All over the map

@Marje and Gracie please look at Oscar's SS. Its all over the map. I need you to read the comments as they pertain to his recent numbers. It's crazy! I don't know what to think. High numbers, then a hypo (honey given) 10 minutes ago. He acts okay but this is NOT okay.
Would love more perspective too but I don't know how to invite others to his SS.

 

@Oscar & his Mom Are you treating that hypo? That's seriously low! Feed him a small amount of gravy from a higher carb food with a little honey or karo syrup added. Test every 10 minutes and repeat the teaspoon of gravy with a little syrup, test in another 10 minutes and so on untill his numbers are rising. Be prepared to take him to a vet because this is a dangerously low number. Please repost in the main health forum with a 911 attached to the title of your thread. You need many pair of eyes on this!

Your insulin dose is too high and you have been basing it on PS numbers that are probably inflated from bouncing. The very low numbers (lime green and green) are telling you that this dose is too high. For now, your immediate issue is his hypo state. Please get to work on that right away with gravy and syrup. You can also try rubbing a little syrup on his gums. It can raise BG quickly but it doesn't last. Don't give too much gravy at once because you want him to be willing to eat for as long as it takes to get his numbers up.

This is a serious situation!

 

For later on:

If he was my cat, I'd go right down to 1.0 unit of Caninsulin, hold that dose for 3 or 4 cycles, test before each dose and at least twice between doses around the time of nadir. A full curve would be even better so that you see the full action profile of a 1 unit dose which is the recommended starting dose for all insulins. If the numbers stay high at 1 unit twice a day, raise by no more than 0.25 u and repeat the process while testing as much as you can. You need more data. Your current dose is too high.

 

Have you tested your cat again? That is a very low number. The cat needs to be monitored (tested and fed then tested again) until the numbers come up to a safe level!

I'll tag more experienced eyes to help
@Doodles & Karen
@jayla-n-Drevon

 

I'm not familiar with canninsulin but can agree his dose is too high. It's important to get mid cycle tests so what you've likely been seeing with those high numbers is bouncing. Anytime you get a bg reading under 50 the dose needs to be reduced immediately.

Hope you have retested and are giving honey/karo.

 

Hi,
How is he doing --can you test and see where he is at ?

 

When using caninsulin Oscar MUST eat a meal before shooting-this is a harsh insulin and it tends to hit hard and drop the numbers low and then begin rising.
If Oscar is not a good eater I would seriously consider a insulin that does not have a quick onset ....
Please update as soon as you have another test....
All of the above is solid advice.....as far as his dose tonight I would test and post for advice.

 

Just did a BG (3:10ish pm) - was 7.7. Put honey on the gums & gave him some food. fell like the world's worst mother but am taking your advice seriously as i love the boy to bits & want to do right by him.

 

Oscar is a veracious eater. Planning to switch to Lantus in the near future (ordered & should be mailed Monday, delivered Tuesday). Will give him insulin at 7pm and will do 1 unit as @Kris & Teasel have recommended.

 

Glad to hear that Oscar is back in safe numbers.

 

Hi,

I suspect that the BG of 139 is due to the honey you gave to your cat.
But honey works quickly, and wears off also the organism quite fast.
That would be good if you can continue to test, in case the honey wears off and BG start to fall again.

I also suspect that the High AMPS is due to the shot of the evening before, with a dose of 1.75 IU on a pre-shot of 90.

Caninsulin is a really harsh insulin, and it is highly recommended not to shoot when the pre-shot reading is less than 200, except if you can strictly monitor BG during the cycle (at least 4 tests between 2 shots).

If Oscar were my cat, I would skip this evening shot.


Congratulations for having catch this hypo episode!

 

As I've mentioned before, planning to switch to Lantus. Wondering which method is best for a novice - TR or Go Slow. Is it that Caninsulin isn't working for Oscar due to my stupidity or because it's harsh? Second-guessing myself under the circumstances.

 

I agree. It would be a good idea to restart tomorrow morning. Be aware: cats are often extra sensitive to insulin after a hypo. It might be wise to go down to 0.5 u to get started more safely.

 

Hi Oscar's Mom,

I'm pleased and very relieved to hear that Oscar's BG has recovered to 7.7mmol/L. You did the right thing to give him honey.

Please can you check Oscar's BG again NOW to make sure he has stayed in safe numbers.


For info, because you've got the spreadsheet link in your signature all members responding to your posts will be able to click on the link and see Oscar's BG information straight away.

I'm very glad that you posted here today to get help.

I see you're planning to switch to Lantus but in the meantime if you keep posting here we can help you with Caninsulin dosing to help you keep Oscar safe.

I would like to recommend strongly that you post for help with determining whether it is safe to give ANY insulin tonight. Is that OK with you? I am worried that Oscar may still be low or bouncing at PMPS.

About 2 1/2 hours before Oscar's next dose is due test him again and if he is in safe numbers don't feed him again before PMPS test (preferably over 5.0 but DEFINITELY NOT below 3.0 - if below 3.0 give more honey).

Half an hour before Oscar's next dose is due please can you do his PMPS test and post the result here so that we can perhaps give you some feedback for tonight's dosing. After the very low BG today, Oscar may be more sensitive to insulin so I would recommend being cautious and conservative.


Mogs
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The experienced members in the Lantus group will be able to help you with dosing and testing.

As others have said above, because the Caninsulin dose is too high that's what is giving you difficulty with Oscar's BG levels at the moment. We can help you to sort things out.




Mogs
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Yes, I saw that you're doing to switch to Lantus : that's really good news!

I have also started with Caninsulin, and it wasn't working neither : it was too harsh, and my cat metabolized it too quickly. I have encountered terrible falls 3 hours only after shots.

When I switched to Lantus, everything was smoother, and only a few weeks after, my cat was in remission.

Regarding the choice of the method, it depends on your availability to test: the TR method requires a lot of tests each day, and low carbs wet food.
With The other method, you need to test before each shot, and you're requested to do a curve each week, testing every 2 hours.

 

I'm glad you got the numbers up but as others have stated, you must stay in the testing to be sure he doesn't come back down after the honey wears off.

He definitely needs less insulin and you should be cautious about what number you shoot tonight. Others who have more experience with this insulin have commented.

I'm glad Mogs pointed out that you don't have to invite other people to view the SS. When I linked it in your signature block, it was so everyone could automatically see it.

 

Please don't be hard on yourself.
Fd can be complicated and most vets know very little or even worse give dangerous advice.

Caninsulin/vetsulin was made for dogs.
It metabolizes faster in cats and they often plummet because of this.
Most vets carry it more than the other insulins and it is much less costly.
I also started with vetsulin and my Dre was so depressed I was heartbroken.
We went to pro zinc and he was back to his bright self but it didn't last longer than 6 hours.
Next was lantus and he would dive even on Lantus usually at +4.
We are now on lev and I really like it. His nadir is about +9.
The difference is he goes down slowly.
Of course each cat is different but I think you will be glad you switched. I agree when you switch to post for help on the dose.
As far as which protocol it depends mostly on your schedule.
Your doing a great job and the lantus lev forum has very skilled members.

 

Thanks for your concern for Oscar everyone. I tested him at 4:30 - it was 12. The I fed the boy. He's more than earned it today. No insulin tonight as per recommendation.

 

Hi Sheila,

Glad to hear that Oscar is in safe numbers. I know he's high at the moment but he's had a lot of carbs today, bless him.

It would be helpful if you could get a test at normal PMPS time just to see how his BG levels are going. Even though you're skipping the dose tonight it would be helpful if you could get a quick BG test done just before you go to bed. The data you get will help us to help you with dosing tomorrow.

Oscar is a handsome boy - and a very natty dresser!


Mogs
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Did a BG at 8pm (an hour after what was supposed to be his evening insulin). Oscar was 18.8. His little body must feel like it's on a roller coaster. Poor fella.

 

Poor guy. You'll get him going again tomorrow. We've suggested 0.5 u twice a day to start. Are you on board with that? You might want to post your BG test results here tomorrow as well.

 

(((Oscar)))

The high number could be partly due to the higher carbs and also partly due Oscar's body responding to the hypo by releasing extra stored glucose and also counter-regulatory hormones to keep his BG levels up (a bounce).

I very much recommend that in the morning you do Oscar's AMPS test, feed him and then post asking for advice on dosing before giving him any insulin. With Caninsulin you need to wait about 30 minutes after feeding to give the dose so you should get a reply within that time.

Also let your vet know about the hypo.


Mogs
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Glad Oscar is safe, now, you did a great job! I also used to use Vetsulin (Caninsulin) and agree with everything that others have posted here about it. I was one of the lucky ones whose cat did fairly well on it, but I ended up switching to Lantus for better control. I definitely recommend you post Oscar's AMPS and ask for advice before giving his AM shot!

He is such a handsome guy, I love Devon Rexes.

 

Good morning, Sheila.

How is Oscar this morning?

If you post your AMPS someone should hopefully be around to help suggest something about Caninsulin dosing for you.


Mogs
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Good morning all from Oscar and I. Oscar's BG was 18.1. Original advice was to dose at .5 do I did & here we are.

 

Good to hear from you, Sheila.

Hope all goes smoothly and safely today. Is there any chance you might be able to do a BG test at +3 hours after the shot? It would help you to check that Oscar is in safe numbers and give you an idea of where the cycle is heading.


Mogs
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Just did the boy's BG at noon (+5). It's 8.2.

 

That's WAY better than yesterday's scary levels, Sheila! Phew!!


Mogs
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I have a meeting scheduled with the vet - earliest I can get is Wednesday at 10:45 (works for me also as Tuesday is nuts). I will be asking updating him & asking him about 1) whether to get a small vial of Caninsulin to see me through the holidays before starting Lantus (original plan is to start Jan 1) 2) Should I start Lantus now inspite of holiday mayhem? and 3) Would there be anything else suspect with the crazy numbers? (He knows the boy). Your opinions weigh into this too - I will add them in our meeting on Wednesday.

 

Here's my take:

• His doses of caninsulin have mostly been too high. The numbers weren't too bad when he was on 1.5 u in early October but it would be nice to see how he would have done on only 1 u, slowly raised if needed.
• Caninsulin is fast-acting and can cause trouble very quickly if the dose is too high. It can work fine properly dosed in a cat that handles it well.
• If you start Lantus this week, you'd likely have the new routine under way before the worst of the holiday chaos.
• It would be very stressful if his BG tanked on Caninsulin again right in the middle of holiday craziness.

 

Don't forget also to take your SS with you, and to show it to your vet.
He will be able to see that yesterday low numbers weren't the first scary numbers you faced since starting Caninsulin.

 

Oscar's reading this evening (7pm) is 15.4. Would it be advisable to give .5U or forego the insulin tonight?

 

Yes, I think you can give 0.5 u tonight. Can you test at +3 again?

 

@Kris & Teasel I went to bed early so no extra reading last night. This morning Oscar's BG was 16.5 & I gave him .5U.

 

He should be fine at that dose but it would be a good idea to get some data for the middle third of his cycle, maybe +3, +5, +7 and +9. His BG picture needs to be "fleshed out" at this dose, especially in light of the hypo numbers you've had. Sound like a plan?

 

At +8 Oscar was 14.5. On his final dose for the day Oscar was 13.8. He was given .5U Caninsulin.

 

@Kris & Teasel and @Critter Mom - Talked to the vet today. He agreed that the lows on Caninsulin are too extreme & that there have been more than enough hypos. He's all for the Lantus switch - waiting on it to be delivered. Around noon +5 and 15.6 this evening.

 

Thanks for updating us, Sheila. That's excellent news about the Lantus.

Great job getting the +5 - 5.2mmol/L reading; quite a drop from today's AMPS of 15.5mmol/L - on only 0.5IU Caninsulin! This is why the mid-cycle tests are critical to understanding what a dose is doing and making sure Oscar is going to be safe: if the only readings taken today were the AMPS and PMPS it would not give a proper picture of dose safety.

Until you make the switch to Lantus it would be great if you could get mid-cycle tests some time between +3 and +5 because that is typically the time when a Caninsulin cat has its nadir.

NB when you start Lantus you need to take into account Oscar's current results on Caninsulin when determining a starting dose. Given that he's got such a strong response to only 0.5IU Caninsulin I think he will probably only need a tiny dose of Lantus to start off.

Be sure to keep us posted with developments and shout out for any help you need.




Mogs
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