New member: OTJ Relapse questions

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Bethany Schultz Tascoe

Bethany Schultz Tascoe

Member Since 2021
Hello. My name is Bethany. My kitty’s name is Nugget. We’ve been on a diabetic journey for a relatively short time. Of course, I started by trusting in my vet, but it seems she not as knowledgeable as I’d like her to be. I apologize I don’t have a spreadsheet.
Nugget was diagnosed 11/12/21 and was started on Lantus. We started at 1 unit BID and slowly climbed to 3 units BID based solely on urine. We have never done testing in her ears. We are on our 5th round of freestyle libre. Because of my job, we are not able to feed small meals Monday through Friday, so to keep her consistent, she gets two meals a day, at 6am and 6pm.
On 1/18/22, my husband and I made the choice to take her off the insulin, because the lowest dose we could measure was bottoming her out (“Lo” on the libre which is <40 for several hours, even after given some higher carb food). She’s never shown physical signs of hypoglycemia other than fatigue, but the libre has been a lifesaver (quite literally). We had a failed sensor 3 days OTJ and contacted the manufacturer. We just reapplied Thursday evening. Forgive me for not knowing all the terms… her pre-meals have been 200+. The lowest she came yesterday was 148. These seem too high, but I’m still a novice.
Can anyone offer advice?
What numbers should we be looking for to remain off the juice? And should we start her back on insulin again based on her current numbers on the freestyle libre?
(I type up numbers every day and send to the vet)
1/30/22:
12:07am 165
12:58am 180
6:03am 147
Ate meal.
8:00am 180
9:00am 157
10:04am 148
10:59am 153
11:59am 172
2:23pm 194
4:04pm 180
6:01pm 245
Ate meal.
8:00pm 174
8:59pm 148
10:07pm 170

I have come to this forum for loads of advice and really appreciate all your collective knowledge. Thank you I’m advance.
 
Hi, remission is usually defined as "
"14 days without insulin and normal blood glucose values. Most remission cats are able to stay in the normal range all of the time (50 to 80 mg/dl), although there are a few cases of sporadic higher and lower BGs. Don't stop feeding low-carb and try to avoid cortisone if possible"

Also
  • We've found many kitties benefit from reducing the dose from 0.25u to 0.1u before stopping insulin completely. During a two week OTJ trial, you want to see mostly green numbers (under 100) with only a few random blue numbers between 100 - 120 to help ensure a strong remission. Most kitties will be in the range of a healthy cat (50 - 80 mg/dL) overall.
This information can be found here

https://www.felinediabetes.com/FDMB...-low-go-slow-slgs-tight-regulation-tr.210110/

What was the lowest dose you where giving her?
 
Hi Bethany and Nugget and welcome to the forum.
Yes it does look as though Nuggets still needs some insulin going by the numbers you have posted.
Also, have you thought about getting a timed automatic feeder for Nuggets so he can have some snacks during the day while you are at work and at night when you sleep.
Having snacks during the cycles is much better than just the 2 meals a day.

I would recommend you think about setting up a spreadsheet which you will find in this link HELP US HELP YOU
Then add the last couple of weeks data into the SS so we can see. We will then be able to help you with the dosing. We recommend going down from 0.25 to 0.1 unit and then a drop of insulin…we will show to you how to do that, …..before stopping. You will get a strange remission this way.
Ask lots of questions
 
The lowest we went was 0.25 units. I saw that the 0.1 is recommended here, but my vet didn’t recommend it and I couldn’t imagine trying to measure that out. I have a hard time measuring out 0.25… probably because I’m a perfectionist. We will definitely try this time, though. Long remission is obviously the goal!
Unfortunately a timed feeder wouldn’t be beneficial for us, because nugget has two non-diabetic sisters who would probably gobble it all up.
I will work on a spreadsheet. I’m sure keeping up on it won’t be as cumbersome as the first time loading it all in.
I did start her on 0.25 units last night. Her nadir was +3 at 98 and she was back up to 208 before breakfast.
 
We can help you with the smaller doses n you get to them.
Can you give him a snack as you walk out the door in the morning? And again at night.
There is also a chipped timed feeder that will only open for the cat wearing the chip, if you are interested.
If you need help with the spreadsheet let me know
 
You are blowing my mind with the fact that there is a chipped feeder!
I think since we got to the point of trying OTJ in just 3 months, I’m going to give it a try again the way we were doing it feeding wise… just extending the end to the 0.1 and drop as you suggest and see how it goes. If we relapse again, I’ll look into more frequent feeds with a feeder.
I think I was just so excited to have her possibly be reverting back, that I just followed my vet’s recommendations when I should have extended it out longer. I have faith we will get there!
 
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