How do you like me now? All blue and green

Hello cat family, I am here to brag and give hope at the same time to those in the midst of the struggle. Simba has gone 16 days now without an injection and has stayed in the blues and greens. Over two weeks ago you can see he had a .01-.02 but I doubt it was even that much. He has his strength to jump and hardly peeing or drinking to excess now. Unlike the hot mess we both were back last Thanksgiving. Hope I am not dancing too soon, but things look great from here now.

I hope 13 year old Simba's pancreas health stays static. I share this success with the many caring members of this board who prodded me along in the struggle with dosing guidance. Stay the course those still in the trenches. There is hope of remission.

 

I'm so happy for you and Simba! It's such a relief when we get there. Thank you for sharing!

 

Very nice.

 

That's fantastic!!! Brag and dance all you want!!! Good going Darwin and Simba!

 

Congratulations well done. So happy for you and Simba.

 

The SS is looking very good but I think you need to be giving insulin for a bit longer to make sure you get a strong remission. It is much harder to get remission the second time around.
We like to see kitties in numbers under 120 or preferably in green numbers all the time before they try remission. Then in the 14 day OTJ trial they need to be staying in those low numbers. You are still getting quite a few blues ones over 120. We suggest going down from 0.2 to 0.1 then a drop to support the pancreas while it heals completely and Simba can get a strong remission.
I’m going to tag @Marje and Gracie who is very experienced for her opinion.

 

Hi and nice to see you and Darwin! I agree with Bron that he could still use some insulin support. I hate to be a kill -joy... but, as Bron said, with a human meter, we want to see the numbers all under 100. Also, looks like you went from 1 unit to 2 cycles of .50 to NS and few more .20 then NS. We usually take them down in increments of .25. So he should have gone from 1 unit to .75 and unless he earned a reduction to a number under 50, he would get one for being in all green numbers for 1 week, then a reduction to .50 unit and then to .25, to 0.1 and then off.

You probably saw some of those lower numbers and reduced. But, remember, Lantus is great at keeping lower numbers flat. We want those numbers to be under 100 and down to 0.1 dose before we start a OTJ trial.

You want the strongest remission and want those beta cells to restore. Each time they have to go back on insulin, it becomes a little harder to get them off the insulin again. Just ask Bubba, three times on and hopefully a 4th time OTJ.

Where do you go from here? I think if it were my kitty, I would get him on at least .25 of a unit and see how that goes. And remember, when doing a OTJ trial, if your pre shot number is a blue number, you want to get another test in about 3-4 hours after eating to see if their pancreas can bring them back down to a green number. He has quite a few blue pre shot numbers.

Let's see what others say.

 

@Bobbie And Bubba you explained that very well.

 

I agree that he still needs a small amount of insulin. Without seeing how low he’s going without insulin, it’s hard to get a good feel for what he needs. However, he is getting into green PSs on his own so I might start with 0.25u but only if you can more tests in. If you can’t test more, I’d start back at 0.1u.

 

OK, will start taking numbers mid PS..... see how that goes. :^) He is in the green after eating when AMPS blue.

 

He is too low (IN the normal range) to give any shots. I don't know how to insure his remission that may or may not last. Only time will tell for this whether it lasts only weeks or for the rest of his lovely furry life with me. Blues turn to green 3+ after feeding. Normal. Will keep checking and spot checking for rest of month.
*Meanwhile I have Oscar - my aging 18+ year "feline aids" kitty going south rapidly..... His passing is expected soon and he has outlived the rest of the original pride by many years. Down to 6 lbs now. It will be a relief to us both in the end I'm sad to say.

 

First, I want to say I'm sorry to hear about Oscar...When our babies are sick, it is always a relief in a way, because it means they are out of pain. Hugs and love.

That being said, maybe you have too much going on to continue juggling Darwin...No one judges on this board that I've seen...He is doing well, congratulations!

However, I believe maybe you have the same misunderstanding I did until recently about SLGS: that's its a "protocol" to be followed to obtain hopefully regulation or remission. I've learned it's not a protocol, rather a set of guidelines. The original no shoot number is 90, but as the cats numbers lower, the caregiver can gradually lower the no shoot number, as now there is more data on the cat, to continue lowering numbers until they are all (or mostly all) in a normal range. From the otj sticky:

"OTJ TRIALS:

Prior to starting an OTJ trial, one wants to see kitty mostly in the range of a healthy cat (50 - 80 mg/dL), but under 100 overall... with only occasional readings in the 100 - 120 range.

Remission is achieved when kitty can go 14 days without insulin while maintaining normal blood glucose values under 100 overall. Most will stay in the 50 - 80mg/dL range. Although, some will occasionally experience BG numbers up to 120 mg/dL."

Darwin has some beautiful green pmps, but overall his numbers are still mostly above normal (and even most of his "normal" numbers can be shot eventually, for example the TR shoots down to 50.)

We *can* and *do* shoot normal numbers. Shooting normal numbers actually helps support the pancreas as it heals...It doesn't have to do *all* the work all at once.

*Shooting a lower number doesn't mean he'll constantly drop or steeply drop, it just helps bring the curve flatter, which is what we want...A shallow curve with green bookends (the preshots).* The curve really does flatten.

Again, this will most likely help Darwin achieve a remission he'll hold. Some cats do hold a remission with similar numbers to Darwin; many do not.

Of course, it's your choice whether to try him now, or whether you opt to lower his shooting numbers to work him down some more to all or mostly normal numbers If you choose not to, that's fine! I just wanted you to understand (if you didn't already) that the SLGS guidelines are just that, guidelines, meant to be altered when we have the data and confidence to do so.

Best of luck with whatever you decide! With love, Nikki

ETA Simba! Replace all the Darwin's with Simbas lol. Sorry about that... I think of most everyone in terms of their avatar, but mixed this one up

 

He is PS ing alot of green so not to overdose him perhaps I should shoot when in the blue to help him along? When so much green is showing I don't want to send him dangerously lower. That is my fear.

 

Yes, it is honestly scary to shoot your first green; I still find it difficult to lower preshot numbers, Willow recently dropped to lower 70s, and it took me a couple of stalling days and data gathering before I could do so easily

That being said, Simba has lowered his numbers wonderfully with the (ahem) rather irregular dosing he was getting . Lantus as I understand it works better with regular dosing twice daily. However, maybe you should pick a no shot number, say any blue (which is down to 100) as you suggested. This will build up your confidence at Simbas response, and Simbas data at being shot in those numbers since the lowest you've ever shot was 124, I think. Be comfortable knowing that SLGS starts shooting down to 90, which is in the greens.

That means you'll be skipping many green pm preshots until you're more comfortable, and maybe his am preshots will come down anyway to green, maybe not. We'll have to wait and see how Simba does

I see @Marje and Gracie recommends starting at 0.1U unless you can get more tests in; if you can test more frequently, she recommended 0.25U. Maybe, if you could, you could test a couple of times every cycle to help build up some more data (like+3 and +9 one cycle, or +4 and +7 another) to "fill in the blanks". Evening cycles are also important, since many cats drop lowest at night, so a before bed test or 2, or a mid-or-late cycle test if you can set your alarm, is always helpful.

That darn am preshot is often the last blue to come down!

I'm a newbie and don't give dosing suggestions, so I'm tagging @Bobbie And Bubba as well as @Bron and Sheba , who can maybe offer better suggestions on lowering your preshot numbers at a *safe*, comfortable pace, and if skipping those green pm preshots is ok at the moment.

You're doing great helping Simba! I can't wait to see more greens and a strong OTJ trial for him

With love, nikki

 

I’m sorry to hear about Oscar. They weave their way into our hearts don’t they and leave such a gap when they leave.
I see you have given 0.1 units for the PMPS of 102. That’s good. It’s also good that food is bringing down the BSL. That means the pancreas is doing what it should. See how you go with 0.1 units.
When Sheba went into remission the first time (after 3 months) the vet had me give her just a drop for several weeks. This was pre forum days for me. But it certainly helped with a strong remission. If she hadn’t been prone to pancreatic flares (which always raised her BSL for a couple of days) she would have stayed in remission much longer. She was in remission for over 2 1/2 years.
Simba is almost there.

 

My sympathies for you and your sweet Oscar kitteh. It is hard losing them. I'm sure Oscar knew a loving household. And you gave him the gift of an extended life. A lot of kittehs don't make it to 18. I hope his remaining days are spent eating all "the good stuff with gravy that we aren't supposed to feed".

 

Trying to smooth out to all green from the intermittent blues so I am thinking of helping him along with a mini shot .1 shot every day to maybe only every other day?
So far so good. Thanks for those of you that know about Oscars downhill slide heading for the rainbow bridge soon..

 

Darwin, I am catching up with people after being off/intermittently on the board and so happy to read about Simba.
I am also saddened to read about Oscar, and know that you will ease his last days as much as possible. You have done so much for him, taken such good care of him. Peace to both of you.

 

Darwin, I'm so sorry you're loosing your Oscar

 

I'm very sorry to read about the sad news of your Oscar...I've walked that last mile myself with a special girl named 'Miss Puss' who had mammary cancer...I knew what the end would be and it tore me up...so it's never easy...but it was a blessing that she was no longer suffering or in pain....sending my sympathies to you. Simba has come a long way baby! Hope you can give that little drop as needed to level the steps to remission...hope for a strong one that lasts for the rest of his life Best wishes to you!

 

Thank you all for the kind thoughts. I lost Oscar yesterday. I sobbed before, during and after bringing him in for the shot that would free him. He was wasted down to barely 5 lbs. I am still in shock and a relief also in some ways. Oscar took a big smelly poop in his carry cage on the way there - he must have known something was up! I'm kind of laughing about that. He never did that before. He was a feral save in 0 degree December weather in Spokane WA 13 years ago - and the alpha cat who outlived the rest of the pride. Now it's only The Simba and me. From 4 cats to only 1 - 15 years later. Simba will be my last. * Simba has been more in the blue than green last coupla days so I am giving him his shots to hopefully get all in the green soon. Ugh. The beat goes on.

 

Darwin, I'm so sorry for your loss, they don't stay with us long enough. You saved him and he was loved for 13 years and it's heart breaking to have to say goodbye. Cuddle with Simba, he will bring you comfort.

 

Yes he does... He has been such furry big personality cat all his life. I've had him for 10 years now and hoping for many more.

 

I'm so very sorry to hear of Oscar's passing. I have a 21 yr. old who will no doubt be taking his final journey in the not too distant future. It's so very hard to watch them go downhill. You gave him a good life and love and were his guardian angel. He is your guardian angel now! RIP Oscar.

 

I am so very sorry it was Oscar’s time. We never have enough time with them. Sending heart healing vines to you and yours.

 

I'm so sorry for your loss. The years fly by too fast with them. Thinking of you with love, Nikki

 

Well, it seems to strange to have only 1 cat, Simba, from 4 total but Simba seems to be handling it very well not having to look over his shoulder at Oscar giving him the evil eye all the time. I have nuthin but greens now and under the advice of the Vet have mostly stopped injections unless I see a blue which is mostly never lately. He is as normal as ever with climbing, eating and peeing. Sim's seems to be in remission at the moment. Hope it lasts.

 

Oh Darwin, just seeing the news about Oscar. So very sorry, and I'm so very thankful you were able to make sure his passing was peaceful. Bless your heart. You are a good pet parent, and Oscar was so very fortunate to have you care for him all those years.
Hugs to you, chin scritches for Simba. Peace and comfort for your grieving heart.

 

Lou, Thank you so much for your kind thoughts.... It seems so strange to be without him now and a relief at the same time for both Simba and me. Simba seems very non-plussed about it all and welcomes all the love and petting he no longer has to share time with me but gets it all now... LOL!! :^)