Micro-dosing insulin in a cat who may be going into remission...

[jwbsings Snowball]

Hi Everyone,
I've been communicating a lot with @Suzanne & Darcy, but didn't hear from her yesterday and haven't seen her post anything. I hope all is ok.
Snowball had been taking 1.5 and then 2 Units of ProZinc from November 18 until Dec. 26th when we stopped insulin due to his very low BG numbers. I use a pet meter to test him. Yesterday, my Vet told me that he believes Snowball is in remission and doesn't need insulin anymore. He further said I should test him once a week to keep an eye on his BG. He took a blood test and I will have the results of that this afternoon. I feel that this is a bit too soon and I'm afraid the remission might not last. At one point, Suzanne told me that there is a possibility of doing very low doses of insulin before completely stopping. I'm interested in trying that but would like more information. Does anyone have any suggestions or experience with micro doses of insulin to support the pancreas before stopping insulin completely?

 

[Bron and Sheba (GA)]

Hi Janet
I’m sure Suzanne will be around again soon to help you with dosing.
I’ve just looked at the SS and I disagree with your vet. Snowball is doing very well but he’s not ready for remission yet.
We recommend going down in doses until you are only giving a drop and your kitty is able to stay in normal BGs at each dose moving down through the tiny doses. We have had much success doing it this way. If you stop while he is still getting numbers in the high 100s and the 200s he will not stay in remission and there is always the risk of ketones if he is not getting insulin when he still needs it.
Not testing the BGs is just putting ones head in the sand and hoping for the best.
The test the vet would be doing is the fructosamine test which will tell if Snowball is in pretty good numbers and we can see from the SS that he is. A fructosamine test is really a waste of money at this point and is the old fashioned way of seeing how a diabetic cat is progressing. A fructosamine test is great to diagnose a diabetic cat but it is redundant since hometesting came in to see how the cat is progressing. I will try and contact Suzanne for you. In the meantime please don’t stop insulin if the Preshot is high enough to give the dose.

 

[jwbsings Snowball]

Hi Janet
I’m sure Suzanne will be around again soon to help you with dosing.
I’ve just looked at the SS and I disagree with your vet. Snowball is doing very well but he’s not ready for remission yet.
We recommend going down in doses until you are only giving a drop and your kitty is able to stay in normal BGs at each dose moving down through the tiny doses. We have had much success doing it this way. If you stop while he is still getting numbers in the high 100s and the 200s he will not stay in remission and there is always the risk of ketones if he is not getting insulin when he still needs it.
Not testing the BGs is just putting ones head in the sand and hoping for the best.
The test the vet would be doing is the fructosamine test which will tell if Snowball is in pretty good numbers and we can see from the SS that he is. A fructosamine test is really a waste of money at this point and is the old fashioned way of seeing how a diabetic cat is progressing. A fructosamine test is great to diagnose a diabetic cat but it is redundant since hometesting came in to see how the cat is progressing. I will try and contact Suzanne for you. In the meantime please don’t stop insulin if the Preshot is high enough to give the dose.

Thanks so much, @Bron & Sheba for getting back to me! I agree with you and Suzanne. We stopped the insulin when his numbers sank. He was at 1.5 units and then 1.0 unit. Where would I start him with the lower dose and what does his BG need tobe for me to start again? I tested him today + after he ate (I have to find a way to separate his food from my other cat's food - she's a grazer and he gets into her food before I get an AM BG testing in.) I will make sure to get a PM BG test that is accurate. By that time, I can put the food for both cats away.
Thanks as well for explaining the fructosamine test - that's what he was testing along with Snowball's kidney numbers. I will get those results this afternoon and will let you know what the results are.

 

[Sienne and Gabby (GA)]

I agree with Bron. If you were to review spreadsheets of cats that are closer to remission, you would see a lot more numbers that are in normal range -- the spreadsheet would have lots more dark green numbers. We also don't advise abruptly stopping insulin. Rather, we encourage tapering down the dose gradually so the pancreas has as much support as possible for as long as possible to encourage healing. @Suzanne & Darcy may be able to direct you to a Prozinc kitty's spreadsheet that has reached remission so you have a good idea of what a spreadsheet looks like and how the dose is tapered.

While this is a post from the Lantus forum, at the bottom of the linked post are photos of a U100 syringe with fine dosing. It will give you an idea of how we micro dose.

Have you given any thought to getting a microchip feeder for your non-diabetic cat? The feeder opens in response to your cat's microchip and it would prevent Snowball from poaching your other cat's food.

 

[CORKY]

I agree with Bron. If you were to review spreadsheets of cats that are closer to remission, you would see a lot more numbers that are in normal range -- the spreadsheet would have lots more dark green numbers. We also don't advise abruptly stopping insulin. Rather, we encourage tapering down the dose gradually so the pancreas has as much support as possible for as long as possible to encourage healing. @Suzanne & Darcy may be able to direct you to a Prozinc kitty's spreadsheet that has reached remission so you have a good idea of what a spreadsheet looks like and how the dose is tapered.

While this is a post from the Lantus forum, at the bottom of the linked post are photos of a U100 syringe with fine dosing. It will give you an idea of how we micro dose.

Have you given any thought to getting a microchip feeder for your non-diabetic cat? The feeder opens in response to your cat's microchip and it would prevent Snowball from poaching your other cat's food.

You can review Corky's spreadsheet, He is on ProZinc as well, you can see his daily BG's with mostly dark greens , yet he is still on insulin

 

[jwbsings Snowball]

I agree with Bron. If you were to review spreadsheets of cats that are closer to remission, you would see a lot more numbers that are in normal range -- the spreadsheet would have lots more dark green numbers. We also don't advise abruptly stopping insulin. Rather, we encourage tapering down the dose gradually so the pancreas has as much support as possible for as long as possible to encourage healing. @Suzanne & Darcy may be able to direct you to a Prozinc kitty's spreadsheet that has reached remission so you have a good idea of what a spreadsheet looks like and how the dose is tapered.

While this is a post from the Lantus forum, at the bottom of the linked post are photos of a U100 syringe with fine dosing. It will give you an idea of how we micro dose.

Have you given any thought to getting a microchip feeder for your non-diabetic cat? The feeder opens in response to your cat's microchip and it would prevent Snowball from poaching your other cat's food.

Thanks for this information! Very helpful!

 

[jwbsings Snowball]

You can review Corky's spreadsheet, He is on ProZinc as well, you can see his daily BG's with mostly dark greens , yet he is still on insulin

Is Corky considered " in remission"? Will he ever come off of the insulin and why does he still need it after doing so well for so long?

 

[CORKY]

Is Corky considered " in remission"? Will he ever come off of the insulin and why does he still need it after doing so well for so long?

After all this time, I have gotten used to even lower numbers, I asked for advise about increasing a couple of weeks ago, I began to notice some high blue BG’s and still to my eyes his BG is still high, he’s number we’re in the high 69-80’s were he should be to continue healing his pancreas, not until the pancreas start releasing its own insulin and start seeing lime green colors to decrease his dose continuously, I believe that’s were perhaps he’ll began remission, I have read some posts where their diabetic cats are on insulin for life, I would love to see him on remission, but he is a very very healthy inside big cat no ailments ever, but diabetes, and that makes me happy

 

[Bron and Sheba (GA)]

Is Corky considered " in remission"

Corky is what we call regulated. You need to achieve that before a cat can go into remission. Corky is maintaining the green. BGs on 1.5 units of insulin. The trick now is to gradually reduce the dose over time…if Corky will let us, and still maintain the green BGs. Only when he is getting a drop of insulin for 2 weeks and has been able to stay in green BGs do we do a trial with no insulin.

 

[CORKY]

Corky is what we call regulated. You need to achieve that before a cat can go into remission. Corky is maintaining the green. BGs on 1.5 units of insulin. The trick now is to gradually reduce the dose over time…if Corky will let us, and still maintain the green BGs. Only when he is getting a drop of insulin for 2 weeks and has been able to stay in green BGs do we do a trial with no insulin.

Wow thank you saying that ,, I had sends you a pm in reference to exactly the same thing since I cannot reach Suzanne , I tried to explain to Snowball how I thought the process would be, thank you for the information

 

[Suzanne & Darcy]

Hello there. I am so sorry for not posting today. Things went crazy and I am just getting a chance to check in this evening. I will also be around tomorrow. I have been thinking about you and Snowball. I didn’t mean to leave you hanging. I was hoping you would get a few more tests on Snowball today. I will look at his spreadsheet now.
I feel like Snowball is a little higher than he would be because of his food - and then there’s also the pet meter, but we can try to work around all that.