2/12 Josie (not on TR, but need advice on going OTJ)

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eccentricfuzzyme

eccentricfuzzyme

Member Since 2011
Josie has been on lantus since this summer when she was diagnosed, and since switching her to a new food (natures variety instinct, dry chicken flavour) 2 weeks ago, and lowering her dose of lantus, she has gotten much better numbers.
In fact, I have not given her any insulin in over a week.
What I am wondering is what are good numbers for a cat to be off insulin? What would be normal for her situation?
I am really looking foward to hopefully being able to get a social life back again, sleep away from home, etc.
But i dont know how long to wait before i can feel comfortable not testing several times a day, every day.

Also, for those who know about b12 for neuropathy, if it was going to work, would it have done it in the first few months? josie has been on it this whole time and it hasnt helped her back legs at all.
 
Angela. I think Josie is looking great but IMHO she is not in OTJ numbers. We usually say they need to have all green numbers to to go OTJ. Josie is still throwing some high blue numbers. I would not have taken her off insulin.

It's hard to say how long she will need the B12......I am pretty sure Binks was still taking it even after he was otj.
 
hi angela!

wow - what a change by getting her to a low carb food! very nice.

a non-diabetic's cats numbers will be 40's to 120's. so you're still seeing diabetic numbers, albeit lower than you've ever had. renal damage (kidney) is said to begin around 250 or so, although we know that cats are all different and it seems that some cats will experience it at lower numbers. one thing you could do to check this is to get the glucose urine strips and test her urine. if it shows glucose then she's till got more than her kidneys can handle.

normally we would encourage a person to continue giving insulin until all the numbers tested were less than 120 and most of them were less than 100. you would decrease the dose in smaller and smaller amounts until josie was getting 0.1unit and then nothing. we wouldn't normally say OTJ until 2 weeks of no insulin and still maintaining less than 120 for all tests. we just know from experience that is the path to the best success for the cat remaining off.

so . . . your choice on what to do next. if you want to try to support her as long as possible, probably returning to a .5u dose and then working down to .25 and .1u would be the best plan. if you don't want to do that, then you can continue to test and see what happens.

either way, for now you should continue testing a couple of times a day minimum for a couple of weeks, then always once a week or so. i don't know the carb count of that dry food, and i know how much you hate the smell of canned food, but switching to low carb canned food might be enough to let her BG remain below 120.

once a cat is diabetic, you must continue to treat them as though they are diabetic, maintain a low-carb diet and test occasionally. any infection or illness can bring it back on.
 
Hi Angela,

You want a range of 50 to 120 for BG readings consistently before you can consider OTJ. I agree with Marjorie, kitty needs to go back on the insulin for a while longer. Here, in TR, we don't necessarily follow the "don't shoot if it's below 150 rule" especially if we've been collecting a lot of data through BG readings.

I would suggest:

1. Go back on the insulin at the last good dose you were seeing results (looks to be 1 unit)
2. Stay consistent with that dose for at least 5 to 7 days
3. Get more mid-cycle readings (AM and PM) to catch when the nadir is occurring
4. Reduce the dose only when you see a reading of 50

I know where you are coming from, I used to do the same thing for Cini thinking that if he was showing a BG reading of less than 150 every once in a while then he must be good to go OTJ, but that just isn't the case. When I did that he lasted 7 days OTJ and then he slowly drifted back up in to the 200's. You're going to see that too with Josie because her insulin shed is draining. That's what's keeping her in the blue range right now.

Keep up the great work you are doing with Josie!
 
Marjorie and Gracie said:
Angela. I think Josie is looking great but IMHO she is not in OTJ numbers. We usually say they need to have all green numbers to to go OTJ. Josie is still throwing some high blue numbers. I would not have taken her off insulin.

It's hard to say how long she will need the B12......I am pretty sure Binks was still taking it even after he was otj.
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WEll, to me, OTJ just means she isnt getting insulin. I didnt "take her off" it, her numbers have been below the levels where I can shoot and leave her, so I started by skipping, and then they stayed low.


What I meant with the b12 is, is it doing her any good? i dont want to waste the money on buying it if it is too late to help her legs.
 
Cini Mini's Mom said:
Hi Angela,

You want a range of 50 to 120 for BG readings consistently before you can consider OTJ. I agree with Marjorie, kitty needs to go back on the insulin for a while longer. Here, in TR, we don't necessarily follow the "don't shoot if it's below 150 rule" especially if we've been collecting a lot of data through BG readings.

I would suggest:

1. Go back on the insulin at the last good dose you were seeing results (looks to be 1 unit)
2. Stay consistent with that dose for at least 5 to 7 days
3. Get more mid-cycle readings (AM and PM) to catch when the nadir is occurring
4. Reduce the dose only when you see a reading of 50

I know where you are coming from, I used to do the same thing for Cini thinking that if he was showing a BG reading of less than 150 every once in a while then he must be good to go OTJ, but that just isn't the case. When I did that he lasted 7 days OTJ and then he slowly drifted back up in to the 200's. You're going to see that too with Josie because her insulin shed is draining. That's what's keeping her in the blue range right now.

Keep up the great work you are doing with Josie!
Click to expand...


I cant shoot when she is this low, as i have to leave her for 10+ hours at a time.
 
julie & punkin said:
hi angela!

wow - what a change by getting her to a low carb food! very nice.


either way, for now you should continue testing a couple of times a day minimum for a couple of weeks, then always once a week or so. i don't know the carb count of that dry food, and i know how much you hate the smell of canned food, but switching to low carb canned food might be enough to let her BG remain below 120.

once a cat is diabetic, you must continue to treat them as though they are diabetic, maintain a low-carb diet and test occasionally. any infection or illness can bring it back on.
Click to expand...

she was already on a low carb dry food, one suggested for its low content, evo dry, but it made her poops stink really bad, so i switched to another dry food, the instinct, and it seems to help, and she isnt as stinky.
 
WEll, to me, OTJ just means she isnt getting insulin. I didnt "take her off" it, her numbers have been below the levels where I can shoot and leave her, so I started by skipping, and then they stayed low.
Click to expand...

Yeah.. they're not staying low. I can see some 190's and she's starting to creep up. In the next day or so you'll start to see more 200's because she's not getting the insulin she needs.

I cant shoot when she is this low, as i have to leave her for 10+ hours at a time.
Click to expand...

Understood on that and it's a good decision.

As Julie said, switching to all canned would be great. It might just be the bump she needs to stay low.
 
angela, do you have a timed feeder? if so, you could set it to go off at +3 and +5 with some food in it so you know she can eat if she gets lower numbers. or is her food available all the time?
 
With regard to B-12, are you giving methyl B-12 (methylcobalamine)? It does take some time to work although it sounds like you've been using it for a while. Have you asked your vet if this is neuropathy? It's possible that what you're seeing is arthritis. If it is, a glucosamine/chondroiten supplement may help. Cosequin is available over the counter. There are other forms that some of the members here use, as well.

FWIW, Josie's SS doesn't look like the spreadsheets of the cats that we've seen that go OTJ successfully. This is a copy of Binks' SS for comparison. Granted, Celi was following TR and shooting lower than what you're comfortable shooting. Most of us don't have much experience with the SLGS approach. When we've seen cats that aren't following TR to the letter and who have gone OTJ, there's a point where the spreadsheet is still largely green. It may be that you just need to keep doing what you've been doing (i.e., giving insulin). It you want to continue to withhold insulin, I would strongly encourage you to still test. I just don't know if Josie's numbers will continue to stay in the lower blue range without insulin and I would hate to see you not getting tests and her to develop ketones unbeknownst to you because you're not testing.

As others are suggesting, if you are able to feed a small meal at around +9, it may cause Josie's pancreas to kick in and produce some insulin which would lower her AMPS/PMPS numbers. Are you leaving food out for her during the day? Multiple, small meals will also help with lowering numbers IF Josie's pancreas is working the way it should. (FWIW, a high quality, canned or raw food diet will cause less smelly poop. It's one of the big advantages of raw food.)
 
since you are not shooting low, here is my advice to try to give Josie the best chance at going OTJ and staying OTJ:

* feed small meals every few hours. If her pancreas is working, she will be able to use food as insulin. Giving frequent small meals can help by not overwhelming her pancreas with a large meal all at once, and a small amount of food might stimulate her pancreas to produce more insulin on its own.

* Test, feed a small meal, then test again in 3-4 hours to see if the number is lower or higher than the number before food. Today's 121 wasn't bad - it would be interesting to see if she went to green a few hours after eating (and if she did, then maybe feeding *another* small meal at that time might bring the number down even more).

* Set a no-shoot number for yourself. If she is higher than that number, give a very small dose of insulin (maybe 0.25u) to pull the range back down. Let's say you are comfortable shooting 180 right now. If she is 180 at preshot time, give a small dose. If she is lower, then you can skip. Gradually lower that number until she can stay flat in a low range without insulin. For example, if your no-shoot number now is 180, maybe in a few days try shooting at 150 to see if that helps flatten her out. Then after doing that for a while, maybe you'll find that you are comfortable shooting at 130 or 120 if needed.

The others are right, the goal is to get the numbers to stay under about 120 as much as possible to give her the best chance at staying off insulin long term. In the TR group, we get them there by shooting at lower numbers. In my opinion, shooting low is easier than trying to do the above and "baby" the pancreas into working, but feel free to try the above if it is more comfortable for you. Good luck!
 
julie & punkin said:
angela, do you have a timed feeder? if so, you could set it to go off at +3 and +5 with some food in it so you know she can eat if she gets lower numbers. or is her food available all the time?
Click to expand...


i dont have one, and i dont think it would work, as there are 3 cats in the home, and they are all scarf and barfers when there is something they like.
 
julie & punkin said:
angela, do you have a timed feeder? if so, you could set it to go off at +3 and +5 with some food in it so you know she can eat if she gets lower numbers. or is her food available all the time?
Click to expand...

there is food out all the time, but i sit with her and make sure she eats her "alloted" amount twice a day, before what were the shot times, so she rarely eats during the day, but has access to it if she gets hungry.
 
Sienne and Gabby said:
With regard to B-12, are you giving methyl B-12 (methylcobalamine)? It does take some time to work although it sounds like you've been using it for a while. Have you asked your vet if this is neuropathy? It's possible that what you're seeing is arthritis. If it is, a glucosamine/chondroiten supplement may help. Cosequin is available over the counter. There are other forms that some of the members here use, as well.
Click to expand...


the vet diagnosed it neuropathy, and she is on 3 methyl b12 pills a day.
 
Libby and Lucy said:
since you are not shooting low, here is my advice to try to give Josie the best chance at going OTJ and staying OTJ:

* feed small meals every few hours. If her pancreas is working, she will be able to use food as insulin. Giving frequent small meals can help by not overwhelming her pancreas with a large meal all at once, and a small amount of food might stimulate her pancreas to produce more insulin on its own.

* Test, feed a small meal, then test again in 3-4 hours to see if the number is lower or higher than the number before food. Today's 121 wasn't bad - it would be interesting to see if she went to green a few hours after eating (and if she did, then maybe feeding *another* small meal at that time might bring the number down even more).

* Set a no-shoot number for yourself. If she is higher than that number, give a very small dose of insulin (maybe 0.25u) to pull the range back down. Let's say you are comfortable shooting 180 right now. If she is 180 at preshot time, give a small dose. If she is lower, then you can skip. Gradually lower that number until she can stay flat in a low range without insulin. For example, if your no-shoot number now is 180, maybe in a few days try shooting at 150 to see if that helps flatten her out. Then after doing that for a while, maybe you'll find that you are comfortable shooting at 130 or 120 if needed.

The others are right, the goal is to get the numbers to stay under about 120 as much as possible to give her the best chance at staying off insulin long term. In the TR group, we get them there by shooting at lower numbers. In my opinion, shooting low is easier than trying to do the above and "baby" the pancreas into working, but feel free to try the above if it is more comfortable for you. Good luck!
Click to expand...


These things all require the ability to sit at home with her all day and up all night. neither of which i can do.
 
Ok. It's up to you. You asked for advice, and we gave suggestions for how to try to do this with insulin and without insulin. You can weigh the options and decide what works best for you and Josie. Good luck!
 
An update: She has been off insulin for over 2 weeeks and hasnt gone over 150 in 9 days.
She is happy and more active, playing more than she has in months.
I still feed her seperatly twice a day and give her b12, and test her once or twice a day, more when i can, but not having to rush home mid day to get a test in sure is making my life easier.
 
Just my 2 cents, I'm somewhat new, but had another cat that was diabetic for 7 years before she passed. I had her on hard food DM, she was 12 when she died, I know now, she would have lived a lot longer if I knew what I know now.

I am on this TR since my Daphne has been diagnosed in Nov. 2011. The first thing I did was change her food to the suggestions here, and picked canned EVO 95%. I read you don't like the smell, and let me just say, I am a vegetarian, and I wanted to vomit when I opened the can, and thought I couldn't do it…well, now, I hold my nose…,just look at Daphne's SS. IMHO, the food made a huge difference, so you may want to try it.
 
these are the best josies numbers have ever been, and she is on dry. she wasnt this good even on the vets food.
i am happy with her numbers.
i know people here think there is only one way to do things, and everyone told me she would be bouncing and rising by now, but she isnt.
no one knows best for other peoples cats in every situation.
 
i wouldnt like if josie got to be 50 all the time, that is very low for her, and i am away for 12 hours regularily. i would always be worried if she was that low.
 
just fyi, cuz a lot of people don't realize it, a cat can't become hypoglycemic if they are not getting insulin shots. whatever their own natural BG is even if it's under 50, that number is safe. i've tested 2 non-diabetic cats that were in the 40's. that's very healthy.
 
eccentricfuzzyme said:
An update: She has been off insulin for over 2 weeeks and hasnt gone over 150 in 9 days.
She is happy and more active, playing more than she has in months.
I still feed her seperatly twice a day and give her b12, and test her once or twice a day, more when i can, but not having to rush home mid day to get a test in sure is making my life easier.
Click to expand...

Considering that you are feeding dry food, and Josie's had no insulin in over 2 weeks, I would think you could say she is her own unique kind of OTJ.

I would continue the B12 because it's good for many other uses, not just neuropathy. My vet has me giving weekly B12 shots for my cat's pancreas inflammation issues and it's worked wonders. So keep up with the B12.

There's one thing that you can keep doing despite not giving any insulin, and that's to keep testing Josie at her am and pm shot times.. You will be able to keep an eye on her numbers and if they start to crawl up higher and higher over time, you may want to think of trying some insulin again.

But for now, after 2weeks of no insulin and an all dry food diet, I think you could say you have succeeded.

Well done to you and Josie!
 
Gayle Shadoe & Oliver said:
eccentricfuzzyme said:
An update: She has been off insulin for over 2 weeeks and hasnt gone over 150 in 9 days.
She is happy and more active, playing more than she has in months.
I still feed her seperatly twice a day and give her b12, and test her once or twice a day, more when i can, but not having to rush home mid day to get a test in sure is making my life easier.
Click to expand...

Considering that you are feeding dry food, and Josie's had no insulin in over 2 weeks, I would think you could say she is her own unique kind of OTJ.

I would continue the B12 because it's good for many other uses, not just neuropathy. My vet has me giving weekly B12 shots for my cat's pancreas inflammation issues and it's worked wonders. So keep up with the B12.

There's one thing that you can keep doing despite not giving any insulin, and that's to keep testing Josie at her am and pm shot times.. You will be able to keep an eye on her numbers and if they start to crawl up higher and higher over time, you may want to think of trying some insulin again.

But for now, after 2weeks of no insulin and an all dry food diet, I think you could say you have succeeded.

Well done to you and Josie!
Click to expand...


i will keep getting tests in for sure. but she seems to be going lower, not higher. hope it lasts.
my cat is on the sublingual methyl b12 pills that i mush up in her food. didnt know there was a shot. is the shot only available at vets, or is it like insuline where you can do it yourself>?
 
You're not going to want to hear this and I know your response will be, "Yes, but..."

Josie's numbers are not within a normal BG range. Normal is 50 - 120. You've seen numbers as high as 197 in the absence of insulin. The spreadsheets of the cats that have successfully gone OTJ are largely green. Libby provided good suggestions. It's your choice to listen or ignore the feedback you asked for. Perhaps the members on the Relaxed forum would provide different feedback or use different criteria for OTJ.
 
Sienne and Gabby said:
You're not going to want to hear this and I know your response will be, "Yes, but..."

Josie's numbers are not within a normal BG range. Normal is 50 - 120. You've seen numbers as high as 197 in the absence of insulin. The spreadsheets of the cats that have successfully gone OTJ are largely green. Libby provided good suggestions. It's your choice to listen or ignore the feedback you asked for. Perhaps the members on the Relaxed forum would provide different feedback or use different criteria for OTJ.
Click to expand...


she has been under 150 for like two weeks. and is getting lower, not higher over all since going off.
but yes, i think i will stick with the other forum from now on.
 
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