Remission? 72+ hours OTJ...more experienced eyes welcome

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sheeboo

sheeboo

Member Since 2016
Cross-posting here and in the Honeymoon forum....

Kahn hasn't had insulin since 7am MST on Friday. His numbers have gone as high as 173 but he's coming back down into low 100s by himself. Today, we haven't seen anything over 125.

Do the more experienced eyes agree with my call to withdraw insulin?

Background:
Kahn was dx'd a few years ago and put on Vetslin. When he came to live with me, I switched him to Levemir about a year and a half ago; went 100% wet food a year ago and has been steadily needing less and less insulin.

He was doing well on 1-.75U Levemir 2X/day and Friskies classic pate for most of the past year. I would check BG on Sundays and sporadically whenever he seemed off somehow.

In Feb, on a spot check, he was 32. So I started testing more often and we dropped him down to .5u/2X day.

He was doing well on .5u but there were a few lows (40s). I finally got some more ketone strips last week so felt safe withdrawing insulin over the weekend while being able to test more often.

Here are the past two days

Am I doing this correctly? Safely? Suggestions? I'm thinking I'll bring him in for general blood work soon - is there anything specific/else I should be thinking about?

Thanks, everyone!
Brie
 
Hey there! His numbers are a little higher than they should be for a OTJ. Did you retest the 46 reading on the PM cycle of 4/28? And was he eating okay that day? It looks like you took him off insulin when he popped that 65 on the PM cycle of the 28th. According to SLGS he earned a reduction and it would have been better to take him to .25 unit rather than off insulin. And after he earns another reduction, you would go to 0.1 dose.

I think he would benefit with some more insulin support. You want them to be under 100 most of the time with an occasional low blue. If it were my kitty, I would go back on a dose of .25 until he earns another reduction then go to 0.1. He is so close........ but not quite there IMHO.
 
I cannot figure out how to dose .25 accurately. Calipers? I know young kids with type 1 sometimes use diluted insulin but I think it is very expensive to have a pharm make it. It would be nice to be able to give him a little when he's higher than I'd like to see.

With his numbers so far today, I'm thinking even .25 may be too much, though, no?

I just ordered some 0 carb food. What he's eating has about 4-5 cho now so I'm thinking I may be able to help nudge him lower w/food.

He hasn't been ill, no puking.

Thanks for thinking this through with me!
Brie
 
Here is what it looks like. I do use calipers, but for you this close to going OTJ I wouldn't bother. Start with a good syringe where the markings are where they should be. Find that by taking the plunger and pushing it all the way up and the top of the plunger should be even with the zero line. Consistency is the most important, so make yourself a sample syringe with colored water or coffee or tea so that you can compare the insulin syringe against it.

upload_2018-4-30_19-21-36.png
 
I agree it's a little bit early to start his OTJ trial the longer you can keep him on even a very small amount of insulin the better chance he has to get into remission and stay there for a longer time I think this post will help you


http://www.felinediabetes.com/FDMB/...ng-reductions-and-starting-otj-trials.150160/

If you need to lower his dose from 0.25 I would suggest you go to 0.1 unit and then to a drop
 
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Thanks. The Cliff Notes are helpful!

Even with his numbers today you'd continue dosing?
AMPS 95
+5 53
+10 93

Thanks,
Brie
 
Brie, those are some good numbers! I think I would try the drop dose to just give him a little more support if his PMBG is over 100. AND if you can monitor him tonight.

Why can I only see from 4/27 to today on the SS?
 
Bobbie And Bubba said:
Brie, those are some good numbers! I think I would try the drop dose to just give him a little more support if his PMBG is over 100. AND if you can monitor him tonight.
Click to expand...

That's my plan too. I really appreciate the hand-holding!

Bobbie And Bubba said:
Why can I only see from 4/27 to today on the SS?
Click to expand...

Before the 27th, I was only spot checking (and not recording on the form). He was usually between 80-170 but then I caught a few 30s-40s towards the end of last week and decided to pick up some ketone strips and check every few hours while withdrawing insulin
 
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