Sophie's AMBG 95 - 110 for 3 days, NS - remission?

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JoshandSophie

Member Since 2010
Hi all,

I've been caught up with digging out from under the worst, heaviest snow we've had in years, so I haven't dropped in for a few. Hope kittehs and beans are well!

I'm wondering if Sophie is going into remission. This is the third day of no Lantus, and she's staying within a range of 90 to 143 for all three days. 143 is the highest, after a meal, and she dropped down to 117 shortly thereafter. She's only been dx'ed and treated since early December, and she had some wild ups and downs. But she's never had a day when she needed no shots at all. Is it too early to hope her little pancreas is starting to work?
 
Josh:

I have very mixed feelings and I hate to burst your bubble. Granted that Sophie's numbers have been good, there's a lot more blue, as well as much higher numbers, than we typically like to see on a SS before starting an OTJ trial. Also, we really ease a cat down the dose scale in order to give a cat's pancreas a great deal of support prior to withdrawing insulin. Doses may be fattened or skinnied and we work the dose down to microdose levels (e.g., a skinny 0.1u). Going from a dose of 1.0u to nothing is unlikely to get a cat solidly into remission.

I'm not sure if you'll remember Dianne's Savannah. This is a link to Savannah's SS. This is a link to Libby's Lucy's SS. These SSs will give you an idea of what a SS of a cat that's in remission looks like prior to an OTJ trial.

Sophie may be getting there. I just don't think she's ready. If you discontinue the insulin too soon, it may make it harder to get Sophie into remission. I also want to make sure that you are not basing your dosing on pre-shot tests. You're skipping shots at a test of 79. If a cat is ready to go OTJ, that is a very shootable number - shoot low to stay low. (I shot a 74 last night and have shot lower and Gabby is by no means ready to be taken off insulin.)
 
Hey, if my bubble needs bursting, I'd rather it be burst. That's good stuff to think on, Sienne. I guess I have this terrible fear of shooting in the green. If 1 unit of Lantus can bring her down from over 400 to the low 100s, it just seems counter-intuitive and scary to consider that when she's in the low blues or the greens. I'm sure there are things I don't understand, and that I'm missing.
 
You're right -- it's counterintuitive. Take a look at Gabby's SS. She is among the reigning Drama Queens on the board. Then, take a look at her numbers the last few days.

Lantus is known to produce "flat" curves. Yes, it can drop numbers precipitously but, it can also flatten out the curve. The last few days, Gabby's numbers have not fluctuated a great deal. When your cat is getting used to being in the lower ranges, there's actually less "distance" for numbers to drop. If a cat's pre-shot is in the 300s, to get into the greens is over a 200 point descent. Once the cat's already in green numbers at pre-shot, you need to monitor and possibly use food to keep the numbers in a safe range, but there's less range available. The BIG however, though, is that you need to be data ready to shoot low numbers. You need to know when onset and nadir are, what the duration of Lantus is for Sophie. I know that with Gabby, onset is frequently early (e.g., by +1 or +2). I'm also very confident of my ability to steer her numbers, should they drop -- and they have.
 
You can see from Maverick's spreadsheet too we often shoot low blues and greens. We have the data to show its okay. This is the important thing. I think I had a near panic attack the first day shooting a green. We knew what to do if he went low though and this gang is here every step of the way - so comfort in numbers there. Maverick though makes diabetes look easy. No dropping, lows or bounces. I think he may be a results not typical cat with the exception of those that go OTJ in days or weeks lol.
 
I think Jezebel is a good example of a kitty going to the green side quickly. It was days of greens with a few blues before her pancreas said "ENOUGH" and her numbers started plummeting.....
Good luck to you and listen to what everyone says here....
Debie & Jezebel
 
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