Is he in remission????

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ObieAndMe

ObieAndMe

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Obie was diagnosed a week and a half ago. Was on Lantus 1unit twice a day for about a week until he started dropping. More so once I switched his food from Hills to Purina and much less dry..(he used to free-feed.) What a huge huge difference in just a week... I did his curve Saturday and emailed the vet his results.. She called me back and said she is incredibly impressed with his progress and to drop his insulin to half unit twice a day. Well...since she told me don't shoot under 9, and here says nothing under 11.5... he's been between 6 to 9 steady the last several days so hasn't had a shot in 3 days!!! Did his little pancreas boot up??? If he stays in this range steady do I keep giving no shots?? Or am I trying to get to 4 or 5?? (MMOL I'm talking..for any Canadians that can help me!) I'm scared to give him even a little.. because when I gave half a unit on the weekend..he still dropped considerably...

Is my kitty in remission???
 
Are you following tight regulation protocol on Lantus? If so, it reads as follows (only if using a meter calibrated for human blood):

Phase 3: Holding the dose. Aim to keep blood glucose
concentration within 50-200 mg/dL (2.8 – 11 mmol/L)
throughout the day.

If blood glucose is < 50 mg/dL (<2.8 mmol/L) Reduce dose by 0.25-0.5 IU depending on if cat on
low or high dose of insulin

If nadir or peak blood glucose concentration > 200mg/dL (11
mmol/L)
Increase dose by 0.25-0.5 IU depending on if cat on
low or high dose of insulin and the degree of
hyperglycemia

Phase 4: Reducing the dose. Phase out insulin slowly by 0.25-
0.5U depending on dose.

When the cat regularly (every day for at least one week), has its
lowest blood glucose concentration in the normal range of a
healthy cat, and stays under 100 mg/dL overall
Reduce dose by 0.25-0.5 IU depending on if cat on
low or high dose of insulin

If the nadir glucose concentration is 40 - <50 mg/dL (2.2-<2.8
mmol/L) at least three times on separate days
Reduce dose by 0.25-0.5 IU depending on if cat on
low or high dose of insulin

If the cat drops below 40 mg/dL once (2.2 mmol/L) Reduce dose immediately by 0.25-0.5 IU depending
on if cat on low or high dose of insulin

If peak blood glucose concentration > 200mg/dL (11 mmol/L) Immediately increase insulin dose to last effective
dose

Phase 5: Remission. Euglycemia for a minimum of 14 days
without insulin.
 
Thanks for the info... but I'm confused.. I thought anything under 4 was dangerously low and bordering hypo... How is it safe to try and get him to that number? isn't 4.4 - 6.6 considered "normal?"
 
Well, I didn't do the research or design the protocol, and I am too new at this to advise you or answer your questions. However, it's my understanding that it is safe because the meters we use are calibrated for human blood (there's another table to follow if you are using a feline meter), and thus the numbers are possibly slightly higher in reality. Also, it's only safe if you are testing as much as possible and supervising your cat. I have been following the protocol with no problems so far. However, my cat is not yet on the correct diet, so he is no doubt at far less risk of hypo.

As far as I know (hopefully an expert will amend if I am incorrect), the goal is to get the cat into non-diabetic numbers as soon as possible after diagnosis, and for as long as possible on insulin, to allow the pancreas time to heal, and hopefully lead to a longer remission. Lantus is a long acting, gentle insulin, and that is why it's safer and more likely to result in remission.
 
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