Looking good. Hang in there. I continue to be impressed at the long duration he is getting from Humulin. He's free feeding, right?
Here is some info. Nothing new really. Just confirms that what you are doing is the way to go. I love that they call it a game of chicken......
Insulin therapy for cats with "sputtering" pancreases
When a diabetic cat's pancreas begins again to produce insulin, that insulin production is seldom predictable or sufficient to immediately put the cat's blood glucose levels in a non-diabetic range. That is, a cat's recovering pancreas usually does not have a "full on" or "full off" switch. Achieving remission may take several weeks or months of careful monitoring and administration of insulin that is reduced in both timing and amount.
If a cat's pancreas is "sputtering," making the decision to administer exogenous insulin at all can be complicated. Some have referred to it as a game of "chicken." It is not unusual for a diabetic cat nearing remission to have a blood glucose level in the high 100s and for that level to fall, without exogenous insulin, to the low 100s or lower within a couple ofhours. Adding exogenous insulin to the mix when that is happening could lead to hypoglycemic levels. In fact, unexpected falls of blood glucose levels to or near hypoglycemic levels on insulin dosages formerly known to be "safe" are a strong indicator of either more efficient use of insulin (healing glucose toxicity), or a sputtering, recovering pancreas.
In the first stage, insulin dosage may be gradually reduced to keep glucose levels in a safe range. This works until the cat begins producing enough endogenous insulin to be able to skip shots, even at the lowest possible doses. Then the next stage of attempted remission begins.
With a cat attempting remission, some caretakers choose a blood glucose level (be it 120 or 150 or 180) at or above which to administer exogenous insulin. The decision of whether to administer insulin in those situations should be affected by knowledge of when the cat last ate and whether the elevated level could be the result of food. Another consideration is the type of insulin being used, that is, whether it is a long-acting or fast-acting insulin. In these situations, even thorough knowledge of the cat's past reaction to various dosages of insulin may not provide sufficient information to make an appropriate dosing decision. You should carefully monitor a cat in this situation after an insulin injection to make sure it does not become hypoglycemic.
