Newly diagnosed. Can't possibly test several times a day.

[Minnie's Mom]

This is my second diabetic cat. First one was years ago when Humulin U was the way to go. And we were a bit more relaxed on testing. I'm rather confused on exactly what the "goals" are now with regards to a Nadir range. All I can find is what happens when you get great results from either increasing or decreasing by .5 or .25. If I keep getting preshots of over 500, then what am I to do? Previously, we would just live with that and try to have the cats get into the low 200's for most of the day. Am I missing something?

By the way, my previous diabetic cat lived over 11 years with diabetes. She finally couldn't fight the hyperthyroidism and high blood pressure that she developed. Her blood glucose was over 600 when first diagnosed.

So, what do I do if I can't test every day except at preshots. I can probably do a curve every two weeks.

What is the "goal" Nadir? What should I do if I can't test during the day. I'm at work at least 14 hours a day but come home to give insulin injections. I'm too exhausted to stay up at night testing blood sugar.

Thanks

p.s. What board am I supposed to post my questions to? She's on Lantus but not sure if it gets posted to this or somewhere else.

 

[Tricia Cinco(GA) & Harvey]

Hi there.

I'm reading a lot of frustration in your post, and I understand.

If Minnie is on Lantus, you are on the right board. There are people here who follow the Tight Regulations protocol, and people that follow the more relaxed method. I'm sure some of them will be along shortly to help answer your questions. You can only do your best, but be advised that shooting insulin and not testing again until the next preshot puts your kitty at risk of going Hypo, which can be deadly. There are many people here who have full schedules. We had one member that worked two jobs and went to school, and he got his kitty into remission. It's not impossible, but you have to figure out what works best for you and your kitty. Hang in there. I'm not a dosing advice giver, but there are many here that can give you excellent counsel. Sundays are a little slow around here, so be patient and someone smarter than I am will come along and help. Please don't give up. It can be done.

 

[Wendy&Neko]

Hi Patti - we have two protocols for people who use Lantus, and it sounds like the Start Low Go Slow or SLGS is more tailored to your circumstances. Take a read of that and see if it'll work for you. It means testing at the preshots and getting curves once a week. Spot checks help too. A common one that people here will do is a quick test before bed. If you think you'd like to follow SLGS, then put that in your signature, so that people who give dosing feedback know what you are doing.

Lantus is different than Humulin in that it is a depot insulin. Lantus is a longer lasting, gentle insulin. It takes a while for a dose to build up. It likes consistent dosing and we determine what dose to use based on the nadir or how low a dose will take Minnie. If your goal with Minnis is remission, you'd like those nadirs to be below 100, as that's the zone where the pancreas can heal. If your goal is to get Minnie regulated but not necessarily shoot for remission, you may not want as low a nadir, but rather to try to get the entire range of numbers under renal threshold. That number varies by cat but is somewhere around the low 200's.

How did you decide on a starting dose of 2.0 units? That's a higher dose than either of our protocols would use, unless Minnie is a very large cat. Is she eating low carb wet food now?

And feel free to post questions here. We love to help.

 

[BJM]

The key tests are pre-shots, to make sure it is safe to give the insulin. Other tests can be done on weekends or days off. Some folks may set a clock to get up in the night to check around the nadir occasionally (sometimes when changing a dose, as many cats go lower overnight). Snagging a test before bed lets you know if you can sleep, or if you need to put on a pot of coffee/tea to stay up and monitor low numbers.

 

[Minnie's Mom]

Thanks everyone. I'll need to SLGS for a few months until I have a bit more time to devote. I didn't realize you could "heal" the pancreas. I'll need to print and highlight those instructions and get my reading glasses out.

Will all number really come down if I follow the stricter protocol? I'm shocked.

Minnie is refusing wet food so far but we're trying different different flavors. She's eating EVO.

 

[BJM]

Either protocol can bring down the numbers safely.
We do encourage urine or blood ketone testing with either protocol, as those can indicate a more serious problem, diabetic ketoacidosis.

See my signature link Secondary Monitoring Tools for tips on urine testing, plus other assessments which may be helpful.

 

[Wendy&Neko]

We've seen kitties go into remission following both protocols.Kitties do have that unique ability to heal if they spend time in normal blood glucose numbers. The TR is a bit more aggressive and is based on a scientific study. Of course, not all kitties go into remission, for various reasons. Regulation is still a good goal. Having a diabetic cat live another 11 years was an amazing milestone.