Kind of a newbie seeking advice

Kiki was dx'd May '09 Given 1 unit Vetsulin 2x daily - later increased to 2unit 2x daily. Did some research and found FDMB. My vet was never supportive of the home testing (he actually told me to throw the human meter away). I eliminated dry food only fed canned foods from Janet & Binky's list. Lo and behold, since Aug '09 we have had a few honeymoons. Now his readings have jumped back into the 400 range all of a sudden and I haven't had alot of success in getting him regulated again. We have an appointment Friday @ 9:20am with a new vet (says he is willing to work with us on the home testing -- we will see) Any advice for us?

 

Hi Donna

welcome to the FDMB, just a few questions that will help others with their feedback,
are u currently using insulin? (vetsulin still?)
Any possibility of infections, teeth issues going on?
Have you been testing for ketones?
Do you have any more BG numbers to share from the past recent days for example?


Others will be along thru the day to offer feedback, so if u can, hang in there, support and suggestions are on their way.

 

A flare up like this can be caused by an infection or bad tooth/gums or if Kiki got into some carbs.

Have you added anything to Kiki's diet recently?

 

Hi Donna,

Welcome to the family.

Good job on finding a new vet willing to work with you on home testing. My kitty Tananda is diet and exercise controlled and not currently on insulin, so I have no advice for you there, but from what I've read here, I'm sure others will chime in on the Vetsulin and steer you in other directions. Good move dumping the dry food, high protein and low carbs are so important to their diets and dry food just doesn't cut it. Right now the best advice I can give is read, read, read. Oh yes and exercise. I actually have Tandy walking on a treadmill, and it works. So if you have one, give it a shot.

Best of Luck
Terri & Tananda

 

WOW you guys are fast - let's see if I can get you the info you need: Yes, still using the Vetsulin. I had bought ReliOn Ketone Test Strips, but as yet have not tried using them (I guess, because his readings had been so good). My original vet had mentioned the tartar buildup on teeth that could effect the absorption -- I had been giving him Hartz Crunch 'n Clean (4-5/day) earlier on -- it seemed to do the trick. His teeth are still yellowish - but nothing like they were last year. Are you able to see the spreadsheet link of BG numbers?

 

spreadsheet works.

couple of questions, how old is ur vetsulin?
are u aware of the warning on vetsulin?

viewtopic.php?f=19&t=311

u may want to ask your new vet about other insulin choices. ProZinc, Lantus, Levemir are some,

others will advise on choices that your vet may not be aware of. But certainly is something to consider.

I would strongly advise you check the urine for ketones too. Just to be sure.

 

The bottle has an expiration of 9/2010 and is practically still full. I will be sure to ask about switching away from Vetsulin.
Should I really be giving him a full dose of insulin when his readings are only in the 200's when it is time for PM shot?

 

How did you initially get him to walk on it? Kiki is almost 18 years old and weighs right around 7 lbs -- AND he is very skiddish. Is there a secret? do you hold him on it? use a leash? walk with him?

 

Hi Donna!!

Great job on getting Kiki's spreadsheet up so quickly, i know it can be challenging. Also, i have to comment on how adorable she it!! What a cutey and very lucky to have you as her mommy!

I do not use Vestulin (we use Levemir) and am not familiar with it but with any insulin consistency is key. I noticed on your SS that you are hoping around on doses.

What is her feeding schedule/shot schedule?

And i'm pretty curious as well about Kitty on a treadmill!!

I never even said welcome - WELCOME DONNA! Nice to meet you! Michele & Molly

 

Donna, if the vetsulin was opened more than about 6 weeks ago, it could have gone bad (meaning not potent anymore). But as you can see it either has some action and/or Kiki's pancreas is kicking in - hence to drop on the 2.5u dose.

When were you giving the tooth treats? Do you know the carb content on them? I pretty much think those products are useless. Only brushing at home or taking then in for a dental will help. Remember that dry food was sold to us based on the "dental" benefits and those turned out to be totally false... and we ended up with diabetic kitties... sigh.

I had a recent flare of BGs with Beau after he got into some dinner rolls. He just could not keep his BG down on his own after that, but 9 days of insulin as needed and he has been OTJ again (anti-jinx). So, any chance Kiki got into some carbs, or has found a source of them - like a bag of dry food in a closet or something? Does he go out and is there any chance someone else is feeding him?

I switched both my cats from vetsulin to levemir and have been very, very happy with it. I am using the same cartridge I started last June and it is still OK. (my boys get/got very, very tiny doses).

Going to a new vet is good - home testing is the best way to monitor diabetes in any species, so if you can test do it (a few can't). To ignore that vital data is, well, stupid on that old vet's part. See what the new vet thinks and see about a new typr of insulin. Then take it fromthere.

 

The Vetsulin recall is serious. Please see your vet immediately about getting off the Vetsulin. The sudden 400s you're seeing could be a reaction called rebound, normally caused by too high of dose, but which is also possible because of the reported problems with Vetsulin's consistency of action. If you bought this bottle recently or even within the past 2 months, it's possible that it's from a batch which was affected.

She had a huge drop today, so affected insulin or not, 2.5U is too much and the drop you saw today will probably result in another 400 this evening, a result of rebounding off the 65.

Agree with Michele about consistency of dose. Lantus & Levemir insulins have excellent remission rates, upwards of 70% with a lo-carb diet and proper monitoring. Hopefully the new vet is familiar with Lantus, as it is the more common of the 2. There is also the new Prozinc, akin to PZI insulin which worked well for some cats.

 

The spreadsheet is the best I could put together -- I know in the past there were times that I gave him shots, but didn't write them down or I lost the paper or something. I guess the hopping around was a panic mood -- I wasnt sure if i was giving too much -- then I thought maybe it was too little. I try to feed him every 12 hours to go along with the insulin shots.

My family tells me KiKi lucky to have me, but I'm still kicking myself right now for not having caught these numbers sooner. He was acting perfectly fine . . .

Does anyone have recommendations as to what the next shot should be? Stay at 2-1/2? He went from 470 to 65 in 7 hours. I don't want to give him too much either.

KiKi is an indoor-only cat. I HAVE had to switch to some other canned foods on the low carb list periodically, but always always stay below 10 carbs. I have 3 other cats, but their dishes are removed before KiKi enters the room. Actually, I hadn't given him any of the dental treats since probably Aug/Sept . . . until just today

Thanks
Donna & KiKi

 

Well done on the feeding Donna - glad you're giving food that is less than 10% carbs and that you're removing the other's food before little Mr. Kiki comes along (sorry for calling him a her earlier).

I hesitate to give dosing advice as i am not familiar with Vestulin and Vicky makes some good points about the possibility of the batch (of insulin) being bad. That said, in my opinion, 2.5u is too much. The swing is way too steep and he already dropped too low. I am also going to hazard a guess that he's prob continuously begging for food? Feed him - with his levels so far off right now, he's hungry and unable to use food most efficiently.

Is there anyway you can see the vet sooner? I know sometimes easier said than done. Levemir and Lantus have proved to be such effective insulins.

In the meantime, with blood glucose numbers that high, check for ketones (strips u hold in Kiki's urine that are available at all drugstores), feed when hungry and please consider dropping the dose to maybe something like 1u and holding until u can get him to the vet.
Hang in there Donna and please keep the questions coming. Michele

ETA - please consider dropping the dose to maybe something like 1u. Again, i am not familiar with Vestulin and should not be making dose recommendations. Stating 1u as most insulin manu's recommend that as an initial starting dose.

 

Can we get some Vetsulin eyes here?

Since there isn't much data on any single one dose I'd like some Vetsulin users to weigh in. Those of us posting right now are not familiar enough with it to help with dose, other than to say the 65 from 470 in 7 hours is a very steep drop so 2.5U is too much.

We usually recommend 1U to start on any insulin. So if we don't hear from any Vetsulin users, she should be OK on 1U. Try to get a ketone test please.

 

How did you initially get him to walk on it? Kiki is almost 18 years old and weighs right around 7 lbs -- AND he is very skiddish. Is there a secret? do you hold him on it? use a leash? walk with him?[/quote]

Kitty on a Treadmill

Tandy took to pretty well right off. At first I walked on it holding her, just to show it wouldn't eat her. Then I put a harness on her and wrapped the leash around the control panel (because of its length), and set her on the NOT moving tread so she could feel it under her feet. I did this a few times without turning it on. I then began turning it on and off with her standing in the tread so she got use to it moving. Now she walks on it quite nicely, however once in a while she lets herself drag, I remedy this by placing the edge of my hand behind her hocks. Since she doesn't care for this, she picks her but up again and continues to walk.
Keep the sessions short and sweet, Tandy had heart disease so I only walk her for up to 6 min at a time, 3x a day. Just remember, 1 to 1.5mph may not seem like much to you or me, but at least kitty is moving.

I'm still trying to work the kinks out with my civvie cat...she tends to panic and leave pee streaks.

 

Donna, were you not giving insulin at all before the evening of the 7th? I just wonder because the 400s is an unusual number for a low carb eater to get to without insulin. I would expect something from 275-350 if he was starting to need insulin again. But, if you were shooting even 1u for some lower numbers that could cause rebound into the 400s and 500s.

My experience with vetsulin and a cat that "wants" to be off insulin is that they need very low doses - something in the .2u to .8u range and anything more can cause rebound.

I see that you shot 1.75u tonight. Glad you didn't give the 2.5u, but I think you may have better luck starting him over at .5u and let the dose settle for 3-5 days before raising it. If he is rebounding it will take about 2 days for the numbers to stop swinging from high to low to high, so have patience. And do a curve before raising a dose so you know what the nadir is. He could have been having days like today where he started and ended in high numbers, but was pretty low in the middle. With vetsulin you don't want him dropping below about 80 because of it's fast onset and shorter duration (shorter time at lower numbers). By raising the dose so fast, from 1u to 2.5u in 8 days, you didn't give his body a chance to adjust and settle into the dose.

And be sure to test for ketones while you are sorting this out.

I bet with a little patience, probably a new insulin, and careful dose changes you can get him back "off the juice" again.

 

Michele - You're right about him being hungry -- and boy does he let me KNOW too :lol:
I guess the problem I am having with testing for ketones is catching the pee -- all my other cats are female and one never squats when she pees. I swear she just pees straight backwards horizontally -- I have 6 litter boxes all 15x22x13 -- clear Rubbermaid totes (this solved the problem of peeing over the sides). With the sides of the box so high it's hard to get in there with him to catch any pee --- i almost need a small ladle with a really long handle. I will keep trying.
I dropped the dose to 1.25 this AM - I will test again @ +6 again. You are correct, I should not have been jumping around as I did And I will remember this in the future . . .

Terri - I will certainly be giving the treadmill a whirl -- thanks for the tips

Sheila - Correct, KiKi had been diet controlled since . . . well about September. How often would you recommend testing when the diabetes is being diet controlled? Cuz I just feel as tho I missed the mark on this one. It was just a random test I had done on the 7th -- not becuz I noticed there was any problems

One other question: How do the ReliOn (WalMart) test strips compare to the Ascensia Contour test strips? Does the ReliOn "sip" the blood sample also?

Thanks for all the advice,
Donna & KiKi

 

Donna,

I am currently using the Relion Ultima, and yes the strips do sip the blood sample quite nicely. As far as cost, Relion is the least expensive I can find, however since it is their brand, you are stuck with buying at Wal-Mart, not that availability is a problem, I just can't find them cheaper anywhere on line.

Best of Luck
Terri

 

Donna, I test once a week for the diet controlled. I know some folks stretch that out further and further, but I never really got past once a week - maybe it was 2 weeks a few times - but then I walked in to the kitchen and Beau had a package of dinner rolls on the floor and was tearing away at it. I tested right away (170) and again a few hours later and he was 325!. He brought himself down the first day, but spent the next 4 days in the mid 100s to lower 200s and thus started his 9 days back on insulin.

My other guy, Jeddie, has been back on insulin for 2 weeks, but on tiny doses. It happens. You just gotta do what you gotta do. He isn't acting sick, so I am not sure what bumped him up into shootable numbers.