When and Hows of going off insulin?

First I want to thank the folks who manage this site and all the kind people who are here to offer support and advice. This site and forum is incredible! Upon diagnosis, our vet told us Pete would never recover. ...well he was wrong...we found this site, put Pete on a regimen of insulin with home testing and changed his diet. Now we are hoping to try a trial OTJ in the next few weeks. His numbers are pretty consistent..although we aren't able to test much between shots and we find it very difficult to micro-dose, but do our best to get it to less than .50. I think his numbers are pretty good. First, is he ready? and What would be the best way to do a trial? Kathy

https://docs.google.com/spreadsheets/d/17KG9_XbDIaQfKb9yPWEiHukdIwIFO-GfFdqDfbYWc2k/edit#gid=0

 

Normally, the dose would drop to 0.1u and the kitty would be mostly in green before we start a trial but we've seen some cats go into remission from a bit higher dose. I don't know whether you are following the TR protocol or SLGS method and can't tell what you've based reductions on.

The numbers you have look fairly good but it would be nice to have a few more tests to see what he's doing especially at night. If you work, can you get an out the door and in the door tests and at night get a +2 and before bed tests?

 

I agree with Marje - I'd get a little more information and that will make things more clear and obvious about how you should move ahead.

Since you aren't testing at all in the pm cycle, I'm going to use the guidelines from SLGS.

• Unless your kitty falls below 90 mg/dL (5 mmol/L). If kitty falls below 90 mg/dL (5 mmol/L) decrease the dose by 0.25 unit immediately.

Remission:
Remission is reached when kitty can go 14 days without insulin. Most cats will remain in the range of a healthy cat 50 - 80mg/dL (2.7 - 4.4 mmol/L) with only sporadic higher or lower BG numbers.

However, some will experience infrequent BG numbers higher than the norm. Continue feeding low carb food. Test the cat's BGs once per month. If BG numbers begin to trend upwards, it's time to bring kitty in to see your vet for a check-up. Common reasons for kitty falling out of remission include dental issues, infection, inflammation, pancreatitis, etc. Just about any illness or disease can do it.

Glycemic Status and Predictors of Relapse for Diabetic Cats in Remission

We do know that giving a cat insulin as long as they will tolerate it, meaning that they don't drop below the reduction point, will help the cat have a stronger remission. I wouldn't rush it along, and I would try going to the 0.25u and 0.1u before stopping insulin. Some people use magnifying lenses to help see the syringe markings better, some people stack a couple of pair of reading glasses to be able to see. There are photos of the small doses here.

By the way, not all cats have their nadir (low point) at +6. Even if they sometimes do, nadirs move around. So a test right before bed could be very revealing in telling what Pete's blood sugar is doing.