? Assistance with Vetsulin Needed - ? too high a dose

Discussion in 'Feline Health - (The Main Forum)' started by MrWorfMen's Mom, Apr 25, 2016.

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  1. Sarah Smith

    Sarah Smith Member

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    I'm still working on getting Cooter swapped over to all wet food, plus he is a very large framed cat, so I can't really give you an answer on how much I feed him. The amount you feed will depend on Tux's weight and his appetite in general. The "pefect portions' on the sheba is a little misleading I think...it may be enough for some I suppose, but others would need more
     
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  2. Kako & Tux

    Kako & Tux Well-Known Member

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    ff means Fancy Feast? I got 10 cans of classics today. I am staying with 1 unit injection and switch food to wet, and will wait and see. :)
     
  3. Sarah Smith

    Sarah Smith Member

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    yup, FF is fancy feast :) Hoping this works out for Tux, you both need a break from the stress!
     
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  4. Kako & Tux

    Kako & Tux Well-Known Member

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    Jennie, thank you so much for detailed advice. I will follow them.
    I got 10 cans of Fancy Feast also. :)
     
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  5. Nederland

    Nederland Member

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    I saw the list of food in an earlier message, great!
    I want to have you well informed by next Thursday, so you know what to do and how to continue.

    If you decide to switch to another insulin, please feel free, because I would switch to lantus. But for the moment you still have caninsulin, so you need to know how to deal with that specific insulin. And we have to get his numbers down, they are way too high.

    I suppose you are sleeping now. Good luck this morning starting the new food-and-shoot-regime. I'll check in later. In the meantime, I'll check how much 1 Oz is. It'probably not the Wizard of Oz ....
     
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  6. Capoo

    Capoo Member

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    Hello Kako,

    I just wanted to add that you need also to protect your insulin bottles from light, which could alter it.
    To preserve my insulin in the fridge, and whatever type it is, I have tinkered a special box starting from an After Eight packing :
    IMG_1263.JPG
     
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  7. Nederland

    Nederland Member

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    That's a great way to store it!
     
  8. Capoo

    Capoo Member

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    Yes, a great way because first, you need to eat all the chocolate :)
     
  9. Capoo

    Capoo Member

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    And, of course, like this, the cartridges remain upwards, protected from light.
     
  10. Nederland

    Nederland Member

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    I suppose you need new boxes all the time, because the carton degrades in the fridge (or some other really good excuse .....:))?
     
  11. Capoo

    Capoo Member

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    Yes, you're right: you cannot imagine the damages generated by the light of the fridge on the carton..... :p
     
  12. Kako & Tux

    Kako & Tux Well-Known Member

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    Good morning Jennie!
    Yes, before your departure to your trip, hope things are settled. :)
    Oh I am familiar with grams. Japanese grow up with grams and kilograms, so.
    I have a Tanita scale, so no problem. I noticed 140 g is more than one can of Friskies. (one can: 5.5 oz =156 g)
    I felt it's too much, so I gave him 70 g Friskies. Then 1 unit injection after 15 minutes.
    As I tested earlier, I wrote the number at +11.
     
    Last edited: Apr 30, 2016
  13. Kako & Tux

    Kako & Tux Well-Known Member

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    First thing I noticed this morning that his dandruff is gone! He's had bad dandrull for the past 1.5 - 2 months, and he doesn't have it this morning!
    When I pull his skin around the neck and let go, it goes back flat in one second. (Yesterday morning it took 5 seconds.)
    Wet food is working. Hope it would help lower BG. :)
     
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  14. Kako & Tux

    Kako & Tux Well-Known Member

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    I smell it~~~~~~..... :) My husband would open the box and say Damn! :D
     
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  15. Nederland

    Nederland Member

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    Good morning! It's almost 5 PM here ....
    Okay, I hope it's not too little food, although I can't tell as I don't know the feeding advice per day of Friskies for a 10Lbs cat. Would he like to eat more? If so, could you give him 30 grams more right now? If he won't eat it, he probably had enough, but if he will, he will have enough of a buffer for the insulin.
    I saw the level was lower this morning, fortunately. He's getting out of the stress mode.

    Next test at +3 (if you want to test more, I can't stop you. But it's not necessary. Only if he starts to be wobbly, looking with glazy eyes etc, then always test). And after the 30 grams now, don't feed anymore until his levels rise again. I'll be here to help.

    I just realised you use the Alphatrak. That means that in my message of yesterday, about taking action when he gets below 72, it should be changed to below 90 (appr.) on the Alphatrak meter.

    Good luck today! And give Tux a cuddle from me.
     
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  16. Nederland

    Nederland Member

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    Very good!

    Not being dehydrated anymore also makes the level drop. there is more moisture in the body to dissolve the glucose in ....
     
    Last edited: Apr 30, 2016
  17. Kako & Tux

    Kako & Tux Well-Known Member

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    70 g was what he wanted to eat. I will give him a bit more after the +3. Yes, I will give him a big hug, telling him it's from Jennie! He now is asleep, snoring. :)
     
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  18. Nederland

    Nederland Member

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    No, don't give him anymore now or after the +3. Just test at +3, +4 and so on until the level rises again without extra food.
    If 70 grams was all he wanted, it should be enough. It's very important at this moment that I can see how long the insulin works without the counter effect of food, even food with low carbs .....
    I'll check every now and then in case he starts to act strangely. And around +3 to see what his level is.
     
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  19. Critter Mom

    Critter Mom Well-Known Member

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    :D

    1kg = 2.2lb

    1lb = 16oz

    1oz = 28.4g (rounding up to 30g is probably close enough).


    Mogs
    .
     
  20. Nederland

    Nederland Member

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    I see, you changed that to +11. I'd prefer it in the AMPS column though (even though it's not exactly the right time). Then I can look at one line and see preshot - lowpoint - next preshot etc. It's easier than scrolling to the right to see what's there in the line before.
     
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  21. Kako & Tux

    Kako & Tux Well-Known Member

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    OK, I will move the number back to AMPS.
     
  22. Nederland

    Nederland Member

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    Thank you!
    And don't feed after the +3, please?
     
  23. Nederland

    Nederland Member

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    +3 lower, but not much ....
    Í wonder what +4 will be.
     
  24. Kako & Tux

    Kako & Tux Well-Known Member

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    Tux has been hiding since +3 test. We both are really stressed. I place "fully hydrate him" our #1 priority at this point, and take break from frequent testing. I just shoot for Am&Pm S and +3 to be sure that he is safe.
     
  25. Nederland

    Nederland Member

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    Okay, stress and fear are also not good for his levels, and hydrating him is the most important thing at the moment. Poor thing.
    Try to stay calm yourself, he also feels your stress. (I know, it's difficult). We always tell our members to actually tell the cat why they want to test him and shoot insulin, because for their health, that it will help him feel better. They understand. Talking calms him (and you). But for now, just leave him be. Monitoring can also be done by looking at his behavior.

    There is no chance that he will have a hypo today, with these levels, so don't worry.
    You can give him some food, if you won't test him anymore today before his next shot. Maybe he wants some, say about 50 grams of wet food? Not more.

    I suggest you give him 100 grams of wet food this evening just before the shot, maybe he will eat all. Then shoot 1 unit. You don't have to test him this evening, maybe some rest will do him good.
    And before you go to bed, give him another 50 grams of wet food. He'll have something for the night.

    By the way, and this is very important, making sure he gets lower levels will also help hydrate him. Dehydration is caused by the amount of glucose in his blood. So we really need to get him down, in a safe way.
    I think tomorrow morning you should increase the dose to 1.5 unit. But I'll post a message before you get out of bed tomorrow.

    Normally we wouldn't change so many things at once (food, dose), but he really is too high in his numbers. I want him to go to pink numbers on his low point for the moment.
     
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  26. Nederland

    Nederland Member

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    Before I go to bed, I want to explain the dehydration as best as I can. His high levels dehydrate him. His levels are above the renal threshold. That means that there is so much glucose in the blood, that the kidneys need to get rid of it through the urine. It requires a lot of urine to pee out the sugar. That causes dehydration. It can not only be resolved by wet food, although it does help. The levels need to get down.

    Testing is always difficult in the beginning. All cats and owners need to get used to it. Fortunately, testing for caninsulin is most of the time only testing the low point (although the US-members are reluctant to accept that and I can understand why). The only thing is, we still need to find the timing of the low point and that requires a series of testing. If you don't manage today or tomorrow, no problem. Maybe Monday or Tuesday Tux is suddenly willing to be tested.
    Until then: keep the feeding pattern (but a little less food than I first suggested, e.g. 100 grams before the injection and 50 grams 4 hours later), and test the +4 during the day time, before his little meal. We'll get an impression of what happens in his body.

    We have cats that come running when the owner calls: 'testing!" They think it means "treat!". You do give him a little treat after testing? Maybe one day Tux will do the same ....
    Keep up the good spirit and keep faith that all will be well.
     
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  27. manxcat419

    manxcat419 Well-Known Member

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    We have very good reasons for that. Insulin is a hormone, not a drug and the way the cat's body uses it varies from cycle to cycle. No matter what insulin you use, a cat's low point can and does change - sometimes over a long period of time and sometimes suddenly. It can also change because the cat's insulin needs are changing. Only testing what was the low point a month ago could risk missing a very low number and, if the cat is starting to bounce at their previous low point could lead to chronic insulin overdose which is a dangerous cycle for the cat to be in.
     
  28. Kako & Tux

    Kako & Tux Well-Known Member

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    Apr 24, 2016
    Oh I must be exhausted. Suggestion 1.5 was for tomorrow AM, and it wasn't set.
    I gave 1.5 tonight. Didn't test but he was acting normal for 3 hours after the injection. Then +3 tested 285.
    I will stay up until I can know Tux is fine. And hope tomorrow AMPS will have a good number.
    Tomorrow morning, I have to leave home after +3 test, and I will come back about time +5.
    I am scheduled to serve for Children's Church so I can't skip church... unless I MUST stay home.
     
  29. manxcat419

    manxcat419 Well-Known Member

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    I see that although Tux dropped quickly from pre-shot to +3, the drop has slowed right down between +3 and +4. I would get another test right before you go to sleep just to make sure, but as long as that drop stays leveled out, he should be OK. He might well be bouncing by morning, so you might see a much higher number at his pre-shot test then - don't panic if that happens. :)

    If you can get pre-shot and +3 tests on him tomorrow morning, I'm sure someone will be able to let you know if it's OK to leave him on his own for a couple of hours - he will most likely be fine but, of course, there's no way of knowing for certain until you get those tests.
     
  30. Kako & Tux

    Kako & Tux Well-Known Member

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    Oh thank you..... It's good to know... I will not be panic in the AM. :)
    I planned to do +5 but Tux no longer wanted to wait to eat, and I am exhausted. So I fed him (he just finished eating) and we are going to bed.
     
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  31. Nederland

    Nederland Member

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    I'm excited to see yellow numbers! Good decision to shoot 1.5, but I see you were worried. Don't worry, he still far from a hypo. But normally I would advise to increase the dose in the morning, when you are there to monitor and don't have to stay up late in case he drops unexpectedly low.

    We seldom see bounces with caninsulin, actually. We do see Somoyi's, but only very rarely when the level was not yet in hypo levels.
    We do see, with both available insulins, that the morning pre shot levels tend to be higher than the evening pre shot levels (also if no significant drop occurred the day before). If the cat has the same rhythm as the person (more active during the day, asleep during the night) it's because when waking we need our body to start functioning fully again, that requires fuel (=glucose), so the body produces some extra glucose to get started: start up hormones are responsible for that. In diabetics it results in a higher morning level. We never base the dose of caninsulin on a preshot level, only (of course) when it's very low, but there are usually signs beforehand that there will be a drop (a +4 that's dropping over the days). But very high unexpectedly? Just shoot the normal dose and look at the low point for more info.
    Low points do tend to move, mostly when the food is changed. And Tux is just starting on his new food, and we are still trying to find the perfect dose (for this moment in time) for him, so things will change. It can take weeks to settle. But for now, we need some guideline of a possible low point to get him into acceptable levels and to make safe decisions on the dose.

    Kako, if you could manage today during the day time to test pre shot, +3 and +5, +6 and so on until there is a rise in the level without food (that food part is important, and I do feel sorry for Tux if he has his low point at +6 ......), it would be very helpful. Just skip the +4 today, we know from yesterday evening that there was still a slight drop. If the +5 is higher than +3, you can give him his food. A good thing about you being away this afternoon is, that you won't have to see his food-begging eyes at +4 .....
    I hope Tux is cooperative for the tests.

    I'm still searching for a good amount of food per day. We use a rule of thumb: 100 grams of wet food equals 25 grams of dry food (in nutritional stuff that's in it). 1 can of 156 grams per day would equal 38 grams of dry food a day, and that is very little .... 2 cans may be too much ...
    Since you will be gone in the afternoon, I would ask you today to give him 100 grams of wet food before the shot, just to make sure he has enough food in his body. If at +3 he is in the red, pink or yellow, it's safe to leave for your appointment. If he is in the blue I would stay at home to monitor or give him his food and do the mini curve another day. If he's in the dark green or light green, he must have his food immediately, don't wait till the next hour, and you really need to stay at home to monitor. Light green also requires dextro or honey, but I doubt very much that he will go that low and by that time (+3) I will be online again.

    If at pre shot, he is black or red, you can safely shoot 1.5 unit. If he's pink (I can't imagine) I would lower the dose to 1 unit. I will not be online at preshot, Sunday - familyday, so this is just to be sure you don't overdose.
     
  32. Critter Mom

    Critter Mom Well-Known Member

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    Hi Jennie,

    Given the cup-shaped nature of a typical Caninsulin curve, I'd be very interested to learn how you on the Dutch forum have been able to distinguish bounces from dose poop-out.

    While I'm here, I'd like to say how much I value and appreciate the way that you are explaining the way that you and the other people on the Netherlands forum work both Caninsulin and feeding schedules. I am learning a great deal from you. When I was treating Saoirse with Caninsulin in the early days after her diagnosis I found myself trying to figure things out on my own a lot because the vets I was dealing with at the time were of precious little help. I am hoping to combine my own experience with what I'm learning about Dutch techniques to be (hopefully) better able to help other Caninsulin/Vetsulin users who arrive here in the future.

    Doei! (sp?)


    Mogs
    .
     
  33. Kako & Tux

    Kako & Tux Well-Known Member

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    Apr 24, 2016
    Good morning! Tux woke me up climbing on my tummy. It's 534 this morning. It's better than 700 or 6oo!
    Exact time is +10.75 but I will write the number at AMPS. And then is it OK to feed him and give insulin even though it will be one hour early?
     
  34. Kako & Tux

    Kako & Tux Well-Known Member

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    Good morning Jennie! It makes sense! In case making a change, morning a day when able to monitor well is better! I will keep in my mind for the future. :)
     
  35. Kako & Tux

    Kako & Tux Well-Known Member

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    About can food: I am giving him 100g per breakfast and dinner, what he eats is 60-70g. As snack (when NOT testing) I've been giving him one tea or table spoon mixing some warm water to make it soupy, thinking it may help him hydrated (3-4 times a day). After the last PM testing, he eats less than 60g. (forgot to scale. I can assume around 30g). All together, he eats about 1.25 cans of Friskies (5.5oz can) a day.
    I gave him 1.5 unit injection this morning at close enough to regular time.
     
    Last edited: May 1, 2016
  36. Nederland

    Nederland Member

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    Apr 20, 2016
    I'm back from my family time. Well done!
    His numbers are dropping, also the pre shot numbers. He's doing really well. Him being rehydrated helps, his wet food helps, and the insulin is doing its job again after the stress caused by the former dose of 3 units.
    We have to monitor what the effect of the food change and the 1.5 unit will ultimately be. The body can take up to two weeks to settle around the new situation.

    If 1.25 can is what he eats per day, than that should be okay. So he's eating appr. 200 grams a day, or almost 200 grams. That should mean that his pre shot meal should be 70 grams, and his in-between-shots-meal 30 grams.

    I hope today we will have an indication where his low point is approximately (at this moment). We will see at +3 and +5 (if Tux is willing to be tested). The low point can move as the body settles on the new food, so we must be careful with the dose and his levels. Better a bit too careful.

    I will suggest some other test moments later, because there is more that I want to know, but first we need the low point. I'll check in later. My cat needs lap-time at the moment.
     
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  37. Kako & Tux

    Kako & Tux Well-Known Member

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    +3 tested 391.
    He refused to come to me, so I fished him with a teaspoon of wet feed (some water mixed). After the test, I gave him the food as I promised him.
    I know..... without food is better..
    Off to go. Will be back in a few hours.
     
  38. Nederland

    Nederland Member

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    That's a pity, because the +5 will not be informative for me after he had his meal now ... And his levels will start to rise again too early. Only the teaspoon would not have mattered, though ...
     
  39. manxcat419

    manxcat419 Well-Known Member

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    How are you telling the difference? Both are, technically, rebound hyperglycemia (or liver panic in the case that the level that caused it wasn't actually too low, just low for what the cat is used to). With the possibility of missing the actual low point when only testing at a set time each day, there really is no way of telling for sure if a cat did go low at some point or not.

    Does it not make more sense to consider a cat's calorie requirement rather than an actual volume of food? Just as with human food, calorie content varies greatly (think about the difference in calories between 50 g of chocolate and 50 g of salad). This page gives a reasonable starting point http://www.allfelinehospital.com/getting-your-cat-to-lose-weight.pml although amounts do, of course, need to be adjusted on an ongoing basis for any individual cat.

    I'm interested in this too. Even the manufacturer of Caninsulin shows the typical curve as being one where the cat is fairly high by the time pre-shot comes around as the dose has stopped working.
     
  40. Kako & Tux

    Kako & Tux Well-Known Member

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    Apr 24, 2016
    I mean by I gave him *one teaspoon* of wet food *after* the +3. Not a whole meal.
    I know by now.
    I can't do +5. It's so nice outside, he is out somewhere in our property. I will just test when he is back.
     
    Last edited: May 1, 2016
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  41. Critter Mom

    Critter Mom Well-Known Member

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    @manxcat419 - Good weight management link, April. Thanks for posting! :)
     
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  42. Nederland

    Nederland Member

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    I thought that this meant that you had given him all the food ..... sorry, I misunderstood. That's what you get when two people are not native speakers of english;)
     
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  43. Kako & Tux

    Kako & Tux Well-Known Member

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    Sometimes it's hard when we communicate in details. :)
    He used to come to me when I call him but now he runs away when he sees me. :( So I have to show food for him to come to me. Then after the test, I need to give it as promised.
    Wish I don't have to do that. :(
     
  44. Kako & Tux

    Kako & Tux Well-Known Member

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    Got done +5.75 (I wrote the number at +6).
    289!!!!! It's interesting!
     
  45. Nederland

    Nederland Member

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    Maybe we don't see them because we seldom test pre shot levels with caninsulin cats? If the level of the low point remains stable, we continue the dose. If the level of the low point goes up, we don't adjust the dose immediately, because tomorrow or the day after tomorrow the level can be normal again. Could be that there was a bounce in that case, which we didn't notice. But then again, if we would see it, we would just continue the dose just as in the case that we hadn't seen it. Remember that caninsulin causes a significant drop every day, the body is used to going form high to low and back again.

    We are trying to figure out now on the dutch forum what the difference is between Somogyi and a bounce, we are still in doubt, but we think we have found a possible difference. I posted in the Thinktank a little piece of text on Somogyi. Maybe check there and continue the conversation there, to prevent this topic from being more about theory than about Tux?

    Yes it does. Calories and nutritional values. But I'm completely unfamiliar with the cat food in the US and it is very important for a cat to have had enough to eat before shooting caninsulin. So I kept on about this.

    What's that?

    (yes, Doei is the right word, though it is a bit slang)
    Thank you, that's why I do it. I saw in the caninsulin/vetsulin area in some topics questions that I would have answered differently and on a serious subject as possible hypo's. I was concerned, so I opened a topic in the caninsulin area, which was moved to the Thinktank. In that topic I address several important things about caninsulin. You don't have to agree with me on what I write, of course, but then again, I learned from our caninsulin expert, who must have seen at least 800 caninsulin cats. And we never lost one on a hypo, using our protocol (if the members listened to advice, some are very stubborn....).
     
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  46. manxcat419

    manxcat419 Well-Known Member

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    Jennie, thank you for the explanations. I think we're all just trying to understand exactly how your protocol works - there are some significant differences compared to how we tend to do things here and I do appreciate I'm asking some difficult questions. But it's all in the aim of a better understanding for all of us so that we can all help everyone's cats better. :) I will, definitely, look at the Think Tank post. :)
     
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  47. Nederland

    Nederland Member

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    Good boy!
    It's indeed interesting, it seems either one of two things: his low point is very late OR he has a really nice second peak. In the last case, he must have been lower before and is very slowly rising again.

    I'm so sorry that he runs from you .... You absolutely must reward him after every test with a low carb treat. You wrote in the beginning that you fed him cooked meat. Just give him one little piece of cooked meat after every test, it has no carbs. He will get used to it and I hope he will come again when you call.
     
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  48. Nederland

    Nederland Member

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    Apr 20, 2016
    We learn from your Prozinc approach and you can just choose what you want to learn from our caninsulin approach.
    We also do things very differently with lantus, there is no comparing the two insulins. Prozinc, as far as we can see now, will also be completely different from Caninsulin, it will be closer to TR with lantus (although not the same).
     
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  49. Nederland

    Nederland Member

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    Kako, maybe if you could test again soon, and see if he rises, he could have his little meal? I feel so sorry for him, he must be hungry ...

    But he's doing great, really, I'm very happy he is showing such good numbers.
     
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  50. Kako & Tux

    Kako & Tux Well-Known Member

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    Oh OK, a small piece of cooked meat. I will use them as after test treat. I wasn't feeding any meat (human food) since Dr. said NO.
     
  51. Kako & Tux

    Kako & Tux Well-Known Member

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    Apr 24, 2016
    Jennie, before your bed time I'd like your advice. How much insulin do you recommended? In case Yellow, Pink, or Black.
    OK, will do! :) And before your bed time, I'd like your advice in insulin dose for tonight.
    In case PMPS is Black, Red, Pink, Yellow, or Blue.
     
  52. Kako & Tux

    Kako & Tux Well-Known Member

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    Apr 24, 2016
    +7 is 274! Maybe should shoot for +8 but Tux is hungry. I fed him.
    I end test here (until PMPS).
     
    Last edited: May 1, 2016
  53. Nederland

    Nederland Member

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    You can give him his little meal now. Otherwise it will be too close to his important meal at the next shot and he will not be hungry enough.

    In these cases we advise to test the pre shot level for the time being. You are already doing that, so please continue to do that.
    I still seems that the second peak is working well, I don't think the low point is at +7 (that would be strange with caninsulin), it could be that the second peak is a little wobbly. Another good possibility is that the pancreas started to help out, which would be wonderful, but it also complicates the decision what the dose should be. So I'm going to think.

    An additional problem is that you use the Alphatrak, which gives other numbers than the human meters. I'm used to reading 'human' numbers and acting upon them. I will have to be extra careful, because Alfatrak numbers are higher than human meter numbers and there is no formula to calculate an alphatrak number to a human meter number.... I have sheets of a cat named menace (on this forum) whose owner has both meters and the differences are enormous, it's really scary for me ... So I really have to be very very careful. Maybe too careful, but I won't take any risks.

    Greens: no insulin (that's the easy one)
    Blue: one drop (that's insulin up to the zero-line on the syringe, not more)
    Yellow 200-250: two drops (just a little more than 1 drop)
    Yellow 250-300: 0.25 unit
    Pink: 0.5 unit
    Red: 1 unit
    Black: 1.5 unit

    And now I'm going to beg you to buy a human meter, e.g. the Relion at Walmart .... I have sweaty palms now. You see, the sheet of Menace that I used to guess what the levels on a human meter would say, has 419 on the Alphatrak and at the same time 272 on the human meter .... or 325 on Alphatrak and 227 on a human meter. Those are huge differences and I'm used to the lower human meter levels ... If I see a 419 I think 'far too high, it requires a high dose'. But if that is in fact a 272 that I'm used to, I would advise a far lower dose ...

    So this was really scary, making the list for this meter. If you feel the advised dose is too high, shoot less. Better safe than sorry. Really, I wouldn't mind. But whatever you do, don't shoot more.
     
    Last edited: May 1, 2016
  54. Kako & Tux

    Kako & Tux Well-Known Member

    Joined:
    Apr 24, 2016
    Thank you Jennie. I now know that I can give insulin starting with one drop.
    I am not changing meter because it would be confusing. I am sorry... if you are scared, I will try to do my own following knowledge I am given on this board.
    Again, Thank you Jennie for everything you've done for me and Tux. :)
     
    Last edited: May 1, 2016
  55. Nederland

    Nederland Member

    Joined:
    Apr 20, 2016
    I can fully understand that you wouldn't want to change the meter, considering I'll be online for only 4 more days now ... I hope the people on this forum have more experience with reading Alphatrak levels. Confusing, yes, it could be, surely in het beginning, but you would get used to it. But anyhow, it's not necessary to change if the people here can understand those levels and can work with them.

    I'll check your topic every day, the coming days, to see if I can assist in anything else.

    What I would like to say is what we aim for. Of course remission, but if that won't be the case: we aim at a level between 108 and 145 at the low point on a human meter. That is a safe low point, because you need a safety margin in case the insulin works really well suddenly. There is some room then before we start to take action to prevent a hypo. We start feeding the cat to prevent a hypo at a level of 72 or lower on a human meter.
    If the low point is anywhere between 72 and 108 on a human meter, we lower the dose a bit. Is it close to 72, mostly the next dose will be 0.25 lower. Is it close to 108 and the cat is usually very stable around the low point, we'll check a next low point and then make an adjustment or not (depending on the level of the next test).
    It is also a matter of 'know your cat' and you get to know your cat by testing.
    I hope someone can convert those numbers to pet meter numbers ....

    We still haven't found the timing of the low point, but another series of tests you could do is a day curve. Since he stays low for such a long time it is interesting to know what pattern his levels during 12 hours show. You would have to test preshots and every 2 hours in between. He will probably show a prolonged low point because of the second fraction of caninsulin actually doing its job. That would be great.
     
    Last edited: May 2, 2016
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  56. Kako & Tux

    Kako & Tux Well-Known Member

    Joined:
    Apr 24, 2016
    AMPS today is 555. I don't know how accurate the number is since Tux really is tired of testing, he moved a lot and I had to poke his ear 4 times. :(
    Both Tux and I are stressed. Since it's a marathon, we'll take easy and find BG lowest time when time comes. :)
     
  57. Nederland

    Nederland Member

    Joined:
    Apr 20, 2016
    Don't worry, morning pre shot levels are usually higher than evening pre shot levels: start up hormones.
    He's doing well, you just started. And this kind of stress is normal in the beginning ....

    The body can take up to two weeks to get used to the new food in combination with the insulin. If you find his low point by then, and keep him in safe numbers until then, it should be okay. After two weeks of the new food, he will possibly have a stable reaction to vetsulin, and maybe you can find a fixed dose for him (fixed until it needs to be adjusted, of course).
    The aim is to keep him low for as long as possible every day. Feeding him when at +3 will make his levels rise too soon. Looking at his spreadsheet, I would feed him between +5 and +6, as he seems to be lowest by then (appr). If he is really really begging for food before that time, nervously looking around for something to eat, test him to check if he isn't too low. If he is, let him eat immediately.
     
  58. Catticus Maximus

    Catticus Maximus Member

    Joined:
    May 2, 2016
    I know I'm a bit late, and this is anecdotal, but I would be cautious about not doing pre shot tests once you have figured out your dosage. My cat was at a dose of 3.5 units and had a usual pre shot level of around 19 to 22 at the time. One time, I did a pre shot and it came back at 13! I thought it must have been a test error so tried again, and got a 14, and to me that would be the same. I am very glad I knew this and was able to reduce the dose way down for that cycle. I also reduced the regular dose to 2 units at that time.
     
  59. Nederland

    Nederland Member

    Joined:
    Apr 20, 2016
    Did you notice a dropping low point in the period before?
     
  60. Catticus Maximus

    Catticus Maximus Member

    Joined:
    May 2, 2016
    No, and I've never had such a low pre shot test since. I don't have my log book with me, but I believe I gave only 1 unit that cycle and tested a few times after. That particular cycle had the same low point as the previous cycles at 3.5 units (low point of roughly 7 at +4.5).

    I wish I knew what happened to cause such a low pre-shot test so I could duplicate it, but I think it would involve ritual sacrifice and a particular alignment of the stars. ;)
     
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  61. Kako & Tux

    Kako & Tux Well-Known Member

    Joined:
    Apr 24, 2016
    My husband took me out to give me a break. We just left Costco, and we are stopping by a pet shop.
    I want to get a treat for Tux for after testing. Someone was saying... frozen meat? be good? Or something else?
    I cooked chicken breast. Didn't put any salt or any flavors but it's salty! I can't give to Tux.
     
  62. manxcat419

    manxcat419 Well-Known Member

    Joined:
    Jan 14, 2015
    Freeze-dried meat with no other ingredients is the perfect treat for diabetic kitties. There are a few brands, but one that most of the pet stores seem to stock is Pure Bites. You can buy the chicken flavor in a large size bag (which works out much cheaper overall) that's labeled for dogs, but they still only have chicken in them - you just break up the bigger treats to make them cat-size. :)
     
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  63. Kako & Tux

    Kako & Tux Well-Known Member

    Joined:
    Apr 24, 2016
    Thank you! Got a bag of Pure Bites freeze dried Duck for dog. Oh I felt like duck.:rolleyes:
     
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  64. Critter Mom

    Critter Mom Well-Known Member

    Joined:
    Jun 16, 2014
    Nice one, hubby! :D

    I hope you both had a grand time, Kako!

    :bighug:


    Mogs
    .
     
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  65. Nederland

    Nederland Member

    Joined:
    Apr 20, 2016
    We give Thrive treats or Cosma snackies, also freeze dried meat and fish. I don't know if it's for sale in the US. Perfect and they like it very much. Also non-diabetic cats ....
     
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  66. Kako & Tux

    Kako & Tux Well-Known Member

    Joined:
    Apr 24, 2016
    Tux loves his new treats. :)

    And... what do you give your kitty to keep his/her teeth healthy?
    Mom of kitty who is newly diagnosed with diabetes has a lot to learn!
     
    Last edited: May 2, 2016
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  67. manxcat419

    manxcat419 Well-Known Member

    Joined:
    Jan 14, 2015
    I'm so glad he likes them. :) They were an instant hit with our cats too. :)

    Low carb wet food. It's actually the carbs in food that cause dental issues rather than the texture of the food. So, fortunately, that's a nice, easy fix.
     
  68. Critter Mom

    Critter Mom Well-Known Member

    Joined:
    Jun 16, 2014
    Excellent! :woot:

    Isn't it great when we can give our little ones something that makes them happy which is also good for them!! :D


    Mogs
    .
     
  69. Kako & Tux

    Kako & Tux Well-Known Member

    Joined:
    Apr 24, 2016
    Yes! :) Feel like I can have a coffee break now since Tux is happier. :coffee:
     
  70. BJM

    BJM Well-Known Member

    Joined:
    Oct 6, 2010
    I like to look at the rate of drop when there are both pre-shot tests and then checks when you'd expect to see some drop, or around the expected nadir period. You can calculate the drop per hour, and based on the insulin, project where the glucose is going. This was helpful for a recent ProZinc poster when the dose was plunging the glucose quite rapidly; the poster intervened and was able to prevent the cat from getting into trouble. Had she not checked, the cat would likely have had a full blown hypoglycemic attack.

    For example, 555-309 over 6 hours is a drop of 246 and about 41 mg/dL drop per hour. Given the usual action of Vetsulin/Caninsulin, it should start going up by this point. What we've seen in ProZinc, is that if a dose is too high, the glucose will continue dropping - have you seen that with Vetsulin/Caninsulin?
     
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  71. Kako & Tux

    Kako & Tux Well-Known Member

    Joined:
    Apr 24, 2016
    How about gum health?
     
  72. manxcat419

    manxcat419 Well-Known Member

    Joined:
    Jan 14, 2015
    Again, the best diet for teeth and gums is a species-appropriate diet. And the closest we can get to that is low carb wet food (or raw if your cat will eat it - mine won't).
     
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  73. Kako & Tux

    Kako & Tux Well-Known Member

    Joined:
    Apr 24, 2016
    [QUOTE="BJM, post: 1669084, member: 2941"Had she not checked, the cat would likely have had a full blown hypoglycemic attack.[/QUOTE]
    Tux saw two vets since 4/22 when he may had hypoglycemic attack. Neither vet made big issue about it. "Boncing happens". One vet told me to raise Vetsulin to 5 units, another one vet we saw later said go back to 3 units. No tests.
     
    Last edited: May 2, 2016
  74. manxcat419

    manxcat419 Well-Known Member

    Joined:
    Jan 14, 2015
    Bouncing does happen, but hypoglycemia shouldn't - or at least should be corrected very quickly. A cat can only bring it's own glucose back up as long as it has sufficient glycogen stores. Once those are exhausted, the cat has nothing left with which to counter the next hypo and then they're in trouble. And that's assuming that the individual cat's body can react fast enough and strongly enough to bring their level back up in time to avoid problems in the first place. If any vet told me to ignore a hypo attack, I'd be looking for a new vet immediately! As for the advice to raise the dose following a hypo...I can't say words fail me, but the ones I want to use aren't suitable for a public forum!!
     
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  75. Nederland

    Nederland Member

    Joined:
    Apr 20, 2016
    I think the 3 units was too much, seeing how he does on 1.5 units, so 5 .... well, I can't even say what I think about that advice. I think you casn also give him 1.5 in the evening, seeing his level (and he was black yesterday). But you have to feel co0mfortable with it.
    As far as I can see, he's having a normal caninsulin curve with a second peak, which keeps the level down for a prolonged period, which is great.
    For the moment keep him on 1.5 as it can take up to two weeks for the influence of the new food to become completely clear.
    When it's clear that he really is too high during his low point, increase with 0.25 and keep that dose for at least 3 days. It also takes some time for a new dose to show its effect: the low point can become lower every day with the same new dose. When he's still relatively high on that point, an increase after 3 days can be done. But if he is near the good numbers, wait 5 days before increasing. Just give the insulin some time to show what it can do. When increasing too soon when the cat is near a good number, you could get him into trouble.

    Unfortunately, you can not say: he gets 1.5 unit and drops 300 points, so if he gets 2 units he will drop 400 points. That would be really easy, but it doesn't work that way. The influence of 0.25 unit extra can be enormous or tiny. And the first 0.25 extra can have a tiny influence, the next 0.25 can have a big influence. So always be careful.

    What we often see with an overdose is a very fast drop and a very fast rise of the levels if the cat produces stress hormones to counteract the insulin with glucose dumping. In fact, they prevent a hypo this way or turn the hypo: survival mode. They will stay in survival mode for at least 3 days, often longer. Not all cats go into that survival mode: the levels will drop to hypo and beyond ..... It will happen fast. If the low point is normally on +4, it will happen before that moment (how soon is depending on how much overdose it was).
    The numbers in the stress period can go anywhere, from very high to very low. So it's necessary to test pre shot levels, because the level could be 'healthy' at that moment and you don't want to give insulin to a cat with a healthy glucose level. But if the cat is very high preshot after a hypo, even higher than he usually was, the dose of caninsulin still must be lowered by at least 1/3. The body is oversensitive to insulin for a period of time.
     
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  76. Kako & Tux

    Kako & Tux Well-Known Member

    Joined:
    Apr 24, 2016
    Thank you again Jennie for your advice. :) I am glad to know that his curve is good. I'm trying to find his lowest time by testing different times from the past.
    This morning Tux is looking/acting just as he was in the past (1.5 months ago). His fur is shiny, he purrs non stop, he follows me all over the house begging food. :) He was with me until I started vacuuming carpet.
    I gave 1.25 units last night after thinking between 1.25 and 1.5. Yes, I will go for 1.5 if it tested in Black tonight. :) I will read over all advises and follow.

    I can't afford to see another Dr. nor trash Vetsulin and purchase different insulun right this moment, but we will go see another Dr. (it will be the third Dr!) as soon as I can afford and go with insulin the new Dr. would recommend.

    It's good to know that cats would take 2 weeks to adjust their new food. I will stay with 1.5 for awhile and will keep testing preshot BG and increase or lower dose as needed (by 0.25 or so) later. :) The best I can hope is for him go into remission before we use up Vetsulin. :p
    Thank you again for all those detailed advice. :)
     
    Last edited: May 3, 2016
  77. Kako & Tux

    Kako & Tux Well-Known Member

    Joined:
    Apr 24, 2016
    Jennie, maybe I will hear from you tomorrow but in case I won't....
    Have a wonderful trip! :cat:
    Where US are you coming?
    Hope Tux's numbers be much better when you are back to FDMB. :)

    Kako
     
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  78. Nederland

    Nederland Member

    Joined:
    Apr 20, 2016
    We'll go to the south-west. Landing in Phoenix, see lots of Parks, then to Las Vegas, some other Parks, and then San Francisco, Los Angeles and flying back home from San Diego. 4 weeks of driving around to see that beautiful country. I will be exhausted when I'm back.

    I will write some extra notes for you later today or tomorrow. How much vetsulin did you buy, by the way?
    And you can also have a look at my topic in the think tank. There is more on vetsulin/caninsulin there.
     
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  79. Kako & Tux

    Kako & Tux Well-Known Member

    Joined:
    Apr 24, 2016
    Hi Jennie! Sound like fun plans you have on your trip! :)
    I got one 10ml bottle of vetsulin. 2/3 left.
    It's almost 2am. I will come read first thing in the morning. Good night! :)
     
  80. Critter Mom

    Critter Mom Well-Known Member

    Joined:
    Jun 16, 2014
    @Nederland -

    Just a quick note to wish you bon voyage, Jennie! Have a marvellous time and travel safely. Look forward to hearing from you when you get back. :)


    Mogs
    .
     
  81. Nederland

    Nederland Member

    Joined:
    Apr 20, 2016
    We always buy 2,5 ml bottles, as the quality of the insulin gets bad after three weeks. So we don't have to throw away that much .... 10 ml bottles are meant for dogs (they use more insulin, they are bigger).
    That's something to keep in mind ... if you see his numbers rising on the same dose, when the insulin is older than 3 weeks, you will probably increase the dose to see better numbers. Be very careful when you start a new bottle! The same dose or a higher dose of a new bottle may be far too much for Tux. To be safe, you have to lower the dose when you start a new bottle and first see what the new bottle does.
    But maybe you won't buy a new bottle, maybe you will start on another insulin. We usually see the ones with a long second peak (low numbers) do very well on lantus. I'll say it again, if I had another diabetic cat, I would start with lantus immediately.
     
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  82. Kako & Tux

    Kako & Tux Well-Known Member

    Joined:
    Apr 24, 2016
    How about Prozinc? Is Prozinc similar to Lantus? A hospital I am thinking to try next has Prozinc on hand. A vet may give prescription if I want go with Lantus, though.
    AMPS 543 this morning. I decided to go for 1.75 units.
     
  83. Larry and Kitties

    Larry and Kitties Well-Known Member

    Joined:
    Dec 28, 2009
    No, they are not similar but both are long lasting in cats.
    Lantus is a depot insulin that takes awhile to build up for full effect. ProZinc is more similar to Vetsulin but lasts longer
     
  84. Kako & Tux

    Kako & Tux Well-Known Member

    Joined:
    Apr 24, 2016
    Are you happy with ProZinc?
     
  85. Larry and Kitties

    Larry and Kitties Well-Known Member

    Joined:
    Dec 28, 2009
    When I adopted Badger he was on Lantus and his BGs were erratic. I then changed to Levemir since Another cats was using that already. That was the same. N was a little better. I then changed to BCP PZI which was a little better but when I ran out I started ProZinc. That worked better but still not really good. He was on about 5 units. When I adopted Badger he has ear polyps which continuously oozed. Antibiotics would resolve it for awhile. last July I had the polyps surgically removed. Since then his BGs improved and his dose lowered to 1-2 units. Since I had two cats on Levemir I decided to use Levemir instead when the proZinc ran out. Badger is no on about 1/2 unit Levemir and I can maintain his BG below about 110 all day.
     
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  86. Nederland

    Nederland Member

    Joined:
    Apr 20, 2016
    Before I go on my holiday, just one more message.

    If I were you I would choose Lantus, not Prozinc. And then follow the advice given by the lantuspeople of this forum. With lantus and Tight Regulation, you can get his numbers in the healthy range all day, and most cats feel very well in that insulin. I gave my cat caninsulin first, and only at 5 PM did he wake up and become a little bit active. When at lantus, he woke up at 2 PM. He was very ill, so I was happy with everything that made him feel better. But the cats on our forum that go from caninsulin to lantus, very quickly feel better and become more active.

    You increased the dose to 1.75 because of the AMPS. I had given you a list of doses based on preshot numbers, because we didn't know what was happening that day, it looked as if he kept dropping slowly and I was concerned that he would not stop dropping. In that case the dose should be based on the pre shot level. By now he is rather stabel in his preshot levels, so nothing funny/strange is going on.

    The dose of vetsulin, and I must stress this, is based on the level of the low point, not only on the pre shot level. This is very important. The pre shot level is only important if it happens to be very low.
    The pre shot level was rather high however, but really, you should try to find his low point first, before deciding to increase the dose. I think the low point was still too high, but I need to say this in case next time his low point happens to be really good (and his pre shot very high) .... you cannot increase the dose if in future his low point is okay, no matter how high the preshot level.

    After an increase of the dose, you should stick to that higher dose for at least 3 full days, but better still is 5 full days, and test the low point daily. We aim for the blue numbers with vetsulin: they are safe and low enough.
    If his low point starts dropping to better numbers, his pre shot numbers may also start slowly dropping to better numbers. That is also why the number at the low point is most important for the dose.

    I know Tux doesn't like to be tested, but it's for his own safety and health that you need to find his low point. That is also the moment that he should have his little meal.

    I hope that next time I check this topicb(after my holiday), I will see that you switched to lantus. Or another insulin. But what I have seen of Prozinc up to now .... I would choose Lantus if it were my cat, and ask for advice on the forum.

    I wish you and Tux good luck! And I'm very glad that he is already feeling better and that he looks good. And I'm also really happy that he's enjoying his wet food, and his snacks.
     
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  87. Kako & Tux

    Kako & Tux Well-Known Member

    Joined:
    Apr 24, 2016
    Hi Jennie! Thank you for the last minute (before your departure) advice. I decided on Lantus last night. :) As soon as I can afford Tux will be with Lantus. :)
    Thank you for caring us.

    You enjoy your vacation! :)
     
  88. Nederland

    Nederland Member

    Joined:
    Apr 20, 2016
    Great! Good luck!

    I'll sign off now.
     
  89. Kako & Tux

    Kako & Tux Well-Known Member

    Joined:
    Apr 24, 2016
    No more wait, I am switching to Lantus anytime now! (Wish I could give this news to Jennie before her departure!)
    This evening my husband brought me a news that we will be on a trip (business trip, kind of) on 6/3-6/11.
    I have a friend (neighbor) who come feed and give insulin for Tux mornings and nights during that time. I feel BG testing is too much to ask her.
    It means Tux may need receive insulin without testing same units safely 6/3-6/11.
    In this situation when is ideal time to switch from Vetsulin to Lantus?
     
  90. manxcat419

    manxcat419 Well-Known Member

    Joined:
    Jan 14, 2015
    If you can switch in the next couple of days, you'll have almost a month of Lantus data to work with to figure out a safe dose for while you're away. I would have thought the gentler action of Lantus is probably safer for the sort of situation where you have to have a cat receive shots without testing for a few days. Most people reduce the dose slightly for the time they're going to be away to make sure there's no risk of a hypo - I'm sure people who have done that will be able to help you figure out a safe dose nearer the time you leave for your trip.
     
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  91. Kako & Tux

    Kako & Tux Well-Known Member

    Joined:
    Apr 24, 2016
    Thank you for the quick response! OK, I will go get Lantus tomorrow! Good thing, the second vet we saw uses Lantus and she said she has it on hand! :)
     
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  92. billysmom (GA)

    billysmom (GA) Member

    Joined:
    Feb 26, 2015
    Kako, you might want to check out the supply closet. There are a couple people on there selling single lantus pens so it wouldn't be so much up front. You also need u100 syringes.
     
  93. Kako & Tux

    Kako & Tux Well-Known Member

    Joined:
    Apr 24, 2016
    What is "the supply closet"? Yes, different type of syringes. I will get them too. I won't use u-40.
     
  94. Kako & Tux

    Kako & Tux Well-Known Member

    Joined:
    Apr 24, 2016
    OK, I found the supply closet. Thank you.
     
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  95. manxcat419

    manxcat419 Well-Known Member

    Joined:
    Jan 14, 2015
    You should be able to find U-100 syringes in your local Walmart (or of course any regular pharmacy). Walmart sell them for around $13 for a box of 100 so they're not a major part of your switching costs. :)
     
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  96. Kako & Tux

    Kako & Tux Well-Known Member

    Joined:
    Apr 24, 2016
    Wonderful! $13 sounds really inexpensive after spending $1000 the last 30 days! :)
     
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  97. manxcat419

    manxcat419 Well-Known Member

    Joined:
    Jan 14, 2015
    It adds up quickly - it really does. I try not to total up how much I've spent on vet bills over the last year and a half - I have a feeling the total would be frightening!
     
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  98. Kako & Tux

    Kako & Tux Well-Known Member

    Joined:
    Apr 24, 2016
    I can understand!!!!!!!! But now I am very happy that Tux is saved, also I am finding ways to save costs here! :) I was filled fear the night I came here asking help.
    How often are you taking your kitty to a vet for health check ups? I think the first vet (that I will never go back) said a diabetic cat needs to see a vet once in two months for testings... something like that. Oh I can't afford that for sure!
     
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  99. manxcat419

    manxcat419 Well-Known Member

    Joined:
    Jan 14, 2015
    Rosa really didn't get check-ups specifically for her diabetes at the vet. I spent my money on testing supplies so I could get accurate numbers at home instead of having them run curves. What I did was email them the link to Rosa's spreadsheet so they could see the numbers I was getting and what I was doing with her dose. The real costs of diabetes were around the time of her diagnosis. But now she has CKD, so she has to have very regular blood work while we try and find a way of getting the best control of that we can...and some of the meds she's on now are actually more expensive on a daily basis than Lantus too!
     
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  100. Critter Mom

    Critter Mom Well-Known Member

    Joined:
    Jun 16, 2014
    @Kako, if you don't get lucky with finding your Lantus via the Supply Closet remember it's much cheaper to buy from Marks Marine Pharmacy in Canada.

    I'm very glad you found FDMB, Kako, and I hope you're not feeling quite so scared now.

    :bighug:


    Mogs
    .
     
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