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? How do you know if in remission

Discussion in 'Lantus / Basaglar (glargine) and Levemir (detemir)' started by Nicole dorsey, Sep 30, 2017.

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  1. Nicole dorsey

    Nicole dorsey Member

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    Aug 9, 2017
    hi there, is there a specific range that would be considered to be in remission?
     
  2. Tricia Cinco(GA) & Harvey

    Tricia Cinco(GA) & Harvey Well-Known Member

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    Jul 18, 2011
    From the TR sticky (keep in mind these numbers are using a human meter):

     
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  3. Nicole dorsey

    Nicole dorsey Member

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    Aug 9, 2017
    Thanks so much. I thought normal range for a cat from labs I have is like 80-150 or 170 depending on the specific lab that does them?
     
  4. Nicole dorsey

    Nicole dorsey Member

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    Aug 9, 2017
    Also I see that one of yours has pancreatitis how do you manage the two of them? My boy has chronic panc also with ibd
     
  5. Tricia Cinco(GA) & Harvey

    Tricia Cinco(GA) & Harvey Well-Known Member

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    Jul 18, 2011
    That would be using what my vet used to call "the big machine", not a human meter, hence the difference. Remember, pet meters read shigher than human meters, although the difference is slight at lower numbers. You will get a different answer from just about every source. Here we use the numbers from the paper on the TR protocol by Roomp and Rand.
     
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  6. Tricia Cinco(GA) & Harvey

    Tricia Cinco(GA) & Harvey Well-Known Member

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    Jul 18, 2011
    Sadly, I lost both Harvey and Cinco last year. Cinco to cancer and Harvey to CKD. At the same time I had two non-diabetic cats with cancer, so my hands were very full. Luckily, everyone would eat the low carb, low phosphorus food that Harvey and Cinco needed (most of the time - Harvey was usually the picky one).

    Harvey's p-titis didn't show up until his last six months or so. It was already a little tricky getting him to eat because of the intestinal lymphoma, but I used Ondansetron, Cerenia and Cyproheptadine and they worked pretty well most of the time. Once his CKD got really bad it became much harder.
     
  7. Nicole dorsey

    Nicole dorsey Member

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    Aug 9, 2017
    I’m so sorry to hear about your babies! It’s so hard! Hmm I have a pet meter and it reads lower so I wonder if his values are actually lower then what I even see
     
  8. Nicole dorsey

    Nicole dorsey Member

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    Aug 9, 2017
    What is TR protocol?
     
  9. Gill & George

    Gill & George Well-Known Member

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    Oct 27, 2015
    My George is in remission, if you look back at his SS you can see what a cat going into remission looks like.

    He was diagnosed in Oct 2015, I followed the TR protocol, used a human meter, his dose got all the way up to 3u until he started earning reductions. Initially those reductions came by him dropping below 50 on a human meter (68 is the reduction point on a pet meter)
    Then as his numbers became much flatter, see march April 2016 on his ss, he started earning reductions by staying in normal numbers for a week(mostly between50-80 on a human meter). note that you need to reduce the dose gradually until he's off the insulin altogether.

    I'm not sure if you have all the data entered on the spread sheet????
    Was the last time you tested him 19 September?
    The numbers I'm seeing on that day would suggest he's not in remission. Even for a pet meter those are a bit high.

    If you stopped insulin abruptly when you saw Pablo get into a good range, that might be the reason why when you've done some spot checks you are getting these higher numbers creeping in.
    The healing/new ETA cells are very fragile, and continuing insulin support for as long as it is safe to do so, has been found to best support a strong remission.
     
  10. Wendy&Neko

    Wendy&Neko Senior Member Moderator

    Joined:
    Feb 28, 2012
    Since you are using the AT meter, you should go by what your vet says is the normal range for two weeks without insulin, to be considered in remission.

    TR is the Tight Regulation Protocol, described in a sticky note on the top of this forum.
     
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  11. Gill & George

    Gill & George Well-Known Member

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    Oct 27, 2015
    The link below explains the dosing method that we refer to as the TR protocol.
    It's a set of guidelines that we use to make dosing decisions that will hopefully get our kitties regulated and healthy as quickly and as safely as possible.
    LANTUS & LEVEMIR - TIGHT REGULATION PROTOCOL (TR)
     
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  12. Nicole dorsey

    Nicole dorsey Member

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    Aug 9, 2017
    Thank you. I keep a notebook log and I need to enter them on the sheet, I’m struggling to manage all his issues and keep up his heneral diary and the sheet but I very closely monitor him just need to update the sheet. One vet said he may be headed into remission and to stop for a week and see how he does and monitor
     
  13. Nicole dorsey

    Nicole dorsey Member

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    Aug 9, 2017
    My vets two of them seem to vary and why I’m even more confused there’s no official thought on it from either
     
  14. Tricia Cinco(GA) & Harvey

    Tricia Cinco(GA) & Harvey Well-Known Member

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    Jul 18, 2011
    What dose are you giving now? The last one on your sheet is .75. We recommend tapering down each time a reduction is earned, by .25 units at a time, until you are literally just giving a drop. The longer you can support the pancreas with extra insulin, the stronger the remission will be. Just stopping it to see how he does almost never works unless the cat is already in normal numbers all the time, or something else is going on (and illness, etc.). If you do stop and he goes up, as he likely will, you've lost all that time and momentum and drained the depot. Then you pretty much have to start over.
     
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  15. Nicole dorsey

    Nicole dorsey Member

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    Aug 9, 2017
    .75 right now. When you say support pancreas w insulin do you mean because he also has pancreatitis? I literally don’t get directions from vets or it seems wrong based on what people are saying
     
  16. tiffmaxee

    tiffmaxee Well-Known Member

    Joined:
    Nov 15, 2013
    Giving insulin as long BG as possible leads to a stronger remission. The supporting tge pancreas here doesn’t have anything to do with pancreatitis. Usually reductions are earned in .25 increments and after .25 a drop dose is given. I wouldn’t go from :7$ to no insulin as you want the remission to stick.
     
  17. Gill & George

    Gill & George Well-Known Member

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    Oct 27, 2015
    As others have said, tapering the dose slowly as he earns reductions is the best way to ensure a strong remission. Going from 0.75 to no insulin would not be advisable.

    Maybe start by updating the last few days we'll be able to help you better with a list more info.
     
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