Remission??

[Vtambo & Rex]

Hi All - I know its been a while since I have posted or been to the site. I guess in a way that is good since that means that all is going well.

I do have a question/situation that I'd like to ask for opinions/advice though.

I am not a "regular" tester. My cat just never got over the anxiety/stress/anger factor of the daily ear poking and at times got pretty aggressive with me and I started noticing a change in him (like avoidance of me) that I didn't like and didn't feel was good for his recovery, etc. I could have tested MY blood instead of his sometimes. At any rate, I still do test occasionally, like I would say every 10 days or so just to see where we are at and he seems to tolerate that ok. Its just when I do it repeatedly that he gets annoyed. He seems to be doing well, and I feel like I know the symptoms of hypo enough that I would be able to tell if things were not where they should be. I do also do the urine dip stick testing. So, last week I did one of my random blood tests and he came back at 116 in the AM preshot. I was a bit surprised by that. Normally when I have tested he has been in the 130-140 range. I did not give him his shot that AM, but did give him his regular shot in the PM. He normally gets 1.25 U 2x/day. I did test him again in a AM just a few days later and he was at 108. That was on Friday AM of last week, so again I did not give him his AM shot. We were leaving town for the weekend and having someone come in to feed, etc. and I certainly did not want to worry about him being alone all day with nobody to be able to monitor symptoms and someone not necessarily familiar with what to look for or what to do. I work from home so I can watch him all day every day. So last night on Sunday PM I tested him again to see where he was at after not having had a shot since Thursday PM. He was at 165. I guess I was pleasantly surprised, however a bit concerned at the same time since I know I will be unable to test him daily or multiple times a day and I thought we had this all figured out. Is it possible that after 1.5 years he is in remission? 165 is in the normal range and that is after no shot for 3 days. How do I proceed with this??

I hope that nobody thinks I am a terrible kitty mom because I don't test regularly and I didn't give him a shot for that many days but in my mind it was better to give no shot than to have him go hypo on me when we were away.

 

[MrWorfMen's Mom]

No one thinks you are a terrible kitty Mom. You are doing far more than many people do for their diabetic cats and we all do what we are able. In your situation, I would have made the same decision regarding holding shots for the weekend with no one to tend to Rex.

Yes it's possible for Rex to go into remission after 1.5 yrs. My girl just went into remission after 3yrs 7 mos.

Using the AT2 meter, normal range is 70 to 150 although IDEXX uses a max of 175. So using the IDEXX reference Rex is within normal range at 165 but he is nearly at the top of it. It would be helpful to know if the tests you did were food influenced or taken after a period of 2 or more hours without food.
The process used for an OTJ trial involves testing twice daily and if kitty stays in normal numbers for a period of 14 days without insulin, then you can assume they are in remission.

Based on a few random readings, it's impossible for anyone to tell you if Rex is in remission. Daily testing is the only way to be sure other than perhaps getting the vet to do a fructosamine after 3 weeks or so without any insulin. The caveat to the fructosamine is that if Rex is not in remission but very close to it, not providing insulin support over an extended period of 3 weeks could set your progress back.

Your spreadsheet is showing a dose of 2u as of Sept. 15th and there are no readings listed since then. How did you decide to reduce Rex's dose to 1.25u? Most cats do best when they are weaned off insulin with gradually decreasing doses until they are receiving miniscule doses...even drops. With the readings you've had lately, it's even more important to check his BG before giving any insulin to ensure it is safe to do so.

If you can't test twice daily, try to get at least one test everyday and pay attention to whether Rex has eaten recently or not. If you start to see the numbers rising, then he may need ongoing insulin support. If you do think more insulin support is needed, I encourage you to come ask questions so we can help you keep him safe.

 

[Vtambo & Rex]

No one thinks you are a terrible kitty Mom. You are doing far more than many people do for their diabetic cats and we all do what we are able. In your situation, I would have made the same decision regarding holding shots for the weekend with no one to tend to Rex.

Whew!

Yes it's possible for Rex to go into remission after 1.5 yrs. My girl just went into remission after 3yrs 7 mos.

Using the AT2 meter, normal range is 70 to 150 although IDEXX uses a max of 175. So using the IDEXX reference Rex is within normal range at 165 but he is nearly at the top of it. It would be helpful to know if the tests you did were food influenced or taken after a period of 2 or more hours without food.

I do use the AT2.

I would definitely say food influenced since he is a grazer and eats pretty much all day. I know that is not ideal, but at the time I got him I didn't know any better and that is how we started. pretty hard to change at this point.


The process used for an OTJ trial involves testing twice daily and if kitty stays in normal numbers for a period of 14 days without insulin, then you can assume they are in remission.

Based on a few random readings, it's impossible for anyone to tell you if Rex is in remission. Daily testing is the only way to be sure other than perhaps getting the vet to do a fructosamine after 3 weeks or so without any insulin. The caveat to the fructosamine is that if Rex is not in remission but very close to it, not providing insulin support over an extended period of 3 weeks could set your progress back.

I get that. I will have to sit with this for a bit and try to figure out exactly what to do in this situation.

Your spreadsheet is showing a dose of 2u as of Sept. 15th and there are no readings listed since then. How did you decide to reduce Rex's dose to 1.25u? Most cats do best when they are weaned off insulin with gradually decreasing doses until they are receiving miniscule doses...even drops. With the readings you've had lately, it's even more important to check his BG before giving any insulin to ensure it is safe to do so.

The September 15th reading must be from last September because I have not posted any results for a long time. I was giving him 2U at the advice of the vet after initial diagnosis but noticed that his numbers were pretty low so went down to 1.5 (okayed by vet) and since then seeing lower end numbers have decreased to 1.25 and now seeing even lower numbers. May try to go down to 1U and see how that goes. ?? I feel comfortable adjusting his dose without consulting the vet as I know that would prompt her to want me to bring him in and I don't think that is necessary at this point and he gets really stressed out from going in the car and seeing the vet (who wouldn't??) and it is quite costly and I feel like ultimately she would just tell me to adjust to what I suggested anyway.

If you can't test twice daily, try to get at least one test everyday and pay attention to whether Rex has eaten recently or not. If you start to see the numbers rising, then he may need ongoing insulin support. If you do think more insulin support is needed, I encourage you to come ask questions so we can help you keep him safe.

At this point in the game, giving shots is so simple it is fine if he continues to need insulin, but I am sure he would appreciate not having to be poked every day. it is somewhat of a comfort though knowing that if I need to skip a day or even just one cycle I don't have to worry so much about his numbers rising dramatically. at first his numbers were in the 500's at times. it was quite a roller coaster for a while. I guess I should update my spreadsheet. I do have my own chart that I keep the old fashioned way - paper and pen.

Thank you so much for your insight. it has been helpful.

 

[MrWorfMen's Mom]

My bad....didn't notice the year on the spreadsheet. Obviously Rex is making progress and as I said before, you have to do what you are able to do but just be aware that some cats do NOT show early signs of hypoglycemia and can suddenly have a seizure which can be catastrophic so while testing might seem traumatic for Rex, the lower your readings the more of a safety risk you are taking by not testing, at minimum, before giving insulin. Most folks find that the more they test, the more their kitties come to accept it. A little bribery never hurts either....giving a treat after testing can convince them to co-operate too.

We're here if you need us and I hope with all my heart that Rex doesn't need more insulin and is going into remission.

 

[Vtambo & Rex]

My bad....didn't notice the year on the spreadsheet. Obviously Rex is making progress and as I said before, you have to do what you are able to do but just be aware that some cats do NOT show early signs of hypoglycemia and can suddenly have a seizure which can be catastrophic so while testing might seem traumatic for Rex, the lower your readings the more of a safety risk you are taking by not testing, at minimum, before giving insulin. Most folks find that the more they test, the more their kitties come to accept it. A little bribery never hurts either....giving a treat after testing can convince them to co-operate too.

We're here if you need us and I hope with all my heart that Rex doesn't need more insulin and is going into remission.

I guess I really did not realize they could have a seizure without prior symptoms. good to know. and scary... I actually do try the bribery thing, but what happens is that something that he would normally LOVE he will no longer eat after I try to use it for bribery with testing. He used to LOVE raw hamburger, a little dish of milk, cheese, a little piece of bacon or chicken, some types of kitty treats, etc., now he won't come near them I think because he knows they have been used before as a testing bribe - either that or he is losing his sense of smell or taste. I am hard pressed to find anything to give as a treat. He is a real stinker.

well the bottom line is that I need to come up with a plan.

thanks again!