Lyte said:
Lyte said:
I guess I'll start with getting the right insulin and then figure out that tight/relaxed afterwards? Lyte
Well, I spoke too soon! I just got off the phone with my vet and he's resisting my changing insulins right now. He's not opposed to it but feels he should get Buzz as close to regulated as we can with the Hum N, see what that looks like and then make a determination if we need to change.
I appreciate his caution and I agree one doesn't just up 'n' change things (particularly meds) on a dime! But, I'm starting to feel like he doesn't have much confidence in what I tell him about what I see in Buzz's behavior, what info I'm reading online, what I'm feeding him, how I'm feeding him, what values I was recording... etc... etc... Sigh!
Lyte
Your current vet is talking old school; nobody is going to regulate their cat with Vetsulin(caninsulin) or N, not gonna happen.
For what it's worth, here's some info on N:
Humulin Primer Info
I agree that both Lantus and Levemir are the best of choices - they are long lasting and gentle and you CAN get your cat regulated on these insulins. Actually, you could have a good chance of getting your cat OFF insulin by using one of these two.
I have used Caninsulin, Lantus and Levemir on one cat, and she does much better on Levemir - she is tense on Lantus, and my other cat, did well on both Lantus and Levemir, but I chose Lev for both as it seems more gentle and the longest lasting.
Here's some info on insulins for you:
Most people are using the long-acting insulins today. Most of the other types are only used by humans or in some cats with special needs (ie. high dose cats with Acro etc.) Many of the short and intermediate insulins have been done away with.
Short acting insulins are usually designated by the letter R (Humalin R, Novalin R) they are never used alone, typically they are given as a bolus at Preshot to bring the BG down quickly in the first few hours of the cycle before the basal insulin (a long acting) begins to take effect. This is used by high dose cats with conditions like Acro or insulin resistant antibodies. It may also be used in an inpatient setting to manage a cat with ketoacidosis.
Intermediate insulins (Lente) are insulins like Vetsulin (Caninsulin) and NPH, some of the human insulins have N in thier name
(Humalin N) although some vets are still prescribing them they are becoming less used. Especially since Vetsulin has been taken off the market in many countries. The more successes with long acting insulins have encouraged many vets to avoid these once typical insulins. Many are however still used with good results in dogs with diabetes (dogs have a metabolism more like humans and these insulins work much longer for them) the animal approved insulin (Vetsulin, in Europe/Canada sold as Caninsulin) was made primarily for dogs.
Long-acting insulins are the synthetic analogs such as Lantus and Levemir. PZI and Prozinc are simular to these however thier duration is often somewhat shorter putting them "in between" intermediate and long-acting. Several other long acting insulins are no longer manufactured (Ultratard, Humalin U)
Duration is the length of time an insulin continues to lower blood glucose.
The
four duration categories are:
*
Rapid-acting or Fast-acting insulin begins to work shortly after injection, peaks in about 1 hour, and continue to work for 2 to 4 hours.
*
Regular or Short-acting insulin reaches the bloodstream 30 minutes to an hour after injection, peaks anywhere from 2 to 3 hours after injection, and is effective for approximately 6-8 hours.
*
Intermediate-acting insulin generally reaches the bloodstream about 1-2 hours after injection, and is effective for about 8 to 12 hours.
* Long-acting insulin generally reaches the bloodstream about 2 to 4 hours after injection, peaks 4 to 8 hours later and is effective for about 12 to 18 hours.
Note that an insulin that is long-acting in humans may be intermediate-acting in cats. The duration classes used here are for humans and usually match those in dogs -- their classifications in cats are somewhat shorter due to cats' faster metabolism.
Tell your vet you want to do a trial, for a week or 10days with levemir or even lantus, just to compare. If your vet really is OK with other insulins, then a trial should be OK as well.
I don't know much about the alpha traker other than it's a vet kind of meter and has expensive strips. Most people just use regular human BG meters like Relion if you are in the US, Bayer, OneTouch, Accura, and the like.
If you would be able to post the test numbers you have been getting, the times of the shots, and tests, and the dose you are giving, it would help greatly in others providing decent feedback.
For food, what are you feeding? here are some food links and a list of foods with the carb % listed.... go with under 10%carbs and wet food which will help with keeping BG as low as possible.
Binky’s Food Lists
Feeding Your Cat: Know The Basics of Feline Nutrition
As far as tight or relaxed, how you give insulin will be no different.
The guys in the tight forum pretty much expect you to doing a fair amount of testing and also recording in a google spreadsheet, and following a protocol.
The guys in the relaxed forum may well not be able to meet all the tight criteria.... if you are working long hours, and may have to adjust for the 12/12 shot times, or have a lifestyle that allows for just testing 3 times a day or so, or you cannot get your cat off dry food, or some other sort of situations that make it tough to stay on the tight path, no stress to come over to the relaxed forum to post. We'll try to help as much as we can there, but with limited data, it's tough to say much...
you may want to set up a spreadsheet because it will be helpful for others to see and offer you assistance and suggestions. And it will also be evidence to present to you vet. What you call crazy high unregulated numbers may not be as bad as the next guy, but without knowing your numbers, nobody can say much to help you.
Where are you located?
Tight usually have the best precentage of remission in newly dxed cats, but either one can get them there, it just really depends on how busy your life is and if you are striving for remission or just simple regulation. 
) and it was easy for my vet to sign off on it as she trusted the source. Note the tight regulation protocol on FDMB is a modified version of what's in this paper.
