Oreo OTJ 14.5 days!!!!

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Mel and Oreo

Mel and Oreo

Member Since 2013
Hi Everyone!

Remember Oreo just had a good fructosamine at 285. But now numbers are low!!
Sounds odd because different than most on this forum,but our vet has us test after food. Oreo is on caninsulin. We started at .5 units twice daily and moved up to 2 units twice daily over time. Then a hypo so reduced to 1.5 twice daily. Then a good fructosamine, but now here are our tests: (vet says no insulin if BG <14 30 minutes after food)

Wednesday
Food 5:30pm
BG 4.4 (79.2) 30 min after food
BG 4.9 (88.2) 35 min after food
BG 5.7 (102.6) 2 hours after food

Today
Food 5am
BG 6.3 (113.4) 30 min after food
BG 5.5 (99) 40 min after food

Food 5:05pm
BG 11.7 (210.6) 30 min after food
BG 9.6 (172.8) 65 min after food

So I have given no insulin three times now, any advice? I will start testing before food and 6 hours after food.
He does seem to be rising, but going down over time. I will stay up to 11pm to test again.
Thanks,
Mel and Oreo
 
Re: Possible OTJ ??? Need advice

Hello there :cool:

Interesting. Was the hypo you mentioned symptomatic?

I can't see any history on Oreo and I'm not familiar with Caninsulin, however your vet may be checking to see if Oreos pancreas may be sputtering (producing insulin on their own in reaction to the meal).

It's been a while for us however I believe when a kitty that was freshly OTJ threw an above normal (>120) number, the recommendation was to feed a small meal and test in 3 hours to see if kitty brought him or herself down.

Mel and Oreo said:
Wednesday
Food 5:30pm
BG 4.4 (79.2) 30 min after food
BG 4.9 (88.2) 35 min after food
BG 5.7 (102.6) 2 hours after food

Today
Food 5am
BG 6.3 (113.4) 30 min after food
BG 5.5 (99) 40 min after food

Food 5:05pm
BG 11.7 (210.6) 30 min after food
BG 9.6 (172.8) 65 min after food
Click to expand...

In each case above the missing piece to the puzzle is the BG just before food :cool:
if you collect that data as well, it may paint a more meaningful picture

You would have a starting point (pre food BG) a mid point (BG test after 30 mins - 1 hour for a possible food spike )
The final BG test 3 hours later may help determine if Oreos pancreas has started working again and if so if it is enough, or would support with insulin for a while longer would be in order.
 
Re: Possible OTJ ??? Need advice

Thanks Sandy,
I tested 4:15 am this morning before food and he was 7.4 (133.2). I retested in 1/2 hour after food and he was 9.2 (165.6). I gave no insulin and will retest in 3 hours how you suggested.


Thanks,
Mel
 
Re: Possible OTJ ??? Need advice

We'd like to see him under 130 mg/dL most of the time, and having food triggering the pancreas to reduce the glucose.

For low doses, it is possible to use U-100 syringes with a U-40 insulin. With U-100 syringes marked in half units, each tick mark becomes 0.2 units. The math is 0.4 * the U-100 syringe mark and we've got a conversion table or you can use that formula in a spreadsheet and make your own.
 
Re: Possible OTJ ??? Need advice

He is a little higher than we'd consider for OTJ. We generally say 40-120 with no insulin (some people say 130 for the high end). And if he is going up after food instead of down (down suggests the pancreas is helping out) that is not as encouraging.

Do you have any numbers/doses to share? It's possible that you could give a drop above 120 or so, but I'd want to see how he did with Canninsulin first. Did he drop fast after the shot or did he get a longer flatter cycle? What dose was he on when you stopped giving the insulin?
 
Re: Possible OTJ ??? Need advice

With the caninsulin 2 units bid he went hypo.
I did a curve with the 1.5 bid, but the nadir was 8 hours after the shot at 5.4 (97.2), but before insulin on the next dose he was at 7.9.(142)
He had a horrible craving for food and started waking me up for food. We think he was going hypo on the 1.5 and eating the food to compensate.
So we went for the fructosamine which was 285, but when we tested him on Feb 6 he was 3.1 (55.8) 6 hours after food. On Feb 12 he was 4.4 (79) 30 min after food so we stopped the insulin.
We have not given four doses.
This morning's info:
BGBF 7.4 (133)
30 min AF 9.2 (165)
+6 6.9 (124)
(This is with no insulin)
My vet hasn't gotten back to us yet, I found out she works tonight and I emailed her. I know what you mean when I look at other OTJ cats they are lower. It is like he is just above. Maybe she will tell us that we should give a half unit or less bid. When he was first diagnosed she said she would like to see him average a 10 (180).
Now all of his numbers (except one at 11.7 (210) 30 min after eating food (and he ate a lot that time))has been under 10 (180) without insulin.
Now what, we leave in a couple weeks on our holiday. I have the pet sitter coming twice daily to give him insulin, she may not be able to test so we thought about reducing the dose for that time to be on the safe side. Now this. I hope he stays low. I am going to have to convince her to test. Very stressed.
When he first went on caninsulin 1.5 bid he dropped from 25 (450) down to 14 (252) in 1.5 hours. Then on the 2 units he dropped from a 23 (414) to a 12 (216) in 4 hours and the nadir wasn't for 8 hours after at 5.4 (97) but the BGBF was 7.9 (142)
He was on caninsulin 1.5 twice daily when we stopped.
 
Re: Possible OTJ ??? Need advice

I wonder if you might try a small dose at a time when you can monitor and see if he goes down in lower but safe ranges. Canninsulin works a little bit like ProZinc when the Canninsulin lasts longer and doesn't have harsher onsets in a specific cat. What ProZinc users do when they see these kinds of numbers is to "chase" the number. So they pick a number they will shoot (like 170-180) and when the cat reaches that number, they give a small amount. (Sometimes it's a drop - literally a drop - or they use the conversion chart and U100 needles and shoot .1)

I don't know if that would work with Canninsulin. Oreo doesn't seem to be reacting to it with harsh drops and short cycles like some cats. If that weren't the case, I would be nervous about trying it. But my concern is that if he sits in higher numbers for a week or two, he may need to be back on insulin full time and sometimes the second remission is harder than the first.

I guess the reason the fructosamine came back okay is when they average the higher numbers and the lower ones, they get a number that can be considered remission. We generally see OTJ cats in that 60-80 range all the time.
 
Re: Possible OTJ ??? Need advice

The 285 fructosamine test was when he was on the caninsulin still as 1.5 units bid. The vet said average and that it shows he is still diabetic, but controlled. That is why we are so confused that he is testing so low now. The vet didn't tell us he was in remission from the glucosamine test. We just started getting these lower numbers in the last two days after the test.
I spoke yesterday at work with another diabetic cat owner, her cat is on lantus and she says she keeps him at an average of 11 (198) with insulin and she tests.
I am off work Monday and Tuesday thank goodness.
 
Re: Possible OTJ ??? Need advice

Keep on monitoring.
If you can't get a call from the vet, try dropping off the spreadsheet showing the values he is getting. Those might get his attention.
 
Re: Possible OTJ ??? Need advice

Thanks BJM,

No call or email from the vet yet. No idea why? I called twice and emailed. They put the email in her file.
I know she is busy, but hope she calls soon.
Mel :(
 
Re: Possible OTJ ??? Need advice

Vet got back to us and said keep checking before food and 30 to 40 min after food and if no readings in the 20's (360) without insulin for one week he is in remission.

That seems very high. I am going by the OTJ trial test I saw on another posting. Test am and pm if 5.5 (99) or less you are good, if 5.5 (99) - 11 (198) test in 3-4 hours to see if it is back down. Feed small meals. Continue diabetic food.

Vet told us to continue diabetic food, I didn't have the guts to tell her we stopped right before the good numbers and that he is on Evo and FF. She recommended RC diabetic dry and wet, but high carbs.

Last night Oreo was 6.5 (117) and the same 8 hours later (had to go to work). This am he was around the same (meter downstairs) and when my husband gets home at 6 am we will test because 3 hours after.

Now I don't follow him with his food trying to get him to eat it all because of the caninsulin. It said small meals would be easier on the pancreas.

I just want to say a HUGE Thank you to all the dedicated and caring folks on this site. I have learned so much and everyone is so knowledgeable and caring. I read other posts and my heart goes out to all the cat owners and their babies. Thank goodness for all the kind people on this forum. Even if this doesn't work out or he goes back on insulin I feel way more confident because of all the folks on this forum. cat_pet_icon I love my Oreo and we both thank you.

I believe we are 4 days OTJ so far. I am scheduling another fructosamine for 2 weeks after start of this if all keeps going well. I will keep my fingers crossed.
 
Re: Possible OTJ ??? Need advice

We consider remission when the cat is between 40 and 130, without insulin, for 14 days. You should see food triggering a slight increase which the pancreas then handles.
 
Re: Possible OTJ ??? Need advice

Thank you BJM that is what I will go with. I will schedule a fructosamine test as well.
 
Re: Possible OTJ ??? Need advice

Vet got back to us and said keep checking before food and 30 to 40 min after food and if no readings in the 20's (360) without insulin for one week he is in remission.
Click to expand...
Your vet is ok with BG readings in the 360 mg /dL (20 mmoL) range!!! :o :shock: :o You're kidding me, right? That's way above renal threshold and will do long term organ damage and it's certainly not good for your Oreo.

Here's hoping Oreo continues to do well on his OTJ trial.

Maybe it's time to update your vet or find a new one.

Here are the OTJ Trial instructions for you since you said you did not have them.

Here are the instructions for an OTJ trial:
  • Test at your normal AMPS and PMPS times. Feed multiple small meals throughout the day as much as possible (small meals are less likely to overwhelm a newly functioning pancreas). The morning test is now called the AMBG. The evening test is now called the PMBG.
  • If your cat is green (0-99 mg/L human meter, 0-130 mg/L pet meter, 0-5.5 mmoL) 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 the numbers are blue (100-199 human meter, 130-230 pet meter, 5.5-11 mmoL), feed a small meal and test again after about 3 hours. Food raises BG's. So if the number is lower 3-4 hours after a meal, then the pancreas is working!
  • After 2 weeks, if everything is looking good, we have a party! And boy, do we party hearty. :cool:

Sometimes, the trial doesn't work the first time and we have to give a little more support by starting the cat with a tiny dose of insulin again. I had to do that with Wink. We simply start the cat back on a tiny dose of insulin to support the pancreas with healing for a bit longer. Our goal is a strong remission and it's better to be safe now then sorry later that you rushed it. With just a little more time we will probably get that strong remission we are looking for.

Keeping all our fingers and 3 sets of paws crossed here for Oreo.
 
Re: Possible OTJ ??? Need advice

Thanks everyone for all of the support. We love the Pom Pom Kitties!

Yes Deb that is what the vet has in her email. I thought it didn't make sense. I just checked it again and says if not in the 20's (360) for one week a remission. I knew about the 14 renal threshold. That's why Oreo and I are so thankful for all the help.

He is running at 6.3 (113) to 6.5 (117) before food and around 3 hours after is staying the same. So 4.5 days now.

I took oreo's blood glucose today and I poked and my husband had the meter and I said what is it? And he said 16 (288) let alone 20 (360) and I felt sick. He said just kidding 6.3 (113). He almost got poked! I don't joke about blood sugar! cat(2)_steam

We stopped the B12 this morning. Oreo has no limp at all anymore. We stopped because to get him to take it we had to put it in a soft cat treat that was higher carb. We were desperate to get him to eat it then. Hopefully no more limp issues, but we will try to stick it on his food and see if he eats it by accident.
 
Re: Possible OTJ ??? Need advice

Stopping the B-12 should be just fine, since Oreo isn't limping anymore.

My sugardude Wink had horrible diabetic neuropathy when I first took him in a year ago. I mean, going from hardly being able to walk, to jumping everywhere and chasing my other kitties. The difference is like night and day. After getting him regulated, some methyl-B12 for a short period of time and then getting him OTJ, he no longer needed the methyl-B-12.

I can tell when he's a little tired, because he goes from walking on his tippy toes to more down on the entire paw. At least, it's not totally down on his hocks like he used to be.

Oreo will likely be the same, back to tippy toes.

16(288 mg/dl)!!!!! I think my eyes went really wide when I read that and thankfully I read furthur to learn your DH was pulling your leg. Not a good joke after all the hard work you have put in to get Oreo feeling better. Poking your DH to get a BG reading sounds only fair to me. ;-)
 
Re: Possible OTJ ??? Need advice

Thanks Deb and Wink for the advice on the B12. It has been 6 days now.
His most recent numbers are lowering even more.
Feb 15 AMBG 5.1(92)
Feb 16 AMBG 6.5 (117)
After food BG a few hours 6.3 (113)
Feb 17 AMBG 4.6 (83)
Feb 18 AMBG 4.0 (72)
I am giving him small meals throughout the day, but with work it is a little tough.
Does DH mean dumb husband ;-) it should mean that or bratty husband!

We need to test his PMBG more! but he is more awake and he does not want to get tested now. He was pretty easy to test before almost like he knew he needed it to feel better. Now he is not as cooperative so I try to get him when he is asleep. He doesn't know what hit him. He sleeps in now.

His personality has totally changed back to how he was. He used to cry to go outside and drive us crazy before and when he became diabetic he just sat by the door but didn't cry to go out.

Now he meows and drives us nutty at night. We live in the suburbs, but on the edge of our city. One morning I looked out the back of our home (there is a small lake) and saw a coyote walking beside it, he came up on the side walk and turned left and walked down the sidewalk across the cross walk all the way down to this urban forest area we have down the street. At least he is law abiding and doesn't jay walk. So we are worried he could get eaten if he goes out in the dark.
 
Re: Possible OTJ ??? Need advice

DH can mean whatever fits, from Dear Husband to Dumb Husband to Darn Husband to Damn Husband. Whatever fits for the given situation. :mrgreen:

Glad he is coming down. Did you figure the automatic feeder wouldn't work?
 
Re: Possible OTJ ??? Need advice

That was a good one :mrgreen: ! I wish you and Oliver (I am sorry I wish Oliver was still with you) and Deb and Wink and everyone else lived down the street from us.
I am going over to petsmart today and see if they have a feeder like that. I put out a new post for tips in keeping out wet food for nine hours. Does your feeder have an ice pack or is it ok to keep it out that long?

I see Wink only recently went OTJ! Yahoo. How often should we test after 2 weeks. Every week?
 
Re: Possible OTJ ??? Need advice

Mel and Oreo said:
I am going over to petsmart today and see if they have a feeder like that. I put out a new post for tips in keeping out wet food for nine hours. Does your feeder have an ice pack or is it ok to keep it out that long?
Click to expand...

Depending on the weather you experience, you can add water to it and just leave it out. I live in Southern California so it rarely gets crazy-hot here and never tops 100 degrees so I leave it out all day for them, sometimes up to 12 hours if I'm stuck at work.
 
Re: Possible OTJ ??? Need advice

His personality has totally changed back to how he was. He used to cry to go outside and drive us crazy before and when he became diabetic he just sat by the door but didn't cry to go out.
Click to expand...
That is always so encouraging to read, when our kitties are acting like they used to.

I see Wink only recently went OTJ! Yahoo. How often should we test after 2 weeks. Every week?
Click to expand...
Wink has actually been OTJ for almost a year now. His 1 year anniversary is coming up in about 3 weeks. I still test him at least once a week, just to make sure his BG's are still in a good range. I want to catch any fall out of remission as soon as possible and get him back on the juice ASAP if needed. He may never need that, but I'm playing it safe. He'll occasionally test over 100, so I make sure to do a food test, 3-4 hours later to make sure he's still producing insulin on his own and the pancreas has kicked in to bring those higher BG numbers down.

Some people only check every couple of weeks to once a month. It's all about what your comfort level is.

I'm no help on suggestions for leaving out the food. My 3 gobble the food down in minutes, never leaving any for later.
 
Oreo has now been off the juice for 14.5 days. He continues to be hovering below 77.

A huge Thanks to everyone for all of the support and educational material!!

There is no way Oreo would have done this well without all of the caring, intelligent cat lovers on this site.
We are thrilled that our baby is doing so well. Oreo is very special. I had someone very close to me pass away and after that Oreo slept with me every night and spent every waking moment with me. I would do anything for him.

I have taught our cat sitter how to test Oreo's blood glucose. She has been giving insulin to her cat clients for many years, but she has never been asked to test. She was enthusiastic and very interested. It seems to be a trend where I live that home testing is not taught by vets. I know how important it is now and if I hadn't tested I could have killed Oreo with his next insulin dose when he started to go into remission.

Thank you so much I will continue to test and if he goes back I will be ready!

Thank you,
Mel and Oreo
 
Congratulations!!!

Here are some tips to stay OTJ (off the juice, insulin being the juice).

1. Never feed dry - not even treats. If you change wet food types, be 100% sure the new food is also low carb and same low carb % as your current food. Some cats are very carb sensitive and an increase from 3-6% to 8-10% can spike the BG’s. Don’t feed if you aren’t sure!
2. Weigh every 2 weeks to 1 month to watch for weight changes. Too much of a weight gain can cause loss of remission.
3. Measure blood once a week, indefinitely. You want to catch a relapse quickly. Some people only do checks every 2 weeks to a month.
4. No steroids or oral meds with sugar - remind your vet whenever giving you any medication. Always double check.
5. Monitor food intake, peeing and drinking. If increasing, a sign of losing remission.
6. Regular vet checks for infection such as dental , ear or UTI. And get them treated quick!

If your cat does fall out of remission you need to be more aggressive and resolve issues/ back on insulin as soon as possible as the window for a second remission is tight if any.

Wendy
 
party_cat party_cat party_cat What wonderful news.

Be sure to give yourself credit, Mel. You did the research, resisted the high carb diet, realized the 300s were not remission numbers and did the hard work it took. We are thrilled with your and Oreo's success!
 
Congrats to Oreo! I used to have a great big Tuxedo kitty named Oreo back in the 1980's! He was HUGE (over 25 pounds) but not fat anywhere. Hoping your OTJ trial is forever. My baby had a set back but we are working on it!
 
Yeah Oreo! Congratulations on making it to the falls.
 

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congrats oreo! party_cat drinking09 drinking24 nice name. thot of naming my dog that. her name is cookie. :)
 
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