey could have get to remission by just changing her diet into wet food and she didn't really need insulin to treat diabetes. Is it true? I'm wondering at what BG level a cat needs insulin to treat diabetes and when a cat can get to remission just simply by changing diet.

Oh dear…I would really recommend you don’t seek advice from this source again as I just don’t agree with what this person is saying.
It looks like you are feeding a low carb canned food which is correct. occasionally a cat can go into remission just by food change to low carb but most cats that are diagnosed with diabetes will need insulin. The cats BG would need to be consistently between 50-120 for the diet change alone to have worked and Evey had not done this.
PLEASE keep giving the insulin, at the reduced dose I suggested above and post on the Lantus forum for help and advice daily.
Keep asking questions.

 

[Evey]

Hi,
I’m very glad you have posted here for more information.
I will answer your questions.

I totally disagree with this statement. A cat needs insulin for as long as he/she needs it, and saying if a cat relies on it will never get out of it is just a complete load of rubbish. I have looked at your spreadsheet and while your kitty is doing well, she is not ready to come off insulin.
If you are following TR which is what your SS says, you would need to reduce the dose of insulin down to 0.25 units, and see how that dose goes. Then when Evey drops under 50 next time, you would reduce to 0.1 units. I would recommend you post daily and and for help moving forward. I would also suggest you start posting on the Lantus forum where you will get a lot of help.
Here is the link HERE
I will tag @tiffmaxee and @Bandit's Mom to keep an eye out for you to post in the Lantus forum.


Oh dear…I would really recommend you don’t seek advice from this source again as I just don’t agree with what this person is saying.
It looks like you are feeding a low carb canned food which is correct. occasionally a cat can go into remission just by food change to low carb but most cats that are diagnosed with diabetes will need insulin. The cats BG would need to be consistently between 50-120 for the diet change alone to have worked and Evey had not done this.
PLEASE keep giving the insulin, at the reduced dose I suggested above and post on the Lantus forum for help and advice daily.
Keep asking questions.

Thank you for explaining this~ I was skeptical about this source but I don't want to assume anything. Thank you so much.
I have been posting on the Lantus forum. @tiffmaxee and @Bandit's Mom have been amazing and they helped me a lot. Evey and I are really appreciated❤ I am so lucky I find this group.

If you are following TR which is what your SS says, you would need to reduce the dose of insulin down to 0.25 units, and see how that dose goes. Then when Evey drops under 50 next time, you would reduce to 0.1 units.

Last time she dropped under 50, she just got a reduction. Bandit's Mom mentioned that TR doesn't do back to back reduction. so I keep the same dose. Next time she drops under 50, I will give her reduction. For tonight, should I give her 0.25U tonight or keep the 0.5U? She also has a low preshot number tonight. Her preshot number is 84. i also posted in the Lantus forum asking for help. I don't know what I should do.
Here is the post https://felinediabetes.com/FDMB/thr...t-advice-amps-130-1-151-11-92-pmps-79.288802/

you would reduce to 0.1 units.

Can you tell me how to draw 0.1U? it seems really difficult.

 

[Bandit's Mom]

She also has a low preshot number tonight. Her preshot number is 84. i also posted in the Lantus forum asking for help. I don't know what I should do.
Here is the post https://felinediabetes.com/FDMB/thr...t-advice-amps-130-1-151-11-92-pmps-79.288802/

I responded on the above condo.

 

[Bron and Sheba (GA)]

I think I would reduce the dose to 0.25 U at the next dose as she has dropped to 2.4 a couple of times since the last reduction. It could have been as a result of the depot so See what @Bandit's Mom thinks.

 

[Sienne and Gabby (GA)]

Like Bron, I am quite skeptical regarding the quality of information the "moderator" of the local diabetes support group has been providing. The basic philosophy of TR and FDMB is to provide your cat's pancreas with as much support as it needs for as long as you can in order for your cat to have a strong chance at remission. We want Evey's spreadsheet to be as green as possible. This is an example of an OTJ spreadsheet.

 

[Wendy&Neko]

Our experiences here are contrary to the local support group. We have seen that if a kitty goes off of insulin too soon, the chances are much higher that they will come out of remission quickly. You might want to check out this paper: Glycemic Status and Predictors of Relapse for Diabetic Cats in Remission

 

[Evey]

Like Bron, I am quite skeptical regarding the quality of information the "moderator" of the local diabetes support group has been providing. The basic philosophy of TR and FDMB is to provide your cat's pancreas with as much support as it needs for as long as you can in order for your cat to have a strong chance at remission. We want Evey's spreadsheet to be as green as possible. This is an example of an OTJ spreadsheet.

I agree with the idea of providing support for the cat's panceas a much as it needs it. To be honest, some of their information make sense but some really don't sound right. This forum is way more professional than the local one. I learnt a lot from this forum.

This is an example of an OTJ spreadsheet

Wow, that's lots of beautiful greens. Evey still has a long way to go...