Kobe Update | Post DKA | Trace Ketones

[Kobe (Dean and Lesley) MO]

@Suzanne & Darcy
@Sienne and Gabby (GA)
@Bron and Sheba (GA)
@CORKY

Kobe's previous thread
Good evening! I am posting this update to tell you that we have been seeing some really great numbers over the past week or so: LOTS of dark blue and green. Bounces are getting much smaller - flatter. We are pretty excited. Appetite is good and improving. Activity level is increasing. He's talking again. No signs of nausea. Seems like Kobe is getting some muscle tone back. Poops and pees seem fine. Kobe still has trace ketones, though we had hoped that they would have resolved by now. They seem to be on a downward trend at the moment, but it would be super if they would just leave. We just wanted to check in and thank you for your help.

 

[Wendy&Neko]

That's a great report on Kobe's behaviour.

Your signature says you are following SLGS. The 1.75 units dose is sending him below 90, so you should be reducing down to 1.5 units as his new dose.

Getting blood ketones in the 0.5 or lower range is pretty normal numbers.

 

[Sienne and Gabby (GA)]

It dose look like Kobe is doing better!!

One question -- you noted that you test at 5:10 and feed Kobe at 5:30. Is that a carry over from your pre-Lantus days? If so, you don't need to delay shot time with Lantus. Lantus onset is at about 2 hours after a shot. This is different than most other insulin although it would have not been an issue with Prozinc either. Most of us who use Lantus test, feed, and shoot all within about 5 min.

 

[Kobe (Dean and Lesley) MO]

Oh, you are right. It still does say that. I think the vet asked me to put the shot and feeding time on there when we shared the sheet. It was definitely when Kobe was on PZI. Before he was on PZI, he had a few weeks on Vetsulin when we had to be sure that he would eat enough for his shot, because sometimes he wouldn't. The habit survived the change to PZI. We don't wait anymore. Now his appetite is good, and we just go one after the other: test, meal, shot. If I move fast enough, I can shoot while he's distracted with the end of his meal. I'll fix it.

Reduced dose to 1.5 today as suggested. Thank you!

 

[Kobe (Dean and Lesley) MO]

We reduced dose to 1.5, and I reduced again to 1.25 this morning.

Do I reduce AGAIN to 1 unit tonight or stay at 1.25? Thanks!

After being stuck for weeks, I don't think I was ready for changes to come so quickly!

 

[Wendy&Neko]

When following SLGS, you reduce immediately by 0.25 units if they go under 90. Good catch on that 59!

 

[Kobe (Dean and Lesley) MO]

I have looked and looked but can't find the information I think I found on the forum about how to administer a drop shot. I know that this is a question for the future, but I would like to be prepared. The way Kobe's dose keeps decreasing, I night need to know sooner than later! Can someone share this with me? Thanks in advance.

 

[Kobe (Dean and Lesley) MO]

Is there a post that has information on how to administer a drop shot? I could have sworn I saw it at some point, but now I can't find it.

I reduced Kobe's dose to 0.75 units today; the way his reductions are going, I might need to know in the next week or so. This was his 4th reduction in the last seven days. I would like to know ahead of time so that I can prepare.

Google was shockingly unhelpful when I tried searching. Thank you for your help!

 

[Bron and Sheba (GA)]

To get a drop dose, you push the plunger right in, then insert the needle into the insulin then let go of the plunger. That should draw up a drop dose. You need to test that a few times to see you are doing it correctly.
However you still have a way to go yet before a drop dose is needed.
You have 0.75, 0.5, 0.25, 0.1 and then a drop dose.

 

[Kobe (Dean and Lesley) MO]

Good afternoon! I reduced Kobe's dose to 0.5 units this morning. I just got a +9 BG reading of 59.

My plan is to reduce again and shoot 0.25 tonight. This will be his 6th reduction in 8 days.

Can we please have the information about OTJ trial in case we need it in the next week or so? Kobe's little pancreas is making an amazing come back and we want to be ready! I am so grateful for your support in helping us get this right for Kobe. .

-Lesley

 

[Kobe (Dean and Lesley) MO]

If these are the instructions, I found them! Will you let me know if we should do anything differently? Thank you!

"And here are the OTJ Trial Instructions for going off insulin (Off the Juice/OTJ). Foyi may or may not be ready for a full OTJ Trial, but for future reference.

OTJ trial instructions:

• Start the trial on the next green pre shot.

• If he/she is green at your normal test times, no need to test further until the next "PS" time; just feed small meals and go about your day. If he/she is blue at your normal "PS", feed a small meal and test again after about 3 or 4 hours. If his/her number is lower 3-4 hours after a meal, then the pancreas is working!

• Post every day so we can monitor your progress and see if any tweaks are needed. He/she may have a sporadic blue number. Don't panic but post before you decide whether to shoot so we can have a discussion.

• After 14 days of no insulin, we have a party!!

Sometimes the trial doesn't work the first time and we have to give a little more support in the form of resuming insulin. It's not the end of the world if that happens; we just give him/her the support needed. Our goal is a strong remission and it's better to take our time to get that than to rush into remission just to have it fail later on.

Once he/she is through the trial successfully, you enter a new phase. Your cat is still diabetic but has now become diet-controlled. Continue feeding low carb food in the manner successful for your kitty. If you decide to change his/her feeding schedule, let your meter be your guide to the best times to feed. Avoid medications with sugar in them and steroid medications unless they are medically essential. Continue testing blood glucose weekly for the first month and then monthly forever. It's a good idea to weigh him/her monthly. Weight should remain stable. If he/she seems "off" or sick, or is showing signs of diabetes (excessive drinking, eating, urinating, weight loss), testhis/her blood glucose right away. Keep the teeth and gums clean and healthy; dental issues can bring a cat out of remission. If you see rising blood glucose numbers,it's time for a visit to the vet!"

 

[Bron and Sheba (GA)]

Yes these are the OTJ instructions. But please do not try and start them without recommendations from an experienced member here.
Kobe is doing really really well but don’t blow it by trying to rush it. I know it is exciting for you but hasten slowly and please follow the advice of the experienced members on this. Our aim is to get Kobe a strong remission.

 

[Kobe (Dean and Lesley) MO]

I have been reducing Kobe's dose by 0.25 units when his BG has gone below 90. I didn't expect to have this many back to back reductions. Please let me know if I should be doing something differently. The advice from this forum has made all the difference in my cat's life; I intend to follow instructions.

I just appreciate having information ahead of time because it helps me process. How will we know if/when Kobe is ready for an OTJ trial? What should we be looking for? I will not rush, but I want to be as informed and prepared as possible. Please let me know how I can give Kobe the best chance of achieving strong remission.

I don't know what to do if he earns the next two reductions, 0.1 and the drop shot. What do I do if, by Tuesday, the drop shot sends him below 90? This has happened so fast. I am asking for guidance so I don't blow it.
Thank you!

-Lesley

 

[Bron and Sheba (GA)]

I think you can only take one day at a time. Keep following the SLGS dosing method. you won’t blow it if you follow the dosing method.
We are always here for you.