Nemo OTJ trial Day 1

[Nemo's mama]

Hello!

After reading lots on this forum and Facebook I switched my Nemo's food to Young Again and have been doing fancy feast Pate's as well. I was following the no shoot under 200 rule and we have been insulin free for 2 weeks! My vet was concerned that his BG may be spiking in between so I started testing once a day at various times not necessarily before eating and he has stayed under 100. I just want to be sure that we are good to not do insulin and to go down to home testing once a week. I am planning to have fructosamine labs done in a couple weeks per the vet's recommendation. Anything I'm missing? Thank you!!!

Spreadsheet: https://docs.google.com/spreadsheet...g5yExgellIDH6zHzMACY145qo/edit#gid=1182885903

 

[Juls and Billy]

Everything sounds good, but I can't access Nemo's spreadsheet. Maybe @Deb & Wink can explain what's going wrong with the link. Now, the fructosamine test will tell you a lot. If it comes back under 350, then he'll be in a normal range, so it's totally worth it to get that test done.

 

[Deb & Wink]

Hi Nemo's mama.

I think you missed some of the steps in publishing the link to the web.
I'm copying the information here for you to walk yourself through the setup again. Not the entire setup. Only the steps I think you missed.

It's usually in the "file and Publish to the web steps" that are done incorrectly. Steps 5, 6, and 7.

5. Click on "File" again, scroll down the list and click on "Publish to the web":



6. In the box that opens, be sure that "link" is underscored. If not, click on "link" to underscore it. Next, be sure the box below states "Entire Document". Then click "publish".




7. Google will ask if you are sure you want to "Publish this selection". Click "ok". A link will be provided; before you copy this link, scroll down and click on "published content and settings". Be sure the box next to "Automatically republish when changes are made" is checked.




8. Copy the link and close the text box.

9. Follow the instructions below to paste the Spreadsheet link into your FDMB Signature block.

 

[Nemo's mama]

OK I went through all those steps again... Does this link work now?
https://docs.google.com/spreadsheet...ObZjmHVVnraOJEIMu2xsQOpshB8Mzzx5qX4qB/pubhtml

 

[Diane Tyler's Mom GA]

Yes I can see his SS now, when I tap on the first link, I see he had a morning test and was 148 and another time was 114 and then at night was 119
I can't tell you whether or not he should be off insulin, or you should give a lower dose
I see your no shoot was under 200 but usually when you have a lot of data collected the experienced members may tell you to lower the no shoot number or to lower his insulin I will tag someone for you to give you some advice @Deb & Wink

 

[Deb & Wink]

When we click on the link you put in the post, yes we can read that one.
But the link in your signature is not working still.

Linking it to your user profile signature means you do not have to keep putting the link into each of your posts.
Copy the link you have in post #4.
Go to the upper right, click on your member name, there will be a drop down list that appears.
Select "Signature" from that drop down list.
Highlight with your cursor where it says "Nemos spreadsheet" in your signature
Click on the 7th little icon in the editing tools, the one that looks like a piece of a chain.
A box will appear, and that is where you paste the link.
Click on save changes.

While you try and get that part fixed, let me look at the SS

 

[Deb & Wink]

We need doses in each of the Unit columns on the SS.
If you did not give insulin, put in 0 in the units column.

We also need a row for every day. Even if you did not do any testing or give a dose of insulin on a particular day.

Most recent dates are the most important. Starting with 2/10/2020

 

[Diane Tyler's Mom GA]

We need doses in each of the Unit columns on the SS.
If you did not give insulin, put in 0 in the units column.

We also need a row for every day. Even if you did not do any testing or give a dose of insulin on a particular day.

Most recent dates are the most important. Starting with 2/10/2020

Thanks for answering the tag Deb

 

[Deb & Wink]

Is there a reason you do not get AMPS tests?

The lantus insulin "depot" needs to drain first, before an OTJ trial and starting to count the days. That usually takes 3 days for the "depot" to drain.

Then, we have instructions for an OTJ trial. Nemo is not quite ready to stop the insulin for sure, but he may be close. 14 days of testing AM and PM after the depot drains to tell if he is ready to be considered diet controlled.
Some testing if he is in the blue range at the normal pre-shot time will be needed. About 3-4 hours after his morning feeding.

Once you have the SS corrected, very willing to give you more help on the OTJ trial.

p.s. Are you Cecily J?

 

[Diane Tyler's Mom GA]

Is there a reason you do not get AMPS tests?

The lantus insulin "depot" needs to drain first, before an OTJ trial and starting to count the days. That usually takes 3 days for the "depot" to drain.

Then, we have instructions for an OTJ trial. Nemo is not quite ready to stop the insulin for sure, but he may be close. 14 days of testing AM and PM after the depot drains to tell if he is ready to be considered diet controlled.
Some testing if he is in the blue range at the normal pre-shot time will be needed. About 3-4 hours after his morning feeding.

Once you have the SS corrected, very willing to give you more help on the OTJ trial.

p.s. Are you Cecily J?

That's what I figured

 

[Deb & Wink]

You can't skip the testing, even for an OTJ Trial.

Here are the instructions for an OTJ trial: If on Lantus or Levimir, depot has to drain first before trial starts, about 3 days or 6 cycles. No depot with in and out type insulins (NPH, Vetsulin/Caninsulin, Prozinc).

If you are posting in the Lantus/Levimir forum, please start a new thread each day which says ‘[Cat name] OTJ trial Day 1 BG xx’ (where xx is the BG reading for that cycle PM), then day2,3 etc. If you are posting in the Main Forum, we don’t require you or need you to do that separate post for each day. In fact, if you have never posted before over in the Lantus/Levimir forum or use a different insulin, you are fine staying in the Feline Health (Welcome & Main Forum). We’ll cheer you on!

1. Test at your normal AMPS and PMPS times. Feed multiple small meals throughout the day as much as possible (small meals are less likely to overwhelm a newly functioning pancreas). The morning test is now called the AMBG. The evening test is now called the PMBG.

2. If your cat is green (0-99 mg/dL human meter, 0-130 mg/dL pet meter, 0-5.5 mmol/L) at your normal test times, no need to test further until the next "PS" time, just feed small meals and go about your day. If the numbers are blue or higher (100-199 human meter, 130-230 petmeter, 5.5-11 mmol/L), feed a small meal and test again after about 3 hours. Food raises BG's. So if the number is lower 3-4 hours after a meal, then the pancreas is working!

3. After 2 weeks, if everything is looking good, we have a party! And boy, do we party hearty.

Sometimes, the trial doesn't work the first time and we have to give a little more support by starting the cat with a tiny dose of insulin again. I had to do that with Wink. We simply start the cat back on a tiny dose of insulin to support the pancreas with healing for a bit longer. Our goal is a strong remission and it's better to be safe now then sorry later that you rushed it. With just a little more time we will probably get that strong remission we are looking for.

 

[Nemo's mama]

Is there a reason you do not get AMPS tests?

The lantus insulin "depot" needs to drain first, before an OTJ trial and starting to count the days. That usually takes 3 days for the "depot" to drain.

Then, we have instructions for an OTJ trial. Nemo is not quite ready to stop the insulin for sure, but he may be close. 14 days of testing AM and PM after the depot drains to tell if he is ready to be considered diet controlled.
Some testing if he is in the blue range at the normal pre-shot time will be needed. About 3-4 hours after his morning feeding.

Once you have the SS corrected, very willing to give you more help on the OTJ trial.

p.s. Are you Cecily J?

Thanks! Yes I am Cecily J We started testing 2x a day and it just got too hard to get everything done in the morning before work. I thought since his numbers were good consistently I didn't need to be I will start checking them again tomorrow. I have been nervous to give insulin with us being at work most of the day as when I switched to the Young again food his numbers got much better. Should I always check pre-meal? The vet sounded like it was better to spot check to make sure he was consistently maintaining good numbers. I have been free feeding Yound again and diong FF Pate 2x per day with water mixed in. I think I fixed the spreadsheet.... hopefully.

 

[Deb & Wink]

Thank you Cecily. Found you in our sister/affiliated facebook group.

Spreadsheet looks good. Link in signature is now accessible to us in view only mode.
I see you added rows for each day, and put 0 in the units columns where you did not give any insulin.
Thanks for doing all that.

So starting tomorrow, you want to take food away for the 2 hours before the morning "pre-shot" test. So yes, you will always be doing the pre-shot tests pre-meal.
Then you feed Nemo, his regular amount of food. He can eat normally throughout the day, it's only the 2 hours before the pre-shot tests that we want to be free of food influence.
If the pre-shot test (now called the morning blood glucose test or AMBG) is green, no more testing until the evening cycle.
If the AMBG test is blue, you want to test at +3 hours after that. That test will help us to know if the pancreas is producing it's own insulin.

Do the same thing for the PMBG cycle.

I'm betting it's crazy at your home with work and life responsibilities, so some of those +3 tests if the AMBG was blue might not happen. Don't worry too much about it.

If you want to test at a couple of different random times during the 12 hour cycle, that is fine too.
But see post #11 back in this thread for the testing we like to see for an OTJ trial.

Keep us posted. We like to cheer people on during OTJ trials. On or around March 10th and Nemo & Cicely might get to celebrate.

Think you can do that testing for the next 14 days?

 

[Nemo's mama]

We can definitely try! Testing his BG is a 2 person job generally and my fiance will be gone this weekend but I will try to get it on my own. Thanks for your help. I haven't been giving his lantus since his numbers have been right around or below 100 consistently. Is this the right thing to do? I'm so nervous to give it when he's lower then 150, don't want him to have a hypo episode. Any advice? Thanks again!!

 

[Deb & Wink]

I haven't been giving his lantus since his numbers have been right around or below 100 consistently. Is this the right thing to do?

Yes, you are doing the right thing for now. No insulin with his BG levels on Lantus with him testing <100.

You're using an Alphatrak pet meter. So any BG (blood glucose) test <100 is a good number.
If no insulin, not much danger of him dropping low. Don't even worry if his BG numbers drop under 50, or into the 40's or 30's. There is no danger of hypoglycemia since Nemo is not getting any insulin currently.
Looks to me from Nemo's SS that you have not been giving Nemo any insulin for some time.
Which is fine. We just aren't quite sure yet if the insulin can stop for now.
That is what the OTJ trial will show you.

I'm so nervous to give it when he's lower then 150, don't want him to have a hypo episode. Any advice?

For now, let's see how the OTJ trial goes. If he "flunks", then maybe you start him back on the tiniest dose of insulin, like a drop or 0.1U.

For now, let's think positively and cheer Nemo on during his OTJ trial. Personally, I think he'll pass with flying colors. Summa cum laude.

Have you read this document on testing? I think of it as the "cat whisperer" approach to home testing.
•Ear Testing Psychology•
It's one of my absolute favorite testing links, along with this one. Marje and Gracie's Testing and Shooting Tips
"Testing
We all know the basics:

• Warm the ear with a rice sock or a warm washcloth wrapped in a plastic bag.

• Either freehand or use a lancing device; new members usually start with a larger gauge lancet such as 28g or 29g until the ear learns to bleed; then progress to a 31g or 33g which are finer.

• Be sure to poke in the "sweet spot" and not the major vein that runs along the length of the ear. Poking the vein will not only hurt, but will result in a lot of blood. The sweet spot is on the edge of the ear.

But did you also know there is a particular way for the lancet to be used? It has one side that is beveled so the sharpest part goes in first, if used correctly."

Bribes, I mean yummy treats for you cat at test times can get your cat to accept the testing better. That can be any kind of pure protein food, extra attention, brushing, chin scritches. Something he loves.

Singing to your cat can help also, even if you can't carry a tune. I sure can't sing, sound like a croaking frog when I try to sing. Calms you down, calmer you means calmer cat, less stress all around. "Row, row, row your boat" or "Ring a round the Rosy, Pocketful of Posies." are good choices. Silly childrens' songs to make us smile and laugh and relieve some of the stress.

Keep us posted please.
If you have any more questions, please ask.

p.s. Would you change the title on your thread please? Upper right hand corner at the top of the screen, Edit post, Editing tools and a box will appear where you can change your thread title.

Nemo Day 1 OTJ trial cheerleading funny from Deb is: