Caryn and Powder
Member Since 2012
I am new to this site and don't know if I belong in Lantus "Tight" regulation or "Relaxed"......what is the difference?
Caryn
Caryn
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MommaOfMuse
Member Since 2010
Welcome!
Let's see if I can break down the differences for you. We are a little more free-form on how we post over here, not real picky if you do or don't link one day's condo (thread) to the next day's or if you have a spreadsheet up or not, although a spreadsheet does make it easier for us to help you with dosing since we can get a quick at a glance look at how the insulin is or isn't working for you cat.
The difference in the two protocols is that Lantus-TR follows the Tilly's protocol which requires quite a bit of testing because they raise the doses faster than we do over here. We work off the Start Low and Go Slow since most of us over here either don't have time to do a lot of testing per day do to life getting in the way or we have cats that have thumbed their little whiskered noses at the Tight Regulation for various reasons. For instances my Musette was adopted as a diabetic that had gone several months without being treated consistantly so she needs longer to adjust to a change in dosage than say a cat that was recently dxed and is starting insulin almost immediately.
Lantus-TR is probably the busiest board here beside Health, this one was just recently opened to give those of us that don't wish to or can't follow Tight Regulation for various reasons to post to help each other out, we just do things a little differently over here. However, if you decide that you want to post over here and don't get an immediate response we ask that you post to either the TR group or Health since we just aren't always around over here to answer questions as quickly as they are on either of those other two spots...but while we are a small bunch over here we are really friendly and will do our best to help you understand Lantus and how to best make it work for you, your cat and your lifestyle.
There is really no hard and fast rule on where you belong and if you want you can even post to both groups and just link them together so that your answers all wind up in the same place.
Mel, Maxwell, Musette & The Fur Gang
Let's see if I can break down the differences for you. We are a little more free-form on how we post over here, not real picky if you do or don't link one day's condo (thread) to the next day's or if you have a spreadsheet up or not, although a spreadsheet does make it easier for us to help you with dosing since we can get a quick at a glance look at how the insulin is or isn't working for you cat.
The difference in the two protocols is that Lantus-TR follows the Tilly's protocol which requires quite a bit of testing because they raise the doses faster than we do over here. We work off the Start Low and Go Slow since most of us over here either don't have time to do a lot of testing per day do to life getting in the way or we have cats that have thumbed their little whiskered noses at the Tight Regulation for various reasons. For instances my Musette was adopted as a diabetic that had gone several months without being treated consistantly so she needs longer to adjust to a change in dosage than say a cat that was recently dxed and is starting insulin almost immediately.
Lantus-TR is probably the busiest board here beside Health, this one was just recently opened to give those of us that don't wish to or can't follow Tight Regulation for various reasons to post to help each other out, we just do things a little differently over here. However, if you decide that you want to post over here and don't get an immediate response we ask that you post to either the TR group or Health since we just aren't always around over here to answer questions as quickly as they are on either of those other two spots...but while we are a small bunch over here we are really friendly and will do our best to help you understand Lantus and how to best make it work for you, your cat and your lifestyle.
There is really no hard and fast rule on where you belong and if you want you can even post to both groups and just link them together so that your answers all wind up in the same place.
Mel, Maxwell, Musette & The Fur Gang
Caryn and Powder
Member Since 2012
Ok thanks....I think I would like it here because I am just starting out and due to my work and the fact that I live alone with my 2 kitties, I don't have as much time as I would like to be testing my Powder. I have been told to get the spreadsheet but I do not know where to get it or how.....can you enlighten me.
Ah this question is easy peasy!
in the Tight regulation forum, they pretty much follow a routine like in the following protocol:
viewtopic.php?f=9&t=1581
Below is some of it.... lots of testing and following rules and it just does not fit some people.
I think the best thing for you to do is just say a bit about you, your cat, your history so far with your cat, what insulin and dose you are giving if you have started, what are you feeding, and stuff like that.
Tight regulation has you home testing and tracking test results on a spreadsheet.
it's a pretty good way to go because in the start, you feel like you know less than nothing, so testing helps you know how your cat is handling the insulin, and tracking in a sheet that others can see allows them to give you some helpful guidance and suggestions on what's going on!
So just jump in... tell us abit about you and your cat, and we will go from there.
oh yeah, welcome to the site!!
PLEASE NOTE:
In the interest of keeping your kitty safe, the initial starting dose plus subsequent dosing guidelines suggested in the Lantus Tight Regulation Insulin Support Group are based on users following the Tight Regulation Protocol with Lantus or Levemir.
If the Tight Regulation Protocol isn't the right fit for you, the FDMB's Start Low, Go Slow Approach (SLGS) offers an alternative method in it's
"5 Steps to Regulating Your Diabetic Cat". The Relaxed Lantus Insulin Support Group has been set up by the Webmaster "for Lantus users who are not on the intensive protocol known as "Tight Regulation". If you are not using this protocol but do use Lantus, you will probably be happier in the "Relaxed" Lantus user group." However, you may post wherever you feel most comfortable.
The suggested "guidelines" in the Tight Regulation Protocol are just that... guidelines. Not hard and fast rules.
The Tight Regulation Protocol is a great place to start, but once you gain experience and knowledge of YOUR cat's response to insulin you may find yourself in need of tweaking and refining your approach to treating your cat's diabetes. "Every cat is different" is not just a slogan. Following suggested guidelines is a great place to start, but some kitties will force us to think outside the box. Bring up any concerns you may have. Chances are someone else has been there, done that and may be able to help.
In most cases, Lantus and Levemir are best used on a 12/12 schedule. However, sometimes life does not afford the luxury of adhering to a strict 12/12 schedule every day of the week - every week of the year. Don't let fluctuations in your schedule deter you from using either one of these wonderful insulins. Shooting every 12 hours is best, but many caregivers have worked around their limitations successfully.
REQUISITES WHEN FOLLOWING A TIGHT REGULATION PROTOCOL WITH LANTUS OR LEVEMIR:
Kitty should be monitored closely the first three days when starting Lantus or Levemir.
Blood glucose levels should at least be checked at pre-shot, +3, +6, and +9.
More monitoring may be needed.
It will be necessary to test kitty's blood glucose levels multiple times per day.
Learn the signs of and how to treat HYPOGLYCEMIA and prepare a HYPO TOOLBOX.
Test regularly for ketones and know about DIABETIC KETOACIDOSIS (DKA).
Use U-100 3/10cc syringes with half units marked on the barrel for fine dosing.
Feed a high quality low carb canned or raw food diet.
Feed small meals throughout the day. Some kitties adapt well to free feeding.
Many Lantus and Levemir users in this forum have been successful following a somewhat modified version of this Tight Regulation Protocol for the last few years. These "general" guidelines are based on anecdotal evidence and personal experiences of laypersons frequenting the forum.
"General" Guidelines:
Hold the initial starting dose for 5 - 7 days (10 - 14 consecutive cycles) unless the numbers tell you otherwise. Kitties experiencing high flat curves or prone to ketones may want to increase the starting dose after 3 days (6 consecutive cycles).
Each subsequent dose is held for a minimum of 3 days (6 consecutive cycles) unless kitty earns a reduction (See: Reducing the dose...).
Adjustments to dose are based on nadirs with only some consideration given to preshot numbers.
Increasing the dose:
Hold the dose for 3 - 5 days (6 - 10 consecutive cycles) if nadirs are less than 200 before increasing the dose.
After 3 days (6 consecutive cycles)... if nadirs are greater than 200, but less than 300 increase the dose by 0.25 unit.
After 3 days (6 consecutive cycles)... if nadirs are greater than 300 increase the dose by 0.5 unit.
Reducing the dose:
If kitty drops below 40 (long term diabetic) or 50 (newly diagnosed diabetic) reduce the dose by 0.25 unit. If kitty has a history of not holding reductions well or if reductions are close together... sneak the dose down by shaving the dose rather than reducing by a full quarter unit. Alternatively, at each newly reduced dose... try to make sure kitty maintains numbers in the normal range for seven days before reducing the dose further.
If an attempted reduction fails, go right back up to the last good dose.
Try to go from 0.25u to 0.1u before stopping insulin completely.
Random Notes:
Because of the cumulative nature of Lantus and Levemir:
An early shot = a dose increase.
A late shot = a dose reduction.
A "cycle" refers to the period of time between shots. There are 2 cycles in one day when shooting twice a day.
Sometimes a dose will need to be "fine tuned" by adding some "fat" or "skinny-ing up" the dose.
Using a weight based formula for determining a starting dose of Lantus or Levemir when following the Tight Regulation Protocol:
the formula is 0.25 unit per kg of the cat's ideal weight
if kitty is underweight, the formula frequently used is 0.25 unit per kg of kitty's actual weight
if the cat was previously on another insulin, the starting dose should be increased or decreased by taking prior data into consideration
Online Calculator for Converting Pounds to Kilograms
There are circumstances such as ketones present, an unusually low preshot number, a caregiver leaving the cat with a sitter, relatively high flat curves, loss of appetite, infection, a schedule change, ability to monitor, etc. which may call for adjustments to these guidelines.
in the Tight regulation forum, they pretty much follow a routine like in the following protocol:
viewtopic.php?f=9&t=1581
Below is some of it.... lots of testing and following rules and it just does not fit some people.
I think the best thing for you to do is just say a bit about you, your cat, your history so far with your cat, what insulin and dose you are giving if you have started, what are you feeding, and stuff like that.
Tight regulation has you home testing and tracking test results on a spreadsheet.
it's a pretty good way to go because in the start, you feel like you know less than nothing, so testing helps you know how your cat is handling the insulin, and tracking in a sheet that others can see allows them to give you some helpful guidance and suggestions on what's going on!
So just jump in... tell us abit about you and your cat, and we will go from there.
oh yeah, welcome to the site!!
PLEASE NOTE:
In the interest of keeping your kitty safe, the initial starting dose plus subsequent dosing guidelines suggested in the Lantus Tight Regulation Insulin Support Group are based on users following the Tight Regulation Protocol with Lantus or Levemir.
If the Tight Regulation Protocol isn't the right fit for you, the FDMB's Start Low, Go Slow Approach (SLGS) offers an alternative method in it's
"5 Steps to Regulating Your Diabetic Cat". The Relaxed Lantus Insulin Support Group has been set up by the Webmaster "for Lantus users who are not on the intensive protocol known as "Tight Regulation". If you are not using this protocol but do use Lantus, you will probably be happier in the "Relaxed" Lantus user group." However, you may post wherever you feel most comfortable.
The suggested "guidelines" in the Tight Regulation Protocol are just that... guidelines. Not hard and fast rules.
The Tight Regulation Protocol is a great place to start, but once you gain experience and knowledge of YOUR cat's response to insulin you may find yourself in need of tweaking and refining your approach to treating your cat's diabetes. "Every cat is different" is not just a slogan. Following suggested guidelines is a great place to start, but some kitties will force us to think outside the box. Bring up any concerns you may have. Chances are someone else has been there, done that and may be able to help.
In most cases, Lantus and Levemir are best used on a 12/12 schedule. However, sometimes life does not afford the luxury of adhering to a strict 12/12 schedule every day of the week - every week of the year. Don't let fluctuations in your schedule deter you from using either one of these wonderful insulins. Shooting every 12 hours is best, but many caregivers have worked around their limitations successfully.
REQUISITES WHEN FOLLOWING A TIGHT REGULATION PROTOCOL WITH LANTUS OR LEVEMIR:
Kitty should be monitored closely the first three days when starting Lantus or Levemir.
Blood glucose levels should at least be checked at pre-shot, +3, +6, and +9.
More monitoring may be needed.
It will be necessary to test kitty's blood glucose levels multiple times per day.
Learn the signs of and how to treat HYPOGLYCEMIA and prepare a HYPO TOOLBOX.
Test regularly for ketones and know about DIABETIC KETOACIDOSIS (DKA).
Use U-100 3/10cc syringes with half units marked on the barrel for fine dosing.
Feed a high quality low carb canned or raw food diet.
Feed small meals throughout the day. Some kitties adapt well to free feeding.
Many Lantus and Levemir users in this forum have been successful following a somewhat modified version of this Tight Regulation Protocol for the last few years. These "general" guidelines are based on anecdotal evidence and personal experiences of laypersons frequenting the forum.
"General" Guidelines:
Hold the initial starting dose for 5 - 7 days (10 - 14 consecutive cycles) unless the numbers tell you otherwise. Kitties experiencing high flat curves or prone to ketones may want to increase the starting dose after 3 days (6 consecutive cycles).
Each subsequent dose is held for a minimum of 3 days (6 consecutive cycles) unless kitty earns a reduction (See: Reducing the dose...).
Adjustments to dose are based on nadirs with only some consideration given to preshot numbers.
Increasing the dose:
Hold the dose for 3 - 5 days (6 - 10 consecutive cycles) if nadirs are less than 200 before increasing the dose.
After 3 days (6 consecutive cycles)... if nadirs are greater than 200, but less than 300 increase the dose by 0.25 unit.
After 3 days (6 consecutive cycles)... if nadirs are greater than 300 increase the dose by 0.5 unit.
Reducing the dose:
If kitty drops below 40 (long term diabetic) or 50 (newly diagnosed diabetic) reduce the dose by 0.25 unit. If kitty has a history of not holding reductions well or if reductions are close together... sneak the dose down by shaving the dose rather than reducing by a full quarter unit. Alternatively, at each newly reduced dose... try to make sure kitty maintains numbers in the normal range for seven days before reducing the dose further.
If an attempted reduction fails, go right back up to the last good dose.
Try to go from 0.25u to 0.1u before stopping insulin completely.
Random Notes:
Because of the cumulative nature of Lantus and Levemir:
An early shot = a dose increase.
A late shot = a dose reduction.
A "cycle" refers to the period of time between shots. There are 2 cycles in one day when shooting twice a day.
Sometimes a dose will need to be "fine tuned" by adding some "fat" or "skinny-ing up" the dose.
Using a weight based formula for determining a starting dose of Lantus or Levemir when following the Tight Regulation Protocol:
the formula is 0.25 unit per kg of the cat's ideal weight
if kitty is underweight, the formula frequently used is 0.25 unit per kg of kitty's actual weight
if the cat was previously on another insulin, the starting dose should be increased or decreased by taking prior data into consideration
Online Calculator for Converting Pounds to Kilograms
There are circumstances such as ketones present, an unusually low preshot number, a caregiver leaving the cat with a sitter, relatively high flat curves, loss of appetite, infection, a schedule change, ability to monitor, etc. which may call for adjustments to these guidelines.
Caryn said:
I think you will like it here...
for time, you don't really need as much as you think and plenty of us are able to take good care of our kitties and still have lives... it's not so bad... every 12hours you test before giving shots, and try to get in some more tests say on a weekend or something by doing a curve.
I know, you feel like you are drowning with questions and answers, so ask away and lots of people will help you.
I prefer the relaxed forum because there are people who work a few jobs or go to school and also work or have 12hr shifts.... here is where people can help you set up a good plan for you and Powder.
MommaOfMuse
Member Since 2010
Here is where to get the spreadsheet and how to get it all set up http://www.felinediabetes.com/FDMB/viewtopic.php?f=6&t=18207
To understand the code on it:
amps = the BG reading first thing in the morning before food and insulin
the + numbers are how many hours after the shot was given, i.e. +4 is 4 hours after the shot, +9 would be 9 hours after the shot etc.
pmps = is the same as amps except that it is right before the evening shot.
U=units of insulin given
and then Comments is for anything else you want to put there, like what Powder had to eat that day, was he playful or sleepy, did he vomit etc. Just anything that you think will help you understand what is going on with him better.
Mel, Maxwell, Musette & The Fur Gang
To understand the code on it:
amps = the BG reading first thing in the morning before food and insulin
the + numbers are how many hours after the shot was given, i.e. +4 is 4 hours after the shot, +9 would be 9 hours after the shot etc.
pmps = is the same as amps except that it is right before the evening shot.
U=units of insulin given
and then Comments is for anything else you want to put there, like what Powder had to eat that day, was he playful or sleepy, did he vomit etc. Just anything that you think will help you understand what is going on with him better.
Mel, Maxwell, Musette & The Fur Gang
Caryn and Powder
Member Since 2012
WOW! Thanks. I printed everything out and I will get my spreadsheet. I will be back.
LILandKIT
Member Since 2012
Hi Caryn,
Just wanted to give a quick welcome from Kitten and myself! You got tons of advice on what the difference is between TR and Relaxed already so I just wanted to step in and say hello
Setting up a spreadsheet is super easy (once you get past any initial technical difficulties) and filling it in is just as simple. It makes it a lot easier for others to take a glance and give you some advice if you need it, or just to let you know that you're doing a great job (something that I like to hear every once in a while because I constantly feel like I'm trying to keep my head above water lol).
Hope you have a great evening!
Just wanted to give a quick welcome from Kitten and myself! You got tons of advice on what the difference is between TR and Relaxed already so I just wanted to step in and say hello
Setting up a spreadsheet is super easy (once you get past any initial technical difficulties) and filling it in is just as simple. It makes it a lot easier for others to take a glance and give you some advice if you need it, or just to let you know that you're doing a great job (something that I like to hear every once in a while because I constantly feel like I'm trying to keep my head above water lol).
Hope you have a great evening!
julie & punkin (ga)
Member Since 2011
hi caryn!
i'm a regular poster in the Tight Reg forum and wanted to answer your question also. it's really very simple - the reason so many people follow the Tight Regulation protocol is because it is proven as the best method to help newly diagnosed cats - and others as well - get healthy and off of insulin.
here is the record from the study that resulted in the TR Protocol:
there's nothing wrong with the Start Low Go Slow method. but for a cat, i don't think anyone would argue that the TR is proven to be better. all of us test before we give a shot. we also try to get a test in the middle of the cycle - that's true whether you're follow SLGS or TR. today i tested my cat 5 times - and the 5th time was only because he was running lower than usual in the 4th test. we don't test some incredible number of times.
you don't have to know anything before you start posting there and you don't have to have some kind of perfect life where you sit at home and can test your cat all day. there are plenty of single people taking care of cats who also work, or have little kids or are taking care of their parents - in other words, ordinary people. there are tricks that we use to work around all of those things. people will hold your hand and teach you what you need to know.
i just thought you should hear the reason why so many of us are fans of the TR protocol - right now we have 3 cats that are relatively newly diagnosed that are on their way to being off of insulin. it works. that's why we do it.
best of luck to you - and scritches to your kitter! julie
i'm a regular poster in the Tight Reg forum and wanted to answer your question also. it's really very simple - the reason so many people follow the Tight Regulation protocol is because it is proven as the best method to help newly diagnosed cats - and others as well - get healthy and off of insulin.
here is the record from the study that resulted in the TR Protocol:
there's nothing wrong with the Start Low Go Slow method. but for a cat, i don't think anyone would argue that the TR is proven to be better. all of us test before we give a shot. we also try to get a test in the middle of the cycle - that's true whether you're follow SLGS or TR. today i tested my cat 5 times - and the 5th time was only because he was running lower than usual in the 4th test. we don't test some incredible number of times.
you don't have to know anything before you start posting there and you don't have to have some kind of perfect life where you sit at home and can test your cat all day. there are plenty of single people taking care of cats who also work, or have little kids or are taking care of their parents - in other words, ordinary people. there are tricks that we use to work around all of those things. people will hold your hand and teach you what you need to know.
i just thought you should hear the reason why so many of us are fans of the TR protocol - right now we have 3 cats that are relatively newly diagnosed that are on their way to being off of insulin. it works. that's why we do it.
best of luck to you - and scritches to your kitter! julie
Caryn and Powder
Member Since 2012
Thanks for all of the advise. I will definitely check out both groups. I know that this probably gets easier but right now I am very frustrated and overwhelmed. I feel like for the past 2 weeks I have gotten nowhere. His numbers are not really coming down. He was diagnosed at 538 and he has been around 303 - 323 ever since he started the lantus. I changed his food slowly to fancy feast classic and thought that this would start working. I increased his dosage slowly from .5 to now 1.5...still not coming down. He is still peeing more than normal. I guess that maybe I should increase the dose again ....maybe another .25. I have to start testing him more but won't be able until the weekend. Maybe I should wait until then to do any increase. Is this normal? Does it usually take a long time to regulate them? I just want him to get better.
MommaOfMuse
Member Since 2010
While there are lots of cats that do go into remission on the TR-protocol, over here we also have 2 cats that have already gone into remission on the Start Low Go Slow protocol as well, so I can't say one way works better than another. It is a matter of preference in the care giver. Sure there are more cats in remission on the Lantus-TR group but that forum has also been around a lot longer than this one has been here.
Both approaches work I think equally well, as I have one cat here Maxwell that went into remission on the Start Low Go Slow, as well as seen just recently 2 others get there on the same protocol. Either or works. It is really up to you which protocol you feel the most comfortable in following.
As far as your question about regulation, it really depends on the cat, my Maxwell went into remission on nearly diet change alone, with just a very short course of insulin. My Musette I have been working with since late June and am just now getting her regulated. And then there are some cats on this board in all the different protocols that are still not well regulated. It isn't like a simple mathmatical formula where if you do A + B it equals C. It depends on a lot of things, and some of them will always be a mystery to us.
I can't really answer your question about raising her dose without seeing the numbers you are getting at home and seeing if there is a pattern to how Powder responds to the dose. As there is an interesting factor to insulin in that both too much insulin and too little insulin can look exactly the same if all you are getting are preshot numbers, that is why we hold a dose for 3-5 days with TR and a week or more with SLGS, then run a curve as well as trying to get as many spot checks as we can during that hold period. Because what can happen with too much insulin is the bloodsugar drops lower than what its body has learned is normal, so their liver panics and sends out counter-reglatory hormones and stored sugars to send the bg back up to what now feels normal to them. So they can start out say 365 at the amps, then somewhere during the day drops down to say 200 now since their body thinks that the high 300s and low 400s are now normal, the liver panics and thinks the cat is dropping too low and is going to hypo, so it sends out its built in rescue measures, and the bgs soar back up into the 300s again. Which is why we base dosing changes on the nadir or lowest point in the cycle rather than the preshot numbers. Usually on Lantus the nadir is around +6 but some cats hit that earlier at +3-+4 and some have a late nadir around +7-+8, and to make this even more confusing that nadir isn't a fixed point it can move around some. That is where curves where you test every 2 hours from one shot to the next come in handy in finding that nadir point.
Mel, Maxwell, Musette & The Fur Gang
Both approaches work I think equally well, as I have one cat here Maxwell that went into remission on the Start Low Go Slow, as well as seen just recently 2 others get there on the same protocol. Either or works. It is really up to you which protocol you feel the most comfortable in following.
As far as your question about regulation, it really depends on the cat, my Maxwell went into remission on nearly diet change alone, with just a very short course of insulin. My Musette I have been working with since late June and am just now getting her regulated. And then there are some cats on this board in all the different protocols that are still not well regulated. It isn't like a simple mathmatical formula where if you do A + B it equals C. It depends on a lot of things, and some of them will always be a mystery to us.
I can't really answer your question about raising her dose without seeing the numbers you are getting at home and seeing if there is a pattern to how Powder responds to the dose. As there is an interesting factor to insulin in that both too much insulin and too little insulin can look exactly the same if all you are getting are preshot numbers, that is why we hold a dose for 3-5 days with TR and a week or more with SLGS, then run a curve as well as trying to get as many spot checks as we can during that hold period. Because what can happen with too much insulin is the bloodsugar drops lower than what its body has learned is normal, so their liver panics and sends out counter-reglatory hormones and stored sugars to send the bg back up to what now feels normal to them. So they can start out say 365 at the amps, then somewhere during the day drops down to say 200 now since their body thinks that the high 300s and low 400s are now normal, the liver panics and thinks the cat is dropping too low and is going to hypo, so it sends out its built in rescue measures, and the bgs soar back up into the 300s again. Which is why we base dosing changes on the nadir or lowest point in the cycle rather than the preshot numbers. Usually on Lantus the nadir is around +6 but some cats hit that earlier at +3-+4 and some have a late nadir around +7-+8, and to make this even more confusing that nadir isn't a fixed point it can move around some. That is where curves where you test every 2 hours from one shot to the next come in handy in finding that nadir point.
Mel, Maxwell, Musette & The Fur Gang
Caryn and Powder
Member Since 2012
I have really only been testing him +1 and on the weekends + 1 and +6. I know that I have to due a curve...and I will this weekend. Maybe that will give me a better idea. I really have not been testing him pre-shot.
MommaOfMuse
Member Since 2010
Preshots are probably the most important tests you can get because those are the ones that will tell you if he is high enough to give insulin to in the first place. If you get no other tests at all you need those preshot tests to keep him safe while he is on insulin. You can always stall or skip a shot if he isn't high enough, but it is impossible to get the insulin back out of the cat once it is shot.
Now for me it is reasonably easy to get Musette's amps since she sleeps with us, so I just roll over turn off the alarm and grab the test kit, snuggle up to Musette and test her, then I get up get dressed go out to the kitchen start breakfast for all 14 cats, while DH takes the dog outside to potty. Feed the furry horde, start DH's breakfast while it is cooking I go in and give Musette her insulin, come back finish DH's breakfast get him fed and out the door to work and then start my day. In the evenings I start our dinner while it cooks I go test Musette, feed all the critters and give insulin then the rest of my evening is free to go out with friends, or cuddle with the hubby on the couch etc. Then right before I turn in for the night I get one last test on Musette just to make sure she is still okay and high enough to let me sleep through the night without worrying about her.
Now if you look at her spreadsheet you will see I test her a lot, not because I really have too, but because I'm home with her all day and I happen to finding it fascinating to watch how the insulin works in her body. There are days that I'm either too busy to get a lot of test in, or because I simply want to give her ears a break and will only test at preshots, nadir, and spot check before bed.
Mel, Maxwell, Musette & The Fur Gang
Now for me it is reasonably easy to get Musette's amps since she sleeps with us, so I just roll over turn off the alarm and grab the test kit, snuggle up to Musette and test her, then I get up get dressed go out to the kitchen start breakfast for all 14 cats, while DH takes the dog outside to potty. Feed the furry horde, start DH's breakfast while it is cooking I go in and give Musette her insulin, come back finish DH's breakfast get him fed and out the door to work and then start my day. In the evenings I start our dinner while it cooks I go test Musette, feed all the critters and give insulin then the rest of my evening is free to go out with friends, or cuddle with the hubby on the couch etc. Then right before I turn in for the night I get one last test on Musette just to make sure she is still okay and high enough to let me sleep through the night without worrying about her.
Now if you look at her spreadsheet you will see I test her a lot, not because I really have too, but because I'm home with her all day and I happen to finding it fascinating to watch how the insulin works in her body. There are days that I'm either too busy to get a lot of test in, or because I simply want to give her ears a break and will only test at preshots, nadir, and spot check before bed.
Mel, Maxwell, Musette & The Fur Gang
julie & punkin (ga)
Member Since 2011
caryn, there are cats that are "sky-divers" who might drop 400 points in a few hours. i can immediately think of 5. it's important for you to find out how low the current dose is taking him before you do any increases. lantus is also a cumulative insulin - so you can see changes slowly, or in some cats very quickly. every cat is different. each hour of testing gives different information - although some of it is more important info than other test times.
the preshot test tells you if it's safe to give insulin - it tells you little about what a dose is doing. at the moment punkin is 410 with his preshot but he was 78 7 hours ago when i went to bed. if i increased based upon that 410, i'd have a cat that's overdosed and a potential crisis coming. because i have experience with him i know this is a bounce because of him hitting a range (78) that he's not accustomed to. it will clear in a day or two and then i'll re-evaluate his dose.
a +1 will tell you if your cat is getting a spike from the food carbs.
+2 in an ideal curve would be about the same number as the preshot. it will tell you where your kitty's BG is headed - if it's significantly lower than the preshot, that says that the kitty might be intending to go lower than usual within the next few hours.
+3-+7 - most cats on lantus will hit their lowest point of blood sugar during these hours. not all, and not every cycle, but most. i know from testing punkin and gathering data that he gets his lowest about +5.5.
from this point until the next shot, the blood sugar will rise and usually the highest point is at the next preshot time.
there are things that screw up this ideal curve - if the dose isn't close to being right, numbers will be wonky. if a cat has hit a low number it may bounce like punkin just did. that's the way the cat's liver protects the cat from becoming hypoglycemic. if you're feeding different food, or the cat gets into dry kibbles - those things can send the numbers wonky. even when you raise the dose, about 30% of cats will have higher numbers for a couple of days til their body gets used to the new dose.
i'd suggest that you vary your testing times to gather information about your own cat so you know when his lowest point is and can use that number to determine dosing changes.
the preshot test tells you if it's safe to give insulin - it tells you little about what a dose is doing. at the moment punkin is 410 with his preshot but he was 78 7 hours ago when i went to bed. if i increased based upon that 410, i'd have a cat that's overdosed and a potential crisis coming. because i have experience with him i know this is a bounce because of him hitting a range (78) that he's not accustomed to. it will clear in a day or two and then i'll re-evaluate his dose.
a +1 will tell you if your cat is getting a spike from the food carbs.
+2 in an ideal curve would be about the same number as the preshot. it will tell you where your kitty's BG is headed - if it's significantly lower than the preshot, that says that the kitty might be intending to go lower than usual within the next few hours.
+3-+7 - most cats on lantus will hit their lowest point of blood sugar during these hours. not all, and not every cycle, but most. i know from testing punkin and gathering data that he gets his lowest about +5.5.
from this point until the next shot, the blood sugar will rise and usually the highest point is at the next preshot time.
there are things that screw up this ideal curve - if the dose isn't close to being right, numbers will be wonky. if a cat has hit a low number it may bounce like punkin just did. that's the way the cat's liver protects the cat from becoming hypoglycemic. if you're feeding different food, or the cat gets into dry kibbles - those things can send the numbers wonky. even when you raise the dose, about 30% of cats will have higher numbers for a couple of days til their body gets used to the new dose.
i'd suggest that you vary your testing times to gather information about your own cat so you know when his lowest point is and can use that number to determine dosing changes.
Caryn said:
There are 3 times when it is most important to test, for the safety of your cat.
The first 2 tests are before each insulin shot. The reason for the pre-shot test is to be sure your cat has a BG safe to give a shot. By testing at +1, you will not be getting a result from the insulin, but may see a bit of a rise from food if you feed at shot time. There are many times when pre-shot numbers show a number too low to give insulin, so once you have given the shot.... you can't take it back!
That's why it's important to test at pre-shot, and IF the number is safe to give insulin, you can put down the cat food and give the insulin shot. If the pre-shot number seems a bit too low to shoot, many people wait maybe 15min or so and test again. If the next test is a higher number, then you could give the shot and put down the food.
OK that's your am pre-shot and pm pre-shot tests explained.
The third test that has been shown to be pretty important is the JUST BEFORE BEDTIME test.
This test is important because it's been found that several cats seem to go lower on their pm cycle. so if you tested at pmps, number was OK, you gave the shot and fed, then maybe 4hrs later, you tested just before you were heading to bed and found the BG was "WHOA going low fast", you may want to leave out some higher carb food to try and slow down the BG from dropping much lower overnite.
Those are the 3 tests that are pretty important to get and actually, all owners can get them because you are there to give the 2 shots, and you are home to be going to bed.
I know that some may say that the Tight Regulation is better for the possibilities of remission, but if you stop and think about it, testing is not what results in remission.... just like a scratch lottery ticket - just because you have not scratched it does not mean it is not a winner. You can do just fine, even if you have a busy and hectic lifestyle, by getting those 3 tests a day and then when you have a free day, like maybe a Saturday, you can do a curve, testing every 2 hours between the am shot and pm shot. Most people work Monday to Friday so that's the best they can do and it's plenty good enough.
It's logical that people can help better if there is data, test numbers, available to see, so whatever you can do, we can do our best to help you. It's just tougher when there is little data..... tougher, but not impossible.
See what you can manage and be sure to ask any questions you like.
Caryn and Powder
Member Since 2012
I will start testing him preshot. I think I will try to run home at lunch and check on him. Now I am a little nervous. I have not been able to check him midday because of work. When I checked him midday (+6) on the weekend he was 280 and 343. I feel like I am just making myself crazy worrying about him.
MommaOfMuse
Member Since 2010
We all started out worried to death about our babies when we first learned they were extra sweet. But once you start getting lots of data from testing your worries will lessen. I kind of had the advantage as both of mine were adopted after they were already diabetic so I didn't go through the shock factor and I already knew how to test so I didn't have that learning curve either...But that doesn't mean I worried any less about them when we first started dancing together. Now a year later Maxwell is in remission and Musette is fairly predictable, she will throw me a curve ball every now and then, but she is still mostly predictable.
In the beginning I hated to leave her after giving her a shot to do the simply things like go buy groceries, now I have tested her long enough that I can confidently give her, her insulin and walk out the door to go spend an evening with friends or to go hear my husband's band play without worrying about her the whole time. That kind of peace of mind not only comes from testing her but also watching her when she does go fairly low, I know for example if I leave food out for her and she thinks she is too low she will go eat on her own. I can almost predict if she is high or low by the way she acts etc. But that kind of confidence just comes with time and learning your cat.
It is kind of funny I have owned cats all my adult life but I didn't really get to know any of them until I had my first diabetic. I've always said that having a cat with diabetes has been a blessing to all my other cats, not only did it get them all on a better species appropriate diet, but I got to know them as individuals, I have learned to watch them more closely and now know what is and isn't normal for each of them. A lot of things that I use to just chalk up to a cat being a cat I now know what maybe in this cat just be part of their personality but in that cat is something to be concerned about because that isn't part of his/her nature.
And having two diabetic cats has really driven home the Every Cat Is Different! Maxwell and Musette are as different as day and night. They both were/are on the same insulin, they both eat the same diet, but Maxwell was easy to get into remission while Musette has kept me dancing the quick step to keep up with her.
Mel, Maxwell, Musette & The Fur Gang
In the beginning I hated to leave her after giving her a shot to do the simply things like go buy groceries, now I have tested her long enough that I can confidently give her, her insulin and walk out the door to go spend an evening with friends or to go hear my husband's band play without worrying about her the whole time. That kind of peace of mind not only comes from testing her but also watching her when she does go fairly low, I know for example if I leave food out for her and she thinks she is too low she will go eat on her own. I can almost predict if she is high or low by the way she acts etc. But that kind of confidence just comes with time and learning your cat.
It is kind of funny I have owned cats all my adult life but I didn't really get to know any of them until I had my first diabetic. I've always said that having a cat with diabetes has been a blessing to all my other cats, not only did it get them all on a better species appropriate diet, but I got to know them as individuals, I have learned to watch them more closely and now know what is and isn't normal for each of them. A lot of things that I use to just chalk up to a cat being a cat I now know what maybe in this cat just be part of their personality but in that cat is something to be concerned about because that isn't part of his/her nature.
And having two diabetic cats has really driven home the Every Cat Is Different! Maxwell and Musette are as different as day and night. They both were/are on the same insulin, they both eat the same diet, but Maxwell was easy to get into remission while Musette has kept me dancing the quick step to keep up with her.
Mel, Maxwell, Musette & The Fur Gang
Caryn said:
Please do not worry yourself like crazy! With those kind of midcycle numbers, you are fine to wait till after work, OK? When I was working, there was no way I could get home and back at lunch as travel was over an hour just one way.
You are already doing a terrific job, and please know that we are all a little nervous when we are away. We worry about our kids, our cats, our dogs, and that worry is natural. In time, you will be more sure of your cat's reactions and you will know how to act. Cats are pretty good at eating if they feel their numbers are changing, so just by leaving some extra food when you will be away, you can relax in knowing all will be well.
I bet if you rush home to check and test, you will wake up a sleeping kitty who is not amused at the disruption and all for a stupid test that shows a very safe number! Kitty say go back to work and let me sleep please!
Caryn and Powder
Member Since 2012
I do know what you mean about changing the way we see our kitties now. It is amazing. In fact I blamed myself for giving him the diabetes because I have been feeding him the wrong food all these years...Hill Science Diet Dry Food! Ugh!!
Caryn and Powder
Member Since 2012
You are right, if I run home he will just be sleeping.
Caryn said:
hey, I did not even know cats could GET diabetes, so that's how little I knew in the start!
I think the majority of people fed dry food, thinking it's good food and after all, the pet food companies claimed it was wonderful, right? So if anyone is to blame, it is the pet food companies and also the vets who continue to sell dry food in their offices, so don't you dare feel bad one minute longer.
We did not know before, but we know now!
At one point, I am sure I had a smorgasbord of dry foods for my cats... at least 6 kinds available at all times!
Better late than never and you are now doing the better things, so cheer up.
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