What is upper limit of remission?

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StarburstMom

Member Since 2021
Starburst is creeping up the last few days on her peak BG readings via her new Libre, while also getting quite low still with no insulin (measured 56 on ReliOn this morning). She is getting subQs and although yesterday was an easy subQ session today she struggled a bit and I think her BG is reflecting that and her food today is @9% carbs (will bring this down to 5% tomorrow).
How high is still considered ok for remission?
 
With the in and out insulins it can be a little harder to keep cats in the green numbers Lantus users like to see when you’re trying to get them OTJ since it can be riskier to shoot those borderline preshot numbers. If you start seeing higher blues, it’s good to see what the BG is 2-3 hours after eating. If the BG goes down, it’s a good indicator that the pancreas is working. If it were me, I would not be concerned since you are seeing so much green mid day. My cat went OTJ on Vetsulin while seeing pretty mid range blue numbers, and she still stayed in remission for nearly two years.
 
Are you offering snacks at +9 each cycle?This can sometimes bring down the preshot BGs as the food stimulates the pancreas to produce some insulin.
Are you doing an official OTJ trial?
I'm offering food whenever she wants at this point but biggest meals are AMPS and PMPS. She eats the most between AMPS and +4 typically, with snacks usually around +6 or +8. In the evening I have to remove all food by +4 because I have other cats and she has to eat food with a binder in it (which the other cats can't have). I will make sure she eats at AM+9 today to see what that does. I don't think I can get up at 3am to feed them all (I have 6 cats total) though.
We are doing an official OTJ trial at this point due to how low she's getting during the day with no insulin. She is on day 11.
 
Are you offering snacks at +9 each cycle?This can sometimes bring down the preshot BGs as the food stimulates the pancreas to produce some insulin.
Are you doing an official OTJ trial?
Hi @Bron and Sheba (GA)
Sorry to hijack the thread, i'm lost here, i thought that if you feed your cat it would increase the BG not bring it down or is this just a case of if a cat is in remission or on a OTJ trial.
 
I'm offering food whenever she wants at this point but biggest meals are AMPS and PMPS. She eats the most between AMPS and +4 typically, with snacks usually around +6 or +8. In the evening I have to remove all food by +4 because I have other cats and she has to eat food with a binder in it (which the other cats can't have). I will make sure she eats at AM+9 today to see what that does. I don't think I can get up at 3am to feed them all (I have 6 cats total) though.
We are doing an official OTJ trial at this point due to how low she's getting during the day with no insulin. She is on day 11.
I have six cats too, George is my FD kitty, also CKD, my solution is that at night he sleeps in the kitchen on his own with his auto feeder to get snacks at regular intervals while we sleep, (or if I am out and not around for his snack time) once OTJ his feeding schedule is am +3 +6 +9 pm +3 +6 +9. He gets main Meal at am and pm, with just snacks of 2 TSP at the other times.
Small regular snacks throughout the day are easier on the pancreas and keeps his BG level. You may want to try and adopt that strategy with Starburst. It will of course depend on how good an eater he is and if you are able to separate him while you sleep.

Another alternative if you don't want to separate him out is a micro chip feeder, or placing his food in a room which only he can access via a microchip cat flap,we have had members in the past who have made feeding enclosures to look like furniture so only their FD kitty will have access to the food.

FWIW I have noted that if George fails to eat his snack, (if autofeeder failed to open). Then his ambg is higher, often blue, whereas it is usually green if he has had his snack.

As Starburst is essentially not on insulin, right now, you don't need to worry about the effect of the prozinc cycle as he's not getting it his BG is not being influenced by it.

You can see on the SS that Starburst usually brings his BG down a couple of hours after his am/pm meal. That tells us that the meal stimulates his pancreas into producing some insulin.

If you can get rid of the blues with a change to that feeding schedule, it will increase the likelihood of a strong remission. He's getting a few too many blues for my liking, if he were mine is be trying to manipulate his BG with the food to get rid of them.


Hi @Bron and Sheba (GA)
Sorry to hijack the thread, i'm lost here, i thought that if you feed your cat it would increase the BG not bring it down or is this just a case of if a cat is in remission or on a OTJ trial.

Yes it would if the pancreas isn't working.

But for a cat in remission or approaching it, (so a cat on a micro dose) a small snack will often stimulate the pancreas into producing some endogenous insulin which in turn will bring the BG down.
 
Hi @Bron and Sheba (GA)
Sorry to hijack the thread, i'm lost here, i thought that if you feed your cat it would increase the BG not bring it down or is this just a case of if a cat is in remission or on a OTJ trial.
That’s a good question.
If the pancreas is working normally in a cat (or human), after the cat eats, the pancreas will produce insulin which will bring down the BG. In a diabetic cat, this doesn’t happen because the pancreas is not producing any insulin. But when a cat is getting close to remission and the pancreas is producing some of its own insulin, if you give the cat a snack at say +9, the pancreas will be stimulated to produce some insulin and the preshot or the AMBG should be lower than the +9 BG.
 
I have six cats too, George is my FD kitty, also CKD, my solution is that at night he sleeps in the kitchen on his own with his auto feeder to get snacks at regular intervals while we sleep, (or if I am out and not around for his snack time) once OTJ his feeding schedule is am +3 +6 +9 pm +3 +6 +9. He gets main Meal at am and pm, with just snacks of 2 TSP at the other times.
Small regular snacks throughout the day are easier on the pancreas and keeps his BG level. You may want to try and adopt that strategy with Starburst. It will of course depend on how good an eater he is and if you are able to separate him while you sleep.

Another alternative if you don't want to separate him out is a micro chip feeder, or placing his food in a room which only he can access via a microchip cat flap,we have had members in the past who have made feeding enclosures to look like furniture so only their FD kitty will have access to the food.

FWIW I have noted that if George fails to eat his snack, (if autofeeder failed to open). Then his ambg is higher, often blue, whereas it is usually green if he has had his snack.

As Starburst is essentially not on insulin, right now, you don't need to worry about the effect of the prozinc cycle as he's not getting it his BG is not being influenced by it.

You can see on the SS that Starburst usually brings his BG down a couple of hours after his am/pm meal. That tells us that the meal stimulates his pancreas into producing some insulin.

If you can get rid of the blues with a change to that feeding schedule, it will increase the likelihood of a strong remission. He's getting a few too many blues for my liking, if he were mine is be trying to manipulate his BG with the food to get rid of them.




Yes it would if the pancreas isn't working.

But for a cat in remission or approaching it, (so a cat on a micro dose) a small snack will often stimulate the pancreas into producing some endogenous insulin which in turn will bring the BG down.
I can't separate her at night from the others unfortunately (open plan living/dining/kitchen), but could try and see if a snack @3am helps.
However, she may be in acute kidney failure as her creatinine jumped from 2.0 to 3.2 in a month. Her labs are on Thursday to see where she is after the daily subQs....I will likely wait until then as I don't know if length of remission will really matter in the end
 
Even if ckd is added many cats live years diagnosed with it. Her level is not that high. A great site is tanyascrf.

https://www.felinecrf.org/
Thanks. I've been reading Tanya's site like crazy too, but most members on that forum also think the jump in 30 days is unusual. Thursday's labs should tell me if she is continuing to progress rapidly, she is stabilizing, or (fingers crossed) a latent infection may have caused the increased creatinine.
I'm not worried about diabetes anymore, it's been a complete 180 to worrying about kidney function. I still don't know what caused her to crash in the first place and lose weight so quickly (she has steadily gained since diagnosis).
Part of my concern also is I currently work from home, but will have to go back in the office someday (October is current date but it has been pushed back a lot). Trying to figure out how to do this with separate feedings, subQs potentially daily, and all the other logistics while I'm not here is daunting.
I will make sure she snacks regularly in hopes of keeping her in the greens as much as possible (she was hungry last night, but I couldn't do subqs until later and needed her hungry to be distracted enough for subqs)
 
If it’s acute ckd it can go back to normal. Fluids might just be once a day once this passes. Maybe caused by a uti? Prayers for best case scenario.
 
I just read that egg whites are very low in phosphorus....since I don't want all the cats ingesting phosphorus binders I wonder if I can cook up egg whites during the mid-night feeding?
 
Egg whites won’t but bind with the food. They are good to add low phosphorus protein to the food. If it’s just as a snack snd small amount of food don’t worry about no binder being added.
 
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