What is a regulated cat?

We feel like we’re getting into the swing of testing now, and recognise that this will help us understand his state, whether it is safe to shoot and get the boy regulated, but it occurred to us that we are not totally sure what the regulation goal should be?

I’ve read in one article that a regulated cat is one the stays between 300 and 150, and another that suggested numbers should be tracking lower and more towards the numbers of a non-diabetic kitty.

Other than the chilli incident, Hodgy is averaging ~340 at his pre-shots so if we go by article one we’ve got a little way to go, but if we go by article 2 we are miles off!

 

About 250 (that's on a pet meter, so it is lower on a human one) is the renal threshold which is the point at which excess glucose starts 'dumping' into the urine which can damage the kidneys. So, you at least want your cat to stay below that point. There are different opinions on what the ideal range is. I am comfortable with Mia being between say 80 and 140 (again, this is on pet meter, so that would translate to lower on a human one).

 

Here's some info on Regulation from the FAQs on this site: http://www.felinediabetes.com/fdmb-faq.htm#regulation

It calls tightly regulated between 60-120. Info on this site is given based on human meters. So, it looks like the range given there matches with my preferred range, assuming a 20 point difference between pet and human meters around this range of numbers.

 

Non scientific? You find the perfect dose of the right insulin, curves look like they should, no sudden high numbers and no where near HYPO. It can be done, it just might take some time.

 

On veterinary websites I've seen 'regulation' described as (ideally) the cat's blood glucose being kept just below the 'renal threshold' at pre-shot, and getting down to the middle range of normal numbers at nadir.
In my experience on this forum there are fairly few cats that actually fit that model. There are so many variables. Much depends on the insulin type, the diet, whether there's any concurrent illness, how long the cat has been hyperglycemic, the caregiver's ability to monitor blood glucose, how committed the caregiver is to getting the whole thing to work optimally, oh...and the cat!

I've always found this 'regulation continuum' info from the FDMB FAQ's (that FurBabiesMama linked to above) useful as a general guide to help put things in context.
For a couple of years my cat was in the category at the bottom, "mostly above 300 (16.7) but with good clinical signs". I found his numbers very disappointing and frustrating. But it is worth remembering that it's not just about the numbers. How is the cat in himself? How are his clinical signs? Is he happy, and doing normal cat stuff?
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What is regulation?

There are different definitions of regulation. As hometesting becomes more common, we've been getting a better understanding of what cats and their humans might be capable of. Janet & Fitzgerald propose the following "regulation continuum":

• Not treated [blood glucose typically above 300 mg/dl (16.7 mmol/L), poor clinical signs]
• Treated but not regulated [often above 300 (16.7) and rarely near 100 (5.6), poor clinical signs]
• Regulated [generally below 300 (16.7) with glucose nadir near 100 (5.6), good clinical signs, no hypoglycemia]
• Well regulated [generally below 200-250 (11.1-13.9) and often near 100 (5.6), no hypoglycemia]
• Tightly regulated [generally below 150 (8.3) and usually in the 60-120 (3.3-6.7) range, no hypoglycemia, still receiving insulin

There may also be an extra category of "mostly above 300 (16.7) but with good clinical signs" which occurs with some cats who are getting insulin. We don't know why it happens, but such a cat probably should not be considered to be regulated.

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Eliz

 

@TB25 (Sorry, I don't know your name!),
Do remember too that Hodgson was only diagnosed in September. It's still 'early days'...
.

 

Thanks all. I’m not a patient person by nature so probably need to relax a bit. We’re trying to do the right things- we’ve changed his food to a lower carb and are testing. That’s a start. I’m so glad we found this forum.

Hodgson is definitely in the extra category! Over 300 at pre-shots but he’s a happy playful cat. Bright eyes, shiny coat, eating well, normal toilet habits, no desire for extra water. I would challenge anyone to pick him as the sugar cat in amongst the five cats we have!