Thoughts on current numbers? And questions about OTJ? No insulin for 11 days so far

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Riyah

Riyah

Member Since 2023
Hi everyone!

Here is my last post. Lily hasn't received insulin since 11/19 and her numbers have been blue and then all green since then. They got quite 'low' to my eyes at first, which worried me. But they've now been in the 70s, which has now worried me because the upwards trend. Needless to say, despite the potential good news of being off insulin, I'm still pretty uneasy about her progress and what we can expect in the future.

For past context, this is my parents cat (though I do all of the vet related things) and I live an hour's flight away. I flew back around when we noticed symptoms on 11/1 and have been here since. Part of my anxiety is also about whether I can go back to my place and feel confident that she's okay.

Does it seem like her pancreas is functioning normally now? I guess I feel a bit of whiplash because she wasn't on insulin for very long and I'm really worried about the high numbers coming back. I searched through quite a lot of remission posts and have seen many cats go back on insulin anywhere from a few months to a few years after their remission.

I'd really love any insight or anecdotes on how we can keep her in remission (if that's what's going on!) and if any cats that have gone into remission have stayed that way for the rest of their hopefully long lives. Thank you all!
 
Lily's numbers look great! I don't think I would have predicted what you're seeing.

What we encourage you to do is to test on a regular basis. It may be a couple of times a week and then weekly. Test if you see any change in behavior. Make sure you get regular annual vet checks. The one thing that causes many cats to fall out of remission is that they need dental work. Any infection or inflammation will cause a rise in numbers so if you see elevated blood glucose, get your cat in for a vet appointment.

The other thing to remember is that a cat that is in remission is a diet controlled diabetic. You need to make sure Lily is on a low carb diet and your parents don't "cheat" and give her high carb food.
 
Everything Sienne and Gabby said is spot on. My Snickers was in remission about 3.5 years and only fell out a little over a month ago. She fell out, I think (though am not positive), because she gained weight and also developed arthritis in her back that bothered her physically and emotionally.

She was depressed for a while I think but is way better now once we figured out what was going on. She's on a diet and has started an arthritis med and her numbers are really good. So we're hoping for another remission.

For reference, she started going into remission (the first time) after about a month and a half, which was really fast. But I kept her on micro doses (1 drop) of insulin for a while to ensure it went well when she came off it.
 
Yes, we'll still be testing frequently especially since we haven't hit two weeks yet. I did bring up dental work with our vet during our check up last week because when her numbers were in the red, I was wondering if she had teeth issues that were causing the unregulated numbers. He did a closer visual inspection of her teeth and did recommend a dental but wants to wait til her numbers are stable for another month before scheduling. I'm quite worried about dental work! She's never been under anesthesia aside from when she was a kitten (we didn't own her then) and she's never had a dental so her going under gives me a lot of anxiety.

She does have some health issues like beginnings of arthritis, mild asthma, herpesvirus flare ups every now and then. Nothing that's required long term or daily treatment but things that I'm definitely conscious of and don't want to exacerbate. She's actually been having some sneezing fits and clear nasal discharge (kind of like when a human has a runny nose) since her diagnosis but our vet said it's most likely a flare up and to give it time to resolve on its own.

I do wonder whether we should've microdosed! Since her bounces happened so early on in the diagnosis, from the 400s to low 100s, I wasn't confident enough to shoot low. I'm hoping we didn't hinder her from healing properly. Fingers crossed for another remission for Snickers!
 
Riyah said:
Yes, we'll still be testing frequently especially since we haven't hit two weeks yet. I did bring up dental work with our vet during our check up last week because when her numbers were in the red, I was wondering if she had teeth issues that were causing the unregulated numbers. He did a closer visual inspection of her teeth and did recommend a dental but wants to wait til her numbers are stable for another month before scheduling. I'm quite worried about dental work! She's never been under anesthesia aside from when she was a kitten (we didn't own her then) and she's never had a dental so her going under gives me a lot of anxiety.

She does have some health issues like beginnings of arthritis, mild asthma, herpesvirus flare ups every now and then. Nothing that's required long term or daily treatment but things that I'm definitely conscious of and don't want to exacerbate. She's actually been having some sneezing fits and clear nasal discharge (kind of like when a human has a runny nose) since her diagnosis but our vet said it's most likely a flare up and to give it time to resolve on its own.

I do wonder whether we should've microdosed! Since her bounces happened so early on in the diagnosis, from the 400s to low 100s, I wasn't confident enough to shoot low. I'm hoping we didn't hinder her from healing properly. Fingers crossed for another remission for Snickers!
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Thank you so much! It sounds like you're doing everything you can for your kitty. Just keep an eye on the numbers for a while and see what happens. Hopefully Lily will stay in the greens. :)
 
Riyah said:
She does have some health issues like beginnings of arthritis, mild asthma, herpesvirus flare ups every now and then. Nothing that's required long term or daily treatment but things that I'm definitely conscious of and don't want to exacerbate. She's actually been having some sneezing fits and clear nasal discharge (kind of like when a human has a runny nose) since her diagnosis but our vet said it's most likely a flare up and to give it time to resolve on its own.
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I meant to say that Snickers also gets sneezing and a runny nose from time to time. It's more likely due to seasonal allergies, but our vet once mentioned that it could possibly be herpes flares. When it acts up, we give her an over-the-counter allergy pill called chlorpheniramine maleate, a half a 4mg tablet twice a day (or as needed). I bought it at CVS I think. It really seems to help her!

Also, with beginning arthritis you probably don't have to worry, but if it ever gets really bad I've started giving Snickers something called Solensia for hers. It's a monthly injection. I believe several others on this forum also use Solensia. So far, it's had positive results and does not negatively effect her BG. Just for future reference. :)
 
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Thanks Chrissy! I've never tried anything for the allergies aside from Lysine supplements from a variety of brands. It hasn't helped though! Will definitely look into it.

And I've seen Solensia mentioned on a number of threads. Everyone seems to have positive thoughts on it so bookmarking that as well.

Tonight her PMPS was 86 so higher than usual! But not sure if it's because I was teaching my dad how to take her BG readings and it took a couple tries and a lot of chasing her around the house :arghh:
 
Riyah said:
Thanks Chrissy! I've never tried anything for the allergies aside from Lysine supplements from a variety of brands. It hasn't helped though! Will definitely look into it.

And I've seen Solensia mentioned on a number of threads. Everyone seems to have positive thoughts on it so bookmarking that as well.

Tonight her PMPS was 86 so higher than usual! But not sure if it's because I was teaching my dad how to take her BG readings and it took a couple tries and a lot of chasing her around the house :arghh:
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86 isn't a bad number, really. It's good you're teaching your dad how to take the readings. I've got some lysine too but haven't given it to Snickers in ages. I just use the allergy pills whenever she starts sneezing. Anyways you're doing great. Just hang in there!
 
Hi everyone!

Little update. I've flown back home and my parents have been able to test twice. Tonight's reading is 90 before dinner. I know that's technically a fine number, but just looking at the pattern, it seems like they're going up. Should we be concerned about that?

I will be back down there in a few days, Saturday at the latest. I'm feeling a little paranoid that maybe we didn't dose as much as we could have early on and this 'remission' is temporary. Maybe we should've been giving tiny doses when the numbers were in the mid 100s. Any insight based on your own cats or others that have been on this board?
 
Hey Riyah. Congrats on the quick remission!

It seems pretty common that cats that get to go OTJ will get to do it within a few months. Check out the OTJ success stories on the Prozinc forum and check out the start/end dates for each cat! Many of them look just like Lily's spreadsheet.

Lily will be diabetic for life now, and it isn't that uncommon for them to fall out of remission at some point. But fortunately, now you will be able to spot the signs quicker (glucometer checks, increased hunger/thirst, huge pee chunks, etc.) so you can take action.

Dixie had a dental done when she was 13 years old and had 6 teeth extracted and it majorly brought down her blood sugar values. So keep on top of appointments like that.

Glucometers are never 100% accurate (I think they have a 20% range of variance?) so don't fret if you see small changes in the numbers. It could be nothing at all. Look at the bigger picture... so many nice greens! :cat:

Some small things I have observed about keeping Dixie's blood sugar regulated:
* Not eating for several hours can cause the blood sugar to trend up. I noticed Dixie's numbers would be higher before dinner since she likes to sleep most of the day.
* Eating 0% carbs can lead to higher blood sugar in some cats (this one surprised me!)
* Some cats are allergic to certain foods. I noticed Dixie's values would go way up whenever I tried to feed her beef
* Stress causes their blood sugar to go up. Testing after a vet appointment will cause Dixie's values to skyrocket (she was 187 last time!).

You can always put Lily back on insulin in the future. There is no rush for that now. High blood sugar values in the long term are bad, yes, but low blood sugar values on insulin can be fatal. There is nothing wrong with waiting this out and seeing how Lily does OTJ. Then maybe in the future you can consider drop doses if necessary. I tried to get Dixie OTJ three times and only the third one has stuck so far (although her values are nowhere near as nice as Lily's!)

Getting your parents to get some mid-day tests would be great. And of course, keep feeding the low-carb, wet food!
 
Thank you FarmKitty! Appreciate the detailed response. Lily is due for a dental according to our vet so I'm curious about how that'll go and if it'll affect her numbers.

I also have a suspicion that Lily's allergic to some sort of protein but I'm not sure what. It's so hard to track when cans list themselves as one thing but have generic byproducts or fish listed in a non-fish titled food!

And interesting that you tried three times! I read here that if a cat comes back from remission, it's really hard to get them off insulin a second time, so that's been a worry. Glad that this one has stuck for so many months!

Tonight's reading was 74 - this would be the 15th day without insulin. Think I should have my parents continue to test daily? Or should we move to a less frequent testing schedule? I know my parents aren't enjoying the testing so they'd love to hear they can test less often haha. Although once I'm back this weekend I'll definitely test her the usual way for my own peace of mind. She actually takes to testing quite easily and comes over and sits in her testing position when she hears me preparing the lancet/meter.
 
These are the OTJ instructions. You have already done the 14 days. Congratulations.just follow the other instructions
Instructions for starting the OTJ trial
Start the trial on the next green pre shot.
If he/she is green 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 he/she is blue at your normal "PS", feed a small meal and test again after about 3 or 4 hours. If his/her number is lower 3-4 hours after a meal, then the pancreas is working!
Post every day so we can monitor your progress and see if any tweaks are needed. He/she may have a sporadic blue number. Don't panic but post before you decide whether to shoot so we can have a discussion.
After 14 days of no insulin, we have a party!!
Sometimes the trial doesn't work the first time and we have to give a little more support in the form of resuming insulin. It's not the end of the world if that happens; we just give him/her the support needed. Our goal is a strong remission and it's better to take our time to get that than to rush into remission just to have it fail later on.
Good luck with the trial!!!
Once he/she is through the trial successfully, you enter a new phase. Your cat is still diabetic but has now become diet-controlled. Continue feeding low carb food in the manner successful for your kitty. If you decide to change his/her feeding schedule, let your meter be your guide to the best times to feed. Avoid medications with sugar in them and steroid medications unless they are medically essential. Continue testing blood glucose weekly for the first month and then monthly forever. It's a good idea to weigh him/her monthly. Weight should remain stable. If he/she seems "off" or sick, or is showing signs of diabetes (excessive drinking, eating, urinating, weight loss), test his/her blood glucose right away. Keep the teeth and gums clean and healthy; dental issues can bring a cat out of remission. If you see rising blood glucose numbers, it's time for a visit to the vet!
 
See Bron and Sheba's post for info on the new testing protocol. If you wanna be a bit extra, you could try doing a curve. This can be either in a single day, or over several days. So first day do AMPS +2, second day do AMPS +4, third day do AMPS +6, etc... getting some values in the night time would be nice too. The benefit of this is that you will have some data to compare Lily to in the upcoming months to see if she is actually trending upwards, or if her midcycle values were always like this. I like to do this before any vet appointments and then draw the curve on a line graph so that the vet can see the values throughout the day (since trying to show the vet the spreadsheet will be a lost cause :D). Even with this data, your vet still may not trust the remission without first running a fructosamine test.

To encourage your parents to keep up with the testing, you could let them know that diabetes is really damaging, hurting the eyes, heart, blood vessels, nervous system, teeth and gums, feet and skin, and kidneys... When Dixie was unregulated, she had so many ear infections and her wounds wouldn't heal which would cost $$ and extra time for the treatment + vet visits. After having her diabetes regulated, she hasn't had any ear infections in years! My vet said this is just what happens to diabetic cats... they will be very prone to random infections. So if your parents can keep up the glucose testing and lookout for symptoms then it will likely save them time and money in the future.
 
Riyah said:
Think I should have my parents continue to test daily? Or should we move to a less frequent testing schedule? I
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@Riyah
Just follow the instructions that Bron gave you
Once he/she is through the trial successfully, you enter a new phase. Your cat is still diabetic but has now become diet-controlled. Continue feeding low carb food in the manner successful for your kitty. If you decide to change his/her feeding schedule, let your meter be your guide to the best times to feed. Avoid medications with sugar in them and steroid medications unless they are medically essential. Continue testing blood glucose weekly for the first month and then monthly forever. It's a good idea to weigh him/her monthly. Weight should remain stable. If he/she seems "off" or sick, or is showing signs of diabetes (excessive drinking, eating, urinating, weight loss), test his/her blood glucose right away. Keep the teeth and gums clean and healthy; dental issues can bring a cat out of remission. If you see rising blood glucose numbers, it's time for a visit to the vet!

If you do get a blue Pre Shot then have your parents test Lily @+3 ,if it's green no need to test again, it means her pancreas is working

I would add to your signature OTJ and the date
 
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