Off-board Advising

[Marje and Gracie]

I have moved the discussion from a new member’s thread to here in order to address another member’s questions without hijacking a thread.

Whichever protocol you follow, the increments should be done in quarter units (as in 0.25 IU) as opposed to 0.5 IU.

(With that said there are exceptions to this rule, but only/mainly when the cat has been on insulin for a prolonged time and/or you have enough data to know that he can take such a high increase (0.5 IU) without his BG dropping too low too fast, and when the cat is on a much higher dose of insulin, to begin with. Neither of these conditions apply to Fistuk!)

There have been many situations in the past where we have new members increase the dose by 0.5u even if the method of regulation is SLGS. Certainly, it is built into TR and it does not matter how long the cat has been on insulin or how much data the member has.

From the TR guidelines (this applies to any cat where the member is following TR).

Increase by 0.5 unit after 3 days (6 consecutive cycles) if nadirs are greater than 300.

When you see his BG dropping rapidly (as in more than 4 mmol/L per hour) give him medium carb food,

First, please use mg/dL here. We don’t use mmol/L in threads since this is a US site. Second, the rate of drop is ECID. What you have suggested is feeding a drop of about 72 mg/dL. However, for my kitty, I had to take action at drops of 50 mg/dL. The caregiver has to determine what drops are fast enough that they need to feed them to slow them down. We don’t have a hard and fast rule but certainly, I would start looking at drops of 50 or more and fine-tune up or down from there.

We regard foods "medium carb" that are between 6-8% dry matter carbs (more experienced members: please correct me on this if I'm wrong), not sure what brands are available to you in Switzerland, here we have Whiskas Kitten 7.5% dry matter carbs and Felix Adult 8% ish. Felix Senior is about 10% I believe, which would fall into the "high carb" bracket -

Bhooma has provided the correct information.

Lantus likes consistency, both regarding dosage and ti

We have recently had an involved discussion on the board about this statement. While, on this board, we support shooting consistently in terms of dose and timing, it’s due to our methods of regulation. Lantus has variability and other boards use sliding scales for dosing and different shot times. Again, we believe the TR and SLGS methods are the best methods for regulation but it doesn’t mean they are the only ones.

I'll keep an eye on your spreadsheet, but if I don't pick up your calls in time, definitely post here, so others can jump in and help you.

Off board advising is against the rules of this board and if members are doing it, it is reason for being banned. I would also like to caution all members reading this and especially @shellys that Eve (.:. in.active .:.) has only been here a short time and she has neither the experience nor the knowledge of FD to be providing dosing advice. I would further warn all new members to never accept advice from anyone who does not share their own cat’s spreadsheet with the group by having it linked in their signature block.

You can calculate the dry matter carb % per 100g using an online calculator like this.

Any online calculators which use guaranteed analysis are not going to give you accurate information. In order to get accurate info, you must actually find where the company has posted (or you have to call them) the dry matter basis or as-fed values. You can then follow these instructions to determine the % calories from carbs.

They all essentially say the same though, some format/wording just may be clearer for different members.

We use a modified TR protocol here based on anecdotal information. So, it is not exactly the same or even just vary by format/wording as Tilly’s or the actual TR protocol as written by Roomp and Rand.

My point in all this is most of this advice is given with great confidence that it is correct. It’s not uncommon for members to occasionally give incorrect advice. It happens. But it’s concerning to us when a new member is giving dosing advice with little to no experience with FD and no spreadsheet for other members to peruse. I strongly urge caution to all members that when considering advice given by someone, see how long they’ve been here and perhaps seek advice from more experienced members who have been using the insulin for a while and who actually have a SS for their cat. If a member is not managing their own cat’s FD well, I’d be very hesitant to take their advice. Having said that, emotional support and someone just being there is great and a function all members can have. I am sure that is greatly appreciated, Eve, so thank you for that.

.

 

[.:. in.active .:.]

From the TR guidelines (this applies to any cat where the member is following TR).
Increase by 0.5 unit after 3 days (6 consecutive cycles) if nadirs are greater than 300.

Fistuk's nadir was below (even if slightly) 16.7 on many occasions.

First, please use mg/dL here. We don’t use mmol/L in threads since this is a US site.

If the owner uses mmol/L (which is, just like stated on your sheets, used by majority of the WORLD), I think it's respectful to adhere to that, don't you think? Should you be so against it, why do even give that option to members in their sheets? I believe in mutual respect. Where we (as in non-US people) appreciate the fact that this is a US domain with it's own rules, guidelines and terminology, should the patriotism be so strong within the US community/members that it is even frowned upon to use terminology/measurements used more commonly around the world, why do even bother opening this forum up to other, non-US members?

We have recently had an involved discussion on the board about this statement. While, on this board, we support shooting consistently in terms of dose and timing, it’s due to our methods of regulation. Lantus has variability and other boards use sliding scales for dosing and different shot times.

Could you please link me the discussion and/or the other forums you mention? I'm genuinely curious of what have been said there.

Again, we believe the TR and SLGS methods are the best methods for regulation but it doesn’t mean they are the only ones.

Isn't the term "believe" close to equal to "opinion", which is frowned upon here, on a "strictly peer reviewed" board? (As I was told, this forum is that.)

Off board advising is against the rules of this board and if members are doing it, it is reason for being banned. I would also like to caution all members reading this and especially @shellys that Eve (.:. in.active .:.) has only been here a short time and she has neither the experience nor the knowledge of FD to be providing dosing advice. I would further warn all new members to never accept advice from anyone who does not share their own cat’s spreadsheet with the group by having it linked in their signature block.

The suggestion of 0.25 IU increasement was done publicly, in post #2 of this thread.
My spreadsheet is not shared, because you, the moderators of this site did not like it. Rest assured, Shelly has access to it.
There are other, well-known and active members that do not have their sheets in their signatures. (I refrain from throwing anyone 'under the bus', but I'm sure you know the people I'm referring to.)
You are correct, I have only been here a short time. The emphasis is on HERE. I cannot recall ever engaging in a conversation with you directly, so you saying I have no experience or knowledge is based on assumptions as opposed to evidence. Doesn't this site operate on evidence based information?
I'd be more than happy for you to ban or deactivate my account, I have absolutely no problem with it. As you're likely aware of it, I have tried to deactivate months ago using the relevant option, but your site cannot seem to be able to even do that, it persistently stays on "your account will be deactivated in 24 hours". Another moderator advised me, that you mods cannot deactivate users either? Should you find a way around it, please feel free to purge my account.

We use a modified TR protocol here based on anecdotal information.

an·ec·dotal [ˌanɪkˈdəʊtl]
ADJECTIVE
1. (of an account) not necessarily true or reliable, because based on personal accounts rather than facts or research

Again, isn't this contradictory when you refer to this board as being peer reviewed?


If I'm honest with you, I feel like I have been and I am facing personal attacks while being continuously singled out on this platform in a constant, unapologetic and condescending manner (nice and red, to emphasise what I'm referring to on this specific occasion). To state the (apparently not so) obvious, as opposed to many of your behaviours toward me, I'm not here to show resistance against you or anyone, or to be difficult. Should you perceive my above questions to be personal attacks, then be it. I have a "believe nothing and question everything" mentality in general, so I'm here to question when I see discrepancies between what each moderator/senior/well-known members say, and as pointed out above, when contradicting information being stated that's supposedly "go against" (for lack of better word) the general guidelines of the forum, by the very people that created those guidelines.
I'm trying to converse, without any personal attacks. I just wish most of you would be able to do the same.
Edit: Perhaps if you're up for it and could do the above, we could take it private, so we don't hog poor Shelly's thread.

But again, I am happy for you to deactivate my account if my questions are perceived as threats, resistance or simply shake the foundation of this FDMB empire and they go against your narrative. I gladly go

 

[Gill & George]

If the owner uses mmol/L (which is, just like stated on your sheets, used by majority of the WORLD), I think it's respectful to adhere to that, don't you think? Should you be so against it, why do even give that option to members in their sheets? I believe in mutual respect. Where we (as in non-US people) appreciate the fact that this is a US domain with it's own rules, guidelines and terminology, should the patriotism be so strong within the US community/members that it is even frowned upon to use terminology/measurements used more commonly around the world, why do even bother opening this forum up to other, non-US members?

Actually a lot of europe uses the same mg/dl and its a question of being able to quickly help someone without having to do the conversion, respect doesnt even come into it, to call it US patriotism is ridiculous, I say this as a Brit. Additionally for folk who are less well informed it can become very confusing, so we try to speak in the same 'language'to avoid confusion. In all the time I've been here its bever been a problem for any of our mmol members, certainly no one has talked about being disrespected.

The rest of the world ss, FYI , converts your mmol into mg/dl that ss was made to make it so yes we do allow for differences in units, and have made a ss that converts the units to make it easy for mmol members.

 

[.:. in.active .:.]

My point was, if the owner that seeks advice uses mmol/L - wouldn't it be appropriate for the advisor to adhere to the advisee?
Let's say an "mmol/L owner" is new to this whole diabetes malarkey, is overwhelmed, panicked, and need advice quickly (we've all been there after all) - wouldn't it, in that case, be a better practice from the advising "mg/dl member" (that's clearly calm, collected, more experienced and is likely less emotionally overwhelmed at that crucial time) to adhere to that, and give the advice in mmol/L to, as you say above, lessen the confusion for the new member? I stand by my statement that yes, I think it would be respectful.

The above is a hypothetical situation at this point, but could mean the world to a new member, to you know... perhaps feel more seen and less alienated.
The original conversation which Marje reacted to was between two "mmol/L members" anyway, thus I found the whole "use mg/dl, we don't use mmol/L, we are a US site" very pedantic at the first place, with a patriotic undertone, yes.

And "FYI" I'm fully aware of the layout of the spreadsheet, thank you Again, more experienced members can convert numbers and asses the sheets and their data quicker and perhaps more effectively than those who are new to this all, and overwhelmed with information already.

 

[tiffmaxee]

Sorry but as a long time member I simply don’t t have the time or inclination to convert bg readings. If there’s a spreadsheet I can at least go to the US version of the spreadsheet but appreciate it when the person who posts does that. To me it’s especially important when I’m helping someone who has a cat in low numbers and needs guidance or as has happened at times juggling more than one person.

 

[Marje and Gracie]

Fistuk's nadir was below (even if slightly) 16.7 on many occasions.

You’ve missed the point completely. Go back and read what you wrote. There may be a time when Fistuk will need an increase of 0.5u but also, your second statement I quoted is incorrect.

If the owner uses mmol/L (which is, just like stated on your sheets, used by majority of the WORLD), I think it's respectful to adhere to that, don't you think? Should you be so against it, why do even give that option to members in their sheets? I believe in mutual respect. Where we (as in non-US people) appreciate the fact that this is a US domain with it's own rules, guidelines and terminology, should the patriotism be so strong within the US community/members that it is even frowned upon to use terminology/measurements used more commonly around the world, why do even bother opening this forum up to other, non-US members?

It is not often that conversations in threads occur just between two mmoL users. Even so, on this board, we use mg/dL. That is the format the original owner of the site and the current webmaster have chosen. If you want to use mmoL, please feel free to join our sister forum, the German Katzen Forum or any other European forum.

This has absolutely nothing to do with patriotism and it’s absurd to suggest it does. As Gill said, there are other countries outside the US which use mg/dL as well. We are more than happy to have anyone from around the world participate and we have a SS to make it easy for them. But the bottom line is, we use mg/dL here and it is disrespectful to ignore that. Enough said.

Could you please link me the discussion and/or the other forums you mention? I'm genuinely curious of what have been said there.

It is easy enough to google them.

Isn't the term "believe" close to equal to "opinion", which is frowned upon here, on a "strictly peer reviewed" board? (As I was told, this forum is that.)

I will not engage in baiting. We have chosen the methods of regulation we use here. If someone wants to use different ones, they are free to google other sites and join them. Again, you’ve missed (or chosen to divert from) my point that your statement was incorrect.

The suggestion of 0.25 IU increasement was done publicly, in post #2 of this thread.

You know as well as I that neither Sienne nor I referred to your dosing advice in post 2 when we mentioned off-board advising. I even provided your quote so I am not going to reiterate it.

There are other, well-known and active members that do not have their sheets in their signatures. (I refrain from throwing anyone 'under the bus', but I'm sure you know the people I'm referring to.)

This is not about anyone else and, actually, I am not aware of any experienced members giving advice who do not have a SS posted. There were in the past but we have long discouraged any member taking advice from someone who does not publicly display their cat’s SS. And no one should be privately sharing a SS that is not publicly posted.

I belong and have belonged to several types of feline health boards. They all have their specifics on posting formats, spreadsheets, etc. The need for consistency is because there are so many members needing assistance and if everyone did something different (e.g. devised their own SS), it would take much more time and effort for other members to figure out what is going on. It’s a safety issue.

The emphasis is on HERE. I cannot recall ever engaging in a conversation with you directly, so you saying I have no experience or knowledge is based on assumptions as opposed to evidence. Doesn't this site operate on evidence based information?

Just because I have not posted before in response to a comment you’ve made doesn’t mean I am not aware of them. And in reading them all, it is quite easy for me to tell you have extremely limited knowledge and experience with regard to FD. That is evidence-based, not assumptive.

I'd be more than happy for you to ban or deactivate my account, I have absolutely no problem with it. As you're likely aware of it, I have tried to deactivate months ago using the relevant option, but your site cannot seem to be able to even do that, it persistently stays on "your account will be deactivated in 24 hours". Another moderator advised me, that you mods cannot deactivate users either? Should you find a way around it, please feel free to purge my account.

My question is, if you wish your account to be deactivated and it hasn’t been, have you contacted the webmaster directly? He controls that action as has been explained to you. But even more importantly, if you wish your account to be deactivated and no longer wish to be part of this community, why are you still posting here? If you cease to post and don’t visit this site, it is, in effect for you, the same as having your account deactivated.

Any scientist, as you claim to be, understands the term “anecdotal” and how it is used here. How you manage to focus on that word and say it is antithetical to a “peer-reviewed” board is unbeknownst to me, as a scientist.

You don’t seem to understand this is not about “you”. These are not personal attacks. This board has always had at the forefront safety first. If you are doling out incorrect and unsafe advice, we will comment on it. That goes for anyone, not just you.

The moderators here through the board’s history are always looking at new insulins, new methods, new equipment. We have done more “out-of-the-box” techniques here that have worked fantastically but which vets constantly state can’t be done.

You seem to think we live in a vacuum and never have updated our information within the forum itself. You don’t have the history to know how things have changed here over the years and how we continue to try and implement new ideas. It’s your prerogative if you want to “believe nothing and question everything” and if you would like to always reinvent the wheel. We always welcome questions but that’s not generally where you are coming from. You aren’t asking questions to acquire knowledge as most members do. You ask questions as an eternal skeptic.

We welcome new ideas from members who have actually been here a while, learned how the insulins work and how to manage them and the curve, are happy to post their cat’s SS for their own and the groups’s education, and have posted daily to engage in community learning. What is not conducive to helping new members is someone who just wants to stir the pot but shouldn’t even be in the kitchen.