otj trial?

Discussion in 'Prozinc / PZI' started by hailey & oscar, Feb 13, 2020.

  1. hailey & oscar

    hailey & oscar Member

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    Jan 5, 2020
    hi!
    it seems that after a period of drop dosing oscar and having him get stuck in dive/bounce cycles, he suddenly leveled out a few days ago. i guess i was in a bit of disbelief and expected him to hit a high and shoot again at some point, but he has been consistently in 'no-shoot' number ranges for the last *5* days-so fingers crossed that he will maintain this!

    ss updated with most recent checks, he still seems to be coming down a bit more each day so i take it that means his pancreas is picking up/strengthening a little each day?
    today has been the lowest so far, seems a little concerning for me but i suppose bc i am not used to those numbers......

    he was switched to purina DM food in mid december after diagnosis and been only on that with the exception of here and there supplements of FF grilled (12% carbs) that i started mixing in to certain feeding intervals to prevent him dropping in an effort to help curb the bouncing... and seems that may have helped out.

    he is still getting fed 'meals' 2x per day with snack intervals in between am and pm meals 3-4 times, using an autofeeder when i am not home. he sometimes does and doesn't finish the snacks between meals.

    if he continues to drop in numbers, should i consider finding a food that lands between carb percentage of the purina and the FF? (aka between 6 & 12%)
    or would it be a better idea to keep the both 'levels' of food around for if and when he needs a boost or seems like he could be decreased?

    id be interested to pursue a 'cleaner' food than the purina DM so long as i can stay within carb/phosphorous ranges since hes had urinary issues, but haven't been aggressively in pursuit of that since we were already making a transition from dry to wet with introduction of insulin...

    please let me know if i should cross-post or if there is official ss ways to update the otj trial- fingers crossed!!!
     
    Last edited: Feb 13, 2020
  2. Deb & Wink

    Deb & Wink Well-Known Member

    Joined:
    Jan 31, 2013
    Since Prozinc is an in-and-out insulin, with no lasting effects from one cycle to the next, you should not worry about those low BG (blood glucose) numbers. They are normal BG readings. It's been so long, you probably did not know what normal numbers looked like.

    Yes, may seem scary, but those BG levels < 100 are perfectly normal for a non-diabetic cat. Excellent for a diabetic cat on an OTJ trial. Some cats even test down in the 40's when they are off insulin. Oscar is perfectly safe. He is not getting insulin. There is no "depot" storage area to be providing little doses of insulin like there is with lantus or levemir.

    His pancreas is doing the insulin production on it's own. All by it's little healing self.

    One little high blip the morning of 2/10/20. It happens.

    Keep testing, keep recording the numbers on the spreadsheet (SS). All paws crossed that Oscar stays in those low numbers.

    The one item you could do, is record the foods you are feeding on the SS in the Remarks column, over on the right hand side. That could be a good reference for the future. Gives you a better idea of what foods work well to keep Oscar in the <100 BG ranges.

    Sometimes the slightly higher carb% foods work. With that, and a bit of drop dosing, it looks like Oscar is doing well.

    Not sure what to tell you on the foods. What you are doing now, seems to be working. Why change it.

    To repeat, there is no danger for Oscar to have BG readings that low. For now, I would not change a thing.
     
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  3. HelloKrystie

    HelloKrystie Member

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    Jan 26, 2020
    Hailey this is amazing! I’m so happy for you and Oscar! My Sirius was recently diagnosed, and after a week of him not having his insulin, we’re trying to get back on track, and with some sort of stability.

    Oscars numbers look great! At first I gasped at his lower numbers too, but I think Deb hit the nail on the head: after seeing such crazy high numbers for such a while, low numbers likes he’s producing now are scary! Such great work!

    I too was sent home with the Purina DM food following diagnosis, but for economical reasons, after Sirius finished the 10 cans of DM I went home with, I switched to Fancy Feast Classic Pates. Now I’m second guessing myself after seeing oscars numbers and progress!!

    Congratulations, to you both!
    Krystie & Sirius
     
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  4. Juls and Billy

    Juls and Billy Member

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    Dec 28, 2019
    Look at Oscar's lovely green numbers! Fingers and toes crossed for his off the juice trial! As far as the food goes, every cat is different. The only way to see is to change the food and watch his readings. If you do decide to work his way away from the prescription food, do any changes very slowly and keep an eye on those BGL readings. The food chart can help you with some low phosphorus options.
     
  5. Deb & Wink

    Deb & Wink Well-Known Member

    Joined:
    Jan 31, 2013
    Oscar, how is day 6 of your OTJ trial going?

    Cheering post for today is
    OTJ day 6 cow in green grass.png
    Hoping Oscar is still in the green, loving the green, green grass.
     
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  6. hailey & oscar

    hailey & oscar Member

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    Jan 5, 2020
    oscar is still holding green :)
    amps today at 61
     
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  7. Deb & Wink

    Deb & Wink Well-Known Member

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    Jan 31, 2013
    I'll do a new fun picture, gif every day to help cheer you on. Unless you would rather I not do that.

    I've found a couple of good ones for days 7 and 8. Hope you will like me doing this. Some people find it annoying. :rolleyes:
     
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  8. hailey & oscar

    hailey & oscar Member

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    Jan 5, 2020
    oh yeah love it! taking all the cheers we can!!! thank you :bighug:
     
  9. Juls and Billy

    Juls and Billy Member

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    Dec 28, 2019
    Day 6 and look at Oscar's beautiful greens! Keep it up, Oscar!
     
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  10. Deb & Wink

    Deb & Wink Well-Known Member

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    Jan 31, 2013
    Day 7??

    OTJ day 7 NYC subway train.jpg

    Still going ok?
     
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  11. hailey & oscar

    hailey & oscar Member

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    Jan 5, 2020

    im honestly not convinced that the purina has the totality of credit for this, but i do believe switching him to the lower carb all wet definitely moved things in the right direction. i guess for now i am alright with keeping things as they are, but ideally it would be nice to find a food that seems 'cleaner', with little to no filler. and more economical food as you said... but id love to keep him stable more than anything.
    i think i read somewhere on here, or in the food chart about purina incorporating a lot of soy into their products which can also be problematic for cats so i'm trying to think about his long term health goals and not put blind faith in a 'vet' diet in the way i did with the urinary s/o food for the last handful of years (which i do believe contributed to the diabetes). regardless, the wealth of information intake that has occurred since his diagnosis, the majority of it via this website and its contributors, is so invaluable and i am so grateful for it.

    thanks all for the well wishes and support, i know we wouldn't be in this great of shape were it not for finding this incredible community so it will stay very close to our hearts!
     
  12. hailey & oscar

    hailey & oscar Member

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    Jan 5, 2020
    yes today still going strong!
    am 59 pm 63 :cat:
     
  13. Kerri & Tigger

    Kerri & Tigger Member

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    Dec 17, 2019
    Hi Hailey! Is Oscar still doing well? Fingers crossed!
     
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  14. Deb & Wink

    Deb & Wink Well-Known Member

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    Is this day 10? OTJ day 10 bus.png
     
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  15. hailey & oscar

    hailey & oscar Member

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    Jan 5, 2020
    hi!
    oh boy, i have been catching up on a lot the past few days that i put aside and/or got backed up on since diagnosis.... oscar is still looking good :)
    we are on day 12 today! thank you for all the love and cheers :cat::bighug:
     
  16. Deb & Wink

    Deb & Wink Well-Known Member

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  17. hailey & oscar

    hailey & oscar Member

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    Jan 5, 2020
    day 14 and still in the green ! <3

    quick question- how frequently should i be ketone testing?
     
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  18. Kerri & Tigger

    Kerri & Tigger Member

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    Dec 17, 2019
    HOORAY!!!!!!! Congrats to sweet beautiful Oscar!!!
    (I bet Deb has a fun day 14 photo and an answer for the keytones.)
     
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  19. Juls and Billy

    Juls and Billy Member

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    Dec 28, 2019
    Huzzah for Oscar! Okay, I'm fairly a newbie here, but I don't think you have to worry so much about ketones when Oscar isn't taking insulin. I know the most common time ketones happen is with a cat on insulin that has to skip a dose. Or course, there's nothing wrong with a spot check, but since Oscar's been off insulin for 14 days, I don't think ketones are a big worry anymore. Deb will be able to tell you more about it. (And tell you if I'm completely wrong, lol.)
     
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  20. Deb & Wink

    Deb & Wink Well-Known Member

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    Jan 31, 2013
    Congratulations to Oscar and Hailey! Officially OTJ!
    Scroll down, and down and down.
    OTJ day 14 cat diving thru waterfall.jpg
    This is how Oscar feels today, taking a dive in the falls.

    Why do we call it the falls when a cat goes OTJ?
    Because they made a trip to Niagara Falls and are now on a "honeymoon", not needing insulin.
     
  21. Deb & Wink

    Deb & Wink Well-Known Member

    Joined:
    Jan 31, 2013
    Here are some tips to stay OTJ (off-the-juice, insulin being the juice)
    1. Never feed dry - not even treats. (freeze dried is ok, Dr. Elsey's chicken flavor is ok.) 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. Too much of a weight loss alerts you to other issues, such as hyperthyroidism.
    3. Measure blood once a week, indefinitely if possible. You want to catch a relapse quickly. Some people only do checks every 2 weeks to a month. BG checks can sometimes alert you to other issues.
    4. No steroids or oral meds with sugar - remind your vet whenever giving you any medication. Always double check. (Steroids may be needed for other medical issues. But remind your vet your cat is a diabetic, diet controlled.)
    5. Monitor food intake, peeing and drinking. If increasing, a sign of losing remission. Or another medical condition like Hyper-T or kidney disease.

    6. Regular vet checks for infection such as dental , ear or UTI. And get them treated quickly!

    7.Continue to ketone test even if your cat is OTJ. Ketones can develop if the cat’s pancreas is not producing enough insulin, or burning off too much fat if your cat is not eating properly and other reasons.

    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. Pancreatitis, hyperthyroid, dental issues are the most common reasons cats fall out of remission.

    "Once a diabetic, always a diabetic." They are simply diet controlled.
     
  22. Deb & Wink

    Deb & Wink Well-Known Member

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    @Juls and Billy
    I have to admit, I never ketone tested my Wink in the 4.5 years he was OTJ. So maybe test Oscar once a week to start? If the appetite is diminished and a concurrent infection/inflammation (think bad teeth) then the risk for ketones is there.

    I did BG test Wink whenever he seemed "off", not his usual self. Kitty cold, UTI a couple of times made his BG's spike up 30-40 points from his normal <90 BG levels.
     
  23. hailey & oscar

    hailey & oscar Member

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    Jan 5, 2020
    upload_2020-2-23_13-7-26.jpeg


    honeymoon vibes over here ;)
     
  24. Deb & Wink

    Deb & Wink Well-Known Member

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    Jan 31, 2013
    Looks like Oscar is enjoying a sunny day.
     
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  25. Deb & Wink

    Deb & Wink Well-Known Member

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    Jan 31, 2013
    Hi Hailey,

    Want to add Oscar to the sticky post at the top. The one that lists recent remissions.
     
  26. Deb & Wink

    Deb & Wink Well-Known Member

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    Jan 31, 2013
    Hi Hailey, I simply wanted to make you aware of this. I know Oscar just went OTJ, but just in case, I wanted to let you know about the changes to the Prozinc stickies.

    All the "Sticky" or pinned posts in the Prozinc forum have been updated and there are a couple of new ones.

    Highly recommend that everyone using Prozinc or helping those using Prozinc read them thoroughly.

    I'll be doing that myself. Been expecting this for some time. Came about a week before I thought it would.
    Thanks Marje, and Robert, and especially Djamila for the Modified Prozinc Method. You folks are FANTASTIC!
     
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  27. hailey & oscar

    hailey & oscar Member

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    Jan 5, 2020
    wow yes great updates, some content i hadn’t come across before now even- so nice and big thanks to the folks following up on it :)

    will add oscar to the remissions sticky too !
     
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  28. hailey & oscar

    hailey & oscar Member

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    Jan 5, 2020
    hi!
    oscar has been maintaining good and low levels consistently although the last two readings (yesterday pmbg and this ambg) were mid 70s as opposed to the 50-60 range he’s held the last several weeks. i suppose i’ve come to understand the normal range of bg levels, but curious about fluctuations within said range and when it should be an indicator -
    in looking out for signs of relapse, if and when do you decide when to restart insulin? number range, for example... like if he were consistently creeping higher up.

    i’m not trying to sound pessimistic about anything but trying to stay proactive and informed. we are due back to the vet for a follow up in the next week or two and i’m still crossing my fingers that he can keep this up.
    i don’t own a scale currently but was going to look into it. aside from that have still been testing twice daily because i’m basically still in disbelief about it all... and don’t trust to not test at this point.
    he’s been on only purina dm 6% food for the last two weeks, i’ve been reluctant to even reintroduce the ff i was using to flatten his drops prior to stopping dosage. if anything i’ve noticed he will turn up his nose at certain times to the purina, and would like to maybe have a same carb/protein alternative to offer him for those occasions so that his intermittent feedings stay consistent....in concern that skipped snack times might play a part in throwing him off? or i’m overthinking that bit.....
     
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  29. Deb & Wink

    Deb & Wink Well-Known Member

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    Jan 31, 2013
    Fluctuations of BG levels when the BG levels are <100, I never concerned myself with. Simply thought of them as Wink playing a bit more, or eating a bit less from one day to the next.

    When Wink went OTJ, I went from daily to weekly testing fairly quickly. In the first month.

    If Wink seemed off, had diarrhea or was vomiting, I'd test him for several days in a row. Both at normal PMBG and AMPG and if the levels stayed higher than normal, I would simply test more. For about a week or so. At PMBG, AMBG and about 3-4 hours after food. Like you would for an OTJ trial.

    Sometimes the BG's crept up to the 130-140 range. Then I monitored more closely.
    The BG numbers never stayed high for long, not for more than a week.
    The creep up in BG numbers always seemed to coincide with a "kitty cold" - weepy teary eyes, sneezing, appetite off a little bit. Always cleared up in about a week.
    Or the higher numbers occurred when he might have had the start of a UTI. Again, never lasted more than a week.

    I never did much night time testing, usually only in the morning when he was in remission. Look at his 2015 tab, starting with 9/26/15. Kitty cold.

    If he vomited up a hairball and some food, I might test him.
    After his dental, I tested him. 1/15/14.
    Not himself 4/17/14. 10 days of test and he was back to normal pretty early on for those 10 days,but i wanted to test him to make sure.

    I think if Wink had ever stayed above 120, I would have tested him a lot more and put him back on a tiny dose of insulin if he stayed above 130-140.

    If he had ever been back in the higher blue range, > 150, or in any of the higher colored ranges (yellow, pink, red, black) he would DEFINITELY have gone in for a vet visit and back on the insulin. He never did.
     
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  30. Deb & Wink

    Deb & Wink Well-Known Member

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    Jan 31, 2013
    Most of the Fancy Feast pate style foods are either the same carb level or fewer carbs than the Purina DM. The plain one, not the Savory Selects which are around 10%.
    The Fancy Feast "classics" are around 1-3 percent.
    The Fancy Feast "naturals" are 0 percent carbs.
    The Fancy Feast "roasted/flaked/chunky" are all in the 4-6% range.
    Even the Fancy Feast 2 kitten flavors are around 3% carbs.

    I understand your nervousness in changing food. But if you were using the FF pates to "flatten his curve", it was probably due to the fact you were giving him a "snack" that helped, more than the lower carb content.

    No way to know for sure. Without feeding some to Oscar.
    Remember too, that manufacturers change their recipes and ingredients and the food labels can lag behind for months. Plus, those numbers on Dr Lisa Pierson's list are averages, from the "as fed" food trials. Which pet food manufacturers only need to do with a limited number of cats for 6 months.
     
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  31. Deb & Wink

    Deb & Wink Well-Known Member

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    Jan 31, 2013
    My pet scale broke. I use my own "human scale" to find the weight of my civie Dancer. Hold her in my arms, test twice, let her down, weigh just myself, subtract to find her weight.

    Not as accurate as a scale at the vet, but close enough to monitor her for weight loss/gain.

    Scales, human baby scales can sometimes be found on ebay or craigslist for a low price.
     
  32. hailey & oscar

    hailey & oscar Member

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    Jan 5, 2020
    thanks for your quick replies, deb. i really appreciate the guidance.
    i’ll have a look at winks chart to see your references.
    this definitely eases my concerns, i have certainly been on glucose hyper-alertness through the last two+ months, and trying to ease back into a ‘normal’ routine (for me, haha) but finding it hard and thinking any change with him could be indicative of....a disaster

    at the end of dosing, he was having a bit of ff ‘grilled’, a higher low carb (12%) which i mixed into the purina for some of the feedings to try and balance the dive/bounce cycles, mainly to slow the dive and try to avoid the bounce that he seemed caught in for a while.
    it seemed to align in helping, but maybe it had nothing at all to do with him leveling out, since his greens seemed to occur somewhat spontaneously. no complaints either way!!! but wouldn’t reintroduce that same food at this point.
    thanks for the tips on scales too- totally didn’t occur to me to weigh him in my arms, but makes it seem a bit easier than trying to keep a squirmer on it ;)
     
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