2/26 Quincy AMPS 100 - OTJ trial qs

[Laura and Quincy]

What exactly does an OTJ trial consist of? I know that it means no insulin, and testing AM and PM at what would have been the standard shot times (5:30am/pm for me) for 14 days. Is there anything else to it, like spot checks? Also, what constitutes success - every reading <100?

I am starting to think about Quincy's trial, depending on how he does with the "one drop" dose he started Wed night.

Yesterday

 

[Ronnie & Luna]

Hey LAura!
wow - no kiddin'!

Hopefully Jill will be by soon to give u some info on that!
dont ya just love that one drop? Good luck!

 

[Jill & Alex (GA)]

hi laura! a little birdie suggested i stop by here today.

quincy's numbers look great! as you've mentioned, an otj trial consists of testing at what would have been amps and pmps times. if quincy gives you a blue number, feed and retest 3 - 4 hours later to see if he brought himself down on his own. feeding small mini-meals instead of two large meals helps to not overwhelm the pancreas.

we like to see kitties in green throughout the otj trial, but it usually doesn't happen that way... and it's fine. numbers often bobble up and down a bit before they settle down. you don't want to abort a trial based on any one number. what we look for is trends. if you see an upwards trend, we may want to step back and re-evaluate. here's what the tight regulation protocol says:

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.


if it's convenient for you, a little snack fed at around PM +9 will probably bring some of those amps numbers down.
this is exciting! :mrgreen:

 

[Laura and Quincy]

hi laura! a little birdie suggested i stop by here today.

quincy's numbers look great! as you've mentioned, an otj trial consists of testing at what would have been amps and pmps times. if quincy gives you a blue number, feed and retest 3 - 4 hours later to see if he brought himself down on his own. feeding small mini-meals instead of two large meals helps to not overwhelm the pancreas.

we like to see kitties in green throughout the otj trial, but it usually doesn't happen that way... and it's fine. numbers often bobble up and down a bit before they settle down. you don't want to abort a trial based on any one number. what we look for is trends. if you see an upwards trend, we may want to step back and re-evaluate. here's what the tight regulation protocol says:

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.


if it's convenient for you, a little snack fed at around PM +9 will probably bring some of those amps numbers down.
this is exciting! :mrgreen:

Thanks for dropping by Jill. I wanted to let you know that Quincy's been on mini-meals for a few months now. While I shifted him to that in response to an uptick in vomiting (Quincy's a lymphoma/IBD kitty, with vomiting as the main clinical sign), I think it really helped on the diabetes front too. Currently, when I go to bed, I set a timer to open at +8. That means he gets a snack at 1:30am, and his shot is at 5:30am. Do you think there's much of a difference with a +8 snack versus a +9 one in terms of a possible influence on the AMPS value?

I didn't want to set the timer to open much later just in case he didn't run to it immediately upon opening (i.e., I didn't want to run the risk that a snack would be available at +9 but not discovered/eaten until +11). I'd be game for changing the timer to open at +9 instead of +8, but lately, though, Quincy has woken me up around 12-12:30 (his +7) with his desperate, persistent attempts to break into the timer feeder. He can be very loud in that pursuit! Do you think 2 night time snacks would be a good idea? Not sure if anyone ever does that? I probably would just split 1 snack in half so that it's roughly the same amount of food. I can play with the timer feeder some, perhaps. Most of the time, he does go to it promptly.

Also, you quoted part of the tight regulation protocol. It stated that normal range is 50-80. Are those numbers for a human glucometer or a feline one? Quincy's usually under 100 on my Accu-chek Aviva, but much less often under 80, at least now.

Thanks again! I hope a trial is in Quincy's near future. Funny, my parents are coming out in 3 weeks, and I was thinking I either wanted to do the whole trial before they got here, or to wait until after they left. I didn't want any changes in Quincy's environment other than no insulin to influence his OTJ trial.

 

[Ronnie & Luna]

hey Laura

during our trial I was doing the +6 late nite/and noon snack and a +9 mini meal with Luna, worked out fine.
I always tell others, its trial and error (ECID too) and experimenting while at the same time, tracking the numbers and snack/meals in ur ss.

 

[Jill & Alex (GA)]

Thanks for dropping by Jill. I wanted to let you know that Quincy's been on mini-meals for a few months now. While I shifted him to that in response to an uptick in vomiting (Quincy's a lymphoma/IBD kitty, with vomiting as the main clinical sign), I think it really helped on the diabetes front too. Currently, when I go to bed, I set a timer to open at +8. That means he gets a snack at 1:30am, and his shot is at 5:30am. Do you think there's much of a difference with a +8 snack versus a +9 one in terms of a possible influence on the AMPS value?

i would think not, but there's really no way to know for sure without trying it.

I didn't want to set the timer to open much later just in case he didn't run to it immediately upon opening (i.e., I didn't want to run the risk that a snack would be available at +9 but not discovered/eaten until +11). I'd be game for changing the timer to open at +9 instead of +8, but lately, though, Quincy has woken me up around 12-12:30 (his +7) with his desperate, persistent attempts to break into the timer feeder. He can be very loud in that pursuit! Do you think 2 night time snacks would be a good idea? Not sure if anyone ever does that? I probably would just split 1 snack in half so that it's roughly the same amount of food. I can play with the timer feeder some, perhaps. Most of the time, he does go to it promptly.

you could try 2 snacks. honestly, his blue numbers aren't bad. if changing anything would stress him, i don't think i'd bother.

Also, you quoted part of the tight regulation protocol. It stated that normal range is 50-80. Are those numbers for a human glucometer or a feline one? Quincy's usually under 100 on my Accu-chek Aviva, but much less often under 80, at least now.

human glucometer.

Thanks again! I hope a trial is in Quincy's near future. Funny, my parents are coming out in 3 weeks, and I was thinking I either wanted to do the whole trial before they got here, or to wait until after they left. I didn't want any changes in Quincy's environment other than no insulin to influence his OTJ trial.

lol! you think like i do! with any luck, quincy will be otj before they get there! :mrgreen:

 

[Laura and Quincy]

I'll probably check in next Wed or Thurs to see if people think Quincy's numbers merit an OTJ trial or if he needs time. I would want to start next NLT Fri, or wait until after my parents depart on Tues Mar 23. There isn't any downside to keeping Quincy on a drop of insulin per dose longer than he needs to, is there? That is, beside a hypo risk? I'd like to think at this dose, we're safe in that regard, but he really surprised me with his low numbers at a 0.10 dose!

Tonight's PMPS: 79.

 

[Jill & Alex (GA)]

I'll probably check in next Wed or Thurs to see if people think Quincy's numbers merit an OTJ trial or if he needs time. I would want to start next NLT Fri, or wait until after my parents depart on Tues Mar 23. There isn't any downside to keeping Quincy on a drop of insulin per dose longer than he needs to, is there? That is, beside a hypo risk? I'd like to think at this dose, we're safe in that regard, but he really surprised me with his low numbers at a 0.10 dose!

Tonight's PMPS: 79.

jojo says she's never seen a clinical hypo on 0.1u of insulin.
i think it was nathalie's pelusa who did drop into the 30s on 0.1 unit. no symptoms what-so-ever.

is there a reason why you don't want to start a trial after 7 days on a drop of insulin if he's looking as good as he is now?
what does NLT mean?

 

[Laura and Quincy]

I'll probably check in next Wed or Thurs to see if people think Quincy's numbers merit an OTJ trial or if he needs time. I would want to start next NLT Fri, or wait until after my parents depart on Tues Mar 23. There isn't any downside to keeping Quincy on a drop of insulin per dose longer than he needs to, is there? That is, beside a hypo risk? I'd like to think at this dose, we're safe in that regard, but he really surprised me with his low numbers at a 0.10 dose!

Tonight's PMPS: 79.

jojo says she's never seen a clinical hypo on 0.1u of insulin.
i think it was nathalie's pelusa who did drop into the 30s on 0.1 unit. no symptoms what-so-ever.

is there a reason why you don't want to start a trial after 7 days on a drop of insulin if he's looking as good as he is now?
what does NLT mean?

Oops! I used an acronym not in the giant list for this group?!? ;-) NLT = no later then

I guess I thought Quincy's AMPS #s needed to come down a little and/or be more consistently green before starting an OTJ trial, esp since I'm already doing the mini meals and a wee hour snack in advance of his AMPS test. I know he's been looking pretty good for the rest of the day (anti-jinx!) If bobbling between numbers in the low 100s and under 100 for his AMPS is ok, I'm game to try. I guess we'll know a lot more in a week. Next Wed will mark one week on his one drop dose.

As far as 0.1 unit goes, on 2/15 Quincy dipped to 36 on his evening +3. I thought maybe I didn't measure the dose right, and regarded it as a fluke, but then again this week, on 2/23, he dipped to 35 on his evening +3. That's what finally convinced me it was time to move down the dosing scale from 0.1. He didn't have any clinical symptoms either time, and it was pretty easy to bring him back up to safer greens, but I was surprised he saw that much action on so low a dose. I think he really mellows out at night!

 

[Jill & Alex (GA)]

if quincy continues as well as he's doing now... i don't see any reason not to start a trial after 7 days on a drop of insulin. that'll give him close to 3 weeks on 0.1u or less of insulin (more time than we ask for). those blue numbers he's getting now... they're still "normal" numbers... and the numbers drop into green.

NLT... thanks! i'll add it to my vocabulary. :mrgreen:

 

[Laura and Quincy]

Thank you. I'm glad I asked about this today! I think Quincy will be getting a B-12 shot for the first time next week (recently dx-ed with a slight deficiency, am waiting for my B-12 bottle to arrive). Hopefully that'll help him with this too!