Discussion in 'Feline Health - (The Main Forum)' started by Sue Hammond, Oct 4, 2017.
Molly's +6 is 7.2
See now she's gone from 7.2 at +6, now at +9 she's 26.1, which is insane..almost 4 times as high as 3 hours ago.. Admittedly she had a small amount of food about 30 minutes before I tested, but surely it would make such a big difference would it, not that much of a hike, considering what her numbers have been up until now, with no shot this morning.
Similar pattern to that of 8th and 12th October, although the jump in BG is higher and sooner.
There's an outside chance that it's a 'food spike'. What did you feed Molly?
She had the same as always Mac's chicken, it was a couple of mouthfuls, that all...yes a similar start as the 8th and 12th, but not a massive increase like today
Sue, what is your feeding schedule with Molly?
I'm wondering if there 'might' be an issue with the numbers dropping too fast in the first few hours of the cycle at the moment, which then causes the BG bounce up high again. If that's the case then feeding her a snack about an hour to an hour and a half into the cycle might slow that drop down and reduce any bouncing...
Hi Elizabeth, she does have a small amount of food around that time when I'm here, after her shot.
I did a +3 test and it was 12, this morning it was 22.3
Hi everyone, so just recently we've had some pretty goodish bg results, (in the blues) now all of a sudden, it's shot up to the low 20's (pinks), it's more at +6 than her amps test this morning ..Her food is he same, the insulin cartridge is he same one, the strips are from the same bottle she's eating normally, so I'm at a loss as to why this has suddenly happened...she's playing as normal, seems her normal self to me ....I'm puzzled to say the least
I'm just wondering if her pancreas is beginning to produce insulin? Any ideas please x
Numbers back up again, higher at +6 than amps, completely at a loss, any ideas as to what's going on
Can anyone advise please
Can anyone see my posts at all, posted on Oct 4th with new query
Can anyone help here, any ideas as to what going on
Her +5 today, 19.2, only down by .7??
Hi Sue, it might be best to start a new thread with you specific questions. I saw you were looking for help. I unfortunately am too new, and won't be able to help, but I am sure someone will be able to advise! I do know that it is completely normal for their sugars to be very inconsistent the first few weeks/months after diagnosis.
Hi, thanks for your reply, I can't really start a new thread, because all the previous advice and information is in this thread, I just wondered why those who had helped before, weren't replying, maybe they just aren't seeing it anymore
Hi Sue, it's a little while since Molly has seen blue numbers.
Any change to her diet recently?
Any health issues?
And how old is your insulin?
I think the spreadsheet template must have been adapted since I started using it. I have no dark green either and lime green is actually the norm I’m aiming for.
You can always start a new thread without losing this advice. You’ll have access to all your old posts.
Hi @Elizabeth and Bertie There's been no change to diet, and her current insulin cartridge was started on 16th October, so new ....No health issues at all, she seems perfectly fine looking at her...
When I originally posted a couple of weeks ago we were having good blue numbers for a few days, I thought maybe her own insulin was kicking in, but it doesn't seem that likely now unfortunately
Sometimes insulin needs just change. Try giving 1.75 and see if it helps.
I don't have syringes that go up in .25 doses, only .50
Count how many drops in 0.5 u and half it. That is your .025 eg I get 4 drops in 0.5u. So if I want 0.75 u I fill syringe to 1u and squeeze out two drops.
I have a Vetpen Juliet x
Sorry but how do I squeeze out drops from a glass pen cartridge
You can use syringes with the pen. You can use it like a mini vial. In the meantime you could do 2 units provided you will be sure to be able to test.
Don't you risk going past the best dose by jumping up too high? I am concerned I might have done that with Silver. Considering starting again from scratch and doing 0.5 as I think I shot passed his dose.
Yes I understand I can draw insulin from the cartridge,but I don't have .25 on them, they go up 0.50, I can't see well enough to judge the extra .25....Also I've never been shown how to use a syringe
Another thing I don't understand is now Molly is at her ideal weight, I thought her numbers would reflect that, but they don't seem to be at all, she's lost 1.5kg since starting on insulin..
You’re saying a lot of “I can’ts”. None of us knew how to use a syringe when we started out. We had to learn. YouTube is great for that. I already explained how to measure half units if you don’t have half unit mark in syringes Sotho those would be a good purchase.
Weight and requirement for insulin don’t really go hand in hand. Keep going. Don’t give up and follow the protocol for the insulin you are on and you won’t go wrong.
My close vision is poor, so (even with good reading glasses) I need a strong light source behind the syringe to see exactly where the insulin comes to.
So, I put a little more into the syringe than I need then hold it against a good light source (desk lamp, or light under kitchen cupboards) to see exactly what I've got in the syringe, and gently squeeze out the excess.
Measuring .25 isn't very difficult because you're just finding the (approximate) mid-way point between two lines on the syringe barrel. My cat's dose went down to 0.1 of a unit and that made me go cross-eyed, haha!
An alternative to using the U40 syringes with half unit markings is to use U100 syringes with half unit markings. But these need to be used with a simple conversion chart (that we have here) to measure the right dose. Using U100 syringes can make measuring small doses of U40 insulin very much easier.
Very few of us had ever used a syringe before our kitty became diabetic. I was phobic about syringes, but practiced giving shots on an orange, so my hands could get used to the feel of them. And it very soon becomes routine. None of us know what we can do until we try.
I have the .50 but not the .25 Juliet, what I meant was my vet didn't show me how to use them... I feel like I'm being told off here, that's how your message comes across, all I wanted was some advice, as I don't get much from my vet
Also my vet told me once her excess weight came off her numbers should show some improvement, and the insulin dose become less, but that obviously isn't happening
That certainly can happen, and often does (where weight is a factor in insulin resistance). But it can take a while...
It's also 'possible' that the higher numbers are a winter thing. Some cats do have seasonal variations in their BG numbers. (Bertie's numbers are typically higher during the winter, for example. And that change can happen quite suddenly...)
Sue, can you remind me what you're feeding Molly at the moment?
@Elizabeth and Bertie , she's on low carb, Lily's kitchen, or Mac's, she now weighs 4.9kg after losing 1.5kg... her numbers during the day a couple of weeks ago were in the blues, so winter doesn't seem to have affected her that way, also she's hardly ever out in the cold, she's much more of a summer girl lol x
See now after giving her 1.5u her +5 is 9.2...so glad I didn't increase it
It's very nice to see a blue number again.
Nice to see a blue. Since you are using a human meter keep in mind that a 9.2 is still above normal. Ideally you'd like to see her closer to a 5 at nadir.... But given the high preshot 9 is good.
Yes I know it's still too high, but hopefully tomorrows result's will be as good
I expect to see a pmps at around 19, her +8 was 11.5
Had a great amps by at 6.1, it probably won't last, but it's a good start
Ooh, that's very nice.
OK, Molly's numbers may well come up. But it's SO important to celebrate small victories.
Nice while it lasted @Elizabeth and Bertie +3 bg was 19.1
I have no idea what's going on with Molly, her bg isn't going down much at all now...Her food is the same, the insulin isn't old, been open about 5 weeks...She's eating and drinking normally, litter habits normal, everything is normal apart from these damn readings...Can anyone shed some light please, as I'm clueless as to what's going on
She has the odd good am bg then the next day it's high again, totally confused, and doesn't seem like we're getting anywhere
Insulin needs change. If it’s not enough then raise the dose a bit.
Yes but sometimes her amps is only around the 6 mark so nervous about increasing the dose, if I increase it it could come crashing down during the night, she's never the same two days running now sometimes high, sometimes low...2 days ago she was only 6 amps so had no insulin, if I'd increased the night before when she was high God knows what might have happened during the night
Increase the dose for higher preshots. Lower the dose for lower preshots.
You could try
Ok thank you, I just worry about giving 2u at night as she sometimes has dropped to 6 by morning, also I didn't think you should give any if it's under 10bg?
Do what you feel is best.
That's the problem I have...I don't know what to do for the best
I saw on here, do not give insulin if it's 10 or less, now you say give 0.5, so it's very confusing
If you aren’t comfortable shooting lower numbers, that’s oK. We say not to shoot under 10 for newer folks without much data. You eventually will want to.
When you get an unexpected low number you can stall without feeding for up to an hour. If the number is going up shoot.... If it's about the same then skip.
Thank you for your advice
Sue @Sue Hammond, the advice to not give a shot below 11 (200) is for newcomers who are still getting comfortable with hometesting, and who don't have much data to show how their cat responds to insulin.
Once a caregiver has data to show that it may well be safe to do so it is very possible that they will give shots at lower numbers. But this depends on the cat's own response to insulin, and also on the caregiver's ability to monitor and to take any necessary action. (Trying to give shots at lower preshot numbers is always an experiment initially...)
Have you seen the new Beginner's Guide to Caninsulin/Vetsulin (put together by a group of members here)? Here's the link:
Beginner's Guide to Caninsulin (Vetsulin)
Another thing to consider maybe, if Molly's numbers don't improve, is to see if your vet would prescribe a different insulin? 'Prozinc' is also licensed for cats in the UK. .....Or it may be (though is less likely) that your vet would prescribe a 'human' insulin such as Lantus, Levemir, or Hypurin PZI.
Some kitties will get more stable numbers on insulins with longer durations.
But a change of insulin would mean using syringes rather than the pen.
@Elizabeth and Bertie He's already said no to changing the insulin...I've upped her dose to 2u, but her numbers are still high, but it was only increased this morning, so I'll see how it goes.. I'm not always here during the day to test, but made a point of rearranging things for today, so I can watch her....Yes I have read that about the Caninsulin xxx
@Elizabeth and Bertie She was 22 amps, +2 19.2 +4 16.3, so not come down as much as I expected , I'll do another test at +6
@Elizabeth and Bertie if you look at Molly's chart for the last 3 days, you'll see what I mean, increasing to 2u has made no difference x
After giving her 2u last night and again this morning, her bg today is higher than when she was on 1.5u night and morning, why is this, can anyone help
Hi Sue & Molly from Pat & Tut. Not experienced enough to give dosing advice -- sorry. Only wanted to share that I was also confused about the "Diabetes for Beginners' recommendations about reducing or even not shooting when BG drops. I think I now understand that is for BEGINNERS without any data. (Better safe than sorry.) I'm mostly looking at the Lantus site now and, now that I have some data, am encouraged to shoot through drops. A little scary, but it has been OK so far. I also have had what's been referred to as "bouncing" when numbers go down and then up again (so frustrating!), and am told to hang in there and let the cat do her/his internal adjustments.
It's very hard. Hang in there.
Hi ]Pat & tut, I don't understand what you mean by shoot through drops?.. I'm still very ignorant about this whole thing to be honest, even when I increase the dose it makes no difference, it goes even higher, I really don't know what to do xx
sorry to be unclear; I meant you continue to give the decided upon insulin amount even though the Blood glusose number has dropped (as long as you are not too near the dangerous hypoglycemic area). As I read "Diabetes for Beginners' it said if there was a significant drop, you should 'back off'.
I also feel am a 'beginner' by virtually any standard -- just started insulin last month. But I found that, since I had some numbers, others did not think the "Diabetes for Beginners" sticky was the place for me to be getting advice. (I don't even have any idea how this print turned to italics!)
Really just wanted to share that I have found things confusing, but am trying to hang in. And, hope you do, too.
Oh I see what you mean now, it's been just over 3 months for me and Molly, but I'm still getting nowhere, hopefully we'll get there eventually, hope you do too.. nice to meet you by the way x
Let's see what happens tomorrow. Stick with 2 tomorrow. I feel there is insulin resistance going on.
Ok Janet thanks x
Her +3 last night after 2u was 18.8.and this morning amps was 20.8, . She's lost the excess weight, she's seems perfectly well on the outside, no other issues whatsoever
(@Sue Hammond , @ppp )
Just a quick note on the 'Beginner's Guide to Caninsulin/Vetsulin'. This was written by a group of folks here for several reasons:
First, it's intended to be a comprehensive source of general information for those completely new, or relatively new, to dealing with diabetes or to using Caninsulin/Vetsulin.
Second, it should be a good source of information for Caninsulin/Vetsulin users generally. And, since it's a new document, those who have been using C/V for a while might also find benefit in reading it.
Third, it has been written as a source of information for those FDMB members who are advising other members whose kitties are on Caninsulin/Vetsulin. Many members here have never used Caninsulin/Vetsulin and yet may still need to answer urgent questions from members whose kitties are on C/V. The beginners doc is an attempt to provide the basic key information that advisers might need in order to give advice that is safe.
For members using C/V the doc should also provide basic information in the event that they cannot get any responses on the forum.
For specific questions about a particular cat though the forum is probably the best place to get that information, if possible.
I would strongly suggest that all C/V users read the basic info in the Beginner's doc, and also print it out if possible. Some things are much easier to understand when read on the printed page.
Having a background understanding of 'how your insulin works' is key to getting the best out of it. And when people here answer your questions on the forum you will have some 'context' in which to better understand those answers.
Sue, in a situation where the numbers increase as the dose is increased bouncing/rebound should always be suspected and investigated.
Bouncing is not the only reason for higher numbers, but is a very common one.
You have a lot of data for the am cycles currently, but very little for the pm cycles. So, we only know what's going on for half of the day. And quite a few cats have lower blood glucose at night.
I strongly suggest that you routinely get some tests (or at the very least one test) during each pm cycle. This may help us to confirm whether bouncing is or is not the cause of the higher numbers. If bouncing can be confirmed - or ruled out - then it makes it easier to decide how to proceed from here.
Regarding change of insulin, if it turns out that Caninsulin really doesn't work for Molly then the data you've collected should ably demonstrate that fact to your vet. And there are several other insulins your vet can prescribe.
Vets in the UK vary in their willingness to prescribe alternatives. Some really want to get the best outcome for the cat (and will prescribe an alternative insulin). Some vets, for whatever reason, aren't so willing to help. But if your vet doesn't want to help then maybe you can try a different vet? Often, even vets within the same practice will have different views on prescribing.
Her +2 by is 14.8, so it must be working I guess
It's difficult getting pm tests, as she has her insulin at 9pm
Are you able to give insulin earlier in the morning, so you can also give earlier in the evening? Maybe move it all back by a couple of hours?
No, that's the only time that suits me and Laura, as one of us is always around at that time
Then is it possible to get a 'before bed' test a couple of hours after the shot, and/or to set your alarm clock to get some tests during the pm cycle?
Good! I am curious to see how the day goes.
Yes that's possible, I started doing them again last night before bed
That would be great. Getting data from pm cycles could really help you to help Molly.
+6 bg is 8.2, so a big improvement
Only 1 test is possible, or I'm going to be up all night
Molly's +6 is 8.2, a massive difference from the last few days, this is what's really worrying and confusing me, how can there be such fluctuations, when everything else remains the same, feeding, toilet habits etc
Only you can decide what is possible for you, Sue.
But in this situation (fluctuating numbers, with a lot of high 'flat' numbers) the more data you can get, the more it becomes possible to get insight into Molly's situation; and the more it becomes possible to identify how it might be resolved.
I can do one around midnight, but that's all until morning
This is why I suggested getting pm data. Bouncing is a possibility.
I also see from an earlier post that your vet hadn't entirely ruled out switching to Prozinc. So, that could also be an avenue you could try...? A slightly longer-lasting insulin may help to even out the numbers.
I have done them up until 4am, but it's just exhausting, so stopped
I know. It ain't easy, that's for sure.. (((Hugs)))
But isn't 8.2 a good number
Sorry but what is bouncing again, I thought her 8.2 was a good result..
Here's something I wrote a while ago about bouncing:
Here's how it works:
BG goes low OR lower than usual OR drops too quickly.
Kitty's body panics and thinks there's danger (OMG! My BG is too low!).
Complex physiologic processes take glycogen stored in the liver (I think of it as "bounce fuel"), convert it to glucose and dump it into the bloodstream to counteract the perceived dangerously low BG.
These processes go into overdrive in kitties who are bounce prone and keep the BG propped up varying lengths of time (AKA bouncing).
Bounce prone kitty repeats this until his body learns that healthy low numbers are safe. Some kitties are slow learners.
Too high a dose of insulin can keep them bouncing over and over until the " bounce fuel" runs out and they crash - ie., have a hypo episode. That's why we worry so much about kitties that have had too high a starting dose prescribed by the vet and the owner isn't home testing.
Kris, that's a great explanation.
@Sue Hammond, maybe keep a note of this information somewhere for future reference?
So @Kris & Teasel do you think giving Molly 2u twice a day is too much...There was me thinking a bg of 8.2 +6 was good after the last few days...I was told you adjust it according to by results, told to me here somewhere further up..??Thank you for that information xx
Should I reduce her doses then, I really don't know what I'm doing anymore, being told so many different things
So am I right in thinking Molly is dumping excess glucose in her blood because she's not comfortable being lower?...how do we right that situation then...Giving higher doses isn't necessarily going to be the right thing to do?
I stupidly always thought bouncing meant up and down numbers, up one minute and down the next
It's hard to say but that blue today is very nice. Here's what I do know, though:
You might need to try 0.25 u dose changes. It requires some eyeballing skill but can be done relatively easily if you're willing to use U100 syringes with half unit marks. Does your Vetpen allow half unit doses?
Bouncing can be aggravated by too many dose changes. So far you've been very consistent and that's good.
Bouncy cats will bounce and there's not much you can do about it. Some bounce less as they get better regulated but some don't stop. Sometimes feeding a small snack around +2 can forestall the steep drop to nadir that can trigger bouncing. We call it "steering with food".
Caninsulin is known to drop BG quickly and by a lot. That can aggravate bouncing. Some kitties will settle on it eventually but some need a longer lasting, gentler depot insulin like Lantus.
Ok don't think we have lantus in the UK....The Vetpen we use goes up in measures of .5
I have some syringes, but they also only go up in .5 doses, I'm not comfortable drawing up and using syringes, as have never been shown, also I can't see the measures even with my glasses on and using a well lit magnification glass
Kris has given you some great advice, Sue.
It's 'possible' that Molly is bouncing, yes. ...That could be one explanation for the pattern of numbers you're seeing. That's why it would be good to get some pm data to see more of the picture.
And bouncing is very common.
Some cats are more prone to it than others.
Bouncing can be tricky to deal with.
Some folks stick with the same dose and let the cat bounce (as long as the number triggering the bounce isn't too low for the cat's safety); and the cat may (or may not) get used to lower numbers and stop bouncing.
Some folks reduce the dose a bit to see if they can get the cat used to a higher range of numbers first, and then increase the dose and take the cat down to lower numbers.
As has been said before though there are other things that can also cause higher numbers; illness, infection (esp dental and UTI), diet, food intolerance, stress, or insulin that is not suitable for the cat.
Regarding insulins in the UK, Lantus is available. Here's what I wrote to you yesterday:
"Another thing to consider maybe, if Molly's numbers don't improve, is to see if your vet would prescribe a different insulin? 'Prozinc' is also licensed for cats in the UK. .....Or it may be (though is less likely) that your vet would prescribe a 'human' insulin such as Lantus, Levemir, or Hypurin PZI.
Some kitties will get more stable numbers on insulins with longer durations.
But a change of insulin would mean using syringes rather than the pen."
I've heard of Prozinc, as I spoke to my vet about it a while ago, he's still not keen to change from Caninsulin though....Today her numbers after insulin have improved, and i still don't understand why it's changing every couple of days. Would it be best to carry on giving 2u depending on bg or lower it back to 1.5u.... I explained earlier that my sight isn't good enough to see syringes numbers plus I've never been shown how to use them...My Vet insists the Vetpen is the best thing to use especially with my poor eyesight....I very much appreciate your help....There has been no change in diet, daily routines, no stressful situations, she appears on the outside well, is eating, drinking normally, her coat has improved, the dandruff she had has gone, she's lost the excess weight...On the outside she's a picture of health, sadly not inside though...
Thank you Kris for your help too, but I'm still as muddled with all this as ever...it feels like we're getting absolutely nowhere with this treatment xx
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