How to decide on tight lantus vs relaxed lantus regulation?

Status
Not open for further replies.
T

Tomtomsmom

Member Since 2012
Hi I am new to this board and have I am wondering how to proceed. In short, Tommy was diagnosed on 1/18. He is a 4 year old tabby who at one point was at 22 lbs. He is now about 15-17 lbs. Tommy is a big boy and the vet does not want him to down lower than 15 lbs. He was eating a mixed Iams dry and wet food, but quickly changed him to all wet when we noticed he was drinking water like crazy and had an inkling that he may be diabetic in December 2011 right after the holidays. He has been on all wet food only since then (he is currently DM and iams kitten can). We just started him on Lantus yesterday. I am sorry I still rather new here and even though I have a ss, I have no idea how to post it on the board yet.

His AMPS yesterday to begin were 240 and he was given 1 unit at 8 am along with a 5.5 can of DM. At about 4 pm he got about 3 oz of food for a snack. I did not get a chance to test him until 8 pm and he was at 295 at that point and he received another 1 unit along with another 5.5 oz of food. I tested him again at 11 pm before going to bed and he was at 201. This morning he was at 256 and again I gave him 1 unit along with another 5.5 oz of DM. Now I wont test him again until 7pm tonight when I get home. I live in NJ and work in NY and my commute is approx 1 hour each way (not because of distance, its ALL TRAFFIC :evil:) and for tight regulation do I need to test him more frequently?

MImi
 
Re: How to decide on tight lantus vs relaxed lantus regulati

Hi Mimi! Welcome to LL! Tight regulation isn't as scary as it sounds, although we do a lot of testing. There are many peeps here who work, though, and they adjust things to work for them. Tomtom is young for FD and IMHO tight regulation early is the best hope of getting him off insulin and diet controlled. The longer a cat is on insulin the harder it is to get them OTJ (off the juice.) Basically in TR we try to get BG numbers into the normal range asap, but giving insulin in those ranges means a lot of monitoring and frequent dose adjustments. Keeping BG in the normal range allows the pancreas to start healing and also eases demands on the kidneys and liver. An all over healthier cat.

We have a lot of stickies at the top of the forum, please read to get started understanding the TR protocol.

First off it's great that you got him off of the dry food, just that can make a big difference in BG values and it is a good thing to have gotten done before starting insulin. There are a lot of better foods out there than the DM. In the "New to the Group" sticky there are several lists showing the carb% of various foods which are lower carb and better quality than the prescription foods.

Lantus is a depot type insulin, it builds up a reserve in the body which is why it has a slower gentler action. It can take up to a week to build up the reserve and start seeing results. it also means that every time you adjust the dose it will need to rebalance itself out, usually up to 6 cycles (time between shots). Whether following TR or not Lantus likes consistency, so regular shot times are important.

With lantus dosing is based on the nadir, the lowest point int the cycle. It is usually about +6 (6 hours after the shot time) but different cats react differently. it is also not a constant, but you can usually count on a couple of hour span. So the mid-cycle shots are important, but if you work you can just try at night and the weekends. Work schedules can be accommodated.

The preshot tests are important too, but there we are checking that it is safe to give the shot, that the BG is not too low. For beginners we recommend that you ask for advice when a preshot number is below 150. You will see that many of us shoot much lower numbers, but we have a lot of data behind us to judge where the numbers may be going.

This is a very active forum with eyes on nearly 24/7. When you need help just post and some one will respond.
 
Re: How to decide on tight lantus vs relaxed lantus regulati

Hi there and Welcome to Lantus Land!

Regarding which protocol, you can certainly start with SLGS until you get in the swing of things and then re-evaluate if you want to go with Tight Regulation.
There is a lot of info to wrap your mind around as well as the changes to your daily routine that caring for a sugar kitty requires..
You'll quickly get a feel for how often you can test. There are many folks here that have challenging work schedules and they can offer tons of tips.

Get your ss linked (I'm not a techie but there are plenty of folks here to help with that!), regardless of which protocol you choose, decisions are based on the data you collect on the ss.

His numbers don't sound too bad - what was his BG at diagnosis?
you may want to consider changing his food. There are plenty of high quality low carb foods that will likely be easier on the pocketbook.
there is a link to food charts in the "New to the Group" sticky at the top of this forum. You will also find information on how to post your daily thread (we call them "condos" - after all it is a community) here in Lantus Land in the same sticky.

Finally, don't hesitate to post here with questions, regardless of whether or not you choose to start off with TR. There are many veterans here and tons of 'tribal knowledge"

One thing I will point out as food for thought - the TR protocol does give the best chance for regulation and even remission.

:-D
 
Re: How to decide on tight lantus vs relaxed lantus regulati

Thomas' first test at the vets while (sedated) was 468 and we were already on canned food only. Since I started testing his numbers at home this week they have remained in the 200s. The highest being 295 and lowest 201. I am planning to do his first curves this weekend since I will be home. I hope to then have better numbers and see where we stand then.

Mimi
 
Re: How to decide on tight lantus vs relaxed lantus regulati

Hi Neighbor, we have three people here from central NJ, me being one of them.(maybe more, but thats all I know of). I'm pretty new here myself, 12/11. I know the commute to NY well, (for health reasons), but I took the train, so I wouldn't know much about the traffic. The train station is very close to my house so it makes sense to take the train for us. IMHO, I like it here in LL land, you really do feel like you are in a community, with everyone wanting the same thing, that their kitty be off insulin and food regulated. I can't believe how fast Daphne has come down from her original BG of 300-400's. I don't work, but I do have an illness that keeps me in bed for about 11 hours a day, and, for some reason, I only sleep from probably 3am to 2pm, (not sound asleep, unfortunately,since that's part of my illness). But I manage, with my DH, to get in about six or so tests, and I try to get the +1 and +2 when possible, and the +10 and +11. My DH does the AMPS, and I do the PMPS. Also, you can use a timed feeder if you are away from the house longer then 5 or so hours (Daphne just can't get down a whole 1/2 can of food at one time, so I do feed her 1/4 can's most of the time, @ about 5 times a day)

Well, like I said, I'm pretty new here too, so I won't give too much advice, except maybe to read all the information on this site, as much as you can. Being educated about FD is the best way to help your kitty.

Its nice to have another neighbor on the board, so a big WELCOME, and good luck with TomTom!
 
Re: How to decide on tight lantus vs relaxed lantus regulati

Just another NJ neighbor saying "hi" - welcome aboard!

You're already on a great path - testing, food switch, SS up and running! You've gotten some great info to start with. It can be overwhelming in the beginning, but it does get easier, and everyone here is very generous with their time, support, and knowledge...ask as many questions as you need!

We hope to see more of you here!

Amy
 
Re: How to decide on tight lantus vs relaxed lantus regulati

Here's a post about how to get your SS in your signature. Not too hard once you find the right place to click in user control panel.
http://felinediabetes.com/FDMB/viewtopic.php?f=6&t=18207&start=0

Welcome! I'm only a little more than a month into this game as well.

I think you'll find lots of help here in LL, and I also think that you will find guidance even if you can't do a perfect job of testing. In some cases, without enough data, you'll just have to opt to do the safe thing (like skip a shot). But there are lots of people who will help advise you, especially if you can show them the info on your SS.

Best of luck :razz:
 
Re: How to decide on tight lantus vs relaxed lantus regulati

Welcome Mimi to lantus land!! I'm your neighbor too in LI, NY, and am an old timer here(almost 4 yrs)
There was no choice when I came here, only one lantus forum then.
As I see it, you have a very young cat, whose numbers are not that high, and tight regulation is a very likely choice in view of that..The DM has a LOT of carbs in it so it would be wise to change that soon.
I am sending you the link to our food lists, you would want to choose low carb wet foods like fancy feast, friskies, or perhaps better quality food for your kitty--there are old & new lists, but all have the carb counts.
Here is the link: http://binkyspage.tripod.com/canfood.html--

Everyone here helps each other..You can ask questions any time, there is always someone here to help.
My kitty is a long term diabetic, but I still choose to use tight regulation as she has been very well managed all this time..
Going into remission is a possibility for any kitty that comes here, but no guarantees.
The goal of TR should be to restore your cat to better health that he was in before he was dx'd with FD.
Having a healthier cat that is well regulated is the best way to look at this disease.
Hopinbg you have great success in whichever forum you may choose...
 
Re: How to decide on tight lantus vs relaxed lantus regulati

Welcome Mimi and TomTom to Lantus Land,

It's great that you are up and running. Everything you learn to do here will help your kitty. Please read the "New to the Group" sticky and the sticky on Tight Regulation Protocol. These will give you a good idea of how we proceed. Many people here have jobs and are away from home for the workday, but it is possible to fill in many of the blanks in the evening and on weekends. The most important thing to remember is that Lantus likes consistency and you should strive to give the shot every 12 hours. Also, as Ann mentioned, Lantus builds a "depot" (also called the storage shed, or "the shed") where it stores an amount that corresponds to the dose you are giving. It takes a few days to "build" this shed, so some of the Lantus you are shooting now is going into building the shed and therefore is not immediately available to "work" on TomTom's blood glucose.

We are all in agreement that DM is not a great food. The commercial lo-carb options have much better ingredients and cats like them much better than DM. Check out Janet & Binky's list. Even buying premium foods such as Wellness, EVO, Merricks, By Nature, etc. will save you money over what you are paying for the prescription food and will please your cat. Fancy Feast "Classic" patés are a good overall choice. Most of us have found that feeding several smaller portions over the course of the day works better than giving all the food at once (unless your cat is a grazer who free-feeds). We use timed automatic feeders to do this. If this might be a good option for you, ask in one of your posts which feeders people use and how they like them.

The FD learning curve can be overwhelming at first, but it all falls into place as you go along. Ask as many questions as you need. Someone will always be here to help you. Good luck in getting your spreadsheet going.

Ella & Rusty
 
Status
Not open for further replies.
Back
Top