Starting OTJ trial!

JulieL

JulieL

Member
Liberty has been on 0.25 dose since mid February, and he’s been pretty consistently in the greens. (My 0.25 dose is actually 1.5 drops as I have checked and measured my dosing).
I have two questions…do I need to make any changes or try to see what he would do on his own (OTJ) or just keep things as they are?

My second question… I have to go out of town for the day on Saturday and will not be home for his PM shot. My husband will be here and is willing to learn to give the shot, but he is nervous. We’ve practiced drawing up the tiny dose, but he’s not consistent, and he hasn’t done an injection. Liberty doesn’t have loose skin and it’s tricky to get a nice “tent”. So, I’m wondering if skipping his PM shot would be an option? Trying to weigh my options and reduce stress to both Liberty and my husband, lol!
 
Hi Julie! I’m sorry for not getting back with you sooner on Liberty’s progress. Liberty is doing so well on the .25 dose. If you are really uncomfortable about your husband giving the p.m. dose on Saturday night, I don’t think it will hurt him if you just skipped that night. It would be very good, though, if you could get a few tests that evening to see what happens with the skipped shot.
 
Suzanne & Darcy said:
Hi Julie! I’m sorry for not getting back with you sooner on Liberty’s progress. Liberty is doing so well on the .25 dose. If you are really uncomfortable about your husband giving the p.m. dose on Saturday night, I don’t think it will hurt him if you just skipped that night. It would be very good, though, if you could get a few tests that evening to see what happens with the skipped shot.
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He’s great at testing! I also just talked to him (he gets back in town today) and he wants to practice giving the shot tonight and tomorrow so we can see how he (and Liberty!) does. I’ll let you know how it goes.
 
JulieL said:
He’s great at testing! I also just talked to him (he gets back in town today) and he wants to practice giving the shot tonight and tomorrow so we can see how he (and Liberty!) does. I’ll let you know how it goes.
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Have y’all ever tried shooting in a different area than the scruff? Or have you tried the roll method? I never did, but some people like shooting in different areas and find they get better absorption of the insulin.
 
Suzanne & Darcy said:
Have y’all ever tried shooting in a different area than the scruff? Or have you tried the roll method? I never did, but some people like shooting in different areas and find they get better absorption of the insulin.
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I tried the roll method, but I wasn’t a fan of that, and Liberty winced. I avoid the scruff area and seem to get better absorption if I shoot more on his sides. Recently though I’ve been shooting closer to the scruff and it seems his numbers have been slightly higher, so I think I’ll try some different locations to see if there’s a difference.
 
Suzanne & Darcy said:
Hi Julie! I’m sorry for not getting back with you sooner on Liberty’s progress. Liberty is doing so well on the .25 dose. If you are really uncomfortable about your husband giving the p.m. dose on Saturday night, I don’t think it will hurt him if you just skipped that night. It would be very good, though, if you could get a few tests that evening to see what happens with the skipped shot.
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We decided to skip the PM shot last night. He stayed in the greens and AMPS this morning was 111 (a pretty typical PS number). I was curious to see what his numbers would be.

On another note- food question. Liberty has been eating FF pate Turkey and Giblets exclusively. It has a lower (but not as low as I would like) phosphorus content than the other flavors (except the Savory Salmon , but I limit fish). Second ingredient on the Turkey and Giblet is liver, so now I’m wondering if he’s getting too much liver. So, my question is- should I be concerned about the amount of liver he is eating?
 
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Hi there! About the liver, cat nutrition guru Dr. Lisa
Pierson on her catinfo.org website says:

“Avoid foods listing “liver” as a first ingredient. (Example: Purina’s prescription diet DM canned for feline diabetic patients. There are far better options available that are healthier and not as expensive.)

Liver is a very nutritious organ meat – and should be present in small amounts – but it should never be the first ingredient as it is very high in vitamin A and possibly D and you don’t want to feed too much of those vitamins. Liver is cheaper than muscle meat so it will increase a company’s profit margin when used in high amounts.”
 
JulieL said:
Yes, I was pretty happy about that! Do you think we should see how he does on one drop dose? (My 0.25 dose is 1.5 drops) Or do we just maintain the 0.25 dose?
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I have been thinking about this for a few weeks now as I have been studying Liberty’s spreadsheet. I very much would like to see how he would do on a one drop dose. It’s good that you have measured out your .25 dose. Do you feel confident in drawing a one drop dose? We recommend inserting the syringe into the vial with the plunger depressed and then let it go so that the syringe will draw in a drop of insulin. You can test it out to see if you can get a drop in by that method.
 
Suzanne & Darcy said:
About the food issue, do you think it would be possible to switch him to a different type of food other than the Friskies pate?
Here’s a food chart I have on Weruva foods that are low carb and low phosphorus.
https://www.bizave.com/foodlists/Weruva Low Phosphorus.pdf
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I’ve got the Weruva BFF Topsy Turvy and Take a Chance that I have been slowly adding. The carbs are a bit higher (5%) than the FF (2%). I wondered if the slightly higher carbs will affect his BG but testing will tell. Although if I also drop his dose to 1 drop at the same time it will be hard to know. Hmmm. I’d really like to see how he does with 1 drop.
I’ll be gone for several hours today, so will use the timed feeder, but won’t be able to test. I work with a wildlife rehab organization here-Appalachian Wildlife Refuge- and I need to transport a baby great horned owl to Carolina Raptor Rescue in Charlotte today. But I think I’ll start the 1 drop dose either this evening or tomorrow.
 
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Suzanne & Darcy said:
I have been thinking about this for a few weeks now as I have been studying Liberty’s spreadsheet. I very much would like to see how he would do on a one drop dose. It’s good that you have measured out your .25 dose. Do you feel confident in drawing a one drop dose? We recommend inserting the syringe into the vial with the plunger depressed and then let it go so that the syringe will draw in a drop of insulin. You can test it out to see if you can get a drop in by that method.
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I’ve been practicing my 1 drop dose, and I’m actually able to consistently get 1 drop by drawing up a 0.5 dose and pushing out 2 drops. (My 0.5 dose is 3 drops). I tried the other method you mentioned, but it didn’t work for me. Such tiny little doses!
I’ll be interested to see how his numbers look with a 1 drop dose and the transition to Weruva BFF. Can’t tell right now if he likes the Weruva- he seems to leave some in his bowl and I have to add “magic dust” (Pure Bites sprinkles). Could just be that he knows how to coax more “magic dust” from me!
 
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So far okay on the one drop. I just wanted you to know that I didn’t forget y’all! I care about you and about Liberty even though I have been struggling a little lately!
 
Suzanne & Darcy said:
So far okay on the one drop. I just wanted you to know that I didn’t forget y’all! I care about you and about Liberty even though I have been struggling a little lately!
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Oh, Suzanne- I know you care! You care so much and offer so much help. And, I know you have a lot going on with your life and kitties, and I worry about you struggling. Liberty is stable, and we are cruising along. There are others having pressing issues with their kitties- we are fine.
 
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Hi Julie! Liberty has been in normal BG numbers for two weeks now (50-120) and, in fact, pretty much all green! So he’s earned a “reduction,” which in Liberty’s case means an OTJ TRIAL since he’s been on this drop dose for quite a while. I am really excited! Here are the official instructions for the OTJ Trial.

OTJ trial instructions:
  • Start the trial on the next green pre shot.
  • If he/she is green at your normal test times, no need to test further until the next "PS" time; just feed small meals and go about your day. If he/she is blue at your normal "PS", feed a small meal and test again after about 3 or 4 hours. If his/her number is lower 3-4 hours after a meal, then the pancreas is working!
  • Post every day so we can monitor your progress and see if any tweaks are needed. He/she may have a sporadic blue number. Don't panic but post before you decide whether to shoot so we can have a discussion.
  • After 14 days of no insulin, we have a party!!
Sometimes the trial doesn't work the first time and we have to give a little more support in the form of resuming insulin. It's not the end of the world if that happens; we just give him/her the support needed. Our goal is a strong remission and it's better to take our time to get that than to rush into remission just to have it fail later on.

Once he/she is through the trial successfully, you enter a new phase. Your cat is still diabetic but has now become diet-controlled. Continue feeding low carb food in the manner successful for your kitty. If you decide to change his/her feeding schedule, let your meter be your guide to the best times to feed. Avoid medications with sugar in them and steroid medications unless they are medically essential. Continue testing blood glucose weekly for the first month and then monthly forever. It's a good idea to weigh him/her monthly. Weight should remain stable. If he/she seems "off" or sick, or is showing signs of diabetes (excessive drinking, eating, urinating, weight loss), testhis/her blood glucose right away. Keep the teeth and gums clean and healthy; dental issues can bring a cat out of remission. If you see rising blood glucose numbers, it's time for a visit to the vet!
 
Suzanne & Darcy said:
Hi Julie! Liberty has been in normal BG numbers for two weeks now (50-120) and, in fact, pretty much all green! So he’s earned a “reduction,” which in Liberty’s case means an OTJ TRIAL since he’s been on this drop dose for quite a while. I am really excited! Here are the official instructions for the OTJ Trial.

OTJ trial instructions:
  • Start the trial on the next green pre shot.
  • If he/she is green at your normal test times, no need to test further until the next "PS" time; just feed small meals and go about your day. If he/she is blue at your normal "PS", feed a small meal and test again after about 3 or 4 hours. If his/her number is lower 3-4 hours after a meal, then the pancreas is working!
  • Post every day so we can monitor your progress and see if any tweaks are needed. He/she may have a sporadic blue number. Don't panic but post before you decide whether to shoot so we can have a discussion.
  • After 14 days of no insulin, we have a party!!
Sometimes the trial doesn't work the first time and we have to give a little more support in the form of resuming insulin. It's not the end of the world if that happens; we just give him/her the support needed. Our goal is a strong remission and it's better to take our time to get that than to rush into remission just to have it fail later on.

Once he/she is through the trial successfully, you enter a new phase. Your cat is still diabetic but has now become diet-controlled. Continue feeding low carb food in the manner successful for your kitty. If you decide to change his/her feeding schedule, let your meter be your guide to the best times to feed. Avoid medications with sugar in them and steroid medications unless they are medically essential. Continue testing blood glucose weekly for the first month and then monthly forever. It's a good idea to weigh him/her monthly. Weight should remain stable. If he/she seems "off" or sick, or is showing signs of diabetes (excessive drinking, eating, urinating, weight loss), testhis/her blood glucose right away. Keep the teeth and gums clean and healthy; dental issues can bring a cat out of remission. If you see rising blood glucose numbers, it's time for a visit to the vet!
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Hooray!! I am so excited! I can’t thank you all enough for helping Liberty and I navigate this journey. I dread to think what would have happened if I hadn’t found this wonderful forum. Thank you, thank you!

Ok, here we go…
 
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