? What is the definition of regulation?

Hi. I,ve been looking through the stickies because I'm sure there was something that said if the cat is between ? and ? for ? days he is considered regulated or something like that. I can't find it now. Can anyone oblige?

 

Hi Sue,
I've found this following info from the FAQ's to be quite helpful. (Data is from tests using human meters.)

(Note: It says here that the normal range is approx "60-120 (3.3-6.7)". Although we more commonly seem to suggest 50-130 (2.7 - 7.2) these days. But these are only approximate figures anyway. And some cats will quite naturally run a little lower or higher than these numbers.)

"6. REGULATION

Q6.1. What is regulation?

A6.1. 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]
• Normalized [60-120 (3.3-6.7) except perhaps directly after meals -- usually not 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. On the other end of the spectrum, it is possible for a cat who is not getting insulin to have blood glucose as low as 40 mg/dl (2.2 mmol/L) on a home glucometer. If you have a non-diabetic cat, try testing her with the same meter to get a safe comparison figure."
.

 

This info on 'blood glucose guidelines' from the Petdiabetes Wikia may also be of interest:

http://petdiabetes.wikia.com/wiki/Blood_sugar_guidelines

Eliz

 

Thanks @Elizabeth and Bertie. That was exactly the one I was thinking of. It seems both Rom and Frankie are well on the way to being regulated!!

 

Hi Sue from a very wet Surrey!

You're doing really well. You can never do enough reading of the Stickies and other members' threads, all of which are a great source of information as you continue this sugar dance!

Whilst on the subject of regulation, it might be worth noting the difference between that and "remission". Some people get confused. I'm not sure which Sticky to refer you to but my understanding is that a cat is in remission if he/she has been in normal numbers without insulin for 14 days. Maybe you could confirm that @Elizabeth and Bertie ?

Keep up the good work Sue!

Diana

 

Ooh, I don't know of any sticky that mentions the specifics of how 'remission' is defined here, Diana. Although there may well be one that I don't know about. (I'm still finding things here that I never knew existed!)
But yes you're right, in FDMB-World, we consider that if a cat has been in normal numbers for 14 days without insulin then they can be considered in remission. And some people don't start that 14-day countdown if the cat is still at the very top end of the normal range. Some wait until the cat has dropped a bit more toward the middle of the range.
.

 

@Diana&Tom

Hi Diana from a very soggy London!!

Yes I know the difference between regulation and remission. Unfortunately my two are nowhere near remission. But I'm still hoping!!

 

Don't stop hoping, Sue!!!
Well, not for the first five years, anyway....

And I think Diana was just using your situation to point out the difference between regulation and remission to any newcomers or 'lurkers' that might chance upon your thread.

Waving to you from a soggy Surrey!

Eliz

 

Thanks Eliz, yes I was attempting to make the distinction between regulation and remission here, for the benefit of anyone reading Sue's thread.
Sue, that's great that you know the difference, good for you. It's helpful for all concerned to get terminology right ;-)

Diana

 

Only got two and a half years to go then!! I should hope I knew the terminology by now, but good point about any lurkers or newbies around.

Waving to you too Eliz from a very wet London that is getting wetter by the second.

 

Hello from what was a totally drenched Berkshire! And up half the night and into the early hours of the morning comforting two very scared cats!

Smiffy's BG was somewhat raised this morning as a result but has gone down now thank goodness.

I am interested of course Sue like you about what IS and ISN'T considered to be remiss in .....

As you know I have not been able to update Smiffy's spreadsheet for the last five days which just happens to coincide with me not having to give her insulin (Caninsulin/Vetsulin).

Now She is now in numbers nicely below the renal threshold and her urine tests negative for both glucose and keystones and she is now usually at AMBG and PMBG 10 (180) or just below or above and so too low too give insulin in my opinion and that of some other experienced members here and her Vet and she is really well with all clinical signs wonderful.

From experience now I know that dosing would run the risk of her falling too low and l am not wanting to risk her going so low as to risk a hypo. She falls nicely by herself into the top of the remission range mentioned above so my question is is she in remission?!

She is too low to be given her insilin and all the other clinical signs are really good but doesn't fall in that lower range of numbers but I think she will get there gradually by herself with no insulin supplement.

So what is Smiffy considered to be?

In remission or 'peri in remission'?

I ask this question for myself and others with the same circumstances (similar to those that you are approaching Sue) and for those using Caninsulin/Vetsulin who don't want to dose aggressively to ultimately achieve a perfectly normal range for their cat without risking potentially hypo numbers.

Hope that makes sense and helps you Sue as we are at a similar stage now with Romulus and Smiffy?

 

Unfortunately @Looby & Smiify Rom is nowhere near going into remission. He was getting fairly stable and semi-regulated but unfortunately brain of Britain here forgot to inject him this afternoon with the inevitable result. I could kick myself. I just hope I haven't pushed him back into high numbers all the time again,

 

I will have to look at your spreadsheet when I get my new laptop.

I thought on your other thread he was egging numbers below 10(180)?

Don't worry about missing one shot ....he will go back to his lowenumbers quickly.

Smiffy got a higher number this morning because of the thunder but is back on track tonight .

We can pick up the discussion once I've seen Roms spreadsheet. You may be closer to remission than you think ..... Smiffy was giving me nice blue numbers during the day then 'bouncing' back to a higher AMPS and then all of a sudden her little pancreas started to show signs of working and now she has not needed shots for nearly 5 days ....

Talk further at the weekend if I am up and running and we can look closely at each other's spreadsheets and discuss xx

 

Yes you're right @Looby & Smiify , Rom was getting preshots around the 10 (180) number. Unfortunately he can only get them by using insulin unlike Smiffy who can do it all by herself. Last night's forgotten shot proves how much Rom needs his insulin.

 

Lucille, please see Diana's and Elizabeth's posts above.
.

 

I know I have read them and acknowledge the information and knowledge.

I am giving Smiffy as an example of a cat on Caninsulin (Vetsulin) that is not requiring injections now or she goes too low, whose pancreas is working again and bringing her numbers down for her by itself.

When I update her spreadsheet you will see what I mean.

However, having said that, since the big storm the other night Smiffy's numbers have risen (temporarily I hope) and I had to give her a shot (cautious shot as she is so sensitive to Caninsulin) and so I can no longer say she is in her 'remission' albeit not within the tightly regulated numbers set by the FDMB - really disappointed but I am hoping she will get back on track in the next few days

Elizabeth kindly helped me along time ago and suggested I believe that I should not let Smiffy go below 5.6 (100) on Caninsulin so I abide by that rule and don't dose her agggressively to bring her too low ..... she did to below this at one point so I have been careful not to let her go that low again.

I am going to update her spreadsheet today if I can as I have my c0mputer fixed now

Sue I will speak to you later this weekend ..

 

Lucille @Looby & Smiify - according to the data on your chart your cat has not been in remission at any point.