Kitty OTJ for 36 hours. BG between 100-200. What now?

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sanelson

sanelson

Member Since 2011
Hi, all. I've lurked in here a bit, but never posted. My 12? year old cat (named Kitty ;-) ) was diagnosed with FD about a month ago. Took her in for severe diarrhea and weight loss and her BG was around 650. The vet prescribed Humulin and a high fiber diet, which I did for a few days before doing some research and learning that that's not the proper way to treat FD, and asked the vet to prescribe Levemir instead. Got her on a low carb canned diet (Weruva), and experimented with raw for a little bit, but with everything else going on, that's just too much to deal with at the moment.

Anyway, on 1 unit of Humulin BID, which I did for about a week, her BG fluctuated wildly between 200 and 600. Started her on 1 unit of Levemir, increased briefly to 1.25 and then 1.5 and had to quickly drop her down to 0.5 and then 0.25 units BID. BG's have been under 200 for the most part for about the past 3 weeks. Over the weekend I noticed her BG drop down to 32 on .25, so I tried a smaller dose (I'm guessing about 0.1 units) and again dropped into the 30's. That was yesterday, and I haven't been giving her any insulin since yesterday morning. Last night and today, she's been in the 100's while OTJ, spiking briefly into the 200's after breakfast. While this is definitely good news, I'm not sure if I should leave her there, which is why I'm here. I know this is a little higher than she should be, but it is still under the renal threshold. If she's able to stay below 200 on her own, should I leave her there? I'm guessing it's probably not going to stay there forever and either get better or worse eventually. Or should I try put her back on 0.1 (or maybe try to to see what I can squeeze from the 0 line) and try to keep her under 100 for a week before taking her off?

I've created my own Google spreadsheet (not the template others are using) for tracking her progress here.

Thanks,
Scott
 
An injection of Levemir first fills the shed/depot. When insulin is needed, it is then pulled from the shed for the cat's needs, so the low numbers you got for the 0.1 dose were very likely affected by the shed and not a result of the 0.1 dose itself.

I would resume insulin with the 0.1 dose and see how he does.

Lana
 
Alright, thanks. I just gave her 0.1 again. We'll see how she does on that for a while. So, unfortunately, she's no longer OTJ. :YMSIGH: We'll get there soon, though, I'm sure.
 
I think she's doing well on .1U, the BGs are getting steadier, so lower was definitely the way to go.

Have you seen the microdose pictures?http://felinediabetes.com/FDMB/viewtopic.php?f=10&t=34424#p360982

You didn't say if you were having trouble drawing that small amount or not, but thought I'd offer it.

At this stage it can become necessary to set a preshot BG rule where you only give insulin if the preshot BG is above that level, say 125. So shots can become off schedule, not necessarily every 12 hours. You may not be there yet though, because even though she went low yesterday, she went up after her shot a fair amount. That is typical of Levemir's action though.

You've done excellent though without much support. Good job doing your homework!
 
Hi Vicky,

Thanks for the reply. I hadn't seen those pictures, but I've seen similar. It's still very hard to measure out those tiny amounts with any degree of accuracy. It looks like my 0.1 might have been closer to 0.15.

So, I put her back on the juice last night, with 0.1 (or maybe 0.15). She went from 182 down to 59 at +4 and was at 37 at +6. This morning 79 at +11.5 (before feeding) and 93 at +12. Trying her now at 0.05 (plunger at 0, and able to squeeze a tiny drop out of it) and see what happens.
 
It's amazing what even a half drop can do. And it's not unusual to need to dial doses down this low before the pancreas can really keep the BGs down on its own. You'll get there, but it may not happen overnight.
 
Hi, Scott. Kitty is following the same path that Beau did when he went OTJ (2 years ago yesterday).

Anyway, I set a do not shoot below number of 150, I think and tested. If he dropped below 50 at any time in the cycle, I lowered the dose.He went down to .1u pretty fast and then to .05u (yes, it can be drawn with consistency - might not actually be exactly .05, but if itis .04, or .06, but always consistent, doesn't matter). When that dropped him to the 30s, I skipped shots or shot as needed. I tried to not let him get above 200, or 180. Shot began to be +12, +24, etc. The last week looked something like: shot, skip, shot, skip, skip, shot, shot, skip, skip, skip, shot, skip, skip, shot, skip, skip......

The thing that probably really helped Kitty was the diet change and a short course if insulin, it can turn around diabetes is cats sometimes.

Practice drawing a .5u dose of your old insulin in a used syringe and twist the plunger until a drop forms on the tip of the needle. Practice getting 5 drops from a .5u draw - those are .1u. I would draw .5u and "bead off" 4 drops to get .1u doses (wasting insulin, I know). Next is to practice getting a drop HALF that size. that leaves .05u in the syringe. Push the plunger, a half sized drop should be on the end of the needle. Next is to shoot that into the cat, lol. I swear somethings I was sure I gave nothing, but those would be the days he dropped to 39 or something.

If you are into spreadsheets, look at Beau's for Sept '09. That shows what his BG was doing and how I was dosing.

You are going a great job with her!
 
Welcome Scott & Kitty,

You're doing an awesome job with Kitty - who is beautiful. I really like your ss. It doesn't look like you get much sleep tho. Great job getting so many tests in!
 
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