Difference between tight and relaxed protocols

Status
Not open for further replies.
M

mtdenise

Member Since 2013
Hi everyone!

I'm relatively new to these boards and you might have seen by posts on the main board regarding Screechy. What is the difference between the tight and relaxed protocols? I've read through a lot of stuff but not really understanding the difference. Just curious. Thanks.
 
I'm sure you'll get a lot of people chiming in, but IMHO I think the biggest difference is that in Relaxed, there isn't as much testing, usually due to work schedules, etc.

We try to make sure that kitty gets tested before each shot, to make sure it's safe to give insulin, before bed, just to see where they're headed and once or twice in between, just to be on the safe side.

I'm probably the biggest exception to that, since I'm home 24/7 and I'm sure my cat feels like a pin cushion. :lol: But, then again, Lucian throws some crazy numbers and he's not anything like the vast majority of kitties here. As we refer to him, he is Predictably Unpredictable. :o

I'm sure there are other things, but that's what stands out in my mind and I have a lousy memory. :lol:
 
In the vein that nckitties3 follows, I think it also means if you are tight, you might be willing to shoot a full does at a lower number/reading. But due to my 7 day a week work schedule, i might not give him a full dose if he gives me, say 100 at amps. I wouldn't be home to see what happens (althoug food usually takes care of that problem...it doubled his reading yesterday!)
 
True! :thumbup

Schedule has a lot to do with Relaxed. I think most people on Relaxed work full time and if you aren't there to monitor, you are much more cautious. Not to mention, it takes a lot longer to get the data you would need, to know if it's safe to shoot at lower levels.

I'm sure a very large percentage of those that follow Tight Regulation are able to be home most of the time. Seriously, you'd have to be.

This is the only time in my life I'm glad to be unemployed. With Lucian the way he is, I couldn't handle him if I was working. I'm amazed that ya'll are able to do what you do and still handle the kitties. :o

Of course, I don't consider myself to be following Relaxed or TR, I'm just doing whatever I can to try to control his numbers, whatever it takes. @-)
 
Thanks. I guess I kind of fall in the middle. I work at home as a medical transcriptionist but also do pet sitting. With the pet sitting, my schedule can be all over the place from day to day.
 
I'm late chiming in, sorry...

it is a common perception on the board that tight regulation requires more testing. There are people in the TR forum who choose to test a lot, for whatever reason. Actually, all that is really "required" (so to speak) is a minimum of 3 tests per day (usually at each shot and at bedtime), plus curves or extra spot checks whenever you are able. Progress can definitely be faster if you can test more because you can adjust the dose more often, but many people who work full time do follow the Lantus/Levemir tight regulation protocol.

from the Dosing protocol for cats on glargine or detemir using daily home monitoring of blood glucose concentrations to adjust insulin dose:

Table 3A. Parameters for changing insulin dosage when using insulin glargine (Lantus) or detemir (Levemir) together with home monitoring of blood glucose concentrations in a protocol aimed at achieving intensive blood glucose control. Blood glucose should be measured at least 3 times daily with a glucometer. This protocol was tested in 55 diabetic cats for glargine and 18 diabetic cats for detemir. Owners measured blood glucose an average of 5 times daily and adjusted insulin dose based on the protocol. This has not been tested with veterinarian-measured blood glucose curves once every week or two weeks, and Table 2 is recommended if intensive home monitoring is not being performed.
Click to expand...
KK is my third cat on TR and I am gone about 12 hours per day during the week. I always get a bedtime test, and I grab whatever tests make sense on the weekends. It means that sometimes I can't make dose adjustments as often as I would like, but such is life. ;-)

So, in answer to your question, what is the difference? The "Tight Regulation Protocol" is a published protocol for using Lantus and Levemir in diabetic cats. The goal is to get cats into normal numbers (mostly under 100) as quickly as is safely possible, with the ultimate goal of remission. There is no "Relaxed Protocol," but rather an approach aimed toward people who want or need to be less aggressive. Many members in the Relaxed forum follow the "Start Low Go Slow" approach or some variation thereof. Remission is still possible, but not aggressively pursued.

There are members in the Relaxed forum who follow the Tight Regulation Protocol, and there are members in the Tight Regulation forum who follow Start Low Go Slow. LOL! Bottom line is to post wherever you are comfortable and where you can get what you need, and if you don't get what you need then try the other group.

I hope that helps.
 
That's actually really good to know, thanks! I'm fairly new to this and for a variety of reasons it took me a while to get up and testing. I'm now getting AMPS/PMPS and at least one other test at night, but am out of the house 11-12 hours five days a week. I was feeling fairly badly that I can't test during the day on weekdays. I finally got my vet to ok upping the dose, so hopefully we're on the road to better numbers. :-D
 
I will add that if I get that bedtime test and it surprises me, then I will stay up as long as I need to to get the numbers up before I crash. That used to happen a lot with Lucy. She's a drama kitty. :roll: Ordinarily, though, a +3 or +4 will give you a lot of information and will hopefully help eliminate some of the surprises.

Other times you can test are in the door (right when you get home from work, errands, whatever), out the door (right before you leave), etc. Any spot check is a good spot check and will eventually help you put together the puzzle pieces.
 
Oh I would too. She's on a high carb food because of gastro issues (which is another saga in itself), so she seems to stay pretty level. We'll see what happens when we start getting to an amount that brings her lower. She might get bouncy on me...
 
Status
Not open for further replies.
Back
Top