Oscar - old timer update; Need opinions

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Kelly & Oscar

Kelly & Oscar

Member Since 2010
I am not sure if many of you here remember us. Oscar has been on insulin for almost 3 years now. Life got in the way, and my doctoral work got accelerated, so I had to pull away from posting on this board a lot.

To make a long story really short - we found out through trial and error that Oscar had a food allergy to chicken (or at least something in the FF chicken classic). We put him on EVO 95% duck and he has been doing great - holding his dose reductions for the most part. Through the last year he has continually lost weight, no matter how much I feed him and how good his numbers look. We moved to NC from IN and scheduled an appointment with a new vet. They were running a special on dentals so we took advantage of that. Come to find out, he had at least 50% bone loss around his lower canine and first molar, so those 2 teeth had to be removed. After the dental and removal of those teeth, he has gained almost a pound!

The new vet is convinced that the 0.25u that Oscar gets BID is not a therapeutic dose. In an effort to prove him wrong, I took him off insulin 4 days ago and Oscar didn't get out of the mid 200's. He also apparently lost 6oz of weight during that time too. I gave him his first dose starting back last night - 0.25u from a new pen (didn't want to open up a new pen only to find out he really didn't need insulin) and this morning I wake up to a 46. This just doesn't make sense to me. He has no shed left - how the heck can he be at a 46? I gave him only 0.1u this morning (barely daylight past the zero line) and 2 hours later he is only at 68. Obviously we will be monitoring today.

The big question is - how is 0.25u too much but yet he doesn't do well with no insulin on board? What am I to do?
 
Hi Kelly - yep I do remember you and Oscar.

This, actually, makes total sense to me, but only because I have "been there, done that".

When Beau was switched to lev, I started at .5u. On the third shot he dropped into the 30s, so I backed off on the dose (I think to .3u) and it didn't seem to hold him. I spent about 6 frustrating weeks bouncing him from .5u to .4u and back. The .5u dropped him into the 30s and back up to the 300s, but the .4u he just sat in high numbers. It turned out both doses were too much. Once I dropped him below .3u his numbers started flattening and coming down. He was off insulin in a few weeks.

So, I think the .25u dose might have been a bit too much and caused Oscar to rebound a little, nit not so much more than he needed that it caused real lows.

But while getting him off, and stepping down the dosing scale, I was shooting .1u and even .05u, which at the time (3 yrs ago) people here pretty much though were useless. He got to where .05u shot below about 130-150 dropped him in to the 30s, but he could not quite go it alone. No one believed .05u shot on a 125 could cause 30s, but it did.

So, I think Oscar wants to get off the juice. Having been on insulin for so long, I am guess that he will need a very slow, weening process. Beau was on insulin for over three years too when he went OTJ. And there is another cat I know of that was on insulin 7 years and has been OTJ for about 4 months now.

I found with Beau that his hold on normal numbers was tenuous in the beginning when he got into some bread and shot up into the 300s. He brought himself down, but could not hold it and I ended up needing to shoot those .05u doses as needed over about 9 days before he was back OTJ. This was 3 months after he went OTJ.

I would encourage you to stick with the .1u dose, get some data to see how low he goes and start looking for a do not shoot number where he can hold the numbers down himself. He may go 24 hrs without a shot and then need a little boost. If you look at Beau's SS for the last of Aug and early sept of 2009, you can see how that went for him. I was actually out of town during the first part of Sept and my sitter was testing, but did not feel he was high enough for insulin, so he went 6 days without any insulin - and was then OTJ about two weeks later.

Good luck!
 
Here is a link to photos and instructions on getting .1u and .05u increments:

http://felinediabetes.com/FDMB/viewtopic.php?f=10&t=34424#p360982

Also, I just adopted Cami about a month ago and took her to the vet between picking her up and bringing her home and the vet asked me what starting dose I was thinking of (she had tested in the mid 300s) and I said .5u or 1u and he said "I think 1u", so I just nodded. But I started her on .5u and she was down to .25u in less than two weeks. Now she is at .2u, maybe .1u (that's what I shot this am) in just over a month.

Vets (most) don't recognize doses below .5u, I think. But I have data on more than one cat I was/am treating that not only do you need those doses in your arsenal, but that below 1u (esp below .5u) the dose changes need to be made in .1u increments to fine tune things - and that does make a difference with these long acting insulins.
 
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