Please help!

Discussion in 'Feline Health - (Welcome & Main Forum)' started by Kako & Tux, Apr 24, 2016.

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  1. Kako & Tux

    Kako & Tux Well-Known Member

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    Apr 24, 2016
    Hello,
    Tux, my cat has diagnosed with diabetes two weeks ago. Blood glucose was 583. Kidney is fine.
    We started insulin.

    I have been reading blood glucose 3 times a day, and giving insulin shots morning and night.
    1 unit first week, now 3 units. When insulin unit was raised, blood glucose dropped but then jumped to over 700! I am so scared.

    He doesn't eat a lot at one time. He likes to munch all day.
    Though since the insulin started, he is allowed to eat mornings and nights only. He asks for food other times but I haven't given because Dr. said so. His weight has been dropping quickly. I feel I should feed him, or he will be weaken.

    What should I do? Please help!!!
     
  2. Tuxedo Mom

    Tuxedo Mom Well-Known Member

    Joined:
    Dec 2, 2014
    It is very possible that Tux is receiving too much insulin, which can cause glucose nymbers to "bounce" up quite high. When starting on insulin it is advised to hold a dose for at least one week to start in order for the kitty's body to get "used" to external insulin. After that insulin is raised by 1/4 or 1/2 unit and again held for 3-7 days. It sounds like your vet has increased the dose too quickly.

    What type of insulin are you using? Also what type of food are you feeding?

    It would be very helpful it you could start a spreadsheet with whatever readings you have so far.


    ETA This link has the instruction for setting up a spreadsheet:

    http://www.felinediabetes.com/FDMB/threads/fdmb-spreadsheet-instructions.130337/

    If you have any trouble just ask and someone can give you a hand with it.
     
  3. DebG

    DebG Well-Known Member

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    Mar 30, 2016
    Welcome! While I am fairly new to the forum. I am sure someone more qualified will be along soon to answer your questions.
    I do understand your scared as I was too. While I can't advise on dosing, I can say I feed my kitty small meals frequently through out the day and a meal in the evening as diabetic kitties need to eat more frequently. You probably already know not to feed two hours before am and pm Insulin dose. If you do you can get a false Bg as the food can raise the BG.
    Please start a spreadsheet so the members more experienced will be able to see how your kitty is doing on the insulin.
    Good luck with Tux coming to this website is the best thing you could do.
     
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  4. Kako & Tux

    Kako & Tux Well-Known Member

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    Apr 24, 2016
    Oh thank you for your response! Insulin is Vetsulin. Food is *Taste of the Wild* that he has been eating for years. I asked vet if he should get diabetic food, but she said *Taste of the Wild* is fine at this point. She is a young new vet.
     
  5. Tuxedo Mom

    Tuxedo Mom Well-Known Member

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    Dec 2, 2014
    Vetsulin is a fast acting harsher insulin. It tends to bring glucose numbers down quickly and hard and then wears out before the 12 hour time period between shots is over. With a spreadsheet and regular testing you will be able to see how low the insulin is bringing Tux. There was another person using insulin that found that the preshot numbers were high but that the numbers in the first 4 hours after shooting were actually quite low. This is common when numbers are much lower than the kitty is used to the body produces counter-regulatory hormones which raise the glucose levels up.

    Without seeing any data I would still question how much insulin is being given and why the doses were raised so quickly without knowing how low the insulin was bringing Tux's numbers down.

    With Vetsulin (same as Caninsulin) you test, then feed, then give the shot about 30 minutes after feeding. You must have food on board before giving the shot. Testing should be done at +1 hours after shooting, then again at +2 and +4 unless the numbers drop too quickly then you would test more often.

    I am not familiar with Taste of the Wild. Is it a wet food or a dry food?

    Many of the people here use Friskies or Fancy Feast wet food (pate only)
     
    Last edited: Apr 24, 2016
  6. Kako & Tux

    Kako & Tux Well-Known Member

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  7. Tuxedo Mom

    Tuxedo Mom Well-Known Member

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    Dec 2, 2014
    I looked up the ingredients of the wet food Taste of the Wild and with the sweet potatoes, potato starch and pea flour it is too high in carbs for a diabetic cat. If you are using the dry food it is definitely too high in carbs. HOWEVER UNTIL YOU ARE TESTING ON A REGULAR BASIS DO NOT CHANGE THE FOOD. CHANGING FROM A HIGH CARB TO A LOW CARB FOOD WITHOUT ADJUSTING THE DOSAGE COULD CAUSE TUX TO GO INTO A HYPO. Many kitties can drop 100s of points with just changing to an appropriate low carb food.


    ETA Unfortunately many vets are not well versed in treating feline diabetes. Many vets only get a few hours training on diabetes for all types of animals.
     
  8. Kako & Tux

    Kako & Tux Well-Known Member

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  9. Tuxedo Mom

    Tuxedo Mom Well-Known Member

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    Dec 2, 2014
    Can you post some of the numbers that you got from home testing so far, If you could state what the preshot number was and how many hours after the shot the other numbers you got were. Thanks
     
  10. Tuxedo Mom

    Tuxedo Mom Well-Known Member

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    @julie & punkin (ga) @BJM

    I am tagging a couple of more experienced members to assist you as I have to tend to my kitties for awhile.
     
  11. Kako & Tux

    Kako & Tux Well-Known Member

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    Apr 24, 2016
    Thank you again, Tuxedo Mom!
    I have never cheked glucose one or two hours after meal. I was told to do readings 8am, 2pm, and 8pm. I shold check more often!
    Taste of the wild that Tux has been eating is dry.
     
  12. Kako & Tux

    Kako & Tux Well-Known Member

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  13. Tuxedo Mom

    Tuxedo Mom Well-Known Member

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    Dec 2, 2014

    OK The food is too high a carb, but DO NOT CHANGE until you have been testing properly. Vetsulin tends to bring the numbers down very quickly in the first few hours. Those are the numbers that you want to see in order to tell if the dose is too high, which I strongly suspect it is.

    ETA I have to be away for a little while but I have tagged a couple of members to see if they can help you with the spreadsheet and advise you on dosing. I'll check back in abit
     
  14. julie & punkin (ga)

    julie & punkin (ga) Well-Known Member

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    Feb 17, 2011
    Let's tag @Sue and Oliver (GA) - I think she has experience with Vetsulin. I don't have experience with it and would hesitate to make suggestions about dose.

    Getting a spreadsheet going is important. It's an incredibly helpful tool and we suggest everyone start one.

    I do think it's ok to feed more than twice a day. Some kitties will seek out food if their blood sugar is getting low so a cat asking for food can sometimes be telling you that their blood sugar is dropping. Food can also help smooth out fast drops in blood sugar.

    Where do you live?
     
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  15. Kako & Tux

    Kako & Tux Well-Known Member

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    Apr 24, 2016
    Insulin (Vetsulin) 1 unit
    4/14 8am:588, 2pm:381, 8pm:590
    4/15 8am:544, 2pm:397, 8pm:481
    4/16 8am:548, 2pm:484, 8pm:452
    4/17 8am:543, 2pm:458, 8pm:481
    4/18 8am:478, 2pm:408, 8pm:?
    4/19 8am:495, 2pm:494, 8pm:630
    4/20 8am:585, 2pm:512, 8pm:619

    Vetsulin 3 units
    4/21. 8am:449, 2pm:333, 8pm:401
    4/22 7:30am:299, 1:30pm:171, 7:30pm:637
    4/23 7am:629, 1pm:302, 7:30pm:733
    4/24. 7:30am:542, 2pm:478, 7pm:471
     
  16. Kako & Tux

    Kako & Tux Well-Known Member

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    Apr 24, 2016
    We live in Eugene, Oregon.
    I've tried to get spreadsheet, but I can't figure how to download. IWill try again.
     
  17. Kako & Tux

    Kako & Tux Well-Known Member

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    Apr 24, 2016
    Thank you for help, Julie and Pumpkin!
     
  18. BJM

    BJM Well-Known Member

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    Oct 6, 2010
    The insulin dose is adjusted based on the nadir, the lowest glucose post-shot. For Caninsulin/Vetsulin, this is around +4 hours after the shot. We describe tests done by how many hours after the shot because the interpretation depends on when the insulin was given. For now, we suggest you never give insulin when the pre-shot test is below 200 mg/dL until you have collected enough data to show it would be safe.

    When the glucose drops to an unfamiliar number (ex hundreds when it had been in the 400s and up), and/or drops rapidly, and/or goes below 50 mg/dL on a human meter or 68 mg/dL on a pet meter, it triggers hormones which release stored glucose (glycogen). This will raise the glucose back up significantly high, for up to 3 days. That 171 on April 22 looks to have triggered a bounce based on the evening's 637 mg/dL reading.


    For our spreadsheet/grid for recording the tests and insulin you've given, you need to have a Google Drive account first. Then, you save a copy of the template to your Google Drive. After that, you can rename it and start entering data.
    AMPS is morning pre-shot
    PMPS is evening pre-shot
    A test 6 hours after the shot goes in the +6 column (when done, otherwise you leave it blank)
     
    Last edited: Apr 24, 2016
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  19. julie & punkin (ga)

    julie & punkin (ga) Well-Known Member

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    Feb 17, 2011
    I'm just north of you in the valley. Welcome to FDMB - the best place you never wanted to be.

    I'd try getting a few tests in sooner after you shoot. Maybe a +3 or +4 (3 or 4 hours after you've shot) to help you get a better picture of what the dose is doing. Maybe one day get a +2 and +4 and another day get a +3 and a +5. I see the 171 in there on the 22nd. Whenever a cat gets into a range lower than it's become used to, that can cause high numbers. We call that a bounce. At the end of the day after the 171, he was over 600 and stayed high the next day. As BJM pointed out, that appears to be a bounce. If your kitty holds the bounce for 3 days, that would mean you would see him clear it tomorrow sometime. So be on the lookout for lower numbers tomorrow.

    Here is a description of a bounce from elsewhere that might help you.

    Another possibility is if the cat dropped quickly, or if the cat dropped into a lower range of numbers than it was used to, that can cause a bounce.

    BOUNCING

    Here is an example of a bounce from someone's recent condo:

    you can spot a bounce this way (this only took me 6 months to learn and a bunch of people explaining it! i'm a slow learner!)

    yesterday morning you had a 215 - then it went 235, 271, 270, and then 308 this morning - basically straight up. no curve. and then look backwards in the ss and the night before was that sweet little 148 12 hours earlier.

    if you imagine that night-time cycle, starting at 148, kitty probably went down in a nice little curve, hitting something under 100 mid-cycle. that lower-than-usual number would've shocked her body. they get accustomed to whatever range they're in, and any sudden dip lower can set this off.

    "HELLO WE"VE GOT A 911 HERE- KITTY'S GOING DOWN!" yells Mr. Liver. Fortunately, mr liver has a storehouse of counter-regulatory hormones and stored sugar (in case kitty needs a little nommy sweets in the middle of the night) and when Kitty gets into a range of numbers lower than usual, Mr. Liver lets loose with the sugar and the hormones and sends Kitty on a rocket to the moon. this is the cat's body's protective mechanism to keep the cat from becoming hypoglycemic. unfortunately, mr liver doesn't seem to know that anything above 40ish isn't a crisis and it will do this regardless of the range of numbers, even at 200 if the cat has become accustomed to 400.

    A second cause of a bounce is if a cat drops very quickly. 100 points in an hour, for example, regardless of the range the BG number is in, can cause a bounce as well.

    So, what to do now? don't increase the dose because of these higher numbers. once this bounce clears, which can take up to 3 days of high numbers if mr liver is super-active, then if you had increased the dose, it would be too high. you are entering the phase of treatment that we say requires "Patience Pants." when you think you're seeing a bounce, you have to wait it out, then you can see what the dose really does. You will know the bounce has cleared when you start seeing numbers you were seeing before - like that 148 again.

    edited for clarity.

    Punkin's SS
    Punkin's Profile & pictures
    Punkin & Anya video, Punkin Acupuncture
    DX 12/4/10 Lantus, 1/2012 R, 14 lbs, 12.5 yrs old DLH orange male, ACROMEGALY dx 6/2/11
    Punkin's SRT Treatment Sept 2011 GA may 20, 2013 age 15
    Dec 22, 2011EditDeleteReport
    #2Reply
     
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  20. Tuxedo Mom

    Tuxedo Mom Well-Known Member

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    Dec 2, 2014

    Thank you for supplying the numbers. If you look at:

    4/22 7:30am:299, 1:30pm:171, 7:30pm:637
    you will see that the numbers at +6 hours after the shot were down to 171, then bounced back up to 637 at the next shot time. It is very possible that the numbers were even lower earlier in the cycle because of how hard and fast Vetsulin works. This would explain why the numbers were so high at the next shot time.

    4/23 7am:629, 1pm:302, 7:30pm:733
    you will see that the +6 hour after shot was much lower than the preshot number and again could have been even lower earlier in the cycle. If so then this could have caused the higher bounce at the next shot time.

    Also Vetsulin does not normally last for a full 12 hours. Many people find that it fizzles out after 9 or 10 hours.

    Hopefully Sue will be around soon and give some more advice.
     
  21. BJM

    BJM Well-Known Member

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    Oct 6, 2010
    Guidelines for using Vetsulin/Caninsulin to help you use it most effectively.

    Also, check the Secondary Monitoring Tools in my signature for some other assessments to help you evaluate how your cat is doing. In particular, with the high numbers right now, testing for urine ketones would be a very good idea. Also monitor food and water intake and output, and do the dehydration checks as uncontrolled diabetics may get dehydrated easily from the excessive urination.
     
    Last edited: Apr 24, 2016
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  22. Kako & Tux

    Kako & Tux Well-Known Member

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    Apr 24, 2016
    Yes, on 4/22 I was so scared that BG jumped to 637 6 hours after 171.
    I will call the vet tomorrow morning.
    Thank you for help.
     
  23. Tuxedo Mom

    Tuxedo Mom Well-Known Member

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    Dec 2, 2014

    If you are going to be talking to the vet you could ask whether switching to a gentler long acting insulin such as Lantus or Levemir might be a better choice. They are more expensive but US people can order from Mark's Marine Pharmacy in Canada for a fraction of what it costs in the States. You would need your vet to give you a prescription for it and you would need to use U100 syringes.
     
  24. BJM

    BJM Well-Known Member

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    Oct 6, 2010
    Prozinc and BCP PZI are 2 other longer lasting insulins which can work well, too. Because your vet is familiar with Vetsulin (at least somewhat) it may be easier for him/her to work with 1 of these. Both Lantus and Levemir are depot insulins where a little bit of the insulin overlaps the next shot. This often results in smoother numbers. Because of the overlap, the dose needs to be the same at each shot.
     
  25. Kako & Tux

    Kako & Tux Well-Known Member

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    Apr 24, 2016
    Do we need prescription to purchase Lantus from Canada?
     
  26. Kako & Tux

    Kako & Tux Well-Known Member

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  27. Kako & Tux

    Kako & Tux Well-Known Member

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    Apr 24, 2016
    Does it mean we can stay with 3 units and BG maybe drop tomorrow?

    By the way... I have a couple more questions.
    When I called the vet office and asked if insulin is the only option, if *Blood Sugar Gold* would help, I was asked to come back. So I went back to the vet. After 45min. waiting, the vet came in and said "insulin is the only option. Blood Sugar Gold wouldn't do anything ". Then I was charged $42.50 to hear those two simple answers.

    I purchased Vetsulin, syringes, BG reader (AlphaTrak) from the vet office. The vet showed me how to do BG reading and how to give insulin shot. Then I was charged $58 saying it was an exam.
    Is it normal?

    Also have you tried "Blood Sugar Gold"?
     
  28. Kako & Tux

    Kako & Tux Well-Known Member

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    Apr 24, 2016
    Yes, this board is so much helpful! Thank you ladies! :)
     
  29. MrWorfMen's Mom

    MrWorfMen's Mom Well-Known Member

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    Feb 18, 2015
    Welcome to FDMB. So sorry to see you are having problems getting Tux regulated.

    You can purchase Lantus over the counter without a prescription in Canada but if you order it from Mark's you will need a prescription due to drug/import regulations.

    As for your vet, I would be royally ticked off having my time and money wasted to get a quick response to a simple question and I'd probably be looking for a new vet. That said, I'm sure this is not a unique experience. Every vet office has it's own procedures for dealing with phone inquiries but that behaviour suggests to me they are more interested in money than customer/patient service. I have no experience with Blood Sugar Gold so can't comment on that except to say I would be very skeptical about it's value treating diabetes.

    As Julie said above, it would be most helpful if you could get the spreadsheet set up so those familiar with Vetsulin have some history to look at. Without that data it's hard to give you appropriate advice. I see you were having some difficulties with it and were going to try again. If you are still having difficulties and would like one of our members to set it up for you, just let us know. :)

    I would also suggest you start a new post over on the Health board HERE. This board is just our "welcome mat" and as such, doesn't get much traffic and we don't give dosing advice here because this board functions based on peer review of the advice being given.
     
  30. billysmom (GA)

    billysmom (GA) Member

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    Feb 26, 2015
    Welcome fellow Oregonian! In my experience it's not normal to be charged for a simple answer to a question. Also a vet tech should have been able to show you how to test and that shouldn't have been a charge, or at least a greatly reduced charge.
     
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  31. scoobydoox

    scoobydoox Member

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    Mar 21, 2016
    Do any of the fellow Oregon people have recommended vets Kako could check out? sounds like the place she went to likes to make money charging for answers.
     
  32. Kako & Tux

    Kako & Tux Well-Known Member

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    Apr 24, 2016
    I called the vet office. I explained that Tux had bouncing and BG jumped to 733, then staying high. Vet said incrace Vetsulin to 5 units.
     
  33. MrWorfMen's Mom

    MrWorfMen's Mom Well-Known Member

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    Feb 18, 2015
    PLEASE DO NOT INCREASE THE DOSE TO 5U. That is a huge dose of insulin and with Vetsulin, could put your cat into serious danger by causing his glucose to plummet faster than his defences or even your interventions can handle! You don't know what is causing his high numbers and even 3u might be too much insulin so increasing by that much is just plain ridiculous in my opinion!
     
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  34. MrWorfMen's Mom

    MrWorfMen's Mom Well-Known Member

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    Feb 18, 2015
    I am going to start a thread for you on the Health forum and tag a few people with experience with Vetsulin. Can you please let me know if you want me to get the spreadsheet set up for you? It would be so very helpful to be able to see what's been happening and it would allow our experienced folks to give you the best advice possible.
     
  35. MrWorfMen's Mom

    MrWorfMen's Mom Well-Known Member

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  36. Kako & Tux

    Kako & Tux Well-Known Member

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    Apr 24, 2016
    Yes, please do. We really need help. Also I need recommendation of (a) vet(s) who is(are) experienced in feline diabetes in Eugene, OR.
     
  37. Tuxedo Mom

    Tuxedo Mom Well-Known Member

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    Dec 2, 2014

    DO NOT INCREASE THE DOSE


    Please wait until we can get some proper input from Vetsulin users. Your vet does not seem to understand how Vetsulin works or how feline diabetes works.
     
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  38. Tuxedo Mom

    Tuxedo Mom Well-Known Member

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  39. Elizabeth and Bertie

    Elizabeth and Bertie Well-Known Member

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    Sep 6, 2010
    @Kako,

    I am one of those who has used Vetsulin/Caninsulin, and I've followed a lot of Vetsulin/Caninsulin cases on this forum over the last 9 years.

    Kako, I rarely beg, but I honestly do beg you now NOT to raise the insulin dose to 5 units Vetsulin.
    There is a distinct possibility that the current dose is already too high. (Others have explained about rebound, 'bouncing', above.)

    I would suggest doing some more tests at different times; earlier than 6 hours later. It may well be that your kitty's blood glucose is dropping lower than you think....


    Does your kitty have any history of ketones?

    .
     
  40. Marje and Gracie

    Marje and Gracie Senior Member Moderator

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    May 30, 2010
    @Kako im going to send you a private message to get some info so I can set up the SS for you. I can also contact another member who is in OR and see about her vet.
     
  41. billysmom (GA)

    billysmom (GA) Member

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    Feb 26, 2015
    Perhaps the veternary school at OSU in Corvallis might have a recommendation. I live in Portland so can't help.
     
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  42. MrWorfMen's Mom

    MrWorfMen's Mom Well-Known Member

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    Feb 18, 2015
    @Elizabeth and Bertie Thanks for picking up on this thread. I totally forgot you had experience with Vetsulin. Adding you to my list now!:)
     
  43. Kako & Tux

    Kako & Tux Well-Known Member

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    Apr 24, 2016
    No, I wouldn't increase Vetsulin to 5 units. I wouldn't harm my loving Tux. The vet didn't have knowledge that BG stay high for awhile after bouncing.
     
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  44. Elizabeth and Bertie

    Elizabeth and Bertie Well-Known Member

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    Sep 6, 2010
    @Kako ,

    Hi,
    Is 'Kako' your name or your kitty's name?
    What would you like us to call you? And your kitty?

    Eliz
     
  45. Elizabeth and Bertie

    Elizabeth and Bertie Well-Known Member

    Joined:
    Sep 6, 2010
    @Kako,

    With Vetsulin it's quite possible that you'll see the lowest number of the cycle between 4 - 5 hours after the insulin shot (but 'your mileage may vary' ;) )

    Blood glucose tests done over the first few hours of the cycle will give you a lot of useful information.
    You'll find out at what point the insulin starts to work (and how fast the blood glucose is dropping); when you typically see the lowest number of the cycle; and how long the insulin is lasting in the cat's system.
    Vetsulin can drop the blood glucose very fast in some cats.
    If the blood glucose is dropping too fast it is often possible to slow it down by feeding a snack. In fact Vetsulin/Caninsulin users here often routinely give a snack about an hour to an hour and a half after the insulin shot, to counteract the speed of the blood glucose drop.

    Incidentally, Vetsulin/Caninsulin is actually made up of two elements, one is most active early on in the cycle, the other is most active later in the cycle. In dogs this can show two distinct 'dips' in blood glucose over a 12 hour period, but in cats the insulin often (but not always) metabolises too quickly for this to be seen.
    .
     
    Last edited: Apr 26, 2016
  46. billysmom (GA)

    billysmom (GA) Member

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    Feb 26, 2015
    I might have a vet referral for you. I just called a friend in Eugene that has a cat. Her cat is not diabetic but she loves her vet and has been going to her for about 20 years. The vet's name is Dr Samsell. She is the owner of the practice, Cat Care Limited on Willamette St. It's a cat only practice. You should call them and ask about their experience with feline diabetes, if they support home testing, what type of insulin they recommend, etc. I hope this helps!
     
    Last edited: Apr 25, 2016
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  47. Kako & Tux

    Kako & Tux Well-Known Member

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    Apr 24, 2016
    Sorry for confusion. My name (nickname) is Kako, and my cat is Tux.
     
  48. billysmom (GA)

    billysmom (GA) Member

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    @BJM Has a list of vet interview questions in her signature.
     
  49. Elizabeth and Bertie

    Elizabeth and Bertie Well-Known Member

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    Sep 6, 2010
    Welcome, Kako and Tux! :bighug::bighug::bighug:

    Eliz
     
  50. Squalliesmom

    Squalliesmom Well-Known Member

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    Jun 26, 2015
    Hi Kako. I used Vetsulin for almost 10 months so I'm reasonably familiar with it. I agree with the others who have cautioned against raising Tux's dose to 5 units, I would not recommend it at this point. At the very least, I would suggest waiting until you have your spreadsheet set up and can better see/track how Tux is responding to the insulin. It's entirely possible that his dose is too high already, and increasing it could seriously harm him.
     
  51. MrWorfMen's Mom

    MrWorfMen's Mom Well-Known Member

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    Feb 18, 2015
    @billysmom (GA) FYI - those questions are now available in the Health Links/FAQ as a sticky. :)
     
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  52. billysmom (GA)

    billysmom (GA) Member

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    Feb 26, 2015
    Ok, thanks!
     
  53. Kako & Tux

    Kako & Tux Well-Known Member

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    Apr 24, 2016
    Ketones...I have no idea. The receipt says: The vet did:
    - FeLV/FIV snap ELISA test
    - CBC, Chem, T4, UA (senior Pr.)
    I have no idea what is what.
    She said Tux's kidney is a bit dehydrated but fine. Never been mentioned about ketones.
     
  54. Critter Mom

    Critter Mom Well-Known Member

    Joined:
    Jun 16, 2014
    With Vetsulin you may see the lowest number in the cycle as early as +2 - highly likely at +3.

    Vetsulin typically drops BG levels really hard within the first 3 hours (it's engineered that way). You need to test earlier in the cycle - both AM AND PM (many cats go lower at night so you need to establish response pattern for both day and night). Those tests are necessary in order to better determine how your kitty is responding to the Vetsulin so that you might better judge a suitable dose.

    I'm really glad that you have not followed your vet's recommendation to jump the dose up to 5IU Vetsulin BID; that would be madness. As it is, I think it was wrong of your vet to increase the dose from 1IU BID to 3IU BID; it's too big a jump and increases the likelihood of skipping over a 'good dose'. In your situation I would want to talk with my vet about stepping back the dose to less than 3IU BID. If the vet wasn't prepared to discuss this option I would look for a second opinion from another vet (preferably one with a lot of success in treating feline diabetics).

    Whatever you do, DON'T CHANGE YOUR CAT'S FOOD to low carb. You need to get the Vetsulin dose sorted out and establish exactly how your cat responds to it before even contemplating a food transition.


    Mogs
    .
     
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  55. Larry and Kitties

    Larry and Kitties Well-Known Member

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    Dec 28, 2009
    The "UA" should be urine analysis and a UA includes determining if there are ketones i the urine.
     
  56. Critter Mom

    Critter Mom Well-Known Member

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    Jun 16, 2014
    Good news! :)

    .
     
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  57. Nederland

    Nederland Member

    Joined:
    Apr 20, 2016
    In the Netherlands we have lots of experience with caninsulin. I've been moderating a forum for diabetic cats for 18 months now, and have learned quite a bit (not yet all, though).

    The lowest point with vetsulin (if it is the same as caninsulin) is between +3 and (sometimes) +6, but mostly around +4 or +4.5. Caninsulin is designed tot act fast and has a first peak around the mentioned +4, and after that a second peak at +6/+7. The numbers tend not to rise back quickly, but stay in the 'low' numbers for a couple of hours. Not all cats do that second peak (peak as in peak of the working of the insulin).
    Dogs have the lowest point around +6, and some vets think cats are dogs. They are not. A test of a cat 6 hours after the shot is NOT a good base to make decisions on about the dose.

    But first needs to be determined whether the dose is too high or too low. If there is a Somogyi effect, the drop will be very fast, and the rising again will also be very fast, to very high numbers. If the 3 units was too much for a longer time, the numbers will hardly or not drop at all (insulin resistance).
    You home test apparently. Could you please test the preshot value, a +2, +3 and a +4?

    This is a sure sign of Somogyi, a reaction to an overdose (survival mode). I strongly suggest lowering the dose to 2 units twice a day, to start with.

    The dose should never have been increased with 2 units at a time. Increasing should be done wit 0.25 or 0.5 units max.
     
  58. Kako & Tux

    Kako & Tux Well-Known Member

    Joined:
    Apr 24, 2016
    Thank you for helpful information! I've given Tux 2 units last night and this morning. And I will test +2, +3, and +4. :)
     
  59. Kako & Tux

    Kako & Tux Well-Known Member

    Joined:
    Apr 24, 2016
    We got reading strips! :) I will test within two hours and write the number in my spreadsheet. I also will test +2,+3, and +4.

    Here is a good news. Ketones was negative when he was diagnosed with diabetes. :)
     
  60. Critter Mom

    Critter Mom Well-Known Member

    Joined:
    Jun 16, 2014
    Hi Kako,

    Glad to hear you've got your test strips now. Good news on the ketones, too. Be sure to keep monitoring Tux's urine for ketones (with Keto-diastix or similar). How is he feeling/acting today?

    :bighug:


    Mogs
    .
     
  61. Kako & Tux

    Kako & Tux Well-Known Member

    Joined:
    Apr 24, 2016
    Thank you kindly, Mogs! Keto-diastix... do we need prescription for that?
    Tux seems better. :) He's never looked bad but today he seems stronger. Hope his BG test shows good. 45 min. to go.... It will be the first reading since we lowered to 2 units. :)
     
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  62. scoobydoox

    scoobydoox Member

    Joined:
    Mar 21, 2016
    Makes sure you dont feed for a couple hours before you do the meter tests
     
  63. Tuxedo Mom

    Tuxedo Mom Well-Known Member

    Joined:
    Dec 2, 2014
    [​IMG]



    These are the ketodiastix. They measure ketones and glucose in the urine. You do not need a prescription for them.
     
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  64. Kako & Tux

    Kako & Tux Well-Known Member

    Joined:
    Apr 24, 2016
    Yes. :) Food has been away from him for 2.5 hours now.
     
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  65. Nederland

    Nederland Member

    Joined:
    Apr 20, 2016
    I've had a look at the sheet. I'm worried that the level goes up again at +4. With the time difference I don't know what time it is now for you. Here it's 12 o'clock in the afternoon at this moment.... How long ago was your +4 or are you sleeping now?
     
  66. Nederland

    Nederland Member

    Joined:
    Apr 20, 2016
    If you test your cat, don't test at +6, test at +4 in the future. That the level you need.

    I think at April 22 he was too low at +4 (probably even at April 21), the body needed to take counter measures and released stress hormones (glucose), and the level went up and up. It may have happened again, and the body may have decided to realease those stress hormones continually, so the curve became high and reasonably flat (flatter every day).
    After such an episode, the dose must be lowered by at least 1/3 (which you have done). During the following 5 days (max) the body recuperates, but in that period you can see all kind of levels, from very high, to even very low preshot values. This could also explain the relatively low preshot level in the morning of April 22, so probably the 3 units of April 21 did their job far too well .... It's probably that day when everything went wrong. And April 22 did not help. The bouncing levels could also still cause the level to go up at +4 this evening.

    I advise you to test preshot levels, and +4's. Do not increase the dose for at least 5 days, because high levels can still be caused by stress hormones and you don't want to shoot against stress levels, only against diabetes levels.

    If your preshot level is low, don't shoot the normal dose, because you will bring back the survival mode in that case.
    I will think about a safe sliding scale for the next days, although I have little experience in making them (just reading them in the posts on our dutch forum). But maybe it's better than nothing.
     
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  67. Tuxedo Mom

    Tuxedo Mom Well-Known Member

    Joined:
    Dec 2, 2014
    @Nederland


    I copied your post to the other thread in the Health forum. I have suggested that all future postings be done there,. I think to keep all information in one spot that continued posting should be done on the Health thread.

    http://www.felinediabetes.com/FDMB/...vetsulin-needed-too-high-a-dose.156816/page-2



    That way all the information is available without going back and forth between two different postings. :)
     
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  68. Jill & Alex (GA)

    Jill & Alex (GA) Senior Member Moderator

    Joined:
    Dec 28, 2009
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