Attempt at no insulin...curve today...not as good as I had hoped

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Charlie M

Member Since 2016
Please keep in mind I am scared to death of doing the wrong thing for smokey right now, even if you don't agree with me trying no insulin, please try to be gentle about it...I'm really trying to do what I feel is best for him...not giving the insulin is as stressful as giving it for me right now!

So I know no one will think I should even be trying no insulin yet. I've watched him and watched him...every time he dips below 5 he seems so ill...I just can't keep pushing the insulin on him. My gut feeling is telling me not to, and that same gut feeling has saved him and our old girl in the past...I have to listen to it. I've rechecked how much I was giving him...that I was calling 0.25, and it was 1 1/2 drops (even less some days) ...this should be 0.15 units. Vet said due to his behaviour at lower than a 5 he may be hyper sensative to hypo, and may not be able to tolerate the lower ranges of normal. So we've decided to try him off insulin. Today was the first day I was able to do a curve on him to see exactly what's going on with no insulin. It was one of his higher days to start with.

I guess the most important thing to do right now is identify how his BG responds to the food with out insulin, and see what might cause BG spikes.

His BG seems to go up 1hour after finishing his food, but seems to come down again in an hour...Is this good?

I also saw that when he had a treat...this coincided with when he would have been high from food, he jumped up to a 7.9 with in a half hour (was very tired for 1/2 h to an hour here). We are using Lamb chops from the store, pan frying (no oil or anything) them and cutting them into treat sized pieces for his treats...is there anyway this could cause a big BG spike like that?

Thinking of possibly doing another curve on Monday...NO LAMB TREATS...see if it makes a difference, and keeps his numbers in a better range. He was also starting to get annoyed with the hourly testing today(just wanted to get a good picture of what was going on). So only 2 hour testing on the next one...maybe that messed with the numbers too.

Are there any other things I can do to get the BG down just slightly with out insulin.

I'll include a picture of info for the vet...it helps show meal times, to see how it fits together. Please ignore the Alpha readings...this was for the benefit of the vet if she prefers...they don't seem to match the human meter numbers, I've been using the human meter only for quite a while...and that's the pattern I've been using. It also has a 15% accuracy range...less fluctuations than the alpha. Human meter readings are shown on spreadsheet too.
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Actually, if you figure in the meter variances, those are all actually about the same number except that 142 (but that's not that far off either)

It's possible that pork might spike him a little higher than other protein sources....with cats, anything is possible

There's really not any good reason to test every hour unless they're running low....a complete curve is testing every 2 hours for 12 hours or every 3 hours for 18
 
I'm a pet meter user so I'm looking at those numbers too.:) The normal range for cats based on IDEXX lab values is 4.0 to 9.7 mmol or in US scale 72 to 175 mg/dL so according to your AT meter readings, Smokey is within normal range. I think you are doing the right thing by withholding insulin. If as the vet speculates, Smokey is "happier" in the higher normal numbers, he's looking good indeed. Congrats! Looks like he's gone 9 days without insulin. Another five days and you can declare Smokey in remission. Let the party preparations begin!
 
Sorry for rambling, talking this through really helps me understand, and figure things out.

Okay, I've had some time to back away. Feeling a bit better about things this morning. Smokey was at a 7.2 this morning (started to panic again), but now 2 hours later he's back to a 5.8 (even after eating)full of energy...bouncing around the house, happy as can be! Wow...he's really full of it today...just went sliding across the kitchen floor in a spin, haven't seen that for quite a while.

One thing I didn't think about is if we're changing his low target to a 5, then we have to raise the high end as well. So, ussually the high end is 6.6 for no insulin, but an 8.3 is considered tightly regulated for being on insulin. I'm thinking our goal maybe should be to keep him below the 6.6 the majority of the day, but not panic at spikes up to the 8.3, so long as he continues to bring them down on his own. I don't think it would be possible to maintain 5-6.6 on or off insulin! Does this seem reasonable to anyone else if you were thinking that his natural BG may need to be slightly high than most cats?

I have no plans of stopping testing any time soon...we are in a category that is not as likely to maintain its self, and I am very aware of this. Will continue testing twice a day, until I'm satisfied he's holding it on his own. Then maybe we'll move to once a day.

I don't ussually test every hour, unless I'm worried. But I started noticing how his numbers reacted to stuff right at the start yesterday. I don't get a lot of chances to be able to test him when I'm working...I have 9 days off right now(8 left) to try to figure out how I can help him right now. Right off the bat, I saw how much exercise brought his BG down, and figured if I could catch as much as I could as to what spikes and drops his BG I'd be able to help him get through the initial OTJ (yes, I just used the word I've been refusing to use! Still not sure this will be successful though). I did see quite a bit...now that I'm getting the alpha numbers out of my head, I'm seeing even more...it doesn't look quite as bad as it did yesterday having the alpha numbers with it!

For now...as much play time as he'll take, no more lamb...will have to try again to get some turkey breast to cook up for him. I need to do a thorough cleaning of the house, all the nooks and crannies, especaily the basement...I'm sure there's a stash of dry food or something spilled somewhere that he's getting at once in a while.

Most encouraging things I've seen lately...
He is under weight and needs to put some on. He had started to gain some weight, but lost most of it once we started hitting these lower numbers. Since stopping insulin completely he's putting some weight back on! He needs to be close to 7kg, was down to 6 at start, got up to 6.48, went back down to 6.2 with the low numbers, now he's up to 6.38 yesterday!

Energy, running, jumping, playing is all increasing a lot since stopping insulin.

He's started using his cat house/tree...he's never liked to be at hights, or awkward spots because his legs have never been very strong (even before diabetes). He's been going in the house on the mid level a lot lately(seems very proud of himself when he's in there with his head poked out). BUT, this morning he even was looking at the higher perches! I put him on the lowest perch, he was quite happy, then climbed up to the next one! He never wanted to be up there before...seemed like he didn't feel stable on his legs. I'm seeing so many signs of how strong his legs are getting this past week, and how much he's starting to trust them! This is awesome! Now he's trying to see how he can get up to the upper perches on his tree...he's just so full of it this morning!

I was very disappointed yesterday, but am feeling a lot better about this now!
 
I'm a pet meter user so I'm looking at those numbers too.:) The normal range for cats based on IDEXX lab values is 4.0 to 9.7 mmol or in US scale 72 to 175 mg/dL so according to your AT meter readings, Smokey is within normal range. I think you are doing the right thing by withholding insulin. If as the vet speculates, Smokey is "happier" in the higher normal numbers, he's looking good indeed. Congrats! Looks like he's gone 9 days without insulin. Another five days and you can declare Smokey in remission. Let the party preparations begin!


:woot::woot::woot::bighug::nailbiting::nailbiting::nailbiting::bighug::woot::woot::woot: I didn't know that!!! So, I might actually be doing the right thing here! I've been scared to post, because I thought I'd get bashed for following my gut, instead of the numbers!

THANK YOU so much! The alpha numbers were really starting to stress me out again...one reason I stopped using it was because I had no idea what was good or bad with it compared to the numbers used here. I was only doing the alpha for the vet, incase she prefers the alpha readings...but seems like I just backed myself up with it!

Now I'm really confident we might have accidentally hit.....:otj:
 
It never ceases to amaze me how many vets folks to use pet meters but don't provide a whole lot if any reference numbers with which to make decisions! If you have copies of Smokey's bloodwork when he was diagnosed, it should tell you the normal lab values for glucose and the pet meter is calibrated to mimic lab values.

Since Smokey has been off insulin for 9 days and a cat off insulin will not go hypo, you can stick with 2 tests a day until 14 days are complete. At that point, if he is still staying in normal range, you can check him once weekly for a month and then every two weeks to monthly from then on just so if there is any backslide you will catch it early. :D

Fingers crossed! :joyful:
 
Yep, says 9.7-4.0...didn't think of that!
Our vet told us no lower than 5 to keep a safety barrier (based on us already having chosen the alpha). She didn't seem to mind if we used the pet meter or a human meter. We took the pet meter due to work, and no time to do research on meters to know what we actually needed. They didn't push home testing, but they did mention a few times that we could do it at home, once we decided to they were so excited to help us learn how to do it. I think the vet expected us to call in a panic the first time he hit a 5. She was shocked and excited when we walked in with the spread sheet, and finding him on almost no insulin! I think our vet try's to bring you into how it all works more slowly, a lot of people end up putting them down just from the thought of the insulin shots. So if they give you less info, and get you into the routine more slowly, people won't get as overwhelmed and less of them will end up being put down. I do know that they have actually taken in several diabetics as permenantly clinic cats, just to stop them from being put down.

Having said that about our vet, I have seen a lot of people on here that don't have good vets. Weve had bad vets in the past...worst one was $2000 bill for a diagnosis of "she's old, let her die". New vet, $200...thyroid...lived 5 more years!
 
Our vet told us no lower than 5 to keep a safety barrier (based on us already having chosen the alpha).


If you are not currently giving any insulin you do not have to worry if Smokey goes below 5.0 mmol/L (90 US). Since right now Smokey is only using his own body's insulin he will not go hypo.
 
If you are not currently giving any insulin you do not have to worry if Smokey goes below 5.0 mmol/L (90 US). Since right now Smokey is only using his own body's insulin he will not go hypo.
Sorry that was meant as a reply to vets not giving any guide lines with pet meters when you first start all of this. Not worried at all about hypo...if he goes hypo without insulin...we've got some really big problems!
I'm only testing to check how high his numbers are going right now. Not normal to be doing no insulin at the higher numbers...so need to keep a good eye. Vet wanted a curve to check how high he's going. And keep checking to make sure he doesn't start creeping up suddenly. It is a bit early for most cats to go off insulin. But he seems very ill when he hits below 5 (that 5 is from his behaviour, not because the vet told us no lower than 5 when we started, numbers just happen to coincide) so any insulin right now keeps dropping him into those low ranges! Seems happy and healthy at these slightly higher numbers.
 
Every living organism has their own equilibrium so for Smokey to feel badly if he goes below 5mmol. is not surprising. Some humans feel hypo before they get down to what is considered a hypo warning number too. Sometimes their behaviour is the best indicator of all!
 
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