? 10/7 Henri; AMPS 93, +2 53, 47@2.3, 56@2.6, +3 TOO LOW, OTJ TIME?

I had a much more difficult time getting Henri up into the 50's today. She was very cranky with me and didn't want to eat (probably bc she was feeling like poo)
I'm thinkin it's time to go OTJ? I can't be around to monitor her tomorrow other than a couple stop ins and shes on .1
Then next lowest dose would be that drop but it seems everytime we are in the 3rd cycle she drops. I'm thinking it's OTJ time?
 
The next dose is the drop dose. If she goes under 50 I would try it. The depot is still in play. Jennifer’s Kitten who recently went OTJ went through this recently. She did try the drop and Kitten went under 50 so went on to the OTJ trial and so far so good. Still OTJ but it’s just been a few weeks. They have found if the cats can stay on a drop for awhile there’s a stronger remission.
 
tiffmaxee said:
The next dose is the drop dose. If she goes under 50 I would try it. The depot is still in play. Jennifer’s Kitten who recently went OTJ went through this recently. She did try the drop and Kitten went under 50 so went on to the OTJ trial and so far so good. Still OTJ but it’s just been a few weeks. They have found if the cats can stay on a drop for awhile there’s a stronger remission.
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Ah...ok
She did drop below 50...so ill do a drop then.

Is it dangerous being that I can't be home with her tomorrow? My husband has to be in the office and I can only come check on her. And the drop dose...im just pulling in some insulin into the syringe, pushing it a back out, and that last little bit that you have to push really hard on the plunger... thats the drop dose?
 
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Katie_Waz said:
And the drop dose...im just pulling in some insulin into the syringe, pushing it a back out, and that last little bit that you have to push really hard on the plunger... thats the drop dose?
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You insert the needle while holding down the plunger, let go of the plunger, then withdraw from the bottle. Then when you inject, push and hold the plunger in while you withdraw the needle. I didn't when I tried the drop dose and found the drop still in the syringe when I checked. If you are concerned about Henri dropping while you are working, you can add some MC to her breakfast before you head out. I did that often for Rex to prop up his numbers before the onset.
 
See what happens tonight. You can always skip tomorrow morning and that will drain any depot I think. I know the board feels it’s best to try the drop for as long as possible but some cats in my opinion are simply done. Take this cycle by cycle. If there’s any doubt I would skip tomorrow morning. As always others may disagree.
 
Mandy & Rex said:
You insert the needle while holding down the plunger, let go of the plunger, then withdraw from the bottle. Then when you inject, push and hold the plunger in while you withdraw the needle. I didn't when I tried the drop dose and found the drop still in the syringe when I checked. If you are concerned about Henri dropping while you are working, you can add some MC to her breakfast before you head out. I did that often for Rex to prop up his numbers before the onset.
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Ok...and when I withdraw the needle...if I push and the drop is still in should I retry it?
 
tiffmaxee said:
See what happens tonight. You can always skip tomorrow morning and that will drain any depot I think. I know the board feels it’s best to try the drop for as long as possible but some cats in my opinion are simply done. Take this cycle by cycle. If there’s any doubt I would skip tomorrow morning. As always others may disagree.
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Thanks for the input! I think ill do the drop dose tonight and see how she does, it seems early in the 3rd cycle after a dose reduction, she drops too low. If she follows that, ill be home that night to handle it...but if she does it in the morning that's not an option.

I may take her off of everything tomorrow morning to play it safe. She seems to really want to be done lol
 
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tiffmaxee said:
They have found if the cats can stay on a drop for awhile there’s a stronger remission.
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Not quite true. The Dosing Method Sticky Note says "We've found many kitties benefit from reducing the dose from 0.25u to 0.1u before stopping insulin completely." Also see Reminder: *earning* reductions and starting OTJ trials Henri was on 0.1 units for 4 cycles, so long enough to see what that dose did. The drop dose is not part of the protocol, but is a useful tool if a cat is not overall in the 50-80 range before an OTJ trial begins. Henri has been largely in that range.

Katie - have you ever tried counting the number of drops in your 0.1 unit dose? Some people also have found a rather large number of drops in 0.1, in which case a smaller dose may also be of value. Honestly, unless you find lots of drops in 0.1, I think Henri is done this dance.:D
 
So are you saying start the OTJ trial? I would but it’s confusing. So much of the time people are told to go to the drop first. I guess it’s a ECID.
 
tiffmaxee said:
So much of the time people are told to go to the drop first.
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That's because we see a lot of cats that aren't solid green when they get to this point. I'm also taking into consideration the inability to monitor closely tomorrow, given she's going below 50, in what could be a low dose. Looking for confirmation on number of drops in 0.1 first though.
 
Wendy&Neko said:
Not quite true. The Dosing Method Sticky Note says "We've found many kitties benefit from reducing the dose from 0.25u to 0.1u before stopping insulin completely." Also see Reminder: *earning* reductions and starting OTJ trials Henri was on 0.1 units for 4 cycles, so long enough to see what that dose did. The drop dose is not part of the protocol, but is a useful tool if a cat is not overall in the 50-80 range before an OTJ trial begins. Henri has been largely in that range.

Katie - have you ever tried counting the number of drops in your 0.1 unit dose? Some people also have found a rather large number of drops in 0.1, in which case a smaller dose may also be of value. Honestly, unless you find lots of drops in 0.1, I think Henri is done this dance.:D
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I'll count when I get home. What number would you consider a large mount of drops?
 
Mandy & Rex said:
You insert the needle while holding down the plunger, let go of the plunger, then withdraw from the bottle. Then when you inject, push and hold the plunger in while you withdraw the needle. I didn't when I tried the drop dose and found the drop still in the syringe when I checked. If you are concerned about Henri dropping while you are working, you can add some MC to her breakfast before you head out. I did that often for Rex to prop up his numbers before the onset.
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Hi Mandy! Long time no see! Glad to see you're around and that Rex is doing well out there at the Falls!! :)
 
Wendy&Neko said:
That's because we see a lot of cats that aren't solid green when they get to this point. I'm also taking into consideration the inability to monitor closely tomorrow, given she's going below 50, in what could be a low dose. Looking for confirmation on number of drops in 0.1 first though.
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So I just checked...if I squeeze out the syringe until there's nothing there...her .1 dose is 4 drops...maybe slightly less?

Edit: I take that back, its between 2 and 3 drops

Should I do a drop tonight and maybe nothing tomorrow?
 
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Wendy&Neko said:
Not sure what that would get you. Going from 2 drops to 1 drop isn't worth it.
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Ok...I gave her the drop tonight bc I wasn't sure lol

I'll stop completely tomorrow

Is there any risk of her going hypo tomorrow with no insulin if shes pulling from the .1 or even the .25 depot still?
 
yay!! Cant wait to see how tomorrow goes. My guess is that without any insulin tomorrow the risk of hypo would be the limit as n approaches zero. I mean low :D Simon and I will be rooting for you!
 
A cat really can't be hypoglycemic with no insulin. The depot could kick in a bit so leave food out if you won't be home.

Here are the OTJ 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.
  • 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!

Good luck with the trial!!!
 
Oh interesting! I had no idea of any of this!

I'll be sure to make a post daily. And I guess if shes in the blue, you all will explain to me what to do and why? Ate there stickys for this?
 
Katie_Waz said:
Oh interesting! I had no idea of any of this!

I'll be sure to make a post daily. And I guess if shes in the blue, you all will explain to me what to do and why? Ate there stickys for this?
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If you get a blue preshot, feed her and test again in 2-3 hours. If her pancreas is working the bg will come down.
 
It depends on the size of the depot whether you have to worry about a cat going low with no insulin. I fondly remember when Skooter at 5.5 units went off of dry food (well, he wasn't on it but some of the civvies were and Linda didn't think he could get to it). Anyway, she removed dry from the house, he earned a reduction to 5.0 units, then she basically fought a hypo for a day and a half with no insulin given. I was up helping her - it was quite the ride! He didn't have any more insulin after that.

To answer your question about the blue preshot, see the second bullet in the instructions.

Good luck with the trial! :D
 
Wendy&Neko said:
It depends on the size of the depot whether you have to worry about a cat going low with no insulin. I fondly remember when Skooter at 5.5 units went off of dry food (well, he wasn't on it but some of the civvies were and Linda didn't think he could get to it). Anyway, she removed dry from the house, he earned a reduction to 5.0 units, then she basically fought a hypo for a day and a half with no insulin given. I was up helping her - it was quite the ride! He didn't have any more insulin after that.

To answer your question about the blue preshot, see the second bullet in the instructions.

Good luck with the trial! :D
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yikes! thats terrifying! thank you so much!!
 
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