If I had to do it all again, I would immediately start using a basal insulin-based, tight regulation protocol, allowing the cat spending as much time as possible in the blood glucose range of a healthy cat and thereby maximizing the chances for remission.
In the first months after Tilly's diagnosis, I knew very little about feline diabetes and made many mistakes. So please treat everything up until July 2004 with great caution. And even after July 2004 I made mistakes. The reason I have listed all her blood glucose values, even those from the early days, is to give a complete picture.
How often did I measure blood glucose values using Caninsulin®/Vetsulin® and Ultratard®? I chose to follow my vet's advice at the time and what could be read in the scientific literature: I measured Tilly's nadir once per week. With Caninsulin/Vetsulin, the nadir was not to be <100 mg/dl and with Ultratard not <80 mg/dl. There were times when I tested more often: when I changed the insulin type, when I changed Tilly's diet, when she was sick, whenever she acted abnormally or when she was heading towards remission. I changed the dose based on the blood glucose measurements and therefore on average, once per week.
With Lantus® I finally switched to using a more tight regulation approach.
Every day, I recorded Tilly's "body score", a totally subjective measure by me of her progress. It was comprised of her appetite, her thirst/urine production, her level of activity and how her fur looked. The body score always gave me, in addition to the blood glucose values, a good idea of how she was doing.
Here are Tilly's charts. Please remember, every cat is different. Therefore never assume that another cat will have a similar reaction to Tilly in a particular situation:
• Mar 2004 - Nov 2004: Caninsulin/Vetsulin
• Nov 2004 - Mar 2005: Ultratard - Lantus - Remission Start
• Apr 2005 - Jan 2008: Remission
• Jan 2008 - Sep 2012: Relapse - Renewed Remission
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