Debating an OTJ trial, would you try it?

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Lizzysdad

Lizzysdad

Member Since 2012
Hello,

I know this area has a tight protocal for Lantus. I test as much as I can, but my work schedule right now has me out of the house 12 hours a day. That said, would you mind looking at Lizzy's chart and give my your opinion on if I should put her on an OTJ trial or wait a few days. I am going out-of-town for 3 days during the Christmas holiday and cannot take her along (long story as to why). A couple of people stated recently that they thought she may be ready about 8-10 days ago, but she likes to give me a high number every now and then.

Thank you!

Andy
 
IMHO, she is not ready for a trial. We like to be seeing normal numbers for at least a week; almost all of her preshots are way above normal. I think if you could shoot consistently and not skip so many shots, she might get there but she isn't ready now.

Sorry... :smile:
 
Hi, Andy!

To my eyes, I don't think Lizzy is ready. There are still too many pre-shot values that are outside of the normal (50 - 120) BG range. It might help if you took a look at a couple of the spreadsheets of cats who recently completed OTJ trials to see what their numbers looked like prior to initiating a trial.
You'll see a lot more green on their SS's than on Lizzy's.
 
Thank you for replying!

I did look at the spreadsheets. Interesting and were very helpful. I have read in other posts not to shoot insulin on lower numbers and noticed these sheets show the shots were given. With my crazy work schedule I am not consistantly home at the same time every evening. (I am a teacher and then coach basketball after school. Practice times change weekly & then there are game nights to deal with, too.) With Lantus needing a consistant 12 hour window between shots, any idea how long before the 12 hours are up or after the 12 hours are up that I can still give insulin and not mess things up for Lizzy? This is the reason why I have not given many of the PM shots recently.

Andy
 
Usually if you shoot within 20-30 minutes of your shot time, it won't make any difference. But let's say you shoot at 4:30 in the a.m. If you shoot later than, say 5pm at the evening shot, it will have the same effect as reducing the dose. Likewise, shooting early acts like a dose increase. So you want to try and shoot as close as possible to every 12 hours .
 
Question, do you have a timed feeder, or the ability to try splitting her meals up over the next few days?

When I look at Lizzy's spreasheet, I see that when you have tested right after a skipped shot, it looks like she is capable of bringing her numbers down on her own with food (possibly indicating a functioning pancreas that is producing some insulin), but she just can't sustain that for very long. Like last night, she came down from 140 to 78 in three hours without insulin, but then was high again by morning. We call that a "sputtering pancreas" because it looks like the pancreas is kicking on and off again, or getting tired and taking a break.

Breaking the usual larger meals up into multiple small meals can sometimes help level things out. Even just feeding a small snack at +8 or +9 can often help, if that stimulates the pancreas to produce just enough insulin to keep the number from rising until +12. It's worth a try and might give her that next little nudge toward OTJ.
 
Libby,

Thanks for your time and reply. I will try the snack at +8-9 when I can and study the numbers. I think I will have more time to better monitor that for a few days after the 25th. She was at 96 when I tested before going to bed. There was no shot tonight because I messed up and let a distraction get in the way.

Thanks again!

Andy
 
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