Is it the Vetsulin just being unstable causing the low #s?

Ugh. He's hypo again, no sx though really. He's walking fine and he's always laying around and lazy so that's nothing new. He was 339 PMPS so I gave him 2u which had worked just fine 2 nights ago, but now he's at 49. I even tested twice to make sure. I gave him a little corn syrup in his food and some hc treats and will test again soon. It's just frustrating. We went through this the other day, but not this low and his PS #s was 100 points lower so it kind of made sense. This doesn't make sense. I'm definitely called the vet tomorrow to get a different insulin (I'm a very forgetful person, I was supposed to do this today) b/c I want to get his doses worked out and I don't want to have to go through this again after the Vetsulin is done.

 

It could also be due to the fact that you doubled his insulin dose. Going from one unit up to two is a big jump. I don't understand why you're being this aggresive with his dosing. I'm not sure that you had enough time or data at the one unit dose to warrant such a large increase.

 

The vet upped it. We're still working out the kinks. I'm doing the best I can and it's obviously sucking. He was fine this morning but his #s were higher. I didn't even think about giving 1.5u tonight, I just pulled 2 and gave it to him w/out much thought. I should've cut back, but I didn't. I just don't understand how the same dose drops his #s to an acceptable level this morning and tonight it's dropped it way too much. How are you supposed to know what is a good dose if it works differently every time you give it?

 

First off, have you read and are you following the "Vetsulin/Caninsulin user guide" sticky in the Vetsulin forum to make sure that you're using it safely (test, feed, shoot, feed again)? Feeding before and after the shot helps soften the sharp drops that Vetsulin is known for. (Even if you've read it before, it might help to re-read it now that you're more familiar with feline diabetes. Here's the link -- http://felinediabetes.com/FDMB/viewtopic.php?f=19&t=302.)

I've not looked at your spreadsheet, but are you giving each dose time enough to 'settle in' before raising it? Because it can take several days for a cat to fully adjust to a dose; not giving a dose time enough to settle in is one of main causes of hypos in newly diagnosed cats. (The other primary cause being too high a starting dose.)

Also, remember that a hypo will cause unstable blood sugar readings for at least a couple of days afterward. You should not make any decision to raise a dose in the days immediately following a hypo; you need to lower the dose, give it several days for the hypo fluctuations to go away and the lowered dose to settle in, and only then decide whether to raise the dose again. (An exception can be made for ketones, but I don't think they're in play here.)

If you're following the test-feed-shoot-feed guide, have given the lower dose enough time to settle in, etc, etc, then it's possible that your cat is subject to something called the "dawn effect", where the BG levels are higher in the morning than in the evening.

 

Hello.

How long since the 2 units is the 49?
That is not too low at the moment, food as a snack right now should see you fine without the karo
Offer a little snack and test again in about 20 minutes..


As to the whys..it is confusing I know, but there are reasons.
There is a cause and effect of too much insulin. Especially the faster acting vetsulin.

The cause-too much insulin- starts a steep drop,as you are seeing.
The effect is a hormonal response where the body senses it is dropping ;possibly to a hypo, and kicks out its own sugars to stop it.
This causes rebound to occur that shows often as high levels for a few days following the cycle that had the initial steep drop.
If you react to a higher preshot with a higher dose, you will eventually have a day where the peak really drops into worrying levels.

It is like a pendulum, the harder you swing a pendulum the faster it moves and the higher it goes at each end.
The higher the dose with vetsulin the harder it works and you end up as you are.

At 1 unit you had lower preshots and a gentler drop overall.
I personally would return to that 1 unit and hold it steady for at least 3-5 days. gather you info as you can and then once you see how low it is going at peak, and how long the insulin is lasting you can make decisions
A 0.5 unit increase often is too much at once. You can go 0.25 of an increase at a time.
The rollercoaster feels really crappy for your kitty with the higher preshots and drops.

The first goal is to get preshots around 300 and a peak around 100, then you can finetune the dose to bring the whole curve down but keep it shallow.

Does all that make sense?
There are also ways of using food as a snack in the first couple of hours following the shot to help slow the drop.
Have you had a read through of this user guide? viewtopic.php?f=19&t=302

For now though, you will most likely see a high preshot following this, but if you keep giving 2 units, it will cause you more problems.
Things were starting to look good at 1 unit and if you have a preshot that is lower than usual, asking questions about possibly decreasing the dose again is a good idea.

You may even want to consider 180 and under as a do not shoot level, while you are sorting this all out.

Do you have any questions?

I know it is a lit to figure out in the early days and my vet also had me increase quickly, causing hypos with this insulin.
You are hometesting which is fantastic, so you can see the immediate results of what you are doing.

 

Thanks. I'm about go test him again now that baby is back to sleep. I'm exhausted and want to go to bed but I know I can't right now. I just want to get this under control. I'm not one who does well w/ patience and this learning is hard for me! The explanation helped a lot. We'll go back to 1 and just keep plugging away and see what happens. We'll have to push off his shots as the vet doesn't want to do them till he's stable. We'll try and work harder on the feed-shoot-feed schedule too.

 

Patience is the hardest part. I know, but it is not an exact science and it takes time. If you rush the insulin....eeek!
It is a marathon to regulation, not a sprint

Check that the levels are rising, about 3 consecutively higher levels, above 70 and then take youself to a well earned sleep.
I am glad the explanation helped. I went through hellish hypo, rebound cycles when I first began also. I am sooo glad I listened t this board....they saved my cat.

 

It looks like your kitty may have a later peak, on the 1 unit it was around 8 hours after shot, so hang in there..... I will be up for awhile and will check in.

 

Puttz is now on his second, fresh bottle of the uncertain Vetsulin, and has been yo-yoing all week, very high #'s, dropping to the low 100's...I have had to resort to ear-testing him on a 4-hour schedule to tightly regulate whatever I can do with the questionable Vetsulin...He is switching to ProZinc on Monday, but in the meantime, it is frustrating for me to see his little pocked ear, hoping I can do the best I can, PATIENCE, until Monday. Our SugarKitties need us to do the best we can for them, hang in there, and practice being patient, it will all come together for you and your baby.