2/20/14 Wease Progress with Vetsulin. Daily updates

Old thread link http://www.felinediabetes.com/FDMB/viewtopic.php?f=28&t=113640

This AMPS he is at 151, he has never been that low for a pre shot before.

I have been having a hard time considering giving him 1 unit at 170 and then 160, now its at 150!!!???

Thing is when I gave 1 unit at all those ranges it never really went low. The lowest it went was 94 from 170.

Should I try to give 1 unit still at 151?

Thanks.

***EDIT OK Im taking a chance again, since It really never went low even at 160 and 161, it never even went below 100 at 1 unit. I just gave him the normal 1 unit and ill will watch him today. His BG seems to be getting lower and lower every pre shot every day. Im not sure what to do about this actually. Is it ever going to stop and level out? The reason I didn't wait for a reply because his shot was becoming almost a half hour late.

VV See spreadsheet for history

This pic is very old, Wease was like 1 maybe I think. He told me to add this quote to the picture!!

 

Sorry, I missed you. Yes, I would keep an eye on him and maybe test at +3 and 6, so if he drops lower than you want, you can guide it with food. If he'd start down early or get near the 50 range at nadir, you can guide him up with a little low carb at first,then the gravy off higher carb if he doesn't go up.

Another option would be to use a sliding scale, which you can do with Vetsulin as it is not a depot insulin. So, you could shoot .5 on a number 150 and under, one unit in the 170s, for example. Once you see how he does with those doses, you can tweak it up or down.

While nerve wracking, what you are seeing is Exactly what you want to see. He is steadily coming down, with reduced doses and his numbers are improving,downward every day.

 

He's doing great.

When you're able to monitor, taking a chance is OK. Just be prepared to steer the numbers with medium or high carb food if you get concerned. Steering: giving 1-2 teaspoons of food to stabilize the glucose level and prevent it from going too low, followed by monitoring at 20-30 minute increments to ensure safety. If dropping rapidly, you may use a medium or high carb food in these amounts.

 

Hey Jason - your brain IS thinking right! I know it's scary but what you're seeing and doing is something SOME of us only dream of!!! You're both doing GREAT!

Go stinkin' cute baby boy!

 

His blood sugar is down to 84 at +6 after his amps of 151 and 1 unit of vetsulin.

84 is the lowest I've ever tested him at.

 

That's a lovely number.

The lowest he should go midcycle is 50 mg/dL and the lowest you should shoot is about 150 mg/dL.

If you start having to skip because he is too low to shoot, you'll want to reduce the dose 0.25 units.

 

So anything below 150 I lower the dose by .25? If he is around 150 then 1 unit is probably good.

149 to 125 shoot .75
125 to 100 shoot .50

That sound good? How do I know when to skip? anything below 100 skip? Ive looked at peoples spreadsheets and they give doses at 50-60. I don't understand.

 

I would not shoot under 150. His numbers are changing fast and I think you need to be cautious. Some people on long lasting insulins shoot in the 100s, but your insulin acts differently. I haven't seen anyone shoot at 50? Remember, 120 and below are normal non diabetic numbers.

 

Yes, some people give insulin when their cats are at 50-60 but they are using different insulins than you are and some of those insulins do not drop the blood glucose levels so rapidly or so far. On an insulin such as Lantus, clinical hypoglycemia is rare but does happen. So, if you test often and compile that test data on how your cat does on different does of insulin, you can in some cases shoot those lower numbers if you are home to monitor closely.

I would not recommend ever shooting low (under 100) with Vetsulin, because of the rapid and steep drops you get with that combination insulin. I would never recommend shooting low with a NPH type insulin like Novolin N or Humulin N either.

 

so anything under 150 do not shoot at all until the next cycle is checked? That wont make his BG go up to almost 400 again?

 

I would try to chase the dose if that happens. Wait 20 minutes without feeding and retest. If he is rising and around 180, then shoot but maybe a little less than your previous dose. If you retest over an hour with no rise, you can feed him, wait 2 hours and retest (2 hours because it takes that long to have the food wear off). That will mess up your schedule but it is the way to keep him in good numbers. You are right, skipping is not a great idea if you can avoid it.

I would not shoot as low as 100/120. My cut off would be 170-180. He is still reacting to the food change. You can't be sure how he will react.

 

Today looks okay, but I wonder if he is still dropping. You might have a long cycle tonight.

 

That sounded confusing lol. You wouldn't shoot if his numbers where 180-170?

What is chase a dose?

I wish it wasn't so complicated, I haven't had any sleep in a week.

 

I wouldn't shoot under that range.

Chasing means you test until he is in a safe range to shoot. It would be later than your 12 hour cycle because he would have been too low to shoot at preshot.

Sorry, I know this is overwhelming because things are changing so fast with him. I hope it helps to realize that he is doing very well and might (anti jinx) be headed to remission. He is already in well regulated numbers. You really are doing a great job, but yes, it is stressful.

 

I guess I feel safe now at 150 to give him 1 unit. I wont shoot below that. Chasing means not giving him food at his scheduled time also? If I keep checking his BG until its safe to shoot then his whole shoot and feeding schedule changes as well?

 

Well, I would see how your cycle turns out before i'd decide to shoot at 150. It may be that he continues down. I think one unit at 150 is pretty agressive dosing and you'd want to monitor carefully tonight. My cut off would be closer to 170.

 

If you are skipping or delaying shots because he is too low, reduce the next dose by 0.25. Right now you're at 1.0 units; if you can reduce a bit, you may be able to shoot twice a day more easily.

It is possible to use a U-100 syringe with the U-40 insulin; we have a conversion chart. That would allow you to shoot in 0.2 unit increments. The way he's going, he may be heading off insulin (fingers crossed).

Or, you might make a reference gauge so you could determine your half and quarter units.

 

Cut off to not dose at all at 170? What would be the reasoning for not doing like a .50 dose?

Sorry, just trying to understand. I will know what his PMPS level is in about 20 minutes.

 

Let's wait till then and see exactly what you are looking at.

Personally, I would not shoot under 170. I would do the waiting and retesting thing to be sure he is rising. And then I would, at BJ said, reduce the dose a little so you get 2 shootable preshots a day.

 

Ok so you guys are saying I should try to keep him around 170 if I can find a dose that keeps him there every day? That way I don't have to worry about making him go to low?

 

Well, you want preshots you can shoot. If you decide your cut off is 170, then, yes, you'd work for a preshot in that range, whether it means raising or lowering the dose. And a nadir above 40.

Having said that, it's a bit of a dream. What probably will actually happen is that he throws a number and you react. :mrgreen:

 

Pre-shot should be >= 150 mg/dL on a human glucometer
nadir >= 50 mg/dL on a human glucometer

Objective is to shoot every 12 hours IF safe.
If you need to stall or skip frequently, reduce dose 0.25 units.

 

ok his BG is 154, it was 151 this morning and went down to 84 at +6, should I try 1 unit again to see if the numbers all stay close to the same?

That seems logical to me since he is about right back where he started.

maybe this will be his cycle every day hopefully.

Or should I give him .75 to try and raise his pre shot numbers to 170? When his pre shot numbers where 160-161 he only dropped to 124 and 112 at +6

**EDIT, ok I didn't want to get to far of schedule so I have him 1 unit minus one line thickness if that makes any sense.

 

If you'll be able to monitor him around his nadir, go for it.

Just always be prepared to handle low numbers if they happen.

 

I gave him a skinny unit, 1 unit minus the thickness of a line. So that's probably about 85-90%.

If I wake up tomorrow and he is still around 150-160 ill try 1 unit, I can monitor him. He seemed happy and playful today.

 

Let's see, I think it was just a VERY few days ago that you asked what those 'f's and s's on spreadsheets were and you're 'Skinnying' already!

You've both done VERY well Jason and stinkin' cute baby!

 

Hey Jason, you sound just like me a few weeks ago! I had the same dilemmas.

Here's hoping the new low of 84 doesn't give you a bounce. And even tho all this monitoring and up and down readings are tough now, things will probably only get easier. And Wease is heading in the right direction, right?!

 

His AMPS is 127

I don't dare give him a shot obviously.

So what do I do today?

Im still going to give him his food right now tho.

His numbers continue to drop and drop, does that mean he might be OTJ soon? I mean I don't see how since diabetes took a toll on his rear legs, how could it get better so easy?

 

No, I wouldn't give a shot. If it won't completely mess up your schedule, do the feed, wait 2 hours and retest. If high enough, shoot then. But your next shot would need to be 12 hours after that one, so be sure the timing will work.

I think it is time to reduce the dose. You want to be able to shoot twice daily. Skipping shots set you back. Even if he is a little higher today when you shoot, I'd try a fat .5?

Sometimes they just need to eat wet low carb and have a little bit of insulin to go OTJ. If so, he is one of the lucky ones! How are his legs now?

 

His legs haven't gotten worse but definitely lost weight in his rear and legs seem a little unstable. That's why I took him to the vet in the first place. He can just up and down off the bed and my lap. He runs up and down the stairs when he knows food is involved lol.

He only went up 16 points in the last 6 hours. That is surprising to me.

 

You said it yourself that Wease told you that he "no like bee deez". :mrgreen:

It's wonderful to watch you and Wease progress, Jason!

 

Are you giving him any methyl-B12 for the neuropathy?

 

No I am not, I should look into that tho. I was worried about getting diabetes under control.

I still have not given him insulin today, his level at +2 was 147. Ill update this post at his +4 and ask for suggestions. That's 30 mins away.

 

Wow! Nice number and long cycle. Definitely reduce to .5 when you get a shootable number. He is telling you he can get by on less insulin! Way to go, Weese and Jason.

 

He ate at 10am tho, if his number is around 170 do I shoot .50 unit and not give him food? I been feeding him twice a day at 10am and 10pm for 2 weeks now.

 

How many hours ago was 10?

 

I just tested him at +4

ok how is his +4 102?

102 what the heck lol.

It has been 16 hours since he has had insulin.

 

That is fantastic, Jason. He is definitely heading to remission. Sometimes this is how it happens. One day they just stop needing the insulin or one day they need a little booster now and then but not a shot every 12 hours. His pancreas is probably helping out when the insulin stopped. It may work a while and then rest and Weese will need more insulin or it may continue to work and Weese won't……

So, I would chase the number as I said before. Decide what your number is. I would urge higher than 150. Maybe the 180. If his pancreas is helping, you won't know until you see the numbers when it is helping and when it is not, so it pays to be a little conservative. Then when he reaches that number, shoot .5 or maybe less. (get advice) Monitor and shoot when he reaches that magic number again. It will probably be after your +12; I wouldn't shoot before then unless he really shoots up in the 300s, which I can't see happening.

:RAHCAT :RAHCAT

 

Thanks for the help. I will test him again at +6 if its still good ill test him before I feed him again at 10pm that's about 8 hours from now.

 

Wow! Wease seriously means business about this BeeDeez! What you can also do if you see a higher number is a "food test." Feed Wease a little bit of food, wait a couple of hours, and test again. If his pancreas is working, the number should come down a bit. Otherwise, he might still need a bit of insulin to help him along.

 

When should I do the food test? if his number is like 120 at +6 do I just let him go to +12

Feed him at 10pm check his level at +2 then at +4 to see if his level goes down by itself?

 

If you want, you can test him today about 2-3 hours before his next shot time and if he's over 120, give him a bit of food. Then test him again at his next shot time and see if it's gone down at all or just gone up. If up and over 180 as Sue said, then give his shot. If it's down, then that's a great sign that Wease just wants to stop being given insulin. :lol:

 

Ok, ill report back later and hopefully with good results.

I feed him about 7 ounces a day total. Im afraid if I give him a little food before his pm feeding it will mess up his eating. Maybe ill just give him half of what I normally give him and give him the other half at 10.

Ill test him 3 hours before his shot to see what he is at.

 

120 at +6

 

Creeping up from the +4/102, but still not outrageously high and still in non-diabetic numbers.

 

well at + 8 he is at 137. The problem is about a half hour ago he managed to steal a honey barbeque chicken wing off my plate without me looking. I found him trying to gobble it down in a hurry!

I got it tho before he got much of it but im sure he got some sugar out of that.

 

Feed him a little of his regular food and test again at shot time to see if his numbers have gone down at all.

 

ok he is at 142 at his PMPS, should I try to not give him a shot again? Id like to see if it goes down by itself after he eats.

Or a .50 shot?

Well I am going to feed him and wait for one of you to reply before I give him any shot.

 

It's below the 180 that Sue recommended so I would skip and see how he is in the morning.

 

Ok I wont give him any insulin. I pray he is around 120 in the morning

 

just wanted to say hi to such a cute Wease! sorry i dont know anything to give advice, just saying hi. larry says hello wease!

 

Thanks Larry

Wease +2 is 151. I think that's pretty good considering his BG was 142 at his PMPS time. He ate his normal meal and I gave 0 insulin.

I hope it starts to go down that means he is getting better right? But he hasn't went down in a long time, only increasing very slowly.

 

He might need a dose in the morning to help things along; he might be lower tomorrow morning. It's still too early to tell so I wouldn't worry too much. ;-)

 

I just checked it at +4 it went from 151 to 113 in 2 hours, haven't gave insulin in like 28 hours.

That's a good sign?

 

If he ate and the glucose went down, its a sign the pancreas may be working a little again. Definitely a good thing.

Small frequent meals will help the pancreas by spreading the workload out.

 

His amps today is 130, should I just keep him off insulin for now?

 

You can chase the numbers at this point. In other words, until and unless he gets over 200 mg/dL, don't shoot.

If over 200 mg/dL, give a token dose (0.25 of less).

 

Oh stinkin' cute baby....u iz tired ov dat au juis already? Don't blame you....

Jason! WOW! NIIIIIIIIICE!

 

just for conversation sake, how did u get ur name wease? r u part weasel? reminds me a lil of the jeffersons, and weezy. haha
wease is sooo cute! hes a magnet for love. how old is he? glad hes doing so well.

 

When he was little he always weaseled into everything. He still weasels his way all the time.

 

103 at +6, im pretty excited for him I think. Afraid something bad is gunna happen.

 

He's doing well.

 

awww a weaser. so jason, what r beedee's? the syringes i heard about?
wease no like no beedee's

 

Diabetes

It's a word me and Wease made up. That's how we talk. Me and Wease no like the beedeez.

 

I LOVE this.

 

Oh yea? we also always talk about how his poor lil PANKWEEAS needs to make more insulin haha. He loves talking.

(im not weird!)

 

Dude, I have a special voice that I use when talking to my cat. I talk to my cat all the time, with funny little words like beedeez. And he talks back to me. By that I mean, I say outloud what I think he'd say to me, then I reply, then I talk for him, then I reply. lol I don't think it's weird at all.

As I'm sure you know, Wease is the CUTEST thing!

And I just wanted to say congrats on your progress so far. Looks like you guys are doing great!

 

Yea, I get picked on all the time for the kitty voice I talk in lol. Oh well I love my kitty!

His PMPS number is 129, another night without a shot!

Its been 48 hours without a shot now. If anyone cares to look at his spreadsheet do you think his numbers are still high? I thought good was 50 to 120?

I am not sure where to go from here.

 

My DH's friends would never let him live it down if they heard the cartoon voice he uses to talk to our cats.

I'm thinking you may be able to bring Wease's numbers down just a hair overall by spreading out his meals a bit. Rather than feeding two big meals, maybe split it up into four meals? The smaller portions make for a lighter load for the pancreas to work on.

 

wow, jason, arent u glad u didnt blindly follow ur vets advice? and all these ppl helped u guys? i dont think larry would still be here if i hadnt intervened, and these nice ppl hadnt helped us. thank God i knew to research. after having diabetes around in family and friends since i was 9, i knew it sounded insane!
good luck guys! give weaser a kiss for me.
i think the 4 of us would get along great haha. only we have 7 here, and r running over! larry has a big family.
nightie weaser and j

 

I believe if I followed my vets advice of 2 units every 12 hours Wease would have went hypo and cost me thousands of $$ in vet bills. Or even worse died.

He was mad and said you looked up Dr google and didn't follow my advice you should get a new Vet.

 

And he should've gotten himself up to date!

 

sounds like a lot of vets, unfortunately. they definitely dont want u telling them anything new. glad i found a better 1.
how is wease today?

 

I started a new thread since this one is getting long http://www.felinediabetes.com/FDMB/viewtopic.php?f=28&t=114286