Could this really be over in less than two months?

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sofapup

sofapup

Member Since 2015
My Levon has been with me for about a year now. He was diagnosed in Sept. (BG400). Now his vet says to quit the insulin. Perhaps his body has been "shocked" into remission. He'll stay on his new food, b.f.f. canned.

Is this really possible? He was at 48 today on 1 unit insulin twice a day, and 46 last week on 2 units twice a day. We see the vet again in two weeks, and I'll watch his behavior, etc. til then. Do kitties just go into remission after a short treatment?
 
Yes, it's entirely possible, but we don't recommend going from 1 unit to nothing overnight here. What we want is a strong remission and to get that requires the pancreas to have the best chance to totally heal before removing insulin

We usually want them to go down slowly in .25 unit increments..so from 1U down to .75...then down to .5...then down to .25...and then down to .1

At that point, if they're still in normal numbers, we'll try taking them completely off the insulin and hopefully they'll never need it again!
 
Chris, when you say "we" is that a consensus of the community here, or general best practice, or a single vet practice, or..? Being new here, I'm not quite sure what kind of community this is. (insert emoji here that indicates that my tone is in no way challenging. just curious so I know what we're talking about. Can't find the proper emoji to convey said message.)

I've had a good deal of trouble just injecting one unit. The syringe is so tiny, I can't feel if the plunger actually moved when I pushed it. So many times I wasn't sure he actually got it. Using 2 units was much easier for me. I could feel the plunger move, could see the amount in the syringe better. I can't imagine going to such tiny, tiny increments. I was told that since the injection is subcutaneous, it doesn't matter if air gets into the syringe, so adding air to the syringe can make it easier to feel the plunger go in. Is that how you do it?

As I said, I just learned about this, and then it seemed to disappear. Very confusing!

Thanks for your replies.
 
Julia I understand your difficulty totally try giving .05 units.... It is more of a sense of feeling/intuition and monitoring your cats behavior/sugars to know if he got his load. I am a very firm believer in taking it as slow as possible with removing insulin as Magellan has had 2 attempts at otj and has failed both of them. So the choice between DB and myself is to go as slow as Magellan will permit and perhaps drag our feet a bit. I hope this has answered your question and not just added more questions wishing you and your fur-baby the best.
 
I can't speak to how to taper, or adding air (although that doesn't seem like a good idea to me since I have always tried hard to get all air bubbles OUT by flicking the syringe and then expelling the air).

But after pulling slightly more insulin into the needle that I need, to get the syringe exactly down to the unit marking that I want, I first get close to the mark by pushing the plunger. But I stop a little bit short and then turn the plunger to screw it down to exactly what I want. It goes really slow that way and you can literally see one drop at a time coming out of the needle. Maybe that fine adjustment will help?
 
Good idea up to the micro levels that I am currently on and I think Julia is on. I agree about the air bubbles those can cause no amount of harm to the fur children.
 
By "we", I mean the members of this message board who are basing their recommendations on a mix of empirical research (from watching lots and lots of cats get into remission and stay there), published protocols in veterinary journals and seeing cats that were taken off too soon that lose remission.

None of us are vets, but a lot of the information we repeat here has been either published somewhere or has shown to be effective over years and years of real life experience with the kitties that come through here

As for measuring those smaller doses, it's important to either have syringes with half unit markings, or to learn how to use calipers to measure dose. They can be frustrating, that's for sure, but they're definitely possible! We have a cat here, Furball, who's been on Lantus more than 2 years and just started an OTJ trial yesterday (Off The Juice) who had tapered down to .1 before trying to go OTJ. We're all cheering along too!

From the Tight Regulation Sticky:
  • Since 2006 we've encouraged those practicing Tight Regulation to attempt reducing the dose from 0.25u to 0.1u before stopping insulin completely. During a two week OTJ trial, you want to see mostly green numbers (under 100) with only a few random blue numbers between 100 - 120 to help ensure a strong remission.

At the bottom of the "New to the group" sticky there are pictures of what these smaller doses look like.
 
I concur that the teeny dosing is challenging but doable. I used a magnifying glass on a stand. Napa needed 2 months under 1 unit to get to remission (fingers crossed, OTJ in 4 days).

The pictures and explanation toward the end of this post are really helpful (if you are on Lantus):
http://www.felinediabetes.com/FDMB/threads/how-to-give-lantus-75-unit.71575/#post-776906

Another thing that really helped me was to practice drawing up water and "injecting" it on the counter to see the size of the drops...yes they are tiny but it was clear to me that I could drop up a tenny drop by drawing to the bottom of the "0" (zer0) line. Then I drew up to the top of "0" (zero) line the drop was a little bigger. Then midway between the top of zero line and the 1/2 unit line, bottom of 1/2 line, top of 1/2 line, etc.
 
Big Day Today! It's been 2 weeks since we stopped the insulin. We go back to the vet today to check glucose and fructosamine. Levon's been drinking normally, peeing normally for 2 weeks. Wish us luck.
 
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I hope the fructosamine test turns out great. Just for reference, the general range accepted on this forum for a cat in remission is, OFF INSULIN, between 40-120 with the majority of the time in double digits, for 2 weeks.

If it turns out he does need some tiny doses, there are U100 needles that measure in 0.5 doses. These are the easiest for mini dosing. If he is on U40 insulin, we have a conversion chart you can use.
 
But yes it can be all over just that quickly with a diet switch...Now granted I have not read through the entire thread but my Maxwell just celebrated 6 years OTJ and I gave him exactly 2 shots once he was transported from Boston to me in Nebraska after I adopted him as a diabetic. I never walked him down the dosing scale because I never got a chance. Now my other OTJ fellow it took 8 months for him to finally go OTJ.

Mel and The Fur Gang
 
Good news for Levon! After two weeks off the insulin, his glucose was at 75, and the fructosamine level was 172. He even gained a little weight back. So we'll stay on the diet, and watch his water, litter box, etc. He's back to being the perfect, sweet kitty I first found.

One thing worries me. My vet knows me and my pets, knows I work in a shelter, and therefore my attitude toward saving animals. When she first diagnosed Levon, she sat down and started the speech about my options, how it was up to me, but she had to interrupt herself to add "but I think I know what choice you'll make." Suppose I had made the other choice, thought that I couldn't make my schedule work, couldn't bring myself to give injections, couldn't afford care, etc. etc. How many kitties have been lost because their owner made that hard choice too soon?
 
It is more than possible , both of my cats went into remission very fast,one in 12 days the other in 6 days.
 
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