new dose new schedule. How do I adjust?

Night before last Kitty had an episode where bd took huge drop in a couple of hours. Yesterday the Vet said to change dose of Vetsulin to .5 cu 1x daily. I have some questions about this. I thought Vetsulin had a 12 hr "life". The Vet said ECiD and that because she is outside exercising in the day her body was making enough insulin on it's own at that time. If you look at yesterday's SS you can see that w/o insulin her #'s actually did go down a little at the end of the day. This morning b/g was up but not as much as yesterday but still high 315. Gave her shot about 30 mins. ago and all is well. I'll get another test in a 1/2 hr.

1. Does the Vetsulin actually clear out of her body in 12 hrs? How does this effect dosing? If her AMPS is high do I increase/adjust dose on a daily basis or just go with the dose and expect that her body is going to make up for some of it through out the day? Since I'm only giving her 1 dose a day do you expect any overlap in a 24 hr. period with Vetsulin?

2. The Vet's original instructions were to give her 1 cu 1x a day and let it go. She was fine with my suggestion to go to the .5 cu 2x daily. My question is was the 1 cu 1x a day maybe a more appropriate dose in the first
place.

Before this change her numbers were getting more normal and so was her behavior. Her genetics are barn cat and I have noticed that outdoor exercise has a big impact on numbers which I'm sure was part of the explanation for the big fast drop night before last. This morning she's been doing fine but I am wondering if I can expect this to deteriorate through the day as the effects of only .5 cu daily kick in?

I just want her #'s to come down to a more normal range. The day before the big drop was the best day we have had for months. She was her old self, active and interested rather than sleeping all day. Her condition has improved immensely since starting insulin and I would hate to lose ground.

I have another set of questions on feeding and food prompted by the hypo instructions but will submit another question on that.

 

Vetsulin usually lasts less than 12 hours in a cat.... Closer to 8-10 hours. With vetsulin there is no overlap. It is not a deposit insulin like lantus.

This means of you dose once a day she's going more than half the day without insulin support. Cats do better in 2 doses a day unless of course the preshot is too low to shoot. You aren't quite there yet with all your preshots over 200.

Your vet is suggesting doubling the dose from 0.25 to 0.5. I think that's a good idea and may push those high 100's into high double digits... If you gave her 1 unit she would go way too low in the morning (possibly hypo) then bounce and be much higher in the evening. Not a good idea.


My suggestion would be 0.5 twice a day.
Or 0.25 twice a day...
But NOT 1 u once a day.


Under 200 don't shoot.
200-250 0.25
250+ 0.5

 

Thanks Janet. I have to get back in touch with Vet. We tried the 2x dose at .125 but was NOT good and was very evident not working for 2 possible reasons. Too low dose or my inability to administer that small of a dose. The Vet was gone but after 2 days at the .125 cu 2x day I made decision to go back to the .25 1x day until I discuss the .25cu 2x daily with her. Things are settling down and getting better but I need to talk to Vet about the .25 cu 2x daily before switching. I'm thinking that is the next best step but want to avoid too much jumping around. Also time for annual vaccines and need to discuss this with Vet also. I will keep posting to SS. I do think your observation is accurate but the .5 cu early on was just too much. That was when we were getting the big drops.

I know they say to give any changes at least 3 full cycles or ??? maybe it was 6 days but it was so evident the .125 was not working I had to do something and felt the best option was to return to what we had been doing previously. I also thought that going to the .125 cu 2x daily would be a good idea so it's clear that I don't have enough experience or expertise with this yet. Sure appreciate your input.

 

.125 is a drop. It's not enough... Close though. I think you need 0.25 each time while the preshots are in the 200's.

 

She may really do better with full 0.25U twice a day but we were taking your comfort level into consideration by splitting it into the 0.125U dose twice a day . Will be curious to see how your Vet feels about 0.25U twice

 

Ok. Just gave .25 cu PM dose. Will watch. Vet wants to do Fructosin test next week but said to go ahead if it seemed she needed the extra shot. tonight PMPS was 262.
I really do think this is what's needed. Thanks for the encouragement will keep posting to SS.

 

Good decision.

 

Try your best to get a before bed test, assuming that's between +2 and +4

 

Will do.