Need help!! MAX

I got Max home yesterday evening, his last reading at vet was 150 right before we and home. I thought I did good this morning with my first injection, but I am beginning to think it did not penetrate (Max has long hair) because I checked his blood again 2+ after shot and my relion meter just said "hi", they said just give him 2.5 it's Vetsulin once a day. I don't know what to do. Should I give him a dose this evening???

 

Hi, Pamela - Could you try getting another BG test with your Relion meter now?
And did you do a BG test before you injected this morning? If so, please tell us what that # was. (Will give you some more info after I hear back from you. Thanks!) - Robin

 

Here is some great information for you from our "sticky" on Vetsulin - I'd recommend you read through this at your earliest convenience:
Vetsulin/Caninsulin user guide

 

It was 472 this morning at 7:30 before his shot and right after he ate. I will check it again in a minute and let you know. I'm so glad y'all are here, this stresses me

 

This was also before his shot .. I thought

 

Don't worry, Pamela - I'm just so happy to hear you are home-testing Max's blood glucose; that's GREAT!

And you've come to the right place: There are so many experienced people here at FDMB who will help you get Max well regulated. This is a wonderful community of people who really care about you and your kitty. (I can't tell you enough how grateful I've been for all the support I've been given.)

 

Hi Pamela. What's Max's latest BG reading now?

 

Pam, everyone and I mean everyone - even people dealing with FD for years - gives a fur shot. And the wisdom here is that you shouldn't reshoot. If only a small bit of insulin went in, adding more can be a problem. If I were you, I could catch a few tests when you can today and see if maybe he did get some. And then yes, tonight I would shoot one unit. He may be high for a few cycles before he gets back on track after the once a day shots, but you will get him doing well. We'll help.

The other wisdom here is "better high for a day than low for a minute.

How about giving Max a little hair cut today - where you are planning to shoot, trim back the hair some so you can see better.

 

I've had plenty of "Hi" readings on my ReliOn meter recently It does make you worry, I agree. I also think that while the cat is not regulated, in the beginning of the treatment, their BG can do lots of ups and downs. And even if it is said that cats are not supposed to have post-meal glucose spikes, it still makes sense that a meal will elevate their blood sugar. DO NOT give another shot right away if you see that BG reading in the first couple (2-3) hours is higher than before or seemingly does not go down. Even if its a fur shot it is better to wait till you next "shot time" to give insulin. That said, I always thought we are aiming for twice a day shot schedule but people familiar with Vetsulin would be better to answer that question.

 

Vetsulin should also be given twice a day at 12-hour intervals.

 

@Squalliesmom - Oops, I see a TYPO here: That should be 12-hour intervals.

 

I think Lucy meant to write at 12 hour intervals.

 

Yep, I'm 100% sure that Lucy meant to type that "2" just right of the "1"... (Wanna know how many times I have to go back and edit my posts for my typos? Yowza!)

 

I just checked and his reading was 467, that is 5+ hours after what I called his shot that didn't penetrate

 

I'm fixing to do his spreadsheet

 

Glad its going down!

Also, when the meter says "Hi" (how nice of the meter to be so courteous!) it means that the BG level is above the measuring capacity of the meter, right? So , Max's BG level probably was going down during these five hours, and your shot was on target, but it just did not fall below the meter's reading capacity until an hour or two ago.

 

Oh thank you!!! I feel so much better! So you suggest 1 unit this evening? I will

 

Can see my spreadsheet???

 

Thank you all for the backup editing!!! I most certainly DID mean 12-hour intervals! The majority of my laptop number keys do not function (obviously #2 is one of them!) and I have to use the on-screen keyboad to input numbers, but sometimes I forget, sorry! Glad you all were her to catch that and correct the info!

 

Hurray! I can see your spreadsheet!

 

Oh good!!! Thank you!!!

 

I have 3 others too and just Max is diabetic, I have bought all this hi protein canned food and he won't eat it! All my other kitties are mad cause I quit feeding dry!

 

Oh Pamela, I have been in exactly the same boat with my four, lol! I ended up putting away the "old " food and buying something different; when they got tired of that I brought the "old" stuff back out and they all thought it was wonderful, go figure! Cats!

 

Pamela, I hope others will give you advice on the evening dose as well but I would think that your dose should be the same as the morning one , 2.5U. See how high Max is an hour before the shot and just before the shot. I'm not familiar with Vetsulin action but judging by the numbers in your spreadsheet Max did not drop that far from his AMPS number and you want consistency in dosing. I know Novolin clears out of the system pretty much by 10-11 hours after the shot and Lantus/Levemir stay in the system for more than 12 hours. I honestly think if you give him only 1 unit at night and Vetsulin is a kind of mid-range duration insulin, you would see "Hi" number again by tomorrow morning. Again, people that are Vetsulin users would be better advisors here

 

Pamela, what time did you give Max his shot this morning? Vetsulin needs to be given at 12 hour intervals. About 60-45 minutes before he is due his next shot you will need to test him and then feed him (provided his BG is 200 or over). He needs to have food in his tummy before he gets his shot, so you'll need to wait 30 minutes or so before you shoot.

Once you have tested him, post his numbers here and we'll try to help you with dosing, if we can.

 

Okay I'm fixing to prick his poor little ear again, will let you know the number. What dose of Vetsulin dies your baby get?

 

Paula thought her shot this morning could have been a fur shot. It may or may not have been, but I would err on the side of caution. If one unit is not enough, the dose can be raised as home testing indicates. Since there are so many variables here - fur shot/no fur shot, going from once daily shot to twice daily, I would suggest one unit tonight is the best course. If he continues in high ranges and his nadir is not low enough to cause the preshots to be bounces, then I would definitely support a raise in a couple cycles.

Paula, one other factor working here is whether the higher preshots are bounces. When you just have preshots for data, it can be possible that the cat drops low and his body releases extra glucose, resulting in a bounce the next shot time. We don't know if that is the case until you get some numbers.

You mentioned taking Max back to the vet on Monday. I hope you will feel confident enough testing by then that you can suggest to the vet you'll get the numbers and send him the results on your spreadsheet. We know stress raises blood glucose levels and most cats are very stressed at the vet. Some cats test 100+ points lower when they get home and relax.

You had said you got 150 for your first home test. When was that in relation to the shot?

 

And it was at 7:30 am

 

I just checked it (4:50 here) it was 493

 

So it was likely that he did get some insulin this morning, if he is about the same range as this morning. One thing we need to know - did the vet say anything about ketones or DKA?

 

No 150 was at the vet before we left yesterday afternoon anout 3:30. I don't take him back for checkup till Monday after Thanksgiving. Just checked it again ant it was 493, I put it on the spreadsheet. So do y'all think I need to inject him again about 7 tonight with just 1 unit??

 

No not a word

 

Then we don't have to worry about a restart at one unit, if that is what you decide to do. If you give 2.5 units, I'd plan to get some tests in tonight, to be sure he doesn't go too low.

My thinking is that the high pre shot tests you've gotten were when you were shooting 2.5 units once daily. If you're planning on going to twice a day dosing, I'd cut the old dose in half.

 

No do I need to get one of those tests?

 

I agree. I haven't seen many people talk about this since I got on FDMB, but our first diabetic kitty Brady had very long hair, and when he was diagnosed, the vet went ahead and shaved a square about 3" on his scruff so that we would know we got all of the insulin in him. We don't do it anymore, but at the beginning when everything was so overwhelming, we found it helpful.

 

So instead of 2.5 units do little over 1 unit twice a day? Starting tonight? Give him a little over 1 unit???

 

I'm sorry y'all, I'm just so stressed, I sure don't want him going too low

 

He is your cat, Pamela, and you hold the syringe. You get to decide. If he were mine, I would give one unit, get a test a couple hours later to see where he is and maybe a before bed test. We suggest starting at one unit - for any insulin. I don't know why your vet started at 2.5 but it is a high beginning dose. Maybe Max was high at the vet because of stress. I'd start with one unit twice daily, get all the tests you can and then you'll be able to see how the insulin is working and whether he needs more.

I am not a vet; it's just my opinion.

 

Tested him 4:50, 493

 

Pamela, I agree with Sue and Oliver. Best always to err on the side of caution! I would go with 1 unit (or 1.25, if you can eyeball it, but that's a real challenge, I would just go with 1 if it was me) and see where that takes him. You can always increase a dose at the next shot-time, but once you've given it there's no way to get it back out, if it' too much!

 

Think

I will do that, and then tomorrow 1 unit twice a day

 

That's what I will do, thank you both so much

 

If you can manage it, try to get some tests in around the +2 to +6 range. Vetsulin's onset is usually around 3-5 hrs after administration so it would be good to test a couple of times to see how low that first drop is going to take Max.

 

Ok

 

And yes, after you get the shots and testing down, it would be wise to pick up some ketone strips at the drug store. They are the same kind humans use. You stick them in his urine stream (it sounds impossible but we have ways to accomplish it. ).

And Pamela, breathe deeply and often. Think how much you have learned today - about how your insulin works, putting together a spreadsheet. You are testing and giving him a shot. Take a few minutes to relax, breathe, enjoy Max and pat yourself on the back.

 

At some point it wouldn't hurt to get some ketone test strips. There are several different brands, and they're not expensive. The hardest part of ketone testing is trying to catch your kitty in the litter box, lol!

Squallie gets between 0.5 - 1 unit. He started out on 7!

 

Ok I gave max another dose of Vetsulin at 7:00 this evening, just 1 unit and will continue with the 1 unit twice a day for a few days. I also got some ketone strips, I am fixing to prick his ear in a min to see what kind of number we have 2+

 

Gave him 1 unit at 6:30, just tested 3+ and he is at 245, I fed him some canned food, thank goodness

 

Reading at 3+ after 1 unit is 245!!

 

I'm sorry, Pamela - I just got back a little while ago, so did I miss something? I don't see a preshot # on your SS tonight. Did you wait to test until after you fed & shot the 1.0 unit?

 

I thought I posted it, pre shot was 473. Fed him a little before he got his shot

 

This is good, right?

 

Oh, very good! (Whew, I was just afraid you hadn't gotten a preshot ...) That's a hefty BG drop at +2, so was an excellent move that you reduced the dose. GOOD JOB! How much dinner did Max eat, btw? Plan to get a couple more tests in tonight, just to see where he's heading before you go to bed. If needs be, you can always feed a little more food if he's dropping too much. This reduced dose is going to help you with that, too, but is always smart to monitor.

 

He ate about half a can of Little Friskies poultry platter, one of the larger cans, not the 3 1/2 oz cans and I just gave him a little more after I tested him

 

Don't forget to plug that 473 preshot # into your SS so that anyone reviewing it doesn't make the assumption that you didn't get the test done.

Is also not a bad idea to mark down in the "remarks" section how much you fed, and any other helpful info - stuff like, "he hacks up a hairball before test-time", results of ketone tests, any changes in food, or any change in behavior, etc. that might affect his numbers throughout a cycle.
Some of these things written there can really helpful later on when you're trying to figure out his BG trends.

 

Good. That's exactly the kind of info you'd want to put in the "remarks" section each day. (I do this myself on Bat-Bat's SS to help me keep track of the total of her daily rations.)

 

You're doing great, Pamela, keep up the good work!

 

Good morning!!! 7:00 am Sunday, checked BG = 366, fed him half 5oz can little Friskies chicken, just waiting little bit for his 1ut shot of Vetsulin to start off the day

 

Wonderful!

If you're able to, try to get a couple of tests in this morning!

 

Much better preshot number than yesterday. Great! I hope you are feeling more confident about this whole thing. Once you feel more in control, the whole thing seems much more doable. Being able to test is a huge part of that!