Giuseppe- About going OTJ

[Eliza&Giuseppe]

So it was brought to my attention that Giuseppe's numbers are really low and that I might need to try an OTJ trail. I have no clue about what to do when going OTJ, how often you test, do you just stop giving insulin… Any advice would be much appreciated

Thank you guys in advance

 

[tiffmaxee]

His numbers do look fantastic. Congrats on a job well done. He still has been getting .5 units of insulin. I don't give dosing advice but I do know that OTJ trials start after a cat is successful staying in low numbers with .1 units. I see numbers in your ss under 50 that would qualify for reductions and am a little concerned that he could go hypo on the current dose. One of the dosing experts will surely advise you.

 

[Wendy&Neko]

Hello Eliza, I see you are at .5U dose now. Normally the path to trying an OTJ trial is to go to .25U then .1U. There are pictures of the small doses in the New to the Group Sticky. From the protocol:

Reducing the dose:

If kitty drops below 40 (long term diabetic) or 50 (newly diagnosed diabetic) reduce the dose by 0.25 unit. If kitty has a history of not holding reductions well or if reductions are close together... sneak the dose down by shaving the dose rather than reducing by a full quarter unit. See additional notes in the next paragraph about drops into the 20s and 30s. Alternatively, at each newly reduced dose... try to make sure kitty maintains numbers in the normal range for seven days before reducing the dose further.
...
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.

So, after 7 days of normal numbers, you can reduce the dose, unless you get a number under 50. I think you should try a .25U dose now. I agree with Elise that there are some tests on the current dose that look like Guiseppe wants a reduction. The night of 8/21 his PMPS was 53 and morning of 8/22 AMPS was 50. With those sorts of PS numbers, I would have tested more often. For Guiseppe's safety, you want to make sure he's not going too low and that's why we encourage at least one additional test each cycle, and even more if they are low.

If after reducing to .25U, and getting at least 4 tests a day (2 preshot and at least one in each cycle), Guiseppe is still in normal numbers then you can reduce to .1U. Or if he goes below 50 you can also reduce. Do the same on the .1U dose, then once he's gone 7 days of normal numbers in that, you go to an OTJ trial, which is 14 days without insulin, testing at each PS to make sure they are staying in normal numbers. At the end of the 14 days of the trial, they are officially considered in remission.

 

[Eliza&Giuseppe]

Thank you for all the info. I gave him .25 tonight so we shall see how it goes. He takes very well to reductions so hopefully soon he will earn another reduction

 

[Wendy&Neko]

Good luck - paws crossed for more normal numbers.

 

[Sienne and Gabby (GA)]

His numbers do look great. In addition to the information that Wendy posted about how/when to reduce Giuseppe's dose, I'd encourage you to keep getting some spot checks. It's possible that he's dropping below 50 in the middle of the cycle.

 

[Dyana]

Good luck with the new dose.