Dropping numbers. We need advices PLEASE!

Hello sugar parents,
I'm having trouble understanding what is happening with my furbabyboy!
Almost 7 years old, diagnosed 31st of October 2019, his BG was over 500. Confirmed diagnosis with urine test as well. Did an ultrasound where only is liver appeared bigger, consistent with diabetes. First vet advised a diet change before even thinking of giving him insulin. Sounded right to me. In the same clinic the doctor who first did the tests prescribed Hill's m/d but when I went back to the nutritionist appointment (the one who suggested the diet change) she disagreed, adviced an italian low carb brand called Prolife dry and wet, but when she checked on the internet she found out that the dry food by this brand was no longer available therefore I should have fed him dry and wet by Royal Canin "Diabetic". How come? You first disagree to feed him Hill's and then advice Royal??Lost my trust in a few minutes but I was desperate so I thought I could give it a go as I felt a little arrogant. "I'll see you in a month, maybe a month and a half". Tried for 3 weeks, I wasn't happy and changed Vet. Went for a visit on November 21st 2019. He's a big cat who lost weight, one of the reason why I thought of diabetes at first and went for the tests. At that point he was 4.5Kg, he started a curve the day after and he's on insulin from the 22nd of November 2019. Caninsulin. I asked why not Lantus, and him as everybody else " If you want my help, this is what I advice". Asked about the diet. He's another prescription diets lover and everything went so fast that, already on insulin and without any support, I didn't feel good about changing his diet at that point.
"Keep feeding him the same thing, same amount at the same time." I feed him 3 times a day (half of pouch 85gr wet+ 10gr dry at 9am, 25gr dry at 4pm, half of 85gr wet + 10gr dry at 9pm).
Told him I wanted to home test and he didn't find it necessary because of his high numbers. No, I will home test, period. I'm too scared of Hypo.
Alone in this but I got a pet glucometer calibrated for cats, Wellionvet Belua. He didn't have any hope on remission and made me feel miserable. Since Ive been home testing though Ive started noticing that he was adjusting to insulin and his numbers were changing and go lower every two weeks.
Did my own curves, checked his litter box, the water intake ( which dropped from over 200ml a day to between 25ml and 50ml and I have another cat around).
I know this is way too long but I'm going mental on my own interpretation here and I don't like the vets answers most of the time.
First curve every 3hours from 9am to 12am: 428mg/dl, shot of 2UI, 12pm 217mg/dl, 3pm 454mg/dl, 6pm 442mg/dl, 9pm 507mg/dl, shot of 2UI, 12am 293mg/dl. Went on at night.
At 3am I couldn't get any blood to test, at 6am 451mg/dl, at 9am 523mg/dl and 2UI, at 12pm another failure testing and didn't want to stress him. At 3pm 324mg/dl, at 6pm 503mg/dl but we were at the vet because I could not test him AGAIN. ( We do great now, both of us.)
We went on with 2UI, kept testing, we still had high numbers and lowest after 3hours.
He wanted to check on him in a month, but that was in the middle of the Christmas Holidays.I called earlier but he postponed.
And so I did another curve myself.
On the 16th and 17th of December his lowest number were 112mg/dl-111mg/dl after 6hours.
Numbers on the 17th:
417mg/dl before insulin, 2UI at 9am, at 12pm 256mg/dl, at 3pm 111mg/dl, at 6pm 203mg/dl, before the pm insulin 387mg/dl.
6th of January is Holiday AGAIN in Italy, so he postponed again "not to stress him because the clinic would have been busy the day after holiday). Guess what, I did another curve myself on the 4th of January.
Before the am insulin I read 165mg/dl and I was fainting. So I called him and we agreed on changing the dosage to 1UI. And I decided I would have tested him every 2hours this time. Two hours after his shot, the lowest number reading was 103mg/dl. Thought I needed sugar as much as he did at that point.
It went on every 2 hours until 12am. Numbers: 121mg/dl-126mg/dl-158mg/dl-192mg/dl-225mg/dl. AFter the pm insulin, 3hours later the reading was 123mg/dl.
Went on with 1UI for 12 days. Tested him before am and pm shots.
5.01.20= 260/147 mg/dl
6.01.20= 266/194 mg/dl
7.01.20= 211/141 mg/dl ( I was shaking, called the vet, "go on, it's fine". IM SO NOT.)
8.01.20= 212/145 mg/dl
9.01.20= 175/170 mg/dl
10.01.20= 206/175 mg/dl
Went on between 145mg/dl and 235mg/dl until the 15th. Before the PM shot he was 145mg/dl, after shot he looked nervous ( when I leave the house he usually gets my blanket ang goes around the house with it to comfort himself. This time I was next to him and he was literally grinding on it but then calmed down and slept. Me, awake all night).
16.01.20, before AM shot I read 88mg/dl. Called the vet and told him I didn't want to shoot insulin. He agreed and said to me " If he stays under 200mg/dl, no insulin. Damn fine with that and I kept checking: (88mg/dl-114mg/dl-126mg/dl-134mg/dl and 185mg/dl before PM shot which I didn't shoot following the vet advice). Blanket humping again today.
The morning after skipping the PM shot, I read 266mg/dl. Called the vet again and asked if I should start with 0.5UI. He agreed. Everyone who gives Caninsulin knows the 40U sirynges and there's no half units! Went to look for other sirynges and everybody told me, vet included, there's no such a sirynge.
I know there are 100U for Lantus, went to check but those are ml, no help from no one and I did the best I could to split that Unit in a half, kept checking every 3 hours, considering he started with a 266mg/dl.
Now, this is absurd to me: 3 hours later it dropped to 86mg/dl, then 103mg/dl, later 137mg/dl.
Called the vet to know what I should have done for the evening , doubted it was going much higher and he told me "Ok, give 0.4" WHat?? That's impossible to know on that sirynge! Don't like random stuff.
Anyway, before the shot, for the first time, numbers dropped again to 108mg/dl. Tested again few minutes after and read 103mg/dl. Now I'm really confused.
Rang the vet again and I din't want to give any insulin. " Ok, skip it tonight, give it tomorrow".
(We never agree but he's the most available guy on the planet, coming home for free during the first curve, opened the clinic at weekends, brought blood test results at home, and I call his mobile whenever I feel desperate!)
Back to my sugarbaby: no apparent symptoms. Except for that evening when he looked a little nervous, he never drank more, just slightly, no more than 50ml, never peed more, just a little sleepy but not unusual for him, still hungry. Always happy for his meals. Gained weight, he's now 5.1, looking great! Kept jumping on the table for testing to get his treat ( I let him lick half tea spoon of baby food (just mashed meat, low carbs) which I spread all over a plate to keep him busy while i poke him)
Oh, concerning about the dry food I mix a tea spoon of water with his meals though.
18.01.20= I decide to start a new insulin bottle, because it looked like I already shook it, just in case.
Before AM shot and no insulin from the morning of the day before the reading was 204mg/dl, so I gave him 0.4 or what I thought it was less than 0.5!
Two hours after it dropped again to 83mg/dl, then 157mg/dl and before the "PM eventual shot" 123mg/dl.
Guess what!I called the vet again feeling like a stalker but I really needed him to agree even if Im the one deciding basically and I feel BAD. So I asked if we could just give 1 shot a day considering the numbers.
He said that it is advisable to give it twice a day but I could have tried. " Give 0.5 though."
So skipped the PM again and waiting for tomorrow.
Now, Id be happy to try 0.25 twice a day but thats really impossible to check on a 40U syringe.
HELP ME, IM GOING NUTS.
Why are the numbers dropping again after going higher? Why i cant have someone helping me converting a 100U syringe? Nothing made sense no more these past 3 days!And my baby looks ok. Snoring right now!
I know about FF food, I know that no ones agrees on prescription food, me included at first, but ive seen changes and i dont want numbers to drop lower!
Apologies for this MAD POSTfrom Rome!

 

Hiya

Are you an American in Italy?

I've never heard of the pet meter you use - Wellionvet Belua - but if it is similar to the Alphatrak, I hope some used to the pet meters will answer you.

 

Hey,
No I'm Italian. I bought the same pet meter my vet had.Took a screenshot of the name and looked for it! He can be calibrated for cats, dogs and cows and can be used for ketons as well.
Thank you!

 

Okay, that is very good it can measure blood ketones too.


It's almost 3 o clock in the middle of the night here up north in Sweden were I am, so I can't research how your pet meter Wellionvet Belua compares to the pet meter Alphatrak.

@Deb & Wink Can you or any of the other help this pet meter user?

 

On the half-unit syringes you can't find made for the Vetsulin/Caninsulin, these who ships internationally Diabetic Promotion might have half-unit syringes fitting your insulin
https://www.diabeticpromotions.com/insulin-supplies/syringes.html

But you might need an import approval and permit first from your Italian National Medical Board.

 

You want to use U100 Syringes with the U40 Insulin? Is that correct?

 

You think they ship to Italy?

 

I don't know I will take a look , just looked no they don't so I took the point down

 

Go to your local pharmacy in Italy. Ask for 3/10cc, U100 syringes, 29-31 gauge with half unit markings on the barrel. I don't know if you need a prescription from your vet to purchase insulin syringes.

Then you can use a conversion chart to translate doses for a U40 insulin but use a U100 insulin syringe to measure. Conversion charts are below.

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

Printer friendly version of chart to convert U40 insulin amount to U100 syringe.
http://www.felinediabetes.com/insulin-conversions-printer.htm

 

On your pet meter Wellion Belua https://www.wellion.cz/en/animals-products/wellionvet_belua/dogs_cats/belua_meter/
I find very little information about how it's bg scale numbers go.
The only thing I found was that the meter shouldn't read under 70 in bg, that would be hypo under 70.

 

Looks like it reads pretty much the same as the AlphaTrak. 68 is the "time to act" on the AT

 

Laura,

Can you set up a Spreadsheet with the bg numbers you have so far?

This link takes you to how you do that http://www.felinediabetes.com/FDMB/threads/fdmb-spreadsheet-instructions.130337/

In the Spreadsheet you should also write that you use the pet meter you do and slash/Alphatrak. Like this Wellionvetbelua/Alphatrak. So no misunderstandings occur.

And then you go to your Profile page and choose the tab Signature, and fill in your cats name, age, country, dx when, insulin used, meter name used, and link to Spreadsheet.

So it becomes easier for both yourself and anyone helping.

Ask if you need help setting both the Spreadsheet and the Signature up.

 

There's a special spreadsheet specifically for people who use the pet meters. Also there's one for people who live in countries other than the US that will convert their numbers to US numbers automatically.

If your meter tests in mmol/L, then you'd use the World spreadsheet for Pet meters.

If your meter tests in mg/dL, then you'd use the US spreadsheet for Pet Meters

@laura florio If you need help setting up your spreadsheet, feel free to send me a private message. Just click on my name and choose "start a conversation" so I can get some information from you

 

Multiple the 40U insulin dose by 2.5 to get the dose to draw up in a 100U syringe.

To administer Draw to this level
this amount in a U-100 syringe
of U-40 insulin

0.2 0.5
0.4 1.0
0.6 1.5
0.8 2.0
1.0 2.5
1.2 3.0
1.4 3.5
1.6 4.0
1.8 4.5
2.0 5.0
2.2 5.5
2.4 6.0
2.6 6.5
2.8 7.0
3.0 7.5​

 

Thank you very much everyone! I'm going to have a look on spredsheets and conversions. We have 100U syringes here in Italy, humans dose Lantus with these syringes. At the local pharmacy I asked and they told me they're already filled with Lantus. How's that possible? And apparently no one knows that you could convert ml into mg/dl. That would be something I'll have to do that at my vet's back basically. My cat seems fine with a 0.5 once a day, did anyone experienced that on caninsulin? Because the vet said that caninsulin should be given twice a day. What if my case id different? After 24h with no insulin, this morning his reading was 188mg/dl. Basically giving him 1 shot daily in the morning, because in the evening it looks too low to me to give the second shot.

 

just tested him, before shot this morning was 188mg/dl, after the 0.5 shot at 9am, I read 105mg/dl at 11 and at 12.20pm , few minutes ago I read 71mg/dl, I feel im going around a very danger zone here, even if he's not showing any particular symptoms. Im tempted to feed him again but I wouldn't have a "real" number later. When measuring he still licking half a spoon of baby food and I'm going to test him again at 1pm to see if it's getting any higher

 

I think you misunderstood, so I will try to clarify.

Insulins are available at the pharmacy or from your vet.
The amount of insulin you can buy can be a large amount or a smaller amount.

The larger amount might be available in 2 different sizes. Each ml contains 100 units insulin glargine* (equivalent to 3.64 mg). Each vial contains 5 ml of solution for injection, equivalent to 500 units.Or 10 ml of solution for injection, equivalent to 1000 units. (U or IU is the abbreviation for Unit)

The smaller amount of insulin comes in a long thin vial, more commonly called a cartridge or pen. Each cartridge or pen contains 3 ml of solution for injection, equivalent to 300 units. (Because it's long and thin and looks like the shape of a pen is how it got the other name).

This picture shows the box on the left side, the large vial on the right side, the lantus pen is lying down horizontally in front of
the box and the insulin vial.


Because our cats only need small doses of insulin, the cartridge or pen is the better one to buy because the insulin has an expiration date. The insulin will often still be effective after this expiration date with careful handling. If you buy the large vial, you will be having to throw out the larger insulin vial if it no longer works for your cat to control the Blood Glucose (BG) levels.
Please also read further down for another post from me about your other question question.

 

Welcome to FDMB!!

One of the things that will help us is if you can put your test data into a spreadsheet. We are very wed to our spreadsheet format since it helps us to identify trends. This is the link to the spreadsheet instructions.

With regard to converting U40 to U100 insulin dosing, this chart will help.

I'm not sure which food you're giving your kitty. In general, most dry food is high in carbohydrates -- even the prescription diabetes dry food.

 

Insulin is best given to cats twice a day.The duration of the Caninsulin in cats is often 10-12 hours.

To give your cat insulin twice a day, you will need to give half the insulin in the morning and half the insulin dose in the evening. Please ask your vet about the possibility of doing this change. DO NOT change the dose without talking to your vet first.

Keep on measuring as you are doing. We call it testing the blood glucose, or testing the BG levels.

Trying to simplify things since English is not your primary language with you living in Italy.

 

The insulin syringes we are talking about look like this:


The U40 syringe is shown at the top of this picture.
The U100 syringe is shown at the bottom of the picture.

The cap colors on these 2 different syringes are different colors. The U40 syringe is red or reddish in color. The U100 syringes are orange or orangish in color.

Please let us know if you do not understand something.

 

Laura, the Italian word for these ordinary plastic non-prefilled syringes is Siringa.
In Italian No siringa preriempita - Not pre-filled.

 

Thank you all!