Liver Training School

Status
Not open for further replies.
Hi Nicole-

Her SS is looking good - lots of dose reductions pretty quick! I've got Boomer on "one drop" right now and the next thing will be an OTJ trial. Baby seems to be on that path too! Keep doing what you're doing and be patient. nailbite_smile
 
We had a cutoff # of 200, under that and we didn't shoot. For a few days he was right at that so we just didn't shoot, tested in a little bit, and shot then if needed. After a few days, his #s kept getting farther away from the 200 mark and now I just wrote a post about him being at 49! I hope this is it for you!
 
We had a cutoff # of 200, under that and we didn't shoot. For a few days he was right at that so we just didn't shoot, tested in a little bit, and shot then if needed. After a few days, his #s kept getting farther away from the 200 mark and now I just wrote a post about him being at 49! I hope this is it for you!
Click to expand...

Baby is on Lantus and "cutoffs etc." don't apply. Vetsulin is an entirely different story. LTS (liver training school) is something we talk about with cats on Lantus and Levemir. It is not the same thing as Smoygii rebound. It can generally be thought of as a "panicky liver". During the time that a diabetic is unregulated and generally has higher BG the body accustoms itself to the new "staus quo". When the treatment begins to take effect and the BG drops into lower ormal or near normal ranges the body which is used to much higher numbers sets of a overdramtic panic alarm and releases hormones and stored glucose (glucagon) to protect itself from going to low. The effects of these hormones can cause temporarily increased BG numbers for several hours to several days. With insulins Lantus and Levemir we don't react to these flucuations, we continue to hold the dose (afterall this dose was successful in getting us some numbers in the normal range!) We keep giving this dose and eventually the hormones leave the body and the insulin does it job and the BG again comes down into those more normal ranges. This "bouncing" or panicky liver can occur over and over again but we don't give it any thought and eventually the overreaction becomes less severe and shorter lived. The body begins to get used to lower BG (normal levels) and stops responding with a panic response. This "desencitizing" is what we call LTS, it's like overcoming a panic disorder by continually exposing yourself to the fear trigger. Eventually the panic response is eliminated or manageable and we say the cat has graduated from LTS. The time this takes is variable (ECID) some never experience "bounces" others respond for months to every lower BG numbers with a bounce. There are various techniques customized for the cat to help get them through LTS. The important thing is to not respond to the bounces by increasing or lowering the dose (provided you did get better numbers during the cycle) and provided you arrived at the dose by "start low, go slow" and making small changes and based on the BG testing you have done.

This method is specific to Lantus and Levemir (possibly in some capacity to PZI as well) it is discussed in the Protocol for Lantus/Levemir insulin.
 
Status
Not open for further replies.
Back
Top