Dr. Johnson's protocol, feline or human glucometer?

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The information you linked isn't "Dr. Johnson's" protocol. It's the initial protocol for Tight Regulation developed by Marshall & Rand in 2006. That protocol was replaced with Roomp & Rand in 2009. The latter is the Tight Regulation Protocol that we use. You can find the links to it in the Tight Regulation Protocol sticky. Most notably, the initial dose in the 2006 version was set at a very aggressive level. Rand found that this was too aggressive for cats that were being managed in people's homes. It was fine if the cat was hospitalized and being monitored 24/7. It was not feasible for even a diligent caregiver whose cat was at home. The dose adjustment parameters have also been reevaluated in the 2009 version.

You can use either a veterinary or a human glucometer. The difference is where the cut-off values for dose reductions are set. A veterinary glucometer, like the AlphaTrack, is calibrated about 30 points higher than a human glucometer. So, a dose reduction would be when numbers fall below 80 on the AlphaTrack vs. falling below 50 on a human meter.
 
You'll find that the vet meters are most costly, and the strips are too. But either will work fine for home testing.
Most of us use human meters due to the cost of the strips. That's what you'll buy the most often.
And as Sienne said, the big difference is the number which indicates when you would reduce the dose based on the nadir reading. 50 with a human meter, and 80 with a pet specific meter.

Carl
 
We started out using the AlphaTrak and stuck with it for way too long. I would recommend a human meter. It's easier to use and lots cheaper.
Liz
 
Thanks! So this protocol gives numbers that match my alphatrak? Not a human glucometer?
 
They don't specify which meter. Chances are that it's a human meter. I would NOT use this protocol. It is out of date. There is newer research. I would suggest you look at this, more recent version of the protocol. If you look at the instructions in Table 3B, it is calibrated for an AlphaTrack meter.
 
Thanks! This is where I get confused though. It says to increase if peak is above 200 but decrease if bg is below 70. She has had both on same day. I guess It isn't exact science.
 
The low numbers always win. A cat can start out high but the numbers then can drop to a low point. The peak or nadir is what Lantus dosing is based on. If you consider the big picture it will (hopefully) be clearer.

Here's an example: Gabby at one point had an AMPS in the 400s. Her PMPS was also in the 400s. Just looking at those two numbers, you would think a dose increase was needed. However, her low for the day was in the 40s. She got a dose reduction. This also illustrates why getting those spot checks is so important.

If you were to increase based on the high numbers, you could easily put your cat over dose and end up working very hard to get numbers out of the basement. It would be dangerous. While there are a few instances when you might not decrease the dose when you get a number under 80, the majority of the time you decrease the dose.
 
Wow! Thanks for sharing that lesson. What a difference! I am worried. I won't always be able to test this much during the day. I guess I would just have to switch my curves to night time. Who needs sleep? ;)
 
You don't need to be testing 24/7. You need to get your pre-shot tests so you know that it's safe to give a shot. Beyond that, you want to get at least one additional test each cycle (if possible). I often like to encourage new members to get a +2 or +3 test as a place to start. If that early test value is considerably lower than your pre-shot test, it's likely that you're going to see an active cycle. If that's the case, then you can gauge how much you need to test the rest of the cycle.

It's important for you to be gathering data now. You need to be able to sort out when Lucy's onset is and when her nadir falls as well as how much duration she gets. Testing every 3 hours (a "mini" curve) can help you to begin to decipher Lucy's patterns. What's also important to recognize is that the AM cycle and the PM cycle can be different. Many cats have lower numbers at night so it's important to get at least one test in each and every evening. Most of us get at minimum, a before bed test.
 
Thanks for your help! My vet would never give me this much info. She quickly loses patience after just a question or two and tells me NOT to look online. Hmph!
 
Can you please check the formatting on Lucys Spreadsheet so it automatically colors the blocks when you enter the BGs? IMF you need help with that, please PM me.
 
I look at it this way. We've all been new at this and understand how overwhelming it is. In addition, knowledge is power. It lets you manage Lucy's diabetes and gives you the tools you need to keep her healthy.
 
Ah... I get behind on the colors on the spreadsheet because I put them in my phone immediately so I don't forget. I can't choose colors on my phone but will try to update i on my computer more often. ;)
 
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