? "Caninsulin dosing advice needed"

Discussion in 'Feline Health - (The Main Forum)' started by Anthony Morgan, Mar 10, 2017.

  1. Anthony Morgan

    Anthony Morgan Member

    Joined:
    Feb 16, 2017
    My cat Shelley is in her teens and has had diabetes for 6 years which has been controlled with Caninsulin with no problems and a most recent dose of 1.8 units. On February 9th she had a hypo and her blood sugar fell to 1.1. She was in hospital for 2 days when she had another hypo after the vet injected 1.5 Caninsulin units. The hypos happened about 4 hours after the injection. Her insulin was stopped in the hospital and her glucose curves were normal over 24 hours, the Vet thought she was in remission and no glucose was present in her urine.
    As soon as she came home though the blood glucose numbers were above normal and Caninsulin was restarted on very small dose but this was not bringing the diabetes under control.
    On the advice of my Vet her dose was increased to 1.0u and I started to see a more consistent pattern.
    However on the 9th March her amps was lower and the pmps so much so that I delayed injectiong and in the end gave no insulin.
    The numbers remained in a narrow range in the early hours and then rose this morning. I was just concerned that the numbers might fall too low but I probably should have injected something last night. But she seems to have stayed fairly low on that one shot for 22 hours?
    On the 10th I gave a reduced dose of 0.75u but at +4/+5 I got 6.3 and 6.7 . Although not really low these numbers do make me worry because of the previous Hypos.
    So any advice on the way forward would be greatly appreciated.
    Thank you for reading!

    This is the limk to the previous thread:
    http://www.felinediabetes.com/FDMB/...aninsulin-hoping-for-views-on-doseage.174006/
    Shelleys Spreadsheet:
     
    Last edited: Mar 10, 2017
    Reason for edit: edit text
  2. Larry and Kitties

    Larry and Kitties Well-Known Member

    Joined:
    Dec 28, 2009
    I would try 1/2 unit and see what BGs result.
    Next would be to try an insulin like Lantus or Levemir in order to try t get a flatter curve
     
  3. Anthony Morgan

    Anthony Morgan Member

    Joined:
    Feb 16, 2017
    Thank you Larry, I think I will. My Vet wasn't keen on changing insulin before but I will have to speak to him about it again.
    Regards, Anthony
     
  4. Anthony Morgan

    Anthony Morgan Member

    Joined:
    Feb 16, 2017
    So 20.02 hrs PS = 24.5, not eaten for 2 hours.
    Fed Shelley
    Decided to re-check prior to shot 20.50=21.8
    Not easy to know what to shoot?
     
  5. Tuxedo Mom

    Tuxedo Mom Well-Known Member

    Joined:
    Dec 2, 2014
    Anthony

    The 0.75 unit dose today brought Shelley down into nice blue numbers. I don't know if you fed her any higher carb after the +5 reading that could have caused the jump by +6. The numbers are still safe, but some of it will depend on your comfort levels. I know the previous hypo is still weighing in on your mind. My thought would be to keep the 0.75 dose if you are able to do some more testings up until +4 or +5 after the shot, but if you are not comfortable with the drop you could try the 0.50 unit as Larry suggested. This will give you an idea of whether a reduced shot will still get Shelley into good numbers.

    I would really prefer if a few more people weighed in with their opinions. I will tag a couple of people but they may not be on for awhile.
    @JanetNJ @Kris & Teasel @Elizabeth and Bertie @Squalliesmom
     
  6. Anthony Morgan

    Anthony Morgan Member

    Joined:
    Feb 16, 2017
    Thank you Mary Ann for coming back so quickly. Due to the big jump pre shot I went for the 0.75u. I will have to check in the night that all is OK. She did have a little Gourmet Soup. I actually got it for Herbie, it does have derivatives of a vegetable origin but I don't know if that did it?
     
    Tuxedo Mom likes this.
  7. Sootyca

    Sootyca Member

    Joined:
    Oct 3, 2016
    Shelley seems to react much the same way that Sky does. The 1 unit will bring her nice numbers for AM and PM and then she will suddenly throw unexpected lower numbers into the mix to worry and confuse me. I'm sure she somehow manages to store it in her system! I then manage her on a lower dosage (depending on her numbers this will vary) until she shows signs of increasing again when she will then get more. It's just a merry go round - take a look at her spreadsheet, she was lower on an AM dose than on the PM and had no insulin the previous evening as I forgot!

    The Caninsulin does work for her, it's clear from the spreadsheet, but the dosing is obviously tricky for her. I would have given her probably a half unit yesterday evening when she hit the yellow as she was still in a safe range - certainly wouldn't have given her a 1 unit but from your earlier figures a half until would have probably taken her down a little in the blues.

    If you did feed her before the PM shot this evening it could easily be food influenced. Has she had the gourmet soup before and if so did it have similar effect? I don't think we ever know fully what causes spikes - usually just a best guess!

    Hope Herbie is okay :)

    Karen
     
    Tuxedo Mom likes this.
  8. Tuxedo Mom

    Tuxedo Mom Well-Known Member

    Joined:
    Dec 2, 2014

    I am not familiar with the Gourmet Soup but that could have been what caused that bit of a food spike at +6. This is all good information to have as to which foods raise glucose levels. It may be useful if you want to bring the numbers up a bit but not over carb her, or if you want to avoid certain foods when she is higher. One of my kitties is VERY carb sensitive and the other one is much less so. All good information for knowing how Shelley reacts. I will check back at +2 and see what her numbers are doing.
     
  9. Anthony Morgan

    Anthony Morgan Member

    Joined:
    Feb 16, 2017
    Hello Karen,
    Thanks for your comments. I haven't had the soup before. I thought it might tempt Herbie but he wasn't keen. He has had a few small meals today, seems to lose interest after a few mouthfuls. But he has been very bright, playing in the garden this morning. So that's good.
    I will have to get use to Shelley's fluctuations. It just throws me when it seemed I was getting a steady pattern!
     
  10. Anthony Morgan

    Anthony Morgan Member

    Joined:
    Feb 16, 2017
    That's very good of you, thank you!
     
  11. JanetNJ

    JanetNJ Well-Known Member

    Joined:
    Jun 8, 2016
    I like the 0.75 for preshots 290-340, 1 for 340 and over, and 0.5 if preshots are 250-290.
     
  12. Anthony Morgan

    Anthony Morgan Member

    Joined:
    Feb 16, 2017
    That is a useful guideline, thank you!
     
  13. Anthony Morgan

    Anthony Morgan Member

    Joined:
    Feb 16, 2017
    Hi, +2 is 13.7
     
  14. Tuxedo Mom

    Tuxedo Mom Well-Known Member

    Joined:
    Dec 2, 2014
    Thanks Shelley did a pretty good drop from prehot to +2. Are you giving a bit of food after the testings? It might be a good idea to give her a nice snack at this point to slow down the drop a bit. Could you test again at +3 to make sure the drop is not going too fast. Her nadir is +4 to +5 so she still has more time to drop. This is not a worrisome number, but you don't want the drop to be too steep
     
  15. Tuxedo Mom

    Tuxedo Mom Well-Known Member

    Joined:
    Dec 2, 2014
    Also do you have foods on hand sorted by carb content? Low carb, medium carb and high carb. Having a good cross section can be useful if you are trying to slow a drop or just keep her surfing.
     
  16. Anthony Morgan

    Anthony Morgan Member

    Joined:
    Feb 16, 2017
    Yes, I have given her some food. I will continue testing.
    Thank you!
     
    Tuxedo Mom likes this.
  17. Anthony Morgan

    Anthony Morgan Member

    Joined:
    Feb 16, 2017
    Not exactly but broadly. I probably need to be more specific about that.
     
  18. Anthony Morgan

    Anthony Morgan Member

    Joined:
    Feb 16, 2017
  19. Tuxedo Mom

    Tuxedo Mom Well-Known Member

    Joined:
    Dec 2, 2014

    Looking good. Basically the same as the +2. Keep a record of what food you are giving at each meal/snack in order to see if certain foods slow the drop or cause food spikes.
     
  20. Anthony Morgan

    Anthony Morgan Member

    Joined:
    Feb 16, 2017
    OK, thank you very much for your help!
     
    Tuxedo Mom likes this.
  21. Tuxedo Mom

    Tuxedo Mom Well-Known Member

    Joined:
    Dec 2, 2014
    If you can get a +5 test in that should give a good idea where Shelley is going on this dose. ;)
     
  22. Anthony Morgan

    Anthony Morgan Member

    Joined:
    Feb 16, 2017
    I will aim to do that, thanks!
     
    Tuxedo Mom likes this.
  23. Diana&Tom

    Diana&Tom Well-Known Member

    Joined:
    Dec 29, 2009
    This looks like a plan, Anthony, go with this and see what happens.
     
  24. Anthony Morgan

    Anthony Morgan Member

    Joined:
    Feb 16, 2017
    Yes, sounds like a good idea, thank you!
     
  25. Anthony Morgan

    Anthony Morgan Member

    Joined:
    Feb 16, 2017
    Hello,
    Last night at +4, Shelley's blood sugar was 22.1, hardly any change from when she was injected 1.0 u, when it was 21.7.
    I am very careful when preparing and injecting the insulin and I wasn't aware of any problem.
    Is this likely to be a bounce from her having to deal with too much insulin?
    Some thing similar happend on 6.3.17 when at +2 the blood glucose had risen form 21.9 t0 25.0.
    Thank you for reading, I would be grateful for any thoughts on this please?
     
  26. Kris & Teasel

    Kris & Teasel Well-Known Member

    Joined:
    Aug 17, 2016
    Your SS shows that you had nice blues at a dose of 1.0 u. I see that you dropped the dose this AM because you started a new vial of insulin. That's always a safe move. If the numbers are high today and tonight, I'd try working up to 1.0 u again, maybe giving 0.75 u as an interim dose for 2 cycles or so.
     
  27. JanetNJ

    JanetNJ Well-Known Member

    Joined:
    Jun 8, 2016
    How old was the other vial?


    Go back to 1 u.
     
  28. Anthony Morgan

    Anthony Morgan Member

    Joined:
    Feb 16, 2017
    Thank you, that sounds like a good plan. I am I right to think that I needn't worry about the occasional unexpected out of pattern high number?
     
  29. Anthony Morgan

    Anthony Morgan Member

    Joined:
    Feb 16, 2017
    Hi, it was new on 30/1/17. They usually only last a month but ofcourse I didn't use any for a week or so after the hypo. When this occurred to me I ordered a new vial.
    Thank you!
     
  30. Kris & Teasel

    Kris & Teasel Well-Known Member

    Joined:
    Aug 17, 2016
    The only single numbers you should react to immediately are very low ones. Other than that, (over)reacting to individual numbers can lead to less than ideal dosing decisions. It's the trend in numbers over time that tells the story.

    I see that Janet has suggested you go back to 1 u without an in between dose. That is certainly possible. My recommendation was based on your preference for caution.
     
  31. Anthony Morgan

    Anthony Morgan Member

    Joined:
    Feb 16, 2017
    Thank you, I will have to decide looking at the pre-shot numbers but I certainly prefer to be cautious. Also, Shelley's blood glucose does sometimes fall quite quickly and I think I will have to speak to the Vet as to whether she would benefit from a change of insulin.
     
  32. Diana&Tom

    Diana&Tom Well-Known Member

    Joined:
    Dec 29, 2009
    You may be right in thinking that a different insulin would work better for Shelley, Anthony... maybe keep trying with the Caninsulin for another week and if you're still getting these fluctuations ask the vet about a gentler option.
     
  33. Anthony Morgan

    Anthony Morgan Member

    Joined:
    Feb 16, 2017
    Thank you Diana, I will do that. Kind regards!
     
  34. Tuxedo Mom

    Tuxedo Mom Well-Known Member

    Joined:
    Dec 2, 2014
    I see you have got some good input from others. The only thing I would add is that it is important to get some tests between shots. Yesterday morning you did not show any in between tests so it is hard to tell how low Shelley went on that dose. If you look back at some of the other days you will see that the preshots were higher but she did hit some nice blues during the cycle.


    ETA Shelley "seems" to have a nadir around +4 to +5 so having tests before and around these times will tell whether she is hitting lower numbers during the cycle.
     
    Kris & Teasel likes this.
  35. Anthony Morgan

    Anthony Morgan Member

    Joined:
    Feb 16, 2017
    Hello Mary Ann,
    Shelley was sleeping a lot yesterday and she had quite a few test the previous day, so I decided not to disturb her so much and only do a minimum. I know that is not ideal but just trying to get a balance as she is an elderly cat.
    Thank you!
     
    Tuxedo Mom likes this.
  36. Tuxedo Mom

    Tuxedo Mom Well-Known Member

    Joined:
    Dec 2, 2014
    Anthony

    I understand where you are coming from. Getting the preshot tests is so important to make sure the numbers are safe to shoot, but getting a nadir (lowest number) reading is also important, both to make sure the numbers are not dropping too fast or too low and to see how low a specific dose is taking Shelley. However if she hit low enough numbers it could even cause her preshot readings to be higher which you would not be aware of if you hadn't got mid cycle tests. If Shelley were to be at higher numbers at preshot and you didn't know if she had hit lower numbers during the cycle the natural inclination would be to increase the dose. Even trying to get at least one test around her nadir time...approximately +4 to +5 will let you know whether a certain dose is working well or if it needed to be increased or decreased for maximum effect. You are doing a great job and gathering all the data you have definitely gives a much better picture on how the insulin is working with Shelley. :bighug: :bighug:
     
    FelineFriend likes this.
  37. Anthony Morgan

    Anthony Morgan Member

    Joined:
    Feb 16, 2017
    Thank you, Mary Ann, I will keep trying! Kind regards!
     
    Tuxedo Mom likes this.
  38. Sootyca

    Sootyca Member

    Joined:
    Oct 3, 2016
    You're doing really well with her Anthony. I'm not as cautious and would be back up to 1 unit whilst she is still in the purples at preshoot time. When she was on that dose her numbers were gradually dropping and got to nice blues in the middle.

    Did you try and see if there is any correlation between food and high numbers? I only ask as Sky yesterday has shown a fantastic example of how food has a real impact on her numbers. Sky is always on Sheba fine flakes, gets nice consistent numbers most of the time. For lunch yesterday she had Appaws senior. Her evening PM shot showed a massive increase. I increased her dose by a small amount to bring her back and a day on Sheba and she is getting back down but it does show clearly that I have to stick to one food if I want to keep her low.

    Maybe it is time to try a different insulin - beware though if you get Prozinc it is expensive so be sure on the Caninsulin first. The Prozinc was £90 for a vial - was supposed to last 3 months but as Sky didn't react well do it it was wasted money. Before you can go onto the other insulins you have to show you have used the "proper" animal insulins first. I could have switched to one of the others but gave the caninsulin another go.
     
    Diana&Tom and Tuxedo Mom like this.
  39. Tuxedo Mom

    Tuxedo Mom Well-Known Member

    Joined:
    Dec 2, 2014
    I agree with Karen. The 0.50 unit dose is not moving the numbers much at all so it is just not enough to get Shelley into good numbers. I know you were being cautious with starting a new vial of insulin, but the numbers are barely moving on this dose.
     
  40. Diana&Tom

    Diana&Tom Well-Known Member

    Joined:
    Dec 29, 2009
    I do sympathise, Anthony... you're on a new vial and you're very conscious of hypo, but I'm sure you'll agree that 0.5u isn't enough at the moment. So difficult. I don't have anything to add to what others have said but I do echo the comments about how well you're doing. Give yourself a big pat on the back! Keep going... you will get there.
     
  41. JanetNJ

    JanetNJ Well-Known Member

    Joined:
    Jun 8, 2016
    BTW vetsulin lasts longer than a month when refrigerated. My vet said it's good for up to three months.
     
  42. Anthony Morgan

    Anthony Morgan Member

    Joined:
    Feb 16, 2017

    Hello Karen,
    Good to hear from you. I did intend to stick at 1u until that drop to 14.4 pmps on the 9th and then did get some blues on the 10th with 0.75. I probably am being too cautious and not necessarily helping Shelley.
    I did try sticking with Felix for a few days but with changing doses didn't come to a conclusion. I tried the Sheba flakes but Shelley only ate the jelly. She seems to be able to eat pates best and they tend to be Gourmet. I did read somewhere that Gourmet Gold is the same as Fancy Feast. She has been eating mainly Gourmet, so I will try and see if there is a pattern.
    I didn't know Prozinc was so much more expensive, switching may complicate things from what you say.

    Thanks for your comments and encouragement. I will keep trying to get it right!
     
  43. Anthony Morgan

    Anthony Morgan Member

    Joined:
    Feb 16, 2017
    Thank you for keeping an eye on things. I certainly need to increase to 0.75u at least.
     
  44. Anthony Morgan

    Anthony Morgan Member

    Joined:
    Feb 16, 2017

    Thank you Diana, I appreciate that and yes I do agree. Thinking about tonight's shot shortly.
     
  45. Anthony Morgan

    Anthony Morgan Member

    Joined:
    Feb 16, 2017
    OK, thank you. It use to be used up after a month on the previous dosing but I will remember that for the future!
     
  46. JanetNJ

    JanetNJ Well-Known Member

    Joined:
    Jun 8, 2016
    just out of being cautious I changed vials after 10 weeks instead of 12, but I could clearly see the numbers were pretty much the same with the new vial... so it's probably fine to even wait until 3 months as long as it's refrigerated.
     
  47. Anthony Morgan

    Anthony Morgan Member

    Joined:
    Feb 16, 2017
    Thanks for that, it is worth knowing and I always keep it refrigerated.
     
  48. Anthony Morgan

    Anthony Morgan Member

    Joined:
    Feb 16, 2017
    Last nights 0.75u took Shelley as low as 4.4. Gave some Dreamies and food and her level rose to 9.3 after 20 minutes.
    She had been eating before hand as well, so quite worrying.
     
  49. Diana&Tom

    Diana&Tom Well-Known Member

    Joined:
    Dec 29, 2009
    Hmm that is quite a big drop, although the 4.4 is actually a nice number, just scary I know when you're used to so much higher ones. It is looking as if Shelley somehow uses insulin in an unpredictable way... I'd say you're not far off the time now when it would be worth showing your vet your spreadsheet and asking if another insulin might be in order... it does seem difficult to determine a dose or doses that follow the pattern you'd expect on Caninsulin. It is a tricky call though, when there are various factors to take into account - the different foods she eats being perhaps the main one, and the cost of other insulins which are dearer (not that that's insurmountable when it comes to our kitties!)

    This whole issue of unpredictability is probably why Shelley hypo'd in February - the dose at the time was consistent, I think (?) and maybe she did have a little bit of build-up in her system.

    It may be that if you hadn't given her Dreamies she would have stayed in the greens a while longer and ended up at pre-shot this morning slightly lower than her usual... that's the situation we're aiming for but it is certainly easier said than done. See what others say, and perhaps consider callling the vet to ask if you can email a link to your ss and ask his opinion.. I know he's not the most experienced in FD but this is just the sort of thing he should be able to address if he wants to become more knowledgeable in his profession, so he might take it upon himself to do some research.

    Sorry I can't actually say anything useful but I do sympathise and I do wish you the best of luck!
     
  50. Tuxedo Mom

    Tuxedo Mom Well-Known Member

    Joined:
    Dec 2, 2014
    That was a big drop, but still in the safe zone although with the recent hypo I am sure it was a scary drop for you. There is a good chance that the numbers will be higher for the next preshot because of the big drop.

    It is hard to say whether changing insulins is the best approach. Even on the long lasting insulins some kitties are prone to having big spreads between the nadir and the preshot.

    I am going to tag a couple of people and see if they can offer some more insights.

    @Kris & Teasel @JanetNJ @Squalliesmom
     
    JanetNJ likes this.
  51. JanetNJ

    JanetNJ Well-Known Member

    Joined:
    Jun 8, 2016
    I agree. It was a safe number, but I could see why with time to still drop there was concern, but I think there was an over-correction. A little bit of low carb food rather than high carb treats would have kept her in those nice healing numbers longer giving her pancreas a rest.
     
    Tuxedo Mom likes this.
  52. Squalliesmom

    Squalliesmom Well-Known Member

    Joined:
    Jun 26, 2015
    Just scanned through this thread to get caught up a bit. I don't really have anything to add, I agree with the information and advice you've gotten so far, it's what I would have recommended, too. Unfortunately, those big drops are fairly typical of Vetsulin.
     
    Tuxedo Mom likes this.
  53. Anthony Morgan

    Anthony Morgan Member

    Joined:
    Feb 16, 2017
    hello Diana,
    That is all helpful, thank you. Sorry I have been a while but I had a visitor.
    The vet actually said that due to possible inaccuracies with the Alpha Track, that I should take Shelly in if the number fell below 5.
    From what I have seen on the internet I think the Alpha Trak is a lot more accurate than that. But when I saw the 4.4, I just didn't want it to go any lower. Shelley had been eating Gourmet Pate prior to this, that's why I thought I needed some higher carbs but perhaps I over-reacted.
    I did speak to the vet last Thursday and he had the spreadsheet up to the previous Monday and he was adamant I should stick to 1u.
    Whether I would have had a more serious problem if I had I don't know.
    But I will speak to him again and see how things go today but I have only injected 0.5 this morning.
    Thanks once more!
     
  54. Anthony Morgan

    Anthony Morgan Member

    Joined:
    Feb 16, 2017
    Thank you Mary Ann,
    I just explained my thinking in reply to Diana but perhaps if I was more use to the lower numbers I would not have worried. Perhaps this is where Shelley should be more often.
     
  55. JanetNJ

    JanetNJ Well-Known Member

    Joined:
    Jun 8, 2016
    Alphatrak is quite accurate.... Moreso than a human meter with only a 15% variance.
     
    Anthony Morgan likes this.
  56. Anthony Morgan

    Anthony Morgan Member

    Joined:
    Feb 16, 2017
    Hi JanetNJ,

    Thank you for your comments. I have explained my thinking in my reply to Diana but I am sure you are right. Over reaction!
     
  57. Anthony Morgan

    Anthony Morgan Member

    Joined:
    Feb 16, 2017
    Thank You!
     
  58. Kris & Teasel

    Kris & Teasel Well-Known Member

    Joined:
    Aug 17, 2016
    Vetsulin/Caninsulin will often create high pre shot/low nadir situations. That's why your dosing should be based more on how low Shelley goes and less on the pre shot number, barring any bouncing. I see from your SS that you've changed doses often in the last 3 or 4 days and that can lead to erratic BG behaviour in sensitive kitties (and your girl is one). My suggestion is to stay at 0.75 u consistently both AM and PM for a few days. Sliding scale dosing is a useful tool in some instances and in others it makes things more complicated. If you're uneasy giving 0.75 u, try a "fat" 0.5 u instead.
     
    Diana&Tom likes this.
  59. Anthony Morgan

    Anthony Morgan Member

    Joined:
    Feb 16, 2017
    Hi Kris,
    Thank you, that's very helpful and an alternative approach, I will try that.
    Kind regards,
     
  60. Kris & Teasel

    Kris & Teasel Well-Known Member

    Joined:
    Aug 17, 2016
    You're welcome, Anthony. Make sure you can monitor and have high carb food if you need to steer. Try not to overreact if you see green numbers. Easier said than done, I know!
     
  61. Diana&Tom

    Diana&Tom Well-Known Member

    Joined:
    Dec 29, 2009
    Yes that does seem a good plan and definitely worth a try. It IS easy to panic though when you see low numbers, we do understand that. Next time you get a lower than expected number (but still a "good" one), take a deep breath and remind yourself that this is in fact what you're aiming for to keep Shelley in healthier numbers...
     
    Kris & Teasel likes this.
  62. Anthony Morgan

    Anthony Morgan Member

    Joined:
    Feb 16, 2017
    Thank you Kris, I will try.
     
  63. Anthony Morgan

    Anthony Morgan Member

    Joined:
    Feb 16, 2017
    Thank you Diana, that is good advice!
     
  64. Sootyca

    Sootyca Member

    Joined:
    Oct 3, 2016
    I'm with you Anthony, I know the dark greens are good but I don't like them! Must have been a real shock to see it! The only thing I would have done differently is feed normal food rather than a high carb treat and try and steer it a bit gentler.

    God bless sensitive cats!

    @Kris & Teasel Sky is similar in sensitivity! I do my best to stay at a 0.5 but find it impossible at the moment to get a consistent dose for her. How is best to go about trying to get a regular consistent dose? Should I stick at the 0.5 regardless of AM and PM numbers for 3 cycles to try and stop the shifting numbers and then just increase slowly? I always seem to react to the numbers at shot time rather than have a long term view.

    Sorry to highack Anthony!
     
  65. Kris & Teasel

    Kris & Teasel Well-Known Member

    Joined:
    Aug 17, 2016
    As the owner of an extremely volatile FD kitty, I've learned that I have to keep things as simple and consistent as possible to maintain as much stability as I can. And he still shifts like quicksand. In my opinion these kitties become very erratic if you change doses too often by too much. There's no way a sliding scale approach works for Teasel and many of my dose changes when he was on ProZinc were on the order of 0.1 u. And, yes, taking the long view is the way to go.
     
  66. Kris & Teasel

    Kris & Teasel Well-Known Member

    Joined:
    Aug 17, 2016
    I stand by my suggestion in post #58 to give 0.75 u consistently for a couple of days. I don't think it's too high a dose. It might give you some manageable greens and Shelley needs the stability of same dose AM and PM.
     
    Tuxedo Mom likes this.
  67. Anthony Morgan

    Anthony Morgan Member

    Joined:
    Feb 16, 2017
    Shelley's pmps was 25.2 but decided to go with the idea of a fat 0.5. Just tested at +3 and already down to 10.3.
     
  68. Anthony Morgan

    Anthony Morgan Member

    Joined:
    Feb 16, 2017
    No problem Karen, I appreciate your comments. I will be interested to see how Sky responds. Prior to all this Shelley's dose was only adjusted perhaps once or twice a year after the Fructosamine test. I injected her twice a day and didn't worry about it in between times. As you know, this worked fine for 6 years.
    Regards!
     
  69. Sootyca

    Sootyca Member

    Joined:
    Oct 3, 2016
    How's Shelley getting on (and Herbie)? You seem to be getting good mumbers in the middle of the cycle- are those +6 numbers when she eats? She is still high at preinjection though which i would expect to be lower now. I suppose as long as she is low for a lot of the time it's doing it's job :)
     
  70. Diana&Tom

    Diana&Tom Well-Known Member

    Joined:
    Dec 29, 2009
    I've been wondering too, Anthony... am guessing you think that there's nothing new to ask as there have been various suggestions that you've tried...? It is definitely the pre-shot numbers that need to come down but how to achieve that is the question when you don't want to be too aggressive with dosing... very hard call I know. It would be nice to see some more blues though so keep trying and maybe one day Shelley will surprise us all...
    Keep smiling!
     
  71. Tuxedo Mom

    Tuxedo Mom Well-Known Member

    Joined:
    Dec 2, 2014
    I too have been checking in on Shelley's spreadsheet but since you haven't posted in a few days I haven't commented. However, from my point of view I am wondering if you might be open to increasing the dose a bit. Shelley has not hit any blue numbers for a few days now and it would be more healing to get her spending some time in the "healing blues". Just a thought, but it is always up to you what you choose. :bighug: :bighug:
     
  72. Anthony Morgan

    Anthony Morgan Member

    Joined:
    Feb 16, 2017
    Hello everyone, thank you for your comments.
    I have been following Kris's advice and trying to keep the doseage consistent and see if things stabilise. Today's numbers seem a bit better but I know they should be lower. Shelley seems quite well and seems to have a burst of hunger and activity about 2 hours after her injection. But she is not as bright as she was when her diabetes was under tight control. I think her numbers do spike after food especially Felix Agail. I don't usually give her that but I have used a little a couple of times to encourage her appetite.
    I am concerned that the poor control will affect her but when I have increased the dose I seem to get a big drop or a low number that worries me. I do plan to speak to the vet again this week.
    Herbie has had a good week. He has been his normal self really, quite active and eating well. He has been having more wet food but I don't know if this is anything to to with it?
    It's very good of you to catch up, thanks again!
     
  73. Kris & Teasel

    Kris & Teasel Well-Known Member

    Joined:
    Aug 17, 2016
    Hi Anthony,
    You could try raising the dose a little. Those blues today were nice but there some room to go down. Maybe try 0.7 u? 0.75 u? 0.8 u?
     
    Tuxedo Mom likes this.
  74. Anthony Morgan

    Anthony Morgan Member

    Joined:
    Feb 16, 2017
    Hi Kris,
    Yes, thank you. I think I will have to try that.
    Kind regards!
     
  75. Diana&Tom

    Diana&Tom Well-Known Member

    Joined:
    Dec 29, 2009
    How are things, Anthony...? I see Shelley is getting some decent drops from the different doses but is still very high at pre-shot. You were going to speak to the vet this week, you said - what was the outcome of that I wonder?
    No pressure to update us here if you don't feel up to it, but we're here to listen if you do!
     
    Tuxedo Mom likes this.
  76. Anthony Morgan

    Anthony Morgan Member

    Joined:
    Feb 16, 2017
    Hello Diana,
    Thank you for your message. I have been trying to keep to 1u and Shelley does seem more her usual self on that dose.
    After a month without a car I have finally got some transport again, so I decided to put off seeing the vet until next week as using taxis makes it a bit more stressful.
    So, not much to add at this stage. I will let you know how I get on at the vets and I very much appreciate you keeping in touch.
    Kind regards, Anthony
     
  77. Anthony Morgan

    Anthony Morgan Member

    Joined:
    Feb 16, 2017
    Hello,
    I had a vet's appointment with Shelley yesterday. The vet had look at the spreadsheet and said that her diabetes is not regulated. He does not agree with me adjusting her dose and said I need to inject 1.0u consistently for 10 days and then review her results. He is aware of my worry about hypos but said even at a pre-shot number of 14, that is too high and 1.0 u should be OK. He said constantly changing her dose is messing with her pancreas.
    Asked about a different insulin but he said the Caninsulin is working but needs to be injected consistently and there was no reason to change at this stage.
    Thank you for reading, I would be grateful for any comments.
     
  78. Tuxedo Mom

    Tuxedo Mom Well-Known Member

    Joined:
    Dec 2, 2014
    Anthony

    I agree that the current dose is not high enough. You were getting some nice runs of blue numbers before when you were at 1.0 unit. It would be good if you could hold the 1 unit dose for awhile. However if the midcycle numbers drop too low or if the preshot number is lower than you are comfortable with you can always post for help on the forum. Caninsulin is an "in and out" insulin so what you see is the effect of the dose you just gave. The longer acting insulins often have some "carry over" from one shot to the next.

    It is not that changing the dose is messing with her pancreas, but if the numbers stay in the higher ranges it does not allow the pancreas to begin healing in the hopes that it can recover. The Caninsulin is working but the dose does need to be higher at this time. Since you don't have the spread sheet right up to date it is hard to comment on the last day or so, but the other days with the lower dosing aren't giving the best numbers.

    For any days when you have a lower than usual preshot reading please ask for help. Starting a new thread (post) and using the "?" icon from the title drop down box will get more attention. Although shooting a sliding scale is a more advanced approach, it can certainly be done if the preshot numbers are lower than expected.

    :bighug::bighug:
     
    Diana&Tom likes this.
  79. Diana&Tom

    Diana&Tom Well-Known Member

    Joined:
    Dec 29, 2009
    Hi Anthony
    I agree that the dose needs to be higher to get Shelley down from the very high numbers... I think you know this too, but go into panic mode when you get an unexpectedly "low" number and reduce the dose at next shot time... I completely understand that and I'd be just the same, but it is something to try to overcome and, as Mary Ann says, get more tests and post here for help if you need it. I fully appreciate that this is easy for others to say and less easy for you to put into practice; you have my heartfelt understanding!
    Maybe you could go with the 1u dose over the weekend and monitor then (ie do a few more tests than usual)? If after a couple of days you are seeing nicer numbers throughout the cycle and can (hopefully) see that Shelley is not going to hypo on that dose, you will be less wary after that. It is a concern that she has suddenly gone lower before, but if you get into a routine with testing at the critical times of the cycle you should start to feel more in control.
    It is difficult, I know... treating FD is not a walk in the park but it is do-able!

    Let us know what you plan to do and remember, as Mary Ann says, you can start a new thread any time you have a specific or urgent question. People do want to help.

    Best of luck!
     
    Tuxedo Mom likes this.
  80. Anthony Morgan

    Anthony Morgan Member

    Joined:
    Feb 16, 2017
    Hello Mary Ann,
    Thank you for replying so quickly.
    I will try and stick with 1.0u. I will also ask for advice if unsure as you suggest.
    My vets views don't always agree with those I see on the FDMB but hopefully considered together I will be able to improve Shelley's control.
    Thanks again,
    Anthony
     
  81. Anthony Morgan

    Anthony Morgan Member

    Joined:
    Feb 16, 2017
    Thank you Diana, that is very good of you. I am certainly going to try and stick at 1.0 u and monitor to see how it goes.
    I appreciate the support!
     
  82. Anthony Morgan

    Anthony Morgan Member

    Joined:
    Feb 16, 2017
    Shelley had a high AMPS today of 25.3 and the 1.0u hasn't brought her numbers down as well as I had hoped.
    A worrying development is that she is not walking so well today, she seems to have some hind leg weakness. She has a wobbly gait and after a few steps stops as if she is not sure how to go further. I am wondering if this may be neuropathy. I will have to see how things are tomorrow and speak to the vet again.
     
  83. Diana&Tom

    Diana&Tom Well-Known Member

    Joined:
    Dec 29, 2009
    Sorry to hear she hasn't dropped as much as you'd hoped today, Anthony... hang in there and persevere with the 1u, things may stabilise after a few days. Remember too that different foods can cause higher than expected numbers... as can pain. It may well be that she has diabetic neuropathy - there are supplements that can help to address this, see what your vet says.
    Try not to be disheartened - you're doing the right thing by trying the 1u dose so see how that pans out.
     
  84. Anthony Morgan

    Anthony Morgan Member

    Joined:
    Feb 16, 2017
    Thank you Diana, very good of you to reply so quickly. Yes, I certainly will continue with 1.0u. Shelley hasn't had that much strength in her back legs for a while but her walking has been the poorest I have seen it today. But perhaps not surprising when the diabetes has not been properly controlled for some weeks now. I will look into the supplements as well. Thanks again!
     
  85. Diana&Tom

    Diana&Tom Well-Known Member

    Joined:
    Dec 29, 2009
    No worries, Anthony.
    I think the supplement you'll be advised to try is called Cosequin (there may be others, similar) - should be readily available online and worth a try to make Shelley more comfortable.
     
  86. Tuxedo Mom

    Tuxedo Mom Well-Known Member

    Joined:
    Dec 2, 2014
    Many kitties with uncontrolled glucose numbers will develop diabetic neuropathy. A good supplement for this is B12 Methylcobalamin format. In Canada and the US a lot of people use the Zobaline for cats formula, but I don't know if it is available in the UK.

    [​IMG]


    You would want the oral Methylcobalamin format not the Cyanocobalamin format as the latter is not absorbed as well as the Methylcobalamin. For myself I buy B12 Methylcobalamin from my local health food store, making sure it does NOT contain any xylitol (can be poisonous to kitties) I buy a brand in pill form that has no added ingredients or sweetners and crush it and add it to the wet food. There is no taste so the kitties are fine with that.


    Cosequin is very useful for arthritis, but will not be as useful with diabetic neuropathy.
     
    Last edited: Apr 1, 2017
    Diana&Tom likes this.
  87. Diana&Tom

    Diana&Tom Well-Known Member

    Joined:
    Dec 29, 2009
    Thank you for your expert info, Mary Ann!
     
    Tuxedo Mom likes this.
  88. Anthony Morgan

    Anthony Morgan Member

    Joined:
    Feb 16, 2017
    Thank you, I will look into that.
     
  89. Anthony Morgan

    Anthony Morgan Member

    Joined:
    Feb 16, 2017
    Thank you very much for that advice Mary Ann. I will make some enquiries, that is really helpful!
     
    Tuxedo Mom likes this.
  90. Tuxedo Mom

    Tuxedo Mom Well-Known Member

    Joined:
    Dec 2, 2014
    This video shows more advanced neuropathy. Walking on the hocks and rear leg weakness are usual signs:



    There is a great video on this forum but I can't find it right now sorry.
     
  91. Tuxedo Mom

    Tuxedo Mom Well-Known Member

    Joined:
    Dec 2, 2014
    If you let the video play all the way through a second video will start that shows how well a kitty responds to treatment with B12. Of course trying to keep the glucose numbers in good ranges is also part of the process to helping reverse diabetic neuropathy. Both my kitties had signs of this. My girlie kitty is in much better numbers and her hind leg weakness has improved to the point that she is as good as prediabetes. My other fellow is impossible to regulate because of other health conditions so his neuropathy is still evident, but is helped with the B12 supplements.
     
  92. Anthony Morgan

    Anthony Morgan Member

    Joined:
    Feb 16, 2017
    Thank you, Shelley isn't down on her hocks as much as that but she has nowhere near as much mobility as that cat. She has only walked slowly for sometime but today doesn't seem to have as much strength in her hind legs as usual. I suppose it could be something else, I will just have to see how things go.
     
  93. Diana&Tom

    Diana&Tom Well-Known Member

    Joined:
    Dec 29, 2009
    I just remembered a query here not long ago about Zobaline in the UK (it's not available here but there is a thread with some very helpful suggestions... if you do a search on this site for Zobaline by member Elizabeth & Bertie, back in January, that should shed some light...
     
    Tuxedo Mom likes this.
  94. Diana&Tom

    Diana&Tom Well-Known Member

    Joined:
    Dec 29, 2009
    Also look at www.zobaline.net for some amazing testimonials about how it has made a huge difference to kitties...
     
  95. Tuxedo Mom

    Tuxedo Mom Well-Known Member

    Joined:
    Dec 2, 2014
    There is always a chance that it could be part neuropathy and part arthritis. My fellow has both, so I use the B12 supplements and Fish oil as another supplement. Cosequin is very useful for arthritis. My Tuxie never got down to walking on his hocks like the kitty in the video, but did definitely have diabetic neuropathy and the B12 helped with that. With a kitty getting older arthritis can also come into effect, so using an anti=inflammatory like fish oil can be useful to try.
     
    Diana&Tom likes this.
  96. Diana&Tom

    Diana&Tom Well-Known Member

    Joined:
    Dec 29, 2009
    Sorry... just read this again... has some useful info about how to get something similar to Zobaline in the UK and add folic acid to give the same effect... sorry I can't link that thread here but do try and find it!
     
  97. Anthony Morgan

    Anthony Morgan Member

    Joined:
    Feb 16, 2017
    It is going to have to be looked into, see how she does by tomorrow. I was only at the vets on Thursday as well and Shelley was very stressed by the time we got home. I appreciate the help, if it is that I will certainty try those ideas. Thank you!
     
    Tuxedo Mom likes this.
  98. Yong

    Yong Well-Known Member

    Joined:
    Jan 11, 2017
    I think this is the video Tuxedo Mom was looking for:
     
    Tuxedo Mom likes this.
  99. Anthony Morgan

    Anthony Morgan Member

    Joined:
    Feb 16, 2017
    Thank you, I will have a look for it.
     
  100. Tuxedo Mom

    Tuxedo Mom Well-Known Member

    Joined:
    Dec 2, 2014

    That is the one Yong..thanks!! :bighug: It actually plays right after the video I posted the link to, but this certainly is the most impressive video for what B12 supplementation can do to help with neuropathy.
     
    Anthony Morgan and Yong like this.

Share This Page