Sootie: nearing remission or micro dosing?

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HWright

HWright

Member Since 2016
Hello, this is first time posting here (except for introduction in main forum a couple days ago) even though I joined group in June. Wish I had known about fdmb when my 16 year old Sootie was diagnosed Diabetic in October 2015, a month after her sister Guernsey passed away. Can't turn back the clock about the initial dosing protocol suggested by my vet that I abided by. But I say wholeheartedly that fdmb and the fb group helps me to learn something new every day that in turn I feel is helping Sootie in her healing.

Sootie was actually 564 (I in error or typo wrote 576 I think in the intro thread). And vet started us immediately on Lantus at 3 units daily to get her under the renal threshold asap. My vet did not at that time nor at this time go for the idea of twice daily dosing of Lantus (and I did broach this quite a bit with him when I was concerned about the dips and swings I was seeing and thinking that twice daily smaller doses might help to even out her bg patterns). In a nutshell, his concern was that the risk of severe hypoglycemia was too great because metabolizing can vary from day to day. Ironically this is the same argument that at least one fb member wrote about once daily Lantus dosing as if it was evil and irresponsible.

During the past nine months, Sootie's insulin doses gradually decreased from three units once daily to now at zero (0) units to see if she's sufficiently healed to be holding her own. Thanks to Sharon14 and Marje, I've been able to enter Sootie's bg and dosing information, which I've done as of June 1 forward. As well as notes from my daily handwritten log. I'm noting that Sootie and her three bff's have pretty much taken up residence upstairs since the re-arrival of Spunky, a younger cat whose name is an understatement. Also I have lousy back , legs and knees and there are days that I can't do stairs more than once. The days that show no pm readings are either because I got upstairs but she got to the food dish faster than I could deter her or my dh brought Sootie and her bff's their supper (he doesn't do testing). I have not yet entered her lab work information.

The food notations are sketchy. That's because daily I make a 'slurry' that is the base of meals for all of my cats (six, mostly seniors, ranging from 6 years to almost 24). The top three lines in the spreadsheet comments section goes into more detail about food, supplements and treats. I will add that I apply an integrative approach to feline care, often utilizing the synergy of traditional and homeopathic/wholistic/natural care, whether it's a crisis situation or for general well being. And that my recent attempt to very slowly and gradually transition all my cats to homemade has met so far with mostly reasonable success (the two younger ones, ironically, being the more resistant!)

During the past couple of weeks, Sootie's numbers began to indicate that maybe little or no dosing was at hand. Her morning to afternoon and morning to morning numbers have for the most part been very close and quite surprising.

I'm reaching out here hoping for guidance on Sootie's present progress and suggestions on ways to best help for let's hope this is her transition to remission or at least fewer doses and those being micro doses. I'll say this up front: if her numbers go up again to the extent that we resume dosing, i don't think twice daily dosing is an option but we'll know one way or the other if and when we get there!

Looking forward to your suggestions! Thanks, Sina
 
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Hello Sina, and welcome to you and sweet Sootie. :bighug:

From the spreadsheet it looks like Sootie was only getting Lantus once a day since June, is that correct? Just curious, I stopped listening to my vet's dosing suggestions early on and just followed the protocol and advice from the lovely people here. I wouldn't worry about not testing her because she's eaten by the time you get upstairs. Food can take 20-30 minutes to metabolize as a rise in the blood sugar so it's OK to test after she's jsut eaten, or you could just put a note that she'd eaten and we can take that into consideration.

To my eyes, it looks like Sootie isn't quite ready to go off insulin yet. Typically we see cats spending most of their time below 100 when they are ready for an OTJ trial. Our goal is a strong remission. We like to avoid people having to restart insulin with their cats by doing what we can to make the remission holds. Sootie's pancreas is sputtering but needs a bit more support. If you look at the Sticky Note that describes fine doses, you'll see a picture of what we call 0.1 unit. I think giving 0.1 unit twice a day for a little while might be all it needs to get her over the finish line. Good luck, the end is in sight.
 
Wendy&Neko said:
Hello Sina, and welcome to you and sweet Sootie. :bighug:

From the spreadsheet it looks like Sootie was only getting Lantus once a day since June, is that correct? Just curious, I stopped listening to my vet's dosing suggestions early on and just followed the protocol and advice from the lovely people here. I wouldn't worry about not testing her because she's eaten by the time you get upstairs. Food can take 20-30 minutes to metabolize as a rise in the blood sugar so it's OK to test after she's jsut eaten, or you could just put a note that she'd eaten and we can take that into consideration.

To my eyes, it looks like Sootie isn't quite ready to go off insulin yet. Typically we see cats spending most of their time below 100 when they are ready for an OTJ trial. Our goal is a strong remission. We like to avoid people having to restart insulin with their cats by doing what we can to make the remission holds. Sootie's pancreas is sputtering but needs a bit more support. If you look at the Sticky Note that describes fine doses, you'll see a picture of what we call 0.1 unit. I think giving 0.1 unit twice a day for a little while might be all it needs to get her over the finish line. Good luck, the end is in sight.
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THanks Wendy. Sootie's been once daily since diagnosis in October 2015. I see the logic of twice daily and worry less about dosing 'overlaps' especially with micro doses. What are indicators of sputtering (and does this mean that the pancreas is almost functioning on own but gets a little tuckered out during the rhythms?). And what are the signs of "post-sputtering"? Thank you.
 
HWright said:
What are indicators of sputtering (and does this mean that the pancreas is almost functioning on own but gets a little tuckered out during the rhythms?).
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As an example, today you saw her go down to 99, in spite of not having insulin for 48 hours. If the pancreas wasn't working at least part time, the numbers would trend upwards. By giving insulin, you are taking the load off the pancreas and allowing the cells to heal. If pushed back to work too soon, the healing may not last. "post sputtering" would be a mostly solid green spreadsheet without insulin.
 
Thank you, Wendy. What's also interesting but may sound a bit strange and more of an intuitive observation, has to do with the standard process pancreatic and enteric support tabs (and the hepatic support that she nabs from Bella) that she has been taking (and gung ho about eating). Recently she has begun to lose interest in them, which to me doesn't mean bored of them but instead is another indicator that perhaps she feels that her body is beginning to not need that additional support right now.
 
@Wendy&Neko
Wendy,
This morning Sootie's bg was 141 (and added to her SS). Might mostly be bc of the Stella and Chewy's that I substituted for the homemade EZ complete, yesterday ran out of the batch I'd made.

Will see what afternoon bg is. If continues to go up, At what range best to start microdosing?
 
I think you could start the small dose anytime. Maybe tomorrow night if you can monitor most closely on the weekend?
 
HWright said:
Thank you, Wendy. What's also interesting but may sound a bit strange and more of an intuitive observation, has to do with the standard process pancreatic and enteric support tabs (and the hepatic support that she nabs from Bella) that she has been taking (and gung ho about eating). Recently she has begun to lose interest in them, which to me doesn't mean bored of them but instead is another indicator that perhaps she feels that her body is beginning to not need that additional support right now.
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You are a very smart and intuitive mom, Sina! I also use alternative approaches. My vet does Nutrition Response Testing and uses Standard Process supplements, among others. I've also found that when the kitty starts to not want a supplement they've been taking, if Dr. B energy tests them, they test weak for the supplement meaning they no longer need it. So great observation on your part.

Another way to tell if the pancreas is working is to check her BG, feed her, and recheck it in three hours. If the pancreas is trying to work or is working, the BG will be lower by more than 20% meter variance.

Wendy has made some excellent points and one of the major ones is that as the beta cells in the pancreas heal and start to produce insulin on their own, they are fragile. That's why insulin support therapy is still important. If the beta cells are overworked and become unable to continue producing endogenous insulin, you are back to square one.

If she were my cat, I would also restart insulin at 0.1u every twelve hours and see if you can get her truly into a strong remission.
 
Marje and Gracie said:
You are a very smart and intuitive mom, Sina! I also use alternative approaches. My vet does Nutrition Response Testing and uses Standard Process supplements, among others. I've also found that when the kitty starts to not want a supplement they've been taking, if Dr. B energy tests them, they test weak for the supplement meaning they no longer need it. So great observation on your part.

Another way to tell if the pancreas is working is to check her BG, feed her, and recheck it in three hours. If the pancreas is trying to work or is working, the BG will be lower by more than 20% meter variance.

Wendy has made some excellent points and one of the major ones is that as the beta cells in the pancreas heal and start to produce insulin on their own, they are fragile. That's why insulin support therapy is still important. If the beta cells are overworked and become unable to continue producing endogenous insulin, you are back to square one.

If she were my cat, I would also restart insulin at 0.1u every twelve hours and see if you can get her truly into a strong remission.
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Hi Marje and thanks!
Nutrition response testing (kinesiology, energy testing) is amazing. My homeopathic vet does same and it is quite amazing how spot on the results are. Glad you are familiar with the standard process and other approaches to healing and support.

I appreciate yours and Wendy's suggestions, experience and your way of bringing the picture together.

Today I will start first by testing Sootie's bg at 3 hours after today's meals re your suggestion about checking for pancreatic function and go from there, checking in with you both first.

Since your reply (and with Sootie at 137 yesterday am), her evening read was 133 last night and this morning was 130. I've been keeping spreadsheet current and, as you've suggested, been trying to be more vigilant about daily information in the remarks section about food, supplements, behaviors.

Thanks agin and til soon, Sina
 
Hi Sina

I just took a peek at her SS and see she came down but she still looks to me like she needs insulin. A cat in remission should basically have the majority of the numbers under 100. They might occasionally have a BG here or there around or slightly above 100 but her numbers are telling me she still needs some insulin support.

If you don't want to try 0.1u, you could give a drop and see what that does. To give a drop, push the plunger in all the way and insert the needle into the vial or pen and then let go of the plunger. The release in pressure will draw up a drop of insulin.

What do you think? I just want to see a strong remission for her and I don't think she will have one without some longer insulin support.

Here is an interesting publication on predictors of remission relapse.
 
Hi Marje,
Thanks. Just uodated Sootie's SS with her +3.75 bg counting from after her pm (pre meal) test and meal. 95. And today she was gung ho again about her pancreatrophin tablets. Shall I test tomorrow too for more info or you think today is representative?

Thanks for suggesting the article about predictors of remission relapse. Unfortunately, the link didn't open. Maybe it's a the occasional internet quirk. I'll try to open again in a bit. Just in case need to try a google search: author? Publication?

Yes, I'd love for Sootie to have a strong remission. And one in which she is, most importantly healthy AND happy and herself! I ve been feeling though that during this period where her numbers are more consistently on the low side, her food interests and appetite "sputter," too. Eats a lot for a minute or two, then off she goes, sometimes returning for more, sometimes not. Whether it's the menu or her body speaking, not always sure. To come this far and to this point in her healing is, well, quite amazing!

All translating to: yes ok let's give micro dosing a go, starting with a droplet first! Your suggestions about when Best to start morning or evening? How often test during droplet and if increase to micro? At what #s to not dose? Etc?

Thanks and looking forward to reading the article you sent and any others you think of interest for this inquiring mind!

Till soon thanks agin and looking forward, Sina
 
Let me try again: predictors for relapse of remission. Sorry about the first one not working.

I would start microdosing on a morning cycle and I'm assuming you'll be able to monitor her so please be sure you have plenty of test strips, HC food or whatever you use to bring up low numbers, and karo/syrup or honey.

I would suggest you start by shooting the blue numbers. Post at any time you have questions or need help. In the subject line, please be sure and put the date, her name, and list her tests such as "9/18 Sootie AMPS xxx +1 xx +2 xx" where the xx represents the BG. If you need help, add "need help" to the subject line and also select the "?" In the drop down box to the left of the subject line.

I would not shoot a green PS starting out.

Once you shoot, I would feed and get a +2 test to start but if you are more comfortable, grab a +1. How often to test depends on what she does.

How does that sound?
 
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Marje, thanks for all. Sounds good very good.
Will start this morning at droplet dose. Sootie's bg just now 137 in blue zone. Have the essentials you mentioned on hand. And always have jar of honey both upstairs and downstairs just in case.
Till soon and enjoy the day.
 
Just for the future....we do one condo (thread) per cat per day. Putting the subject line as I suggested helps those of us watching keep track of numbers. Sometimes new members don't always understand the significance of a number so we can pop in and make suggestions.

Even with a drop, it can take a few cycles to build the depot so I would stick with this dose for several cycles.
 
The mb navigational nuance newbie part of me wanting to be sure I understand: ok, I think I get it re starting new thread when dosing, crises questions arise, using the new thread new header in format you described earlier right? If routine (in the non crisis pattern we're in now), continue on this original thread, right?

Re your suggestion to continue with Lantus droplet dosing (except for do 0 [zero] doses when in green) for several cycles bc of depot factors: got it! understood and aok! Thanks!
 
Hi not quite, you only do one thread each day. If you have a new question, crisis etc you change that days thread title to reflect what you need
For example say I did one that said 8/31 Gus AMPS 221, +2 219
Then he took a dive and I bpneeded help I would edit my thread title to change it to
? 8/31 Gus need help! Diving AMPS 221,+2 219, +3 49
Does that make sense? And if a crisis emergency add the 911
 
Gussie's mom said:
Hi not quite, you only do one thread each day. If you have a new question, crisis etc you change that days thread title to reflect what you need
For example say I did one that said 8/31 Gus AMPS 221, +2 219
Then he took a dive and I bpneeded help I would edit my thread title to change it to
? 8/31 Gus need help! Diving AMPS 221,+2 219, +3 49
Does that make sense? And if a crisis emergency add the 911
Click to expand...

Hi Gussies mom,
Thanks. Ok let's see if I get it (and not overthinking/missing something!):

The original thread (this one) can remain as is (and continue with as needed for other than what I'll call 'crisis day' threads?). But for situations like "... Sootie need help!..." that you describe above, I start a new thread (aka 'crisis day' thread) but only one new thread a day. If a situation that needs help changes during that day, such as what you described above, say from diving to 911, I amend the title of that new day's thread and post the crisis or bg questions in that thread.
1. Does it help to include a link to the original thread?
2. when I start a second thread on a given day but say, a day or two or a week later have new situation such as "help diving again.." Comes up, can I amend that second thread or do I start a third thread?

Thanks Sina
 
Not quite
Your new thread, one each day with the date first, then cats name, is your one size fits all thread for that day. You will link THE PREVIOUS days thread at the start of each day.
Think of it this way, you want all of your conversation that day, no matter what it is about all in one place, in that one days thread. It's like having a box that everything goes into each day then that box gets put under the next days box. You can get to it if you need to (via the link) but the open box is the new days box.
It would be too hard to go find a convo dealing with something if there were many for each day. If it's all in one place that day it can be easily accessed to help!
You just keep changing that original thread title for what your question, or need is during that one day.
 
So I have a 9/18 Gussie thread..everything, I mean everything re Gussie, my posts, questions, people's replies, help etc that took place today is in that thread. At the top is the link to the 9/17 Gussie thread. That has everything from yesterday no matter how many times I changed the title of it as I needed help.
 
You close the box/folder ( whatever visual works best for you) -at the end of each day. This thread will be done at the end of today ideally and you will start a new thread tomorrow with tomorrow's date and link this one to it.
One thread each day! :bighug:
 
Gussie's mom said:
Hi not quite, you only do one thread each day. If you have a new question, crisis etc you change that days thread title to reflect what you need
For example say I did one that said 8/31 Gus AMPS 221, +2 219
Then he took a dive and I bpneeded help I would edit my thread title to change it to
? 8/31 Gus need help! Diving AMPS 221,+2 219, +3 49
Does that make sense? And if a crisis emergency add the 911
Click to expand...
The title of that 8/31 thread went from 8/31 Gus AMPS 221, +2 219 then was changed, not open a new thread but continue same one with new title of ? 8/31 Gus need help! Diving AMPS 221,+2 219, +3 49 since I needed folks to see I needed help. :bighug::bighug:
 
Ok even though my logic keeps thinking that doing new threads each day breaks continuity of situational changes, the new thread practice/procedure (with updates on that day only, and a new thread on any new day of a situation, that thread being 'good' for that day only) has to do with internal mechanism of expediting fdmb core members to respond to each day's crisis per member crisis of the day?
 
YES!!!! Hahaha big WHEW here! :bighug::bighug:
It keeps everything that has taken place that day all in one place in easy reach of those helping you that day. The link to the day before lets them go back in time for more history if need be. The big piece is keeping your spreadsheet as current as you can because they are looking for patterns in how your cat is responding to the insulin over time each cycle. That is how they can best give advice and actually enables you to give info that saves time when you need it most:bighug::bighug::bighug:
 
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