OTJ v. Continuing Low Dose

Since the first few weeks of therapy, Brutus has been super well regulated while becoming essentially diet controlled. For a big cat (ideal BW 16 pds), he's down to a very small .5 unit dose on Lantus. His BG never leaves the range of a normal, non-diabetic cat, which is 68-118 on the Alphatrak that I use.

The tight protocol I've been following actually dictates further dose reductions based on the numbers Brutus has been maintaining. That essentially means I'd take him OTJ. Once OTJ, the protocol provides that I don't return to the juice if his BG remains within 180% of the highest readings I'm getting now. In other words, instead of maintaining Brutus' maximum BG below 118 (the typical high limit for a healthy, non-diabetic cat) as I have the past few months with .5 unit doses, his BG would likely rise to between 118-218 much of the time without the injections. For example, just the other day we missed 4 consecutive doses because of an unavoidable schedule issue, and his numbers rose to 133, which is about 10% above his typical 118 high mark.

Giving injections is no big deal to me, and I've seen no indication that the small doses he is receiving gives rise to any serious hypo risk. Besides, I always plan do some monitoring almost daily, so if his numbers started trending too low, I'd likely get a sense of it before it became a norm.

Here is my question. If I know Brutus stays in ideal, healthy cat, BG range (i.e., 68-118 on Alphatrak) with a low carb wet diet and regular (or mostly regular) small doses of Lantus, do I really want to end doses altogether if the result is a BG range that expands to 118-218 a fair amount of the time? If there is absolutely no health benefit from keeping him within normal, non-diabetic cat range (i.e., 68-118), then I'll stop the injections so long as he doesn't starting spiking above 218 (per the protocol), which I have a hunch he won't do.

OTJ sounds great, but if the cost is a somewhat elevated BG, then I'm not so sure. Thoughts?

 

Many of the folks in the Lantus forum dose smaller amounts than 0.5 units by using calipers. You might post the question there.

 

That is a pretty small amount of insulin for a cat the size of Brutus. If one thinks about health in general for humans and cats, there are lots of items that are not perfect. Weight, sleep, food, blood chemistry (non-diabetes stuff), etc. I look at a lot of humans (and cats), and many are overweight, or have other issues. Maybe perfect health is hard to acheive.

Brutus may benefit if you go OTJ, from other effects. No more ear pokes, or needle pokes. On the other hand, maybe a 0.25 dose would supplement his insulin. If I got Leo that low, I would consider no insulin. (unlikely with Leo though).