Tina and Salem
Member Since 2019
How do you know your cat is in remission ? Is there sticky notes On remission or over the juice ?
03-06-20 ??? Remission
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SullivansDad
Member Since 2020
There's no sticky note, but this is what Deb posted to me when I asked a similar question:
Generic OTJ instructions we use here:
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 pet meter, 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.
Generic Tips to stay OTJ
1. Never feed dry - not even treats. (freeze dried is ok, Dr. Elsey's chicken flavor is ok.) If you change wet food types, be 100% sure the new food is also low carb and same low carb % as your current food. Some cats are very carb sensitive and an increase from 3-6% to 8-10% can spike the BG’s. Don’t feed if you aren’t sure!
2. Weigh every 2 weeks to 1 month to watch for weight changes. Too much of a weight gain can cause loss of remission. Too much of a weight loss alerts you to other issues, such as hyperthyroidism.
3. Measure blood once a week, indefinitely if possible. You want to catch a relapse quickly. Some people only do checks every 2 weeks to a month. BG checks can sometimes alert you to other issues.
4. No steroids or oral meds with sugar - remind your vet whenever giving you any medication. Always double check. (Steroids may be needed for other medical issues. But remind your vet your cat is a diabetic, diet controlled.)
5. Monitor food intake, peeing and drinking. If increasing, a sign of losing remission. Or another medical condition like Hyper-T or kidney disease.
6. Regular vet checks for infection such as dental , ear or UTI. And get them treated quickly!
7.Continue to ketone test even if your cat is OTJ. Ketones can develop if the cat’s pancreas is not producing enough insulin, or burning off too much fat if your cat is not eating properly and other reasons.
If your cat does fall out of remission you need to be more aggressive and resolve issues/ back on insulin as soon as possible as the window for a second remission is tight if any. Pancreatitis, hyperthyroid, dental issues are the most common reasons cats fall out of remission.
Generic OTJ instructions we use here:
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 pet meter, 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.
Generic Tips to stay OTJ
1. Never feed dry - not even treats. (freeze dried is ok, Dr. Elsey's chicken flavor is ok.) If you change wet food types, be 100% sure the new food is also low carb and same low carb % as your current food. Some cats are very carb sensitive and an increase from 3-6% to 8-10% can spike the BG’s. Don’t feed if you aren’t sure!
2. Weigh every 2 weeks to 1 month to watch for weight changes. Too much of a weight gain can cause loss of remission. Too much of a weight loss alerts you to other issues, such as hyperthyroidism.
3. Measure blood once a week, indefinitely if possible. You want to catch a relapse quickly. Some people only do checks every 2 weeks to a month. BG checks can sometimes alert you to other issues.
4. No steroids or oral meds with sugar - remind your vet whenever giving you any medication. Always double check. (Steroids may be needed for other medical issues. But remind your vet your cat is a diabetic, diet controlled.)
5. Monitor food intake, peeing and drinking. If increasing, a sign of losing remission. Or another medical condition like Hyper-T or kidney disease.
6. Regular vet checks for infection such as dental , ear or UTI. And get them treated quickly!
7.Continue to ketone test even if your cat is OTJ. Ketones can develop if the cat’s pancreas is not producing enough insulin, or burning off too much fat if your cat is not eating properly and other reasons.
If your cat does fall out of remission you need to be more aggressive and resolve issues/ back on insulin as soon as possible as the window for a second remission is tight if any. Pancreatitis, hyperthyroid, dental issues are the most common reasons cats fall out of remission.
SullivansDad
Member Since 2020
I am personally following a slightly altered testing protocol: tomorrow my guy will have been OTJ for a full week (with no testing, just watching for symptoms), and we will be testing him AM, +3, +6, +9, and PM. If all numbers are below 120 on our pet meter (under 130 is our vet's usual goal, but our guy will only eat dry food so we want it a little lower) and the pattern shows that his pancreas is working well (e.g. +3 number goes up a touch from his breakfast but then later comes back down), our vet considers him in remission and says he should stay OTJ and we should test again the same way in a month. We will however be doing an AM, +6, and PM one week from tomorrow as well for our own edification.
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Elizabeth and Bertie
Member Since 2010
If a kitty can stay in normal blood glucose levels for 14 days without insulin, then it is 'highly likely' that they are in remission.
On FDMB the normal BG range for a non-diabetic cat (or one in remission) is deemed to be approximately 50 – 120 mg/dL [2.7 to 6.6 mmol/L] as measured on a human glucose meter. Some kitties will naturally run a little lower or higher than this.
On FDMB the normal BG range for a non-diabetic cat (or one in remission) is deemed to be approximately 50 – 120 mg/dL [2.7 to 6.6 mmol/L] as measured on a human glucose meter. Some kitties will naturally run a little lower or higher than this.
Tina and Salem
Member Since 2019
So what do I see or look for to think hes a good candidate for OTJ ? Hes sugar is pretty green and blue for awhile? Then you do the trail for 14 days ? Thanks !!! This is great information .. i was just wondering One day ....if my cats sugar has been good for awhile whats next ? Then i got to thinking i guess OTJ ..
Tina and Salem
Member Since 2019
Oh and also does his insulin have to be reduced all the way down to almost nothing before you can do the trail ? Or can you just stop ? My cat was DKA in october . Last year .
Juls and Billy
Member Since 2019
I would reduce by .25 every time you see a mid-cycle reading under 90. But I am more SLGS knowledgeably than TR knowledgeable. I do think it's best to reduce slowly than go all at once.
Probably better posted in the LBL forum, but there are a couple notes you might want to read.
Reminder: *earning* reductions and starting OTJ trials
and from the Dosing Methods Sticky Note:
Remission:
From Tilly's Diabetes Homepage - Phase 5: Remission
"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.
Test the cat's BGs once per month. Approximately 25% cats that achieved remission using this protocol relapsed and required insulin again (frequent causes are hyperthyroidism or bouts of pancreatitis). Therefore, it is important to keep your diabetes kit up-to-date. Then you can react immediately by giving insulin and home testing. Importantly, the sooner you react to a relapse (i.e. preventing hyperglycemia and initiating other necessary veterinary treatment), the more likely a second remission will become.
The longer a cat has had diabetes, the less likely it will go into remission. Many long-term diabetics get stuck in Phase 3 or 4. Yet there is a benefit of using this method for such a cat as well: keeping the cat's BG levels as normal as possible is much healthier for it long term. Insulin requirements will often decrease to very low levels too."
Reminder: *earning* reductions and starting OTJ trials
and from the Dosing Methods Sticky Note:
Remission:
From Tilly's Diabetes Homepage - Phase 5: Remission
"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.
Test the cat's BGs once per month. Approximately 25% cats that achieved remission using this protocol relapsed and required insulin again (frequent causes are hyperthyroidism or bouts of pancreatitis). Therefore, it is important to keep your diabetes kit up-to-date. Then you can react immediately by giving insulin and home testing. Importantly, the sooner you react to a relapse (i.e. preventing hyperglycemia and initiating other necessary veterinary treatment), the more likely a second remission will become.
The longer a cat has had diabetes, the less likely it will go into remission. Many long-term diabetics get stuck in Phase 3 or 4. Yet there is a benefit of using this method for such a cat as well: keeping the cat's BG levels as normal as possible is much healthier for it long term. Insulin requirements will often decrease to very low levels too."
Yes, you do have to reduce down to zero units, by 0.25 units at a time. With a history of DKA, you do not want to short cut this.
Tina and Salem
Member Since 2019
Thanks! Do i need to copy and post this to the lantus board ?
No need to post there. You just might have gotten a faster response there.
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