question about BG numbers

Hello everyone, it's nice to find this resource of so many committed, knowledgeable people.

My cat, Mottyl, was diagnosed almost two months ago. She's currently on caninsulin, 2 x 2 units, 12 hours apart. I've been home-testing her BG for just over two weeks now, and for the past week there have been some changes in her numbers. When I started her numbers were erratic but high pre-shot - around 16-20 mmol (I'm Canadian so this translate to something around 288-360). Since last Sunday, though, she's been regularly having readings of less than 12 mmol when I do her morning test - around 6-8.8 (108 - 160). Twelve hours later it's usually climbed back up to 16 or so. This means I'm only giving her one shot of 2 units once a day. I called my vet and she said I should just keep going with two units once a day as needed (rather than, say, lowering the dose). Do people think this is reasonable? It seems a bit like a BG rollercoaster. I'm just looking for some other opinions since it's hard to get my vet to pay attention to me for more than a quick, harried convo.

Thank you!

Anna (& Mottyl)
Montreal, QC

 

You are logical and your vet is not. :mrgreen: It makes little sense to give one shot a day and have her drop for the first cycle and then the second 12 hours for her to be high. It is a better plan to cut the dose in half and give it every 12 hours, giving her better numbers for 24 hours at a time and helping her pancreas heal.

It is hard to go against your vet's advice, but you are your kitty's best advocate and you are being sensible. I'd cut the dose by half, see if you can give it am and pm and not mention that to your vet until you take her back next time, with your beautiful spreadsheet and say "Look, I thought I'd try this and it is working great!"

 

Edited to add: Ooops, cross-posted with Sue! :roll:

Hello Anna and Mottyl, and welcome to FDMB!

Have I understood you correctly that you're skipping the morning shot (because blood glucose too low to shoot) and only giving the evening shot?
If so, then it may be that if you lower the dose the numbers will level out a bit and you'll be able to give two shots a day.
Have you considered splitting the current day's total of 2 units into one unit evening and morning..? That might not be a high enough dose over all but could be a starting point for you...?
I'm sure others here may have different suggestions.

If Mottyl's numbers are low like this in the morning then she would seem to be getting very good duration from the Caninsulin (well, either that or her little pancreas is starting to produce some insulin of it's own....)

Eliz

 

Thanks both! Elizabeth, you're correct - I'm not giving her the shot if her BG is below 12, which it is starting to be once a day or so.

Yes, to me 1 unit 2x a day makes way more sense than 2 units 1x a day, though my vet disagrees. (Though this last time I didn't even get to talk to her, I was just relaying messages through the technician.) I will continue as is for the next few days, and if nothing changes I'll try cutting her dose.

I hope her little pancreas is getting back in action! That would be great news. Anyway, baby steps.

 

Hi Anna and extra sweet kitty Mottyl and welcome to the message board.

You've already gotten great suggestions from Sue and Elizabeth to give a lower dose 2 times a day instead of only one time a day.

Would you tell us what you are feeding Mottyl?

 

I feed her Purina d/m canned.

Last night her bg was 14.7 (265 for Americans) so I gave her only 1 unit instead of 2. This morning it was 8.5 (153) so I skipped the shot.

This new development seems positive to me but I don't want to get my hopes up. One day at a time, right?

 

That's right! But she is looking good. She is getting a nice duration on Canninsulin and many cats don't. It would be best if you could shoot twice daily. Skipping this am means she will probably be very high tonight. How about going down to .5 and see if it gives you shootable numbers twice daily?


If you don't want her sky high tonight and are home, you can test and if she is over 200, give her .5 The next shot will be off schedule (it'd have to be later than +8 from this shot, at least)

 

Hi Anna and Mottyl

Welcome to the FDMB! We are glad you found us. you've been doing a great job with hometesting and asking the right questions.

Is there any reason why your vet put Mottyl on Caninsulin when there are so many better insulins for a cat that give really long duration and increase their chances of going into remission by quite a bit?

Some of the better insulins are Prozinc (or PZI if you can get it compounded), Lantus, and levemir. The last two are what the majority of members use in this forum and the tight regulation protocol for these two insulins is the only one for cats based on scientific research published in a Feline Veterinary journal.

Also, the Purina d/m is not a high quality food and most of us feed higher quality, low carb commercial foods with great results.

If you are interested in more info, please let us know. Caregivers switch insulin in this forum frequently and we have many, many experienced members to help you. We can even help you get a spreadsheet started where you can track numbers and see patterns.

 

Hi Anna,
I'm late to the welcome wagon, but welcome to you and Mottyl

I'd definitely take Marje up on her offer for SS help. It's an extremely valuable tool with helping make sense of what your meter is telling you.

I also agree that it would be a great idea to ask the vet "why Caninsulin?". There are other choices, as others have said, that have proven to work better for cats. Two things I'd ask a vet when it comes to feline diabetes -
1 - how many cases of FD have you dealt with?
2 - what's your rate of success with your patients who follow your advice?
If the answers are "not too many" and "less than half", I'd be finding another vet without a doubt.

And two shots a day will work better than one shot that leaves you with a number too low to shoot next cycle. It might not be as simple as just halving the 2u dose, but to me it looks like the "right dose" is going to be less than 2u, 1u is probably a good place to start over though.

I'm glad you found this place. Nearly three years ago it saved my sanity, and helped my boy Bob (ga) end up going into remission after just ten weeks on insulin. I've watched scores of cats and caregivers have the same thing happen for them since then as well.

Don't be shy. Ask a million questions. You'll get ten million answers. This place is incredible.

 

Oh, and Purina DM canned? While it is low enough in carbs to be appropriate for a diabetic, it is overpriced given its quality. If the cost isn't an issue, you can buy higher quality "off the shelf" food for the same cost. Or you can save money feeding Friskees or Fancy Feast and not suffer any reduction in quality. FF classics did the trick for Bob.

 

Hi all, thanks for your responses. I found a vet who's experienced (thanks to another FDMB member here in Montreal) and she is switching Mottyl to Lantus. I'm going to start a new post about this since I want advice on doing the switch, but it seems like a topic for a new thread.

 

Also, I made an SS for Mottyl, you can see it in my signature, if that helps. Thanks!

 

Thanks so much Marje and Carl for helping Anna.
I'm no longer active here, but knew she would be in good hands with you.