New Diagnosis - starting Caninsulin

Hi everyone,

Wow, thank you for such a fantastic forum. I've spent two full days digesting this, crying, getting on it with, ordering supplies.

Background
I am based in London, UK
My vet gave me Caninsulin, told me to inject 1ml x 2 per days after only two meals p/d.
We made a 2nd appointment in 4 weeks to check on him.

Now
After reading this forum, oh wow, do they just give the basics! I have bought:
Alphatrack kit
He is eating Meowing heads pouches twice a day (within the low carb range, ok for now)
I have stopped all biscuits

Help
I have read you advise to monitor his glucose ... as my vet has told me nothing, I am working with this forum only.

1/ is there a link that shows a chart of how to monitor & how to interpret glucose pls?
2/ i read i need to take a blood sample even 2 hours, for 12 hours:
- Question: is this testing in 12 hours to establish a curve, then from this info you can somehow work out how much insulin he needs?
3/ my vet prescribed Caninsulin ... I will ask for ProZinc next week
4/ will the vet be able to tell me how much insulin to give him using my chart? or can I work it out myself somehow? (again is there a chart or link you have pls)
5/ Also I have bought keynote test strips on amazon uk (as ketostix arrive too late) (Seba Nutrition - Keto Urine Test Strips - is any brand Okay?
6/ how do you interpret this info, again is there a chart? and what do you do?

Sorry to ask obvious questions, I searched around and couldn't find the links.

Much much love to you caring angels and cat lovers

Emma

 

Hi Emma and welcome!

you know, I wanted the same thing when i started testing because I’m all about data and instructions. We have guidelines and the importance of testing is to gather the data so you know how your cat reacts and how to dose him. Every cat is different and that’s why there are guidelines but nothing is 100% set in stone. It also depends on the insulin you’re using. I’m happy to hear you’re going to ask for something else because caninsulin is made for canines hence the name and really not the best option for cats. So the links I can give you depend on the insulin. There are also forums for each. There’s a prozync forum and a Lantus forum. Let me link you with the prozync one since that’s what you’re thinking of going with and I’m also tagging @Deb & Wink who has experience with prozync

also, please start here as it gives you instructions on the basics like setting up your signature and ss and so forth:

http://www.felinediabetes.com/FDMB/threads/new-how-you-can-help-us-help-you.216696/

as far as the curve, you only have to do it about once a week or so and you can share the info with your vet and us here. To be honest, I trust and follow what this group says. Most vets want to increase/decrease dose too fast by full units and we recommend .25 only so you don’t miss the ideal dose by moving too fast. We will help you with dosage until you know enough to be able to interpret the numbers yourself. The important thing with testing daily is the pre shot tests in the am and pm before giving the insulin so you know if it’s safe to shoot. Then you should also try to test mid cycle like at +5,+6,+7 to start to get a feel for when your cat’s nadir (lowest point in the cycle) happens. Deb will suggest other times because I think prozync works faster and may have an earlier nadir. And in the evening, we also recommend doing a +2 test after the shot so you can have an idea of where the BG levels are headed overnight.

It’s normal to feel lost at first, but you’ve come to the best place for feline diabetes and to learn more than you ever thought you’d need to. Congrats on being off to a great start and getting ready to test and knowing what insulin to ask for!

 

Welcome!!! You've come to the right place!!!! We are happy to help. Sorry about the diagnosis. I remember crying 12 hours straight when my cat was diagnosed.... That was 4 years ago. Your cat can live a long healthy life with the right care. .

A starting dose of 1 unit (not ml!!!! That would be 40 units) is a great starting dose. It's really just a few drops.

Good job switching to low carb wet food. .

Great you are going to start home testing. That's really key to keeping your cat safe and finding the right dose. You will want to test before each shot, and when possible a mid cycle number. Every so often is not a bad idea to do a curve, which is a test every two hours for 12 hours. It's too figure out how your cat responds to the insulin. To see when he tends to go lowest and how far he's dropping. I have a video in my signature showing how I test my cat CC at home.


Some cats do fine on canisilun.... My cat did the first few months (vetsulin actually but pretty much the same). I did switch to ProZinc because I needed higher doses (my cat is a high dose kitty because of a pituitary tumor which causes acromegaly) and ProZinc doesn't sting at high doses like vetsulin does.

We can help you with dosing advice if you need it. That's why we add the spreadsheets to our signatures. The main key is you don't want her to go under 3.7 on a pet meter or 2.7 on a human meter. There's no chart that says if your cat is this number give this amount... And that's because every cat reacts differently, and why you want to do all dose increases gradually. Most vets want to raise in whole unit increments.... We always recommend not to raise by more than 0.25-0.5 units at a time. We can help with all of this.

 

Oops sorry, link to prozync forum below:

http://www.felinediabetes.com/FDMB/forums/prozinc-pzi.24/

 

I love how in sync our responses were Janet!

 

The next thing you can do is set up a signature. This includes basic info so we don't have to keep asking the same questions repeatedly. Go up to your name at the top right corner and choose signature. Add info such as your pets name, date diagnosed, insulin type, food you're feeding, meter you use, and any other health concerns and medications. Once you get the spreadsheet set up you will add a link to that as well. We use Google Sheets because it will update in real time when you add info.

 

We were writing at a the same time. Lol

 

Thank you for your fast replies - a quick Q

As he's on a low carb diet already, should I start him on 0.5 of a unit and not 1 (as vet suggested)?
- also this morning he ate his usual meal fast (this is odd) - I then gave him 1/2 more after insulin which he ate fast (super unusual)
- this evening he's eaten only half his usual portion (not given him insulin yet as he's not finished it)

Not sure if to inject him or not (as the meter hasn't arrived yet) - what would you do ?

 

1 unit is usually pretty safe. Do you have any higher carb food just in case you need it? What were his numbers at diagnosis? When do you think you will get the meter? BTW, when you see Americans talk about numbers we use a different system then most of the world (what else is new). So if you take our numbers and divide by 18 you'll get the numbers you will be using. So if we say 300, that would be like a 16.7 on your scale.

 

Use your intuition. If your gut is saying give 1/2 unit then that's OK until the meter arrives. It's also ok if they don't eat all the food at once. My cats are all grazers. They eat a little then go back to it throughout the day. As long as your cat had an appetite and eats SOME food you're good to go. Have you read our section on what to do in case of hypoglycemia?

 

OK thank you for that reassurance and info

The levels in red were:

Glucose: 23.02
GGT: 13
Billirubin: 17
Platlets: 336
Neutrophils: 13.39

 

23 is pretty high. I would go ahead with the 1 unit.

 

Negative on ketones, right?

 

Yes I read it, this made my cry, as my vet said nothing ... but i'm ok now, I kept reading and buying what I need ...it was just a shock

I wanted to print out one of the 'print outs' but the website seems down :
Q1.4. What is hypoglycemia, and how do I handle it?

A1.4. Your vet should have warned you about hypoglycemia, which is dangerously low blood sugar brought on by too much insulin. Hypoglycemia can kill your cat or cause blindness or other permanent damage, so you must always be on the alert for the symptoms. Read the hypoglycemia page at Pets with Diabetes to familiarize yourself with the problem. Then print out Melissa & Popcorn's hypoglycemia page and post it on your refrigerator, because hypoglycemia can come on suddenly, and you don't want to be running around trying to find this information. You should always have a bottle of Karo or other sugar syrup handy in your cupboard.

 

http://www.felinediabetes.com/FDMB/threads/how-to-treat-hypos-they-can-kill-print-this-out.15887/

Print this out

 

Hopefully you'll never need it, but good to know. I always keep gravy food on hand. Just today my cat was too low and I needed to bring her up. She never shows signs she's hypo so it's only through testing that I knew.

 

I can't see keynotes on the blood test, was this from the urine test?
he did say glucose was present in the urine at the vet, but I didn't get that data sheet

 

nothing on there says keytones neg ? Hmm... DO you have a copy of the labs you could post?

 

The neurophiles are high and the WBC are on the higher end. She may be fighting a bacterial infection. Let me tag someone good at reading labs to give some input. @Marje and Gracie

 

There was a Prozinc shortage in the UK a few months ago. Not sure if that is still the case. Tagging @Elizabeth and Bertie who signs on occasionally. She may have updated info on that situation.

A couple of links specific to the UK and Europe for you.
Food, Insulin, and Other Supplies which I think is also included in the links below. So there may be some duplication.
UK Diabetic Cat Food Info (includes some supplies) and UK Cat Food List

From the RVC (Royal Veterinary College) in London, Feline Diabetes Guide.

Many vets in the UK still believe that Caninsulin is the best insulin for cats. There used to be some specific rules in the UK, that vets HAD to prescribe Caninsulin as the first choice for insulin. I do not think that is true any longer, but many vets do not realize that is the case.

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I agree with Janet that he might have an infection but the elevated GGT and bilirubin could indicate cholangiohepatitis or a gall bladder issue. I would discuss with my vet. The GGT is especially elevated.

 

Thank you I will ask my vet

 

Does anyone know a good vet in London?

 

To get attention add on to your subject line to ‘does anyone know a good vet in London’

 

No update on the Prozinc situation, Deb. The manufacturer is still saying there is a "temporary supply issue"...

Hi Emma, I'm in Surrey and currently use a mobile (cat-only) vet service that also covers some of S/W London. I know, given the size of London, that it's 'unlikely' you'll be in their catchment area, but will post the link below anyway.
They charge more for consultations than a typical vet, but they spend a long time with the kitty and are very thorough. And their medication prices are really good; they don't make a profit on those.
https://thecatdoctor.co.uk/

Eliz

 

Welcome to FDMB.

You can pick up a glucometer at any pharmacy. I realize you have on on order but it never hurts to have a back-up meter.

As for dosing, if your kitty is already eating a low carb diet, you should be starting at 0.5u every 12 hours. Caninsulin can drop numbers quickly. Your description of your cat "starving" in the morning could have been due to higher numbers as an unregulated diabetic is hungry all the time since glucose if floating around in the blood stream versus getting into the cells to provide nutrition. Alternatively, when a cat's numbers drop into lower ranges, they also become quite hungry. (If you've ever gone too long without eating and are a bit hypoglycemic, you know the feeling.) This is why home testing is so important.

To be honest, I'm thinking your cat's numbers were lower when he was inhaling food. Chances are that his numbers zoomed up to a much higher range as a result of being low. (We refer to this as a "bounce.") Many cats feel a bit off if they bounce.

Here's the link for getting started. It includes information about setting up your spreadsheet, a hypo toolkit, and other links/information for helping you navigate FDMB.

 

Valuable advice thank you - he is looking much perkier since starting his insulin.

- I have been giving him 1 unit, he settles down to digest and looks very peaceful for about 3 hours,
- then he looks himself from 3-8 hours.
- After that I can tell he is feeling hungry, but is waiting for his 12 hour shot.

So far he looks much better than without it - his fur looks soft and bouncy in only a few days!

I hope this stability lasts

Do you think I should still reduce to 0.5? or keep, as he looks ok?

 

Actually he is eating faster than normal ... and wants more (probably as he's not having his accompanying biscuits)
I will reduce to 0.5

 

If he's hungry, feed him. Most of us feed several smaller meals per day. Just when you get your meter, no food 2 hours prior to the preshot test. Other then that, let him eat.

 

do you have your ss set up yet? We recommend going up or down by .25 increments not .5 but we need to see some data to be able to answer your question correctly. You shouldn’t change the dose based on behavior alone

 

With the elimination of the dry food, the biscuits, that should drop Cheema's BG levels. That drop could be 100 points mg/dL (5-6 points mmol/L) or more that the BG levels decrease. So be cautious, and test before every shot of insulin, and then again in the middle of the cycle, around +4 to +5. Post and ask for help if you get a BG pre-shot that is lower than 200-250 mg/dL (11-13.8 mmol/L). If you can get a test mid-cycle, and that is lower than 90 mg/dL (5 mmol/L), Cheema earns an automatic reduction in the dose. Post for help if the numbers get low and people will talk you through how to bring the BG levels back up safely with food.

Don't know what dry food (aka biscuits) that Cheema was eating, but they were probably high carb. Actually, giving Cheema access to food after the middle of the cycle will cause his BG levels to shoot back up. So no food, UNLESS his BG levels drop too low, after about +6.

Since Cheema is on Caninsulin, the duration may not be the full 12 hours between insulins shots. So don't be surprised if his BG levels shoot back up after +8 and are high at pre-shot test time. Usually 8-10 hours is a more typical duration for Caninsulin (called Vetsulin in the US).

Do get that spreadsheet (SS) setup, since we really rely on that to tell us what is going on with Cheema.

Here are the 2 links, how to setup the SS and what the columns mean.

• FDMB Spreadsheet Instructions
• Understanding the Spreadsheet/Grid

 

Whereabouts in London are you? If you give us a place name or postcode that might get useful responses...London is a big place and what is handy for one Londoner may be totally out of reach for another!

 

• Im in Brixton SW9
• Cheema weighs 4.5kg currently (was 5.2kg 6 months ago)
• He was eating Applaws biscuits (grain free 80% animal protein), but I don't give them any more.
• He eats Meowing Heads (approx 9% carb) 1 pouch a day (100g) and some plain chicken as treats.
• (soon moving to Hunters Pouches (approx 4% carb) by Natures Menu)
• (He doesn't move about a lot so encouraging him to move more now).
• Gave 0.5 unit caninsulin for the last two shots

The glucometer arrived today, so I will just get my head around it and then start to make tests ... gulp!

 

You

can do it!!! There's a video in my signature showing how I test my cat CC at home

 

Ok so you’re in SW9... I know it very well, there are lots of residents and presumably lots of pets and therefore lots of vets! I’ll have a think and see if I know someone who can recommend a good vet around there... but also, what I’d suggest is working out how far you’re prepared to travel and then doing a Google search for vets within that distance... find maybe two or three that you can get to easily and phone them, say you have a diabetic cat and ask what treatment plan they would recommend, or ask them a few specific questions. A good vet practice won’t be averse to this (you are simply being a responsible owner and want to do the best for your kitty).

I think you’re right to be thinking about a new vet if you’re not happy with your present one. Many of us have switched vets after the diabetes dx and finding that many vets do not unfortunately have as much knowledge about the disease as we would wish. Some vets don’t like being challenged on their “instructions” and are very wary of advice from people on the internet. But, a decent vet should be prepared to work with you and learn together. There are vets like that out there and it can be done. But if you can’t find one that you’re happy with, carry on coming here and asking questions, there’s not much this community of cat-lovers can’t help with

 

I noticed above you were cutting dry food out - we did the same and were previously feeding Monty Applaws dry food. My other cat (not diabetic) likes it so we're going to finish what we bought with her but put them both on the same diet after she's eaten all of it.

If your cat is a dry food lover like mine, I'd recommend Ziwi Peak Air Dried Lamb Recipe as a food topper. It's low in carbs but also higher in fat than most wet foods. I feed Monty primarily wet (Thrive Chicken) but top with Ziwi peak to raise his fat intake. I get the best deals on bulk food orders from Zooplus (a £2.50 annual membership gets you 3% discount on all orders, plus you can collect points for free stuff like treats or cat toys).

How are you getting on with injections? We live quite close-ish (I'm in E16), happy to help out if you need practice or guidance on injections sites / technique or just moral support.

 

Cheema isn't a big dry food fan, so that's good! He loves wet food

Thank you for your offer of support : ) - the injections are fine, he does' mind and I'm getting used to it ...
but today I have the glucometer and so far this is the hardest thing ...

- I tried once, but no blood came ... and kitty doesn't like his ears touched at all!
- I'm following the video on getting them calm and treating them, after touching the ear.
- I will try to puncture closer to the edge next, to see if I can get any blood!

- felt a bit distressed today, but will pull myself together again after I've digested this first attempt

He is quite sleepy today after reducing his insulin ... I read somewhere on here, that level can go low at night, so I'm wondering, until I get used to the glucometer, would you recommend 0.5 in the evening and 1 unit in the day (since he's sleeping a lot). Also I'm not able to monitor him at night.

Will do a search for vets and see if any of them have more experience than my local - good point

Thank you for all your replies

 

Yes testing is a challenge but trust me once you get that first drop of blood and KNOW where your kitty is at BG wise? Its the best feeling in the world. Good for you for not giving up!

 

did you warm the ear well before? Also just know it takes a few days for the ears to learn to bleed so don’t be discouraged. You’ll get this I promise!

 

It's best to give the same insulin dose for both AM and PM cycles. A cycle is 12 hours.

Why can't you monitor at night? Maybe we can help you figure something out.

 

This is his Ketones

 

At the moment I have to leave him around 11pm and back at 8am, as he lives in my art studio and I sleep down the road.
But I'm with him all day from 8am - 11pm.

I've tried to get a blood sample, but he's getting very wary of me, so I'm trying to desensitise him gradually
Also get him used to me touching his ears - by rubbing them and trying to get the capillaries up
Also I need to watch more videos on where best to prick to get the blood

I might go back to 1 unit for now, as he looked better on it, the vet said he probably needed 2 units, but to start him on 1

 

anywhere along the edge, on either side.

 

I've never used the urine strips. I always use a meter, so I'm not sure how to interpret that. @Sharon14 . @Chris & China (GA)

 

I always had trouble reading those strips too! Be sure you read them exactly when the directions say too (for the strips I used it was 15 seconds) They will continue to darken after that.

 

I have just got my first meter reading ! 1 hour before his PM shot = 7.2mmo/l

 

That’s a great number! Will you be able to get another reading before PM shot? As @Deb & Wink said above, if Preshot number is below 11 you need to post here for help. You may have to skip the shot

 

OK I will try, what does it mean

2nd one was 7.3mmo/l

 

From the Beginner guide to caninsulin


Q. Is my cat’s BG high enough for insulin?
For those NEW to treating feline diabetes, and/or those who don’t have much data about how their cat responds to insulin, we generally recommend that a shot isn’t given if the pre-shot BG, is below 200 mg/dL [11 mmol/L] on a human meter.
If you use a pet meter, such as AlphaTrak2, you may want to raise the initial ‘no shoot’ threshold. This gives an added margin of safety when using a pet meter. (If in doubt seek advice from your vet.)


Q. It’s time for my cat’s shot, but the BG is a little too low. What now?

• If your cat’s BG is a bit below 200 mg/dL [11 mmol/L] on a human meter, consider ‘stalling’.
• Stalling is waiting - without feeding your cat - for 20+minutes, then retesting to see if the BG has risen to a suitable level.
• If using a pet meter, such as Alphatrak2, you may want to raise number above 200 mg/dL. (If in doubt seek advice from your vet.)
• You are looking for a number that is rising, not falling, and is high enough to give insulin.
• Note: As you gain experience with home testing, and have gathered data to show how your cat responds to insulin, you might consider it safe to reduce the ‘no shoot’ threshold, and to give insulin at lower pre-shot numbers.
• If you have time, you can repeat the stalling process to see if the cat’s BG reaches a number you can shoot. If in doubt, skip the shot. However if your cat has history of ketones or DKA, or other health issues, or you are concerned, DO post on the Main Health forum for further advice.
• Ask for help on the forum before giving insulin if you are unsure, as you can never ‘un-shoot’ insulin.

 

OK the first shot was an hour before the shot, the second was 15 minutes after he ate 1/3 of his meal

He's not eaten the rest of his meal yet, as he's interested in looking at a new girl cat who has moved in next door.
However he will come back and finish it later on.

Not sure what to do

Does this mean if I shoot him with 1 unit, he will go to low and risk a hypoglacimic episode?
But what if I don't give him any tonight?
Then I test again before the 2nd shot in the morning?

I called my vet today and he said to give him 1 unit x 2 per day for the next 2 weeks, to see how his body responds and get his system used to it.
Then when I bring him in in 2 weeks, he will start the curve
He said 1 unit is a low dose

 

Please remember that’s what all vets say because they don’t test daily. To just leave the same dosage for 2 weeks disregarding your test results is not good advice. So, you shot him already I assume? Please take another reading at +2 to make sure he’s still going up. In the future, you need to test right before the shot. An hour before is no good because you don’t know what’s happening in that hour unless you test again right before the shot. Makes sense? I’m not an expert on your insulin, but with Lantus we have the option to give a token dose. I don’t see that in the guidelines above.

let’s see what others have to say!

 

Also know that most of us do the curves at home and send the results to the vet, not at the vet as cats are more stressed there and the numbers will be higher than normal.

 

he's also not finishing his food quickly, he only ate 1/4 ... I remember the vet said no food, no insulin and he has to eat at LEAST 1/2

this first meter reading was 1 hour before the shot.
The second one was also before the shot, but 15 minutes after eating only 1/4 of his food.
- I am giving the shot 20-30 minutes after food, as was suggested on this forum.

He's not eaten 'at least half' of the food that the vet advised and has now fallen asleep
The vet also said 'no food, no insulin'

- as his number was 7.3 and he didn't eat enough, shall leave him to sleep tonight with out insulin?
... then try to test him again in the morning before his shot, but after his breakfast ?
- I will aim to start plotting the curve tomorrow

I assume he will eat the rest of his food during the night ... but I will be asleep ...
would you recommend I take it away? since he has no insulin ?

 

i would say yes, but I’d like someone with more experience with your insulin to answer this @JanetNJ @Marje and Gracie @Sienne and Gabby (GA)

I see. In that case, what you want to do is test again before the feeding. So you tested an hour before the shot, then test again right before you feed, then feed then shoot. Testing an hour before is too long in advance and testing after you feed will give you a higher number

 

I wouldn’t take the food away because you want him to eat just know you may be getting a higher number in the am because of the skipped shot. But do make sure he doesn’t eat at least 2 hours before morning shot. Is that doable?

 

Yes it's a little scary, I hadn't expected not to inject him but it's past the time now, so will wait again for tomorrow
Thank you for your help

 

Also I'm not sure I fully understand the levels ...so I don't really know what I'm doing

 

Is there a chart that you can recommend I read please? So I can know about the levels, I am a little scared to work against my vets advice and I don't have a clear plan.

So far I've just tested him for the first time and now I'm a bit lost with the result

sorry I need to do more reading I think

 

Goooood. way to go

 

I would skip with it that low and without much data yet.

 

I'm wondering with that low of a preshot if maybe starting tomorrow you should do 0.5-0.75 dose instead of 1. 7.3 is on the high end of normal... It makes me wonder how low he went mid cycle. Can you test tomorrow about 4-5 hours after giving the shot?

 

There's no chart... I can tell you that normal is about 68-150 on an alphatrak (3.8 -8.3 on your scale). Usually around shot time new diabetics are way above this, and we hope to get them into this range. Your cat was in this range at shot time which is why we said to hold off. We usually tell new folks not to shoot under about 11-13 because you don't have much data yet. I wonder if your cat is on his way to being diet controlled (Crossing fingers). You don't want your cat to go lower then the 3.8.... it can be dangerous which is why we say to have high carb food and honey on hand JUST in case.

There is not a chart that says if the level is this, give this. THat's because one cat might barely react at all to a certain dose, while another could have a steep drop. You have to get to know how YOUR cat reacts to it. The only way to know is by collecting data.

 

ECID every cat is different but Janet is giving you guidelines to go by. Hope it helps!

 

It’s all normal I felt the same way in the beginning. As you get more data and get to know how your cat reacts, you’ll start to feel more confident and less anxious. Give it time because you’re doing great already!

 

BTW the US uses a different scale. If you multiply your numbers by 18 you get the US scale. If you divide US numbers by 18 you get your numbers.

 

Thank you for your reply, his pre-shot reading was 7.9 this morning - no food

 

Wow another low preshot!!

 

I'm a bit confused 'to shoot or not to shoot'

I had this reading pre-shot this morning, then went on the advice of above and only gave him 0.75 U.
He ate his breakfast, now is sleeping

Will take a pre-shot test in 12 hours and check levels again

Then 'to shoot or not to shoot' ... that is the questions ... as last night I didn't shoot, due to a low reading and very little food intake
Thoughts?

 

I have told my vet, but so far no reply from him ... so a bit concerned

 

So you gave .75u with a Preshot number of 7.9? How long ago?

 

4 hours ago

 

If you have a blue number for your preshot, I would hold off shooting until you have more data. You could not feed and stall for an hour and retest to see if the number comes up... otherwise just skip it until you have more data. Now since you already shot, just keep a close eye and feed her if she's dropping. I would give it a test right now since it's been 4 hours and she will probably be at her lowest in the next hour or two. I'm glad you lowered the dose a little.

 

So you suggest to test, if it's a low number, don't shoot.
Keep testing, if low don't shoot - but just note down in journal.

He is asleep now, he was quite lively before his shot, but then decided to sleep on his mat.
he looks relaxed.

A 2nd vet has told me to test pre-shot, shoot the insulin, then test again at 8 hours, to see how the body digests the insulin
But withhold further food until that test has been done, so to collect data on how he is processing insulin

I am working with 3 different options - so trying to sift through the advice and do the right thing ....

 

Caninsulin typically reaches it's peek 4-6 hours after the shot... (some earlier, some later) Your vet may be more familiar with diabetic dogs who have a slower metabolism. By 8 hours your insulin is wearing off.

Here's what I'm saying.

• ALWAYS GET A PRESHOT TEST. always. esp. since your cat does not have high numbers, you always want to make sure it's safe.

• Don't feed for at least two hours before the preshot tests so that the number is not food influenced. It's ok to feed mid day, just pick it up at least two hours before shot time.

• In the beginning, while you don't have much data, don't shoot blue preshot numbers. Once you know how your cat reacts you might EVENTUALLY give a small dose if in blue but over "normal".
• If you get a blue preshot number, you can hold off on feeding for an extra hour and retest and assess if the number has gone up or not. If still blue, skip. If yellow, feed and shoot as normal.

• Caninsulin reaches peek USUALLY in 4-6 hours... so get some tests in during that time if you can. This is how we know how your cat reacts to the insulin... and you want to make sure they aren't dropping too much (hypoglycemia).

If you haven't had a chance to look at the info on Caninsulin, read through the yellow notes at the top here. http://www.felinediabetes.com/FDMB/threads/beginners-guide-to-caninsulin-vetsulin.186099/

 

Can you get a test now?

 

the reading was 3.8 at 4.5 hours in

 

Since it’s been 20 min, can you get another test? 3.8 is a good number, but is close to the take action number on an Alpha trak, just want to be sure he isn’t dropping anymore.

 

What would this number at this point indicate pls?
That I should decrease the dosage ?

 

We want to be sure he’s not headed to a hypo. @JanetNJ can help with dosage. I’m not familiar with caninsulin

 

well i think when at a similar preshot, yes, I would lower the dose (if you choose to shoot those high blue numbers). If the preshot was yellow .75 would probably be fine... but the preshot was low this morning. 3.8 is the very bottom of safe on an alphatrak (68 US Scale)... please feed your cat some medium carb food. I'd like to see that number just a LITTLE higher. since we don't know when your cat's nadair (lowest point) is yet, we need to assume he could drop a bit further. Feeding him will help even it out.

 

did you take another reading since the 3.8? You'll want to make sure he's not too low.

 

5.2 at 5hrs and 50 mins since injection

 

so perhaps dose a 0.5u for PM shot ?

 

Yes, but lets see what the preshot is. If it's too low, then skip.

 

did you feed to get the number up? If not then it looks like your kitty goes lowest at 4-5 hours. 5.2 is a perfect number.

 

no I didn't feed him, he ran downstairs and probably that's generated some spike up

 

My vet doesn't seem to want to work with me on this testing, so I'm probably going to have to find another vet, since

The pre-shot, pre-food reading was 7.5

 

I don't understand a vet who doesn't want their patients to test. They would never inject a diabetic child without testing.

 

I would skip. Or wait an hour and retest and see what it is.

I think very soon your cat is going to be in remission and controlled just with low carb food.

 

Oh I do hope so!

The AM reading was 7.1 - taken 30 minutes after food, but pre-shot

 

I guess with this number I should not shoot anything then?
- or shall I shoot 0.5 or 0.25 u ?

 

Wow!!! Skip that shot

 

Don't give food before the preshot test. The number was probably in the 6's

 

OK no food next test

What would you suggest going forward now? that I simply test before each pre-shot for the next few days?

 

Thank you so much for your help - I greatly appreciate your replies XXXXX

 

I'm getting a little bit stressed as my initial vet didn't say to adjust anything when I gave him his pre-shot number - he just said it 'looks good' but then keep injecting him 1 unit and come back in two weeks

a second vet has told me NOT to stop shooting him, just lower the dose - as his liver needs to heal

you guys say stop shooting him altogether

I'm really confused what to do

 

7.1 (with food influence) is too low to shoot. It's in the normal range. I think your vets aren't used to seeing cats go into remission. What was his number at diagnosis? Did they do a fructosamine test?