Attempting OTJ in the blues?

[Lizzee]

Hi there,

so I've tried searching for any possible answers in the search bar but couldn't come up with anything. I was wondering if it would be possible to attempt an OTJ trial in the blues. Due to external circumstances, I've went two days so far without administering Shurshishkas dose in the morning and both times she seems..... Fine. Her BG is remaining, for the most part, stable. She has tested negative for keytones on both days.

Would it be a good idea to attempt an OTJ trial while she's mostly in the blue? Would it be better to stabilize her in the green before attempting? Is it an OTJ strategy to slowly wean off, like administering only at night? Or should I still keep administering insulin?

Edit: I know she should have earned a dose reduction when her BG dropped to 4.5 a couple of days ago, but due to external circumstances I haven't been the best insulin cat mom lately

 

[Judy and Freckles]

I've not heard of OTJ when kitty is still in blues. Often times with numbers in blue, the cat is still spilling glucose into their urine.

Lantus is a depot insulin - which means there is a sort of reservoir of insulin. It takes a few cycles to build up the reservoir and a few days to deplete the reservoir. You are still in the process of depleting the depot at this point. With Furbaby having DKA in the past, you may be playing Russian Roulette by not giving insulin every 12 hours.

Just my 2 cents... interested in what others have to say.

 

[Lizzee]

Lantus is a depot insulin - which means there is a sort of reservoir of insulin. It takes a few cycles to build up the reservoir and a few days to deplete the reservoir. You are still in the process of depleting the depot at this point. With Furbaby having DKA in the past, you may be playing Russian Roulette by not giving insulin every 12 hours.

I didn't know that, I just found it to be incredibly odd. In that case I will go back to keeping her stabilized with her regular doses of insulin. No reason to risk it... I was just hopeful that she mightve been going into remission, but alas!

 

[Judy and Freckles]

https://www.felinediabetes.com/FDMB/threads/what-is-the-insulin-depot.150/

Here is some more information on Lantus being a depot insulin. You did the right thing by asking. I certainly don't have all the answers, but I do know where I can find most of them... FDMB! lol

 

[Judy and Freckles]

I noticed you are using the Alphatrak. I started with the Alphatrak as well but found the strips to be terribly expensive. Many, including myself, have switched over to a human meter. Now the strips are far less expensive, so I could test more often without breaking the bank. As well, most of the information on the forum is geared to using human meters.

I was just hopeful that she mightve been going into remission, but alas!

She may be on the road to remission, but what I've noticed is if the caregivers go into remission too hastily, the remission doesn't last and then it's even harder to get kitty into remission again. As all of us know all to well.... cats will do things on their own clock!!

 

[tiffmaxee]

I want to echo what the others have said. We want you to have a string remission and if you try an OTJ trial before ready we have found it to fail. You are so close. I suggest you start posting on the LLB forum daily.

https://www.felinediabetes.com/FDMB/forums/lantus-basaglar-glargine-and-levemir-detemir.9/

 

[Lizzee]

I noticed you are using the Alphatrak. I started with the Alphatrak as well but found the strips to be terribly expensive. Many, including myself, have switched over to a human meter. Now the strips are far less expensive, so I could test more often without breaking the bank. As well, most of the information on the forum is geared to using human meters.

Hi Judy,

I'm actually using Freestyle strips in the Alphatrak. The Alphatrak strips are about 3$ canadian per strip but the Freestyle ones are about 1$. Sadly, living in Canada it seems that all strips are going to be expensive after I did some research into a couple of them. I did test and compare the two strips quite a bit and found the numbers to be quite similar (usually a difference of .1-.3, but can be sometimes as high as .7)

I have given her the regular dose this morning (though havent quite updated my spreadsheet). So far I'm comfortable with her being in the blues as I do more research into how to give her smaller doses and work on getting over this hurdle of being scared of sending her into a hypo episode, especially with this new information about Lantus being a depot insulin.

Thanks for all the advice!

 

[Judy and Freckles]

Sadly, living in Canada it seems that all strips are going to be expensive after I did some research into a couple of them.

I'm in Canada as well and I have found that I can get Freestyle Lite strips off of Ebay for around $35 US per 100. Just need to watch the expiration date and shipping/import charges (and don't bid against me lol)

I do more research into how to give her smaller doses

Using a caliper (I bought one from Canadian Tire) and it allows me to be precise. I'm not much of a morning person, so although we aren't at tiny insulin doses, the caliper gives me that little bit extra of insurance when I'm half asleep and drawing up insulin into the syringe. Somewhere on this site it talks about drawing up 1 unit and then squirting out the insulin drop by drop. That way, you can tell how many drops are in 1 unit, 1/2 unit etc. You end up wasting the insulin, but it is such a little bit, that it doesn't really matter... especially if it means you are getting closer to remission! So when you only have to inject 1 drop, you know how many drops you have to squirt out, so there is only 1 drop left in the needle tip.

sending her into a hypo episode

Yes, that can be a bit stressful and worrisome. Have your hypo kit ready and hope you never have to use it but be prepared just in case.