6/11 Benjamin AMPS 143 OTJ Trial ?

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cindyh

cindyh

Member Since 2012
Good Morning!

I haven't been posting or updating Benjamin's SS, but he has been very stable and I do test him daily at PS and once in between. We've been doing a little dance between .25U and .1U with his numbers being great. PS numbers have been in the 90-110 range and the mid cycle number that I get between +6 and +8 is usually 60-80. A few times over the last couple of months, I have skipped one shot and by the next shot time his BG would be 140 or higher, so I'd go back to shooting.

Then on 6/7, his AMBG was 80, so I skipped the shot and started on OTJ trial. Here's a recap:

6/7 AMBG 80
+6 62
PMBG 71
6/8 AMBG 102
+6 79
PMBG 80
+3 84
6/9 AMBG 127
+3 114
PMBG 96
6/10 AMPS 143 shot .1U
+5 68
PMBG 59 no shot
+4 71
6/11 AMPS 143 shot .1u

So my question, I tried to find the OTJ trial guidelines and was unable to find them. Not sure to proceed if his numbers don't stay low, and not sure if I should have given him more time without shooting. Thank you!
 
cindyh said:
Then on 6/7, his AMBG was 80, so I skipped the shot and started on OTJ trial. Here's a recap:

6/7 AMBG 80
+6 62
PMBG 71
6/8 AMBG 102
+6 79
PMBG 80
+3 84
6/9 AMBG 127
+3 114
PMBG 96
6/10 AMPS 143 shot .1U
+5 68
PMBG 59 no shot
+4 71
6/11 AMPS 143 shot .1u

So my question, I tried to find the OTJ trial guidelines and was unable to find them. Not sure to proceed if his numbers don't stay low, and not sure if I should have given him more time without shooting. Thank you!
Click to expand...
Hi! I'm Kat and Gobbles is my 11 year old non-sugar boy. His OTJ Trial was started on 5/12/13, and after 14 days of NO insulin, he was considered "OTJ" and there was a party for him :-D

Since you shot on 6/10 and 6/11, a trial failed. Once you haven't given any insulin for 14 consecutive days, then we consider kitty OTJ. I suppose you can start a trial anytime, but once you have had to shoot, the trial is over...

It would be extremely helpful to update your SS: start from whatever day you've been keeping track of (6/7?). In fact, you have to definitely update your SS and keep it updated. It is impossible to start an OTJ trial without an daily-updated SS. Not knowing his past few months history (BG readings and amount, time insulin was given), doesn't give us a full picture of how he has been reacting to the insulin.

I'm sure an Advisor will jump in on this post, and give you a definitive answer. I have some experience, but not enough to give you the "rules" on starting an OTJ trial.

If you would like, please take a look at Gobbles' SS to get a better idea of an OTJ Trial.

I sure hope he does go OTJ--that would be awesome!!!

Have a great day! Kat
 
Hi Kat,

Thanks for your reply, but honestly I don't think Benjamin cares whether his SS is updated when he decided to do this! :-D My goal was to just keep him regulated and happy, but apparently Benjamin is thinking differently. He is a very easy cat to maintain, he doesn't have huge highs and lows, but now it appears he may be trying to go OTJ, so I'm just trying to figure out how to work with him.

For now, I will be trying to shoot just a drop to see if that works so I can shoot twice daily and he doesn't go too low.
 
OTJ trial

Test at normal AM and PM test times
AMBG is the notation for morning test without insulin
PMBG is the notation for evening test without insulin

Numbers in normal range of 40-120 on a human glucometer for 14 days and Benjamin would be considered to be officially OTJ.

Keep us posted if you like. We like to cheer on kitties and their beans that are on OTJ trials.

I have seen a note around somewhere that we like someone to go from 0.25U to 0.1U before trying the OTJ trial. It's thought this helps to support the pancreas to heal a bit more and gives a stronger and longer lasting remission.

;-) Benjamin may have other ideas.
 
From the Tight Regulation Protocol Sticky:
Reducing the dose:

If kitty drops below 40 (long term diabetic) or 50 (newly diagnosed diabetic) reduce the dose by 0.25 unit. If kitty has a history of not holding reductions well or if reductions are close together... sneak the dose down by shaving the dose rather than reducing by a full quarter unit. Alternatively, at each newly reduced dose... try to make sure kitty maintains numbers in the normal range for seven days before reducing the dose further.

If an attempted reduction fails, go right back up to the last good dose.

Try to go from 0.25u to 0.1u before stopping insulin completely.
Click to expand...
The bold is mine. Some people will try shooting a drop before stopping insulin. Good luck with that new dose for Benjamin.
 
Thanks so much for all the help! We did go to .1U before he went off for 3 days. We seem to be in a place of being close to going OTJ, but just not quite there yet. We will continue to move forward, and I'm happy to go with Benjamin where ever he decides he wants to be! :-D Maybe he knows his 1 year anniversary of dx and coming to live with me is coming up very soon, and he's trying to plan a big celebration!
 
I have seen a "fat" 0.0u, where the bean pushes the plunger in, sticks the needle in the vial/pen, lets go of the plunger, pulls out the needle. Then gives that dose to the cat. There is a tiny drop and some kitties need that for a while.

I would be interested to see what Sienne says about an OTJ trial for Benjamin. It does seem like he is very close but not quite there. Paws crossed!
Liz
 
Hi Cindy,
been a while....

I have a tho't.

Have you ever taken your syringes (filled to the 1 unit marking or 0.5 unit marking) and counted drops to see how many are in your particular
syringe?
You hold the syringe needle pointed up after filling and gently twist the plunger until a drop forms and rolls down the needle....
that's one drop
and then you keep doing it until it is empty.

Those of us who dose with calipers do this so that we can make sure when we get down to a one drop dose.... that we are giving some insulin.

I found when I did this... that I had to adjust at the very end.....
nothing came out of my syringe at all when I thought I was giving one drop so I backtracked just a tad until I could see at least 1 drop coming
out.
It took a little practice time.

I think you are very close but Benj needs just a little more support to get there and have a stronger remission.
 
Thanks so much for the thoughts on dosing a drop. I will definitely try them out, and get calipers if I need to. It's very exciting seeing Benjamin this close! But most importantly, he feels good. He also started on Tumil K for his CKD a few months ago, and I think that has helped him feel better as well.
 
Hi, Cindy. It's great to hear that Benjamin is doing so well.

I'm going to pass along the "official" (as it were) OTJ instructions since I know you don't post on a regular basis. I tend to encourage people to keep their kitty on insulin for as long as possible in order to give the pancreas as much support as you can. The other folks have passed along some good suggestions on how to micro-dose.

Here are the instructions:
list][*]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).

[*]If your cat 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 is blue, feed a small meal and test again after about 3 hours. If his number is lower 3-4 hours after a meal, then his pancreas is working!

[*]After 2 weeks, if everything is looking good, we have a party![/list]

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 the support he needs. 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.
Click to expand...
 
Thanks, Sienne, that's perfect. Just what I wanted, just couldn't find it. Benjamin and I will continue on and hopefully be back to post good news if he does indeed get OTJ!
 
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