? Confused by numbers

Hi all, I posted an intro a few days ago and I'm back looking for some advice. IttyBit's numbers have me totally confused and a little frightened. He tested at 236 last night and 113 this morning. I worry what he got down to at his lowest last night and we will be testing tonight. We didn't give him his insulin this morning and 2 hrs later he tested at 248. Should be have given him his shot? I worry constantly about a hypo situation, (my biggest fear).

 

I would reduce the dose next time back to one unit twice daily. If using U100 syringes you can also go to 1.2 units.

 

Liz, at 113 you were absolutely right not to give him his shot. Have there been any changes in his diet? Are you still using Vetsulin? If he's over 200 at PMPS I would try just 1 unit, since they tend to go lower at night, and see where that takes him. As the saying here goes, better high for a day than too low for a moment! If you can manage it you might want to monitor him during the night to track his BG, so you will have more information for future reference. Vetsulin tends to bring on a fairly large drop in BG around the +3/4 hr mark, although with my Squallie
(whose nick-name is Itty Bitty Bear, btw, lol) it seems to hit around +5. If you can find this nadir it will help you greatly with dosing.

 

Thank you Larry. Should we base tonight's dose on his pre shot number or just give him 1u whatever his number is? Unfortunately we are stuck with a lot of u40 syringes for now.

 

Hi Lucy, thank you for your reply. Yes we are still using Vetsulin and we are for sure going to test tonight. The only change in his diet recently has been the addition of Young Again Zero Mature. When we did his day time curve he seemed to hit his lowest at +4 so we are going to get at least a +2 and +4 tonight. I'm afraid to test him tonight, I can just see his number be thru the roof. If it's really high do you think we should give him his 2u or just 1u. He's gotten no insulin today.

 

A lot of people use a sliding scale with Vetsulin....if their Pre-shot is X, you give Y with the goal being that the nadir is about half what the PS was

I know @BJM has some experience with sliding scale dosing....maybe she'll hop on and give you some ideas

How long do you have until it's shot time?

 

Hi Liz,

If you do switch to U100 syringes in the future you'll need to use a conversion chart. I'm assuming that you've already been told this, but just in case you haven't found the conversion chart yet, here's a link.

http://www.felinediabetes.com/insulin-conversions-printer.htm


Mogs
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Hi Chris, we've got 3 hrs to go.

 

Might be worth getting a +11 BG test in so that you can get a better idea of whether IttyBit's BG is rising at time of evening preshot test.


Mogs
.

 

Hi Mogs. Thank you. I ordered U40 syringes shortly after he was diagnosed. I just couldn't deal with one more thing at the time. So afraid of making a mistake that converting anything was out of the question. When we run out I will switch to U100 but I'm keeping a positive attitude and hoping we won't be needing anymore

 

Will do!

 

This made me smile!

I was just the same when I (briefly) needed to use U100 syringes for Saoirse's Caninsulin. I had just bought a Caninsulin pen but I only got to use that about 3 times before her race down the dosing scale after the food transition left her needing less than half a unit of that insulin. Couldn't tell you how many times I did the calculations before I could actually bring myself to administer the Caninsulin with the U100 syringe. 'Bricking it' was a fairly good description for my mental state at the time.


Mogs
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From the 2 days when you got a test around the nadir, here's what I see:

213 - 99 = 114, over 5 hours, 22.8 per hour drop, 2 units
165 - 98 = 67, over 4 hours, 16.75 per hour drop, 1 unit

This gives you an idea of how the Vetsulin is working for you
- a drop of about 17-23 mg/dL per hour
- a nadir in the +4 to +5 hour range
- 2 units may drop 114 mg/dL (or 57 mg/dL per unit); 1 unit may drop about 67 mg

Use that info in the most conservative/least risky way - assume the most drop, earlier nadir to monitor, etc.
so if you want to drop about 57-67 mg/dL, you might give 1 unit;
and to drop 114-134 mg/dL you might give 2 units, checking the nadir period around +4 to +5
and logically, to drop in between those ranges, you might test a dose of 1.5 units

 

Another person with Vetsulin experience is @Sue and Oliver (GA) ...I don't see her online but she drops in occasionally to help

Unfortunately, not many of us use Vetsulin since it's not one of the better insulins for cats, but we'll try to help any way we can!

Here's a Vetsulin User Guide that may offer some help for you too

 

Tip: Watch like a hawk for marked upticks in appetite in the first hours after giving a dose of Vetsulin. It's a good clue as to when the amorphous fraction is kicking in.


Mogs
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395 @ +11

 

Thank you so much. Even though my mind is spinning right now this is making sense to me.

 

Honestly, if it was me, I would probably still only give 1 unit, 1.5 at the most, until I could get a handle on where a lower dose would take him. I will always err on the side of caution.

 

As soon as we are out of the Vetsulin we will be switching to Prozinc. When he was first diagnosed the Vet only had Vetsulin on hand and the Prozinc was going to take a few days, so we got started with Vetsulin.

 

Good to hear that...Although I'm no expert in ProZinc either, it's a good quality insulin for cats and hopefully will do great with IttyBit!

Once you switch, you should start posting over in the ProZinc forum. You'll get the most experienced eyes watching out for you there (although occasionally it can be kind of slow, so if you need answers fast, post here in Health)