Gato had his two week checkup today and is doing really well! We should be getting fructosamine results tonight or in the morning. Vet was cautiously optimistic about progress and if we stay at low dose and numbers consistently look good over the next few weeks, we're to try a trial OTJ with monitoring to see how he does. The vet about had a heart attack when I said we switched to U-100s, but I brought in the conversion chart for him to look over and he seamed much more at ease and confident in some microdosing when his levels warrant. I'm getting relieved and excited, but anxious. He needs quite a bit of dental work for rampant absorption. We're still a ways from that as we're waiting for him to be more regulated. I'm assuming numbers may go a bit haywire from any sort of surgery.
Fructosamine came back at 318. Vet would like to try 5-7 days OTJ with more home monitoring and to call him if the numbers get wonky. He seems a bit uncomfortable with the green numbers and lower margin for error. He advised in his opinion Gato may be either too sensitive to PZ or potential considered diet regulated at this point.
I'm not super on board with your vet's advice here. (shocking, I'm sure! ). Gato isn't dropping too low with the small doses right now. And his numbers aren't really low enough to be off of insulin just yet. My hunch is he's going to get there very soon though. For a cat to be diet controlled, most of their numbers should be 50-80, with occasional numbers up to 120. You're still getting numbers over 120. If it was me, I would keep giving micro-doses for a little longer until he's staying in those ranges more consistently. Also, getting the dental done might be enough to kick him into remission. Cats with dental issues usually run higher numbers, so getting that resolved might be the last thing needed to really be safe going off of insulin.
I'm so confused and questioning everything at this point. I thought we were doing so well. The vet and I talked extensively last night, I trust and respect him so it's difficult thinking that his opinion may be a bit off from what we need. I'm sure a lot of people run into this, but man it's so disheartening. I think a lot of the vets apprehension has to do with syringe changes and our work schedules which renders us unable to monitor most weekdays. I can understand this from a liability perspective but I feel like we've been on top of it enough to mitigate these kind of concerns. It would really be nice if u-40s had half and quarter measures! I think he would be more on board if that was the case. He seems to feel that if his BG is on the higher range (still under 200 ideally) paired with an in range fructosamine and clinical symptoms continue being at bay that it's better than being at a potential hypo position on a daily basis. I think I'm going to give it a few days under his recommendation and see how the numbers go. If they start climbing I think we may give their office a call and go back to microdosing.
Please don't let this cause you stress. We have a phrase we use a lot around here: "you hold the syringe". I will always give you my best thoughts on a situation, but if at the end of the day you feel more comfortable taking the vet's suggestion, please don't ever feel badly about that. No hard feelings at all.
We're not supposed to advise people to change U40 to U100 but we're past that now. My vet had a partner who shrieked when I switched but my #1 vet said "I figured you'd do that". It's basic math but there's a huge liability issue. I haven't followed closely enough to comment medically but it sounds like you've done your research and you're the opposite of a panicking newbie. That's all I've got today, I should have stayed in bed.
I'm wishing the best for Gato. And as you said, if his numbers start crawling up you'll know right away because you'll be keeping an eye on him. Keep us posted, because I'd love to know how he's doing. I use U100s for Jack, as his doses these days are no higher than .2. Most of them are .1 or only a drop. Jack's heading in the right direction, but he's not quite there yet. And if you find that you have to go back to using insulin, there are u40 syringes with half marks, and you could also just eyeball a .25 shot. But if things turn out okay, you won't have to worry about syringes again!
Thanks for the feedback and kind words. ❤ Semi off topic diatribe incoming because I'm losing my brain a bit today. Been keeping myself busy today trying to get caught up on all the work I've let slip behind in the past few weeks while I've been focusing on being with our boy. I think what stresses me out about dissenting opinions is that each one makes sense to me and comes from a good intent. Everyone wants the best for our boy so it's a bit disorienting! I deal with a lot of dissenting opinions, disputes, litigation at work. Everyone I deal with has their own self serving intent, and you can usually cut through the bullsnaps and see the truth or at least argue with reason as to what you feel is the truth. In my home life and taking care of our sugarbub I'm faced with a lot more grey areas, different methodology, EMOTIONS, and the real time well being of another living creature that I love so much my heart could just burst. It makes my left brain short circuit! Sometimes I just have to breathe and watch him play with his brothers, nap in the sun, just doing cat stuff. He's so happy lately and has the luxury of not knowing how stressful all of this is!
And I could never thank you enough for always chiming in! The advice and experience of members here, you in particular to all of my dosing questions, has been immeasurably valuable. I'm going to try it his way for a few days and see how it goes, but I'm a bit inclined to agree that I would like to see more consistent good numbers before going cold off. We're going to be vigilant about checking in on him and take action when we feel it's needed.
I don't like making promises I can't keep or pretending something isn't happening but I think this will all work out. It's been a very long time since I hovered over our first sugar cat wondering what we did to deserve this but I know how this feels. I'll send you some luck and show you what brought me here in the first place.
I would put a towel on the table for shots. All I had to do was thump the table and he would jump up. He also loved the car! You're not having a crisis, it only feels that way. There must be someone here who knows what this is.
