? Need help please

I posted yesterday asking about a food question and it came up about the dosage
My cat has only been on insulin since wed . He ended up hospitalized in Thur because he wasn't eating and throwing up. His glucose was at 640
Initially the vet said 1 unit twice a day.When I picked him up yesterday he said 3 units in the morning

After reading here and online it's mostly given twice a day because it lasts 12 hours.
Is there ANY reason he would say once a day?
I can't process this information I'm getting because everyone keeps saying my vet is wrong. I have been with them all 13 years of his life. And they literally saved my cat more than once.
Please anyone have any advice

 

I'm so sorry that what we've said here has caused you more stress. I see above that your vet said 1 unit twice a day and then switched to 3 units once a day. This confuses me. His first recommendation is exactly what you should try first. I'm guessing here: maybe your vet wanted you to give 3 units in one daily dose to knock down the high BG as quickly as possible?

Why don't you call your vet tomorrow when they're open and ask why the recommendation was 1 u twice a day at first then changed to 3 u once a day? Then you'd know from the vet himself what his thinking is. Your feeling of loyalty to a vet practice that helped you a lot over a long time is completely understandable. We've all had to process feelings like those. Following your vet's instructions is your decision to make.

 

I'm not sure what insulin you are giving but yes, doses spaced at equal intervals over a 24-hour period is usual.
Is the vet who said 3u a day the same as the one who said 1u twice a day? I would check to see if they meant 3u because it is a big jump up from 1u. When starting out on insulin it is normal to allow a dose to "settle" for a couple of weeks or so to see how the kitty is doing before raising the dose, and even then you would usually increase in increments of 0.5u or sometimes 1u.
Please check with the vet before giving your kitty 3u.

 

No it was a different vet. He is the head vet there.
Yes it was def three units once a day. He wrote it down for me.

 

Well, if as you say you are putting your faith in your vet - which is understandable - you could still ask to have a conversation about this and ask what response you would hope to see from such an increase. It sounds as if he is suggesting the dose based on very recent high BG numbers but with no data to show how your kitty is actually using the insulin, it is still a big increase. If I were you I would not give 3u but I'm not your vet... I know you're getting differing opinions - ours here v vet - so you have to make a considered judgement... sorry but did you say you had a meter? The safest thing would be to learn how to test before giving an increase like that so you can be more confident your kitty will be ok. I know this tough but in your shoes most of us here would not give an increase like thst without being able to test. Can you hold off until you have a meter?

 

Is it possible your vet meant 1.5 U twice a day for a total of 3U per day?

 

That's what I was thinking too.

 

That does sound more like it. Maybe he made a mistake by saying once a day - vets CAN sometimes get these things muddled.
Def worth ringing the vet to check.

 

That's what he said. That's what he wrote down
I have it on paper. They Rw closed so I can't do anything today.

 

I'm not a vet so I can't advise you, I can only say what I would do. For the sake of one day I would not risk giving one dose of 3 units, safer to give just the one and get high numbers than give 3 and risk a hypo. Safest thing of all is to learn to hometest. Let us know what happens x

 

I have it to him already at 7 am and then around 10 he threw up.

 

You have given him 3u yes? Keep a close eye on him for the rest of the day and if anything worries you call an emergency vet for advice, or post here.

 

how much did you give him? What time zone do you live in? I'm in UK so not sure what time it is where you are x

 

It would be great if you could get a glucometer now (if you don't already have one) and test him.

 

I'm in the USA eastern time
I'm not going to get one and leave him in case he throws up again
It's 180 for strips at cvs and I cannot pay that.
The closet Walmart is 1/2 away
The emergency vet won't help me unless I go there I called

 

That's what I was thinking.

 

Where in the East are you?

If you have Amazon prime you can order and get it fast. What about a local family pharmacy? Some manufacturers offer free meter if you buy strips. If he has stopped vomiting, I'd run out to get one.

 

I have been watching this post and with the very high dose that was given and your kitty vomiting I would suggest that you take your kitty to the ER and at least have them test the glucose levels, if you are unable to get a meter to test at home very quickly. A serious hypo can potentially be very deadly.

 

I agree with Mary Ann. I would try to get an inexpensive meter with some strips at a local pharmacy, just to get you through for right now. You can also pick up some karo or other syrup if you don't already have it, and some ketone test strips.

 

Oh dear!
I understand that you trust your vets and I'm not trying to confuse you even more but I have to be honest with you: we have seen so many kitties ending up in ER due to wrong dose being ordered by vets! some kitties did not survive but I'm saying it with a heavy heart. Our mission here is to keep our beloved kitties safe. Other members were very careful about not trying to scare you but in this situation I believe that your cat's safety is more important than anything else and unfortunately we've seen many vets treating diabetic cats WRONGLY as they sometimes don't know much about FD.
We still don't know what insulin you are using. Please please give us the information we need to help you.
When you first start treating your cat with insulin we recommend a smaller dose to see how it affects your kitty. Remember, insulin is a VERY powerful substance and you can not predict how your cat is going to react to it. Once injected it stays in body for many hours and it is very difficult to counteract its action if it is too strong!
I'm going to be very honest here - you can't trust your vet because you don't know how much they know about diabetes! Your vet might have been very good in the past treating you kitty for something most vets are familiar with but when it comes to FD I would suggest a different approach. And you came to this forum for advice - there are huge numbers of members with a lot of experience. I'm not saying do not listen to your vet, I'm saying check what they know about FD.
For now - please keep us informed as we really care about your kitty and your wellbeing.

 

(Mary Ann has advised that the OP - Jamie I think? - has also been posting with this query on Facebook and has got plenty of support. Hopefully all will be well.)

As Marlena says - not all vets are as clued up about FD as they could be. Not saying that this is the case here but when in doubt, always err on the side of caution.

 

I'm using vesulin
And yes I posted on Facebook and there was extremely helpful people there who talked me through it
My concern is it's been not even a week and with the vet closed I don't know what to do
To be honest if it was an emergency I would take him to the er if I knew something wasn't right but I try very hard not because my last visit there was not a pleasant one.
Do I just change the dose on my own? How can that be safe? I don't even know what I am doing here. We were giving a week and then we were going start testing at home.
Then he stopped eating.
He has other things going on with him. He has ibd and a heart issue. Most likely the pred jumpstarted his diabetes and he is over weight from the steroid use so I'm battling four things here and it's all really hard for me.
Also starting last nov it's been non stop emergency visits and vet visits and it cost me well over 4000.00 and I went to cvs and the strips were 180 I can't afford that and I wasn't leaving him alone for two hours to go to Walmart in case I had to take him to the er

 

You're feeling very upset and stressed. It's understandable - too much info coming at you, conflicting advice, new diabetes diagnosis, other kitty health issues, etc. Let's take things one at a time and first things first:

1. Your kitty hasn't been eating. This has to be dealt with first. Can you tempt him with tuna, salmon, sardines, human meat puree baby food (unseasoned), kibble? Anything he'll eat is fair game until you can call your vet tomorrow. He might need antinausea meds and/or appetitite stimulant meds.
2. Insulin: you gave him a 3 u dose this AM and he threw up. Wait until tomorrow when you can talk to your vet again before giving him another dose. If you feel up to it, ask your vet about splitting the 3 u into two 1.5 u doses.
3. Has your vet showed you how to test your kitty's BG at home? Is you vet on board for that?
4. Many people on here test BG with a reliOn meter from Walmart that has cheap test strips. Others can give you more info on that if you post a question about it on the main health forum. You could buy one tomorrow.
5. Give yourself permission to feel upset, frightened, and so on. Take some deep breaths. Then, start reading small amounts of info on FDMB and letting them sink in. Don't try to do too much at once.

Believe me, we ALL know what you're going through because we've ALL been there.

 

I'm sorry I wasn't more clear he wasn't eating on thur the day he got his first shot which was one unit twice by Thur he was not eating and throwing up and went to the vet and was hospitalized until sat that's when his dose changed.
He threw up today after four of the dose.
I can't wait until after I talk to the vet or he won't get the shot at all because I have to go to work all day. Can I just skip a shot like that?

She was showing me in Tuesday when He went back . I have no idea what I'm doing throwing in everything else he has going on. She wanted to give it a week and then she was showing me.

 

Also he was giving mirtazapine but I think the vet dosed him way too much and I had to deal with that last night

 

If you can't be home tomorrow after giving your kitty a 3 u dose I strongly recommend skipping that shot. You can tell from what we've said to you that we think it's a high dose. You don't want your kitty to drop too low when you're not there to look after him. Better safe than sorry. When your kitty was in hospital did you get any feedback from your vet about why he was vomiting? What procedures did they carry out while he was there? Did your vet mention anything about pancreatitis? diabetic ketoacidosis? hepatic lipidosis?

 

I was having my cat sitter come check him at 11

It could be from the pred. It could be because his sugar was so high. Could he ibd can't really ever tell because he has so many issues

He had none of that. They tested for everything

They had to give him fluids and watch his glucose levels

 

Also someone suggested giving him 2 units instead

 

It's good to have your cat sitter check. However, a dose given at 7 AM might not be having full effect until noon or even later even if you're using one of the faster acting insulins like Vetsulin (Caninsulin). Would your sitter be there for a few hours?

Good news!

You could certainly try this. My opinion is that 1 u is safer until you're testing and have talked at length with your vet.

 

No I was giving it to him at 630 am I leave at 815 and I was having her come at 11 for a little bit
Other than that I can't really do much else
Wouldn't not giving him anything put him in danger as well

 

Then your best option to get some insulin into him but keep him as safe as you can is to give a 1 u dose at 6:30 AM. Your cat sitter will be there to check on him and that's good. Giving no insulin on this one occasion won't put him in danger. Giving too high a dose could be very dangerous. You gave 3 u today and he didn't show hypo symptoms but that doesn't mean it couldn't happen tomorrow. There's no way to know until you get into a testing routine. I'm not trying to frighten you, only to help you keep your kitty safe.

 

This is so frustrating for you, we all understand totally. It's a lot to understand and cope with.

I'd suggest a few basic things. First, get your meter and familiarise yourself with it. It's a vital tool for treating your kitty safely. Then, know that it's always better to give a lower dose if you're concerned. Most of us here would have stuck at 1u yesterday which is pretty much the accepted starting point for a kitty. If necessary it would be increased gradually, not after a mere few days and especially when there is no data to show the kitty's response. Do ask the vet if he had special reasons to suggest this. Also, read up about FD as much as you can here so you understand the basics of treatment and will feel more confident when talking to your vet. And if you can add some info to your profile here - kitty's health issues, type of insulin and starting dose - that will help members here to see your situation at a glance and offer more than generalised advice.

This site is a phenomenal source of information needed to keep your kitty safe (and yourself sane!) You will also get a lot of help on the FDMB FB page, although not all members there come to this site very often so won't necessarily have the full story of what's been happening.

Good luck with the vet and let us know how it goes.

 

With the vomiting and bad appetite ask your vet today to test for pancreatitis (SNAP fPL gives immediate yes/no, Spec fPL needs to be sent to lab but gives a numeric result indicative of severity of inflammation) and also for ketones (bring a urine sample with you).

Cyproheptadine is a gentler, more controllable appetite stimulant and it doesn't carry the risk of serotonin syndrome (mirtazapine can induce serotonin syndrome).


Mogs
.

 

Thanks it's hard thinking the vet is giving me correct info and me not knowing anything about this. Like I said yesterday was only the second time of me doing this. I know nothing
His urine was tested and so was pancreatitis

How do I add info here?

 

Take heart - you'll learn and we can help. What you're working with here on FDMB is the combined experience of many, many owners of diabetic cats who've seen/heard/lived it all. Your vet, like most, can't possibly have that range of experience because they're trained to look after a variety of diseases in different animals. Some are more used to treating diabetic dogs - very different from a diabetic cat. I actually had my horse's vet comment on how complex cats were to treat when it comes to diseases of the endocrine system like diabetes. You aren't being disloyal to your vet by seeking out info here. At some point down the road you might want to have a conversation with him/her about all of this.

 

He is going there tomorrow.
It is just confusing to me about how I am supposed to know what dose to give him. I cannot just guess it and do what I want.
That is what is bothering me.

 

I know how confusing and overwhelming everything is in the beginning. I wish there was a qualified vet on here to set your mind at rest. Like I said before, I can only say what I would do if it was my cat and that is give him 1 unit for now especially if you aren't testing. Too much insulin can be as bad or worse as none at all.
Remember you're not alone, we are all going through this together x

 

You aren't supposed to guess at a dose yourself. There are standard recommendations for starting doses of various insulins when administering to a cat. These are either found in the reference material for the insulin (eg. ProZinc) or from vet reference documents (eg. Lantus). My cat has been on both Lantus and ProZinc. His weight at diagnosis was about 14 lb. In both cases my vet told me to start by giving 1 unit twice a day and I was taught how to test blood glucose at home. Her instructions to me were to do a blood glucose curve (take BG at AM dose, then every 2 hours until the PM dose for a total of 12 hours of readings) at home after a week on the insulin. Then I was to email the numbers to her and she discussed them with me and gave instructions about what to do with the dose - ie., lower, raise, keep the same. So - she promoted the basics of owner involvement but I've learned a lot more since I've come to FDMB.

 

Jamies,
Have you read all the info provided here about treating diabetic cats? You need to go to vetsulin/caninsulin forum and read yellow stickers.
You must educate yourself about Caninsulin and how it works because it will make your life easier if you understand what you're doing as it is you who is giving your cat injections of this powerful substance and you need to know what to do in case of emergency. All information is here on this site. You can ask any questions and we are really happy for you to ask anything as we will help you all the way.
I have an experience of using caninsulin but it is not the best insulin for cats. I don't want to make things more complicated for you at this stage so let's just try it as it might work well for your kitty.
The most important thing with this insulin is that it is a mixture of two different types: very short acting which means it will start having an effect in about 2 - 3 hours and this effect will wear off quickly and then longer acting insulin. You have a cycle of 12 hours so let's say you test, feed and inject your kitty at 7AM and the next cycle starts at 7PM. You have to check what the insulin is doing in the meantime and you need to establish a nadir which is a lowest BG (blood glucose) in the 12 hour cycle. This is a very important information.
When you first start insulin it is better to go slow with it and let the cat get used to it, you can always go up with small increases.
The initial dose depends on BG reading at the vet and other things as well. Do I remember correctly that your kitty is on steroids?
When Rocky started on caninsulin his BG was 24 (430) and the dose was 2 units bd (twice a day). If I was you I would probably try no more than 2 units if I remember correctly that his BG was over 600. If your kitty is on steroids I wouldn't commit myself to recommending any dose as I have no experience with that. Other members will be able to help and also you have to press the vet to show you a graf or table with caninsulin dose for cats. They might have more experience with treating diabetic dogs so be very vigilant.
So EDUCATE yourself and ask questions.

 

Wow, you are one of the lucky folks who had a vet with a good handle on feline diabetes, and getting owners involved in care! It's nice to hear a vet-success story for a change!

 

Yes, lucky!

 

Thank you Marlena. Didn't even see that forum
I will read up on it now

 

Great! It will make you feel better. You might need to read many times to grasp everything but as I said before we are here to guide you through. Even with my medical background I struggled to comprehend everything as it is not straight forward and you're tired and panicky when you get this diagnosis.

 

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