Remission trial rationale

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drjsiems

drjsiems

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I assume that the main purpose of the two-week remission trial is to track BG numbers to make sure they are staying within remission range. Is there any other rationale/reasoning/theory behind the two-week remission trial? I have yet to find anything in the literature about this. i think that it would be interesting to know.

Thanks,
Judy & Jake (Day 10 - no insulin - all is well - **anti-jinx**)
 
I don't know where the two weeks originated from, but what I was told is that two weeks is long enough to know if the cat will stay within the remission BG levels.

Maui had two trials, as halfway through her first, she got into dry food and her BG's skyrocketed and she had trouble bringing it down. So, we stopped the trial and gave her insulin for a few more days, then restarted the trial. Wed. will be one year since her OTJ party.
 
Judy - I am not sure the origination of the two weeks. But it is the last phase of the Tilly Protocol that we follow (with some modification)

Tilly's Diabetes Homepage Protocol: Tight Regulation with Lantus®or Levemir® for Diabetic Cats
Phase 5: Remission
14 days without insulin and normal blood glucose values. Most remission cats are able to stay in the normal range all of the time (50 to 80 mg/dl), although there are a few cases of sporadic higher and lower BGs. Don't stop feeding low-carb and try to avoid cortisone if possible. Test the cat's BGs once per month.

Approximately 25% cats that achieved remission using this protocol relapsed and required insulin again (frequent causes are hyperthyroidism or bouts of pancreatitis). Therefore, it is important to keep your diabetes kit up-to-date. Then you can react immediately by giving insulin and home testing. Importantly, the sooner you react to a relapse (i.e. preventing hyperglycemia and initiating other necessary veterinary treatment), the more likely a second remission will become.

The longer a cat has had diabetes, the less likely it will go into remission. Many long-term diabetics get stuck in Phase 3 or 4. Yet there is a benefit of using this method for such a cat as well: keeping the cat's BG levels as normal as possible is much healthier for it long term. Insulin requirements will often decrease to very low levels too.
 
Thanks Hilary and Paige for this information. This is pretty much what I was thinking, but I was not sure. Paige, you said that LL people generally follow Tilly's Phase 5 remission guidelines, but with some modications. What are those modifications?

Thanks,
Judy & Jake
 
Judy- I meant that the entire protocol may be modifed based on each cats individual needs. Not the trial phase.
 
Good to know that things can vary a little and still be okay! Jake was 116 this morning so I fed him and checked him again 3 hours later and it was 56. At post 12 hours, tonight, he was 70. You are right, it wasn't that long ago that Jake was so sick with DKA and we did not know if he was going to make it. Then I was thrilled when he finally became regulated. I would have settled for that. Now to have him on the edge of full remission is truly an added blessing.

Judy & Jake
 
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