Questions re: OTJ Trial - Day 1

Ok, we skipped Hoss’ shot last night & this morning. Starting his OTJ Trial. What BG range are we looking to stay in on remission? My Vet said for the trial, her threshold for restarting insulin is 150. Hoss free-feeds, so I often don’t know when he’s eaten last or how much. He’s a grazer. I’m doing an 18-hr curve today and will do another curve tomorrow- not sure how long it takes to completely drain the Lantus depot?

 

Normal range with a human meter is 50 - 120. So, you want to see Hoss in mostly green numbers. Your vet's suggestion re. numbers above 150 is likely based on the vet's using either a meter designed to test animal blood or a serum chemistry analyzer.

Free feeding is fine during an OTJ trial. Small amounts of food stimulate the pancreas to produce it's own insulin and will help to keep numbers in a lower range.

Personally, I wouldn't worry about doing a curve. Either Hoss is OTJ or she's not. I would test at your usual pre-shot times and if you're wanting to be compulsive, get another test or two. With a trial, you want to test for 14 days. Below are the instructions.

• 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.
Good luck with the trial!!!

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), test his/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!

 

The depot can take 4-6 cycles to drain, so you are likely still seeing some good numbers from the depot. Typically we'll go down to 0.25 units, and most often even down to 0.1 units before starting a trial. However, Hoss has certainly been in a hurry to go down dose. Paws crossed for success on the trial.

 

Great advise as always. Keep going you two. You got this.

 

Lovely numbers, good luck with the trial! It's looking good so far