First Month, Still Confused

Hi everyone - my first post although I have spent quite a bit of time jumping around the forum reading as much as I can. And visiting other sites trying to understand it all.

Raven, our office cat, was diagnosed on June 2nd. She looked terrible, had been very thirsty and urinating a lot and her dandruff was worse than ever. Her BG was 360, although blood panel resulted closer to 400. She has no other health conditions, is 15 years old and weighs about 6 lbs. She is a tiny female.
I was sent home with Vetsulin U-40 and Feline MD dry food and couple cans with instructions to give 1 unit twice a day.

4 days later, BG 420 (10hrs after morning shot) - told to increase to 2 units

another 4 days later, BG 460 (10 hrs after morning shot) and had a bout of diarrhea - told to increase to 2.5 units. I dumped all the Feline MD food, bought FF pate foods all around 3-5% carbs and fed her only this food while giving her 2.5 units twice a day.

another 4 days later, BG 110 (4 hrs after morning shot). I told vet tech I stopped Feline MD and switched to FF. She said I need to give her only Feline MD and when I refused she got angry! I asked if I still need to give 2.5 units as soon as I get back to the office and was told yes continue.

4 days after that, BG 166 (10 hrs after morning shot). Was told to continue. I thought I read somewhere I should not give insulin if below 200 so became very uncertain. I called at said I want to see the vet again and not just a vet tech.

So 1 week later I finally got an appt and BG was 27 (3 hrs after morning shot)!!!!! And Raven seemed just fine and didn't show any symptoms. On the other hand the vet and techs looked a little panicked. They tested her 3 times just to be sure. They gave her some food and a vitamin shot. I was told not to give her insulin that evening or the following morning and bring her back in exactly 24 hrs later.

24 hrs later, BG 221. So they tell me give only 1 shot that day, another following morning and come in again 24 hrs later. Reduce to 2 units. I must have had a look on my face as the vet said okay try 1.5 units.
I took her back to the office, gave her treats (freeze dried chicken/no carbs!) and more food, waited about 20 min and gave her only 1 unit.
Next morning, fed her well, waited 20 min and again only gave her 1 unit.

back at vets 24 hrs after last test, BG is 51!!! And I am told no shot this evening, give 1 unit tomorrow morning. She may just need once a day.

I am thinking no more insulin and just monitor her diet and keep an eye on her. Maybe after a week have her tested again. Honestly I don't know what to do, but 4 hours after giving her 1 unit she drops to 51. I am afraid to give her insulin anymore.

 

BTW - vet just left me a voicemail and said no more insulin today and only give 1 unit in the evenings. Come back in a few days to see if she is still giving low numbers.
Sound like good advice????

 

I don't think it is good advice. We have found that insulin lasts 12 hours or less (with Vetsulin)in cats. So giving a shot once in 24 hours means that the cat may drop after the shot and then rise until the next shot. So it is a little like a roller coaster, from a lower number to high numbers and back again. It makes more sense to me to give a smaller amount every 12 hours

If she were mine, I'd hold off a day and get some data. What is her level in the am? How long before she starts to rise? When she is at her highest, how high? Once you have an idea of what she does without insulin, then you can figure out a safe dose - which might be smaller than one unit and twice daily.

What are you feeding? You might lower the amount of carbs and see how that impacts her numbers downward. Are the Fancy Feasts pates?

 

Looks like I will need to start home testing to get all that data. Or leave her at the vet for a day to be tested throughout the day.
I just know that she went from 27 mid day, same time next day 220 without any insulin. Thought it might be a fluke but when back on insulin 1 unit only she went from 220 to 51 within 24 hours.

I feed her fancy feast pate only, all 3-5% carb calories. No gravies or grilled or any of the other ones. Treats are all the ones recommended on this forum - mainly freeze dried chicken, turkey and salmon and tuna flakes.
When I switched her completely off MD food and any dry foods/treats, her numbers dropped rather dramatically.

and thank you very much for your reply.

 

Yes, home testing is the best data. Lots of cats test much higher at the vet because of stress - all the noise, strange people and other animals. Lots of people report that their cats are 100+ higher at the vet. Then doses based on those inflated numbers can be too high.

We can help you learn how to home test. This thread has lots of good info.

http://www.felinediabetes.com/FDMB/threads/hometesting-links-and-tips.287/

 

ok finally got my home kit and did my first trial run this afternoon. Raven was a trooper through my amateur testing.
It has been exactly 1 week since she last tested at the vet with BG 51. I have been too scared to give her any vetsulin since then. I have just been watching her behavior and eating habits carefully.
Now it is nearly evening and she usually has her dinner in about an hour. Her BG tested at 192.
I don't know if that means anything on her diabetic state, but tomorrow I plan to begin testing throughout the day. I am just relieved we are not back up to the 400's!

Should I test every 2 hours or every 4 hours?

 

If you're doing a curve it would be every 2 hours for 12 hours OR every 3 hours for 18 hours.

 

Although far better than running to vet every 4 days, home testing is not easy! Well nothing about this is easy and I am very grateful you are all here giving support.
I finished doing a curve test without insulin and thought I understood much more. But follow up days have given me numbers all over the place, so am back to being uncertain on Raven's progress and status.
I would greatly appreciate it if anyone can have a look at Raven's spreadsheet numbers (hopefully done right!) and tell me what you think.

 

You need to change the "Permissions" so we can see it....Go to the top right where it says "Share" and click...a new box will come up....Look at the very bottom right of that box for "Advanced" and click there .....then change it to "Anyone with the link" and "save"

 

can't see your SS. access denied. please try what chris mentioned above so we can view it.

 

Sorry about that! Ok changed permissions. Hope it works.

 

still cant see it

 

It is only showing through July 1 on my computer. Let's see if @Marje and Gracie can help. She is the spreadsheet guru.

 

ok I had to move to personal gmail and then I could share with anyone who has link.
Just updated the link in my signature and now crossing fingers.

 

Yea! It works. Her numbers are looking pretty good! Sometimes cats on Vetsulin have only 8 hour cycles, but it seems to be lasting her longer. And other than thatn early green on 7/9 there doesn't seem to be an early harsh onset.

I think you are doing great. 0.25 looks good for the pinks. Maybe let out a drop or two when you get a yellow preshot? I'd say keep doing what you are doing. Try to get the nadirs so you can reduce if it is 68 or under.

 

Um, nadirs?

When trying to interpret Raven's numbers, it seems she goes high starting around late morning to mid-day and then it begins reducing. Do you think it is because of her morning meal? But then you would think it would do the same after her evening meal, but it doesn't.

 

Nadir is the lowest point in the cycle, with vetsulin it can be anywhere from 4 to 6 hours post dose, I see a food effect around 2 hours, if at all, but each cycle is slightly different. To find it you would need to do a full curve, we don't have enough numbers yet to be able to properly identify it. When I do a curve I do testing every 2 hours, then hourly from 4 hours until the level starts to rise again then back to 2 hours. If you have a day you can do this it is very useful in assessing her response to the insulin.

 

Thank you! I feel much better moving forward.
I just ordered more test strips as I wasted an incredible amount of them doing the curve test without insulin. Poor Raven - what a day that was. Once I get them, I plan to do another full day testing with insulin.

 

Just checking in and it looks like it is working fine. Good job. If you have any future issues with it, please send me a private message and I'll help you with it.