Newly diagnosed and overwhelmed.

Discussion in 'Caninsulin / Vetsulin and N / NPH' started by Dana & Ninja, Dec 17, 2019.

  1. Dana & Ninja

    Dana & Ninja Member

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    Dec 15, 2019
    My almost 12 year old kitty was diagnosed Friday 12/13/19 by my vet. He started him on 4 units of Vetsulin every 12 hours. We had a low of 23 on Saturday, I did karo syrup and kitty treats and called the vet right away. The vet dropped his dose to 3 units every 12 hours. I have been very conflicted about what the vet tells me and what I have been reading on this site and the facebook group. So I think I have come up with a workable plan. Please let me know what you all think.

    1. Switch all the cats to a 2x day Classic Fancy Feast meal. I have a total of three cats. 1 diabetic now.
    2. Set some kibble out before I leave for work for “grazing” purposes and transition to an automatic feeder with wet food.
    3. Check his blood sugar just before his insulin shot/meal to be sure he is above 200.
    4. Drop the vet prescribed 3 unit dose every 12 hours to 1 unit dose every 12 hours.
     
    Last edited: Dec 17, 2019
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  2. Beth 73

    Beth 73 Well-Known Member

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    Hi Dana :bighug: Glad you are here :) I’ll tag Linda ....she is away from the Board but should be back soon, so hang tight . @MrWorfMen's Mom
     
  3. MrWorfMen's Mom

    MrWorfMen's Mom Well-Known Member

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    I agree with your plan but I'd hold off transitioning to wet during the day until we see how your kitty is doing. What kind of glucometer are you using? Pet or human? What kind of kibble are you currently feeding your furkids?

    It would be helpful if you could set up a signature (the light grey text under our messages) so we don't keep asking the same questions over and over. You can include your cat's name, your name, type of insulin, type of glucometer, date of diagnosis, any other health concerns, your general location or time zone. We have members from all over the world here so knowing roughly where you are is sometimes useful and it allows us to provide you with pertinent supply info if needed.

    To set up a signature, hover your cursor over your user name in the upper right corner of the screen. This will drop down a menu and you select "Signature" from the left column menu. This opens up a text box into which you can enter the info you want to share. When done, scroll down and click on "Save Changes".

    The other thing that would be helpful is if you would set up one of our spreadsheets to keep track of your kitty's BG readings. We are extremely data oriented here and our spreadsheet really helps us see the patterns of the readings you take. The instructions for setting it up are HERE and THIS DOC explains how to use the spreadsheet. If you need any help setting up the spreadsheet, just holler and we can help you with it.

    As mentioned before making it a habit to get at a minimum a test before bed every night will help collect data to see how your kitty is doing. Tests taken in the early hours of the night cycle often predict where the cycle is heading so they can be very telling. Use days off to grab more tests in the expected lowest period of the day cycles which is between +2 and +7 (concentrate between +3 and +6).

    Keep the questions coming.
     
  4. Dana & Ninja

    Dana & Ninja Member

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    Dec 15, 2019

    OK I did the signature. I'' work on the spreadsheet later as I am at work now. Vet wants me to feed wet food every 12 hours with the shots, and then use Royal Canin Glycobalance for free feeding. He prescribed 3 units of Vetsulin every 12 hours. I feel so conflicted, he has been my pets vet for over 18 years. Do I just not trust him anymore and go rogue?? UGH!!
     
  5. Sarah&Soph

    Sarah&Soph Member

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    The thing is, a lot of vets are fantastic and mean well, but they simply do not have much experience dealing with feline diabetes. I loved most of my cat’s vets. They were great for many things. But their advice nearly killed her from a severe hypoglycemia incident, and then took A LOT of my money afterwards trying to get her regulated, to no avail. It is ultimately your decision what advice you want to follow and that’s totally your choice. But I personally think it’s safer to start with a lower dose as Linda has recommended and then increase as needed, rather than start too high and have to chase low numbers
     
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  6. Dana & Ninja

    Dana & Ninja Member

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    Thank you, I do love my vet, but I think I will follow everyone's advice to go to 1 unit every 12 hours. I guess it would better for him to be a little high than go low. Although his blood sugar first thing this morning was "HI". Ugh.
     
  7. Sarah&Soph

    Sarah&Soph Member

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    Yes, that’s my thought as well, especially with that 23 reading! It’s hard to know why he was high this morning without seeing spreadsheet data yet, but some possibilities are that if you’re still giving the increased dose, he could be dropping low and then dumping a lot of glucose to compensate for that. Vetsulin is also a harsher insulin that can drop the blood glucose very fast and cause the same reaction because it can cause the kitty’s body to panic. It also does not typically last a full 12 hours like some of the other insulins, so it could also be wearing off. More tests when you can will help you to know what’s going on with Ninja :cat:
     
  8. MrWorfMen's Mom

    MrWorfMen's Mom Well-Known Member

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    I agree that the HI could be for a various reasons and until you have some testing data, everything is just speculation right now. The saying around here is better too high for a day than too low for a moment. If numbers don't start to improve in the next 3 days, then the dose can be adjusted by 0.25u or 0.5u.
    Are you using the vet pen or a vial with syringes? If the latter, do your syringes have half unit markings? If not, it would be a good investment to order syringes with the half unit markings so that dose adjustments can be done in quarter unit increments. Many folks here order from https://www.adwdiabetes.com/
     
  9. Dana & Ninja

    Dana & Ninja Member

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    I am using syringes and a vial. No half units on these syringes. I'll make sure to get ones that do. I will start doing the 1 unit every 12 hours tonight. I am off this weekend, so I will do blood sugars at the +3 and the +6 mark as you suggested and start the spreadsheet. I just wish this had never happened. I feel so bad for his little ears.
     
  10. Dana & Ninja

    Dana & Ninja Member

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    Why am I feeling so guilty for not following the vet's orders?
     
  11. Sarah&Soph

    Sarah&Soph Member

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    I used to feel the same way! I think it’s hard for many of us to feel like we’re going against authority figures or people we see as being experts. But at the end of the day, your vet works for you and you have the right to decide what’s best for you kitty. As I mentioned, many vets don’t have a lot of experience with diabetes. Id be willing to bet that the number of cats that have gone into remission alone on this board in the last few months is higher than the number of diabetic cats most vets have treated in their entire career. Vets also treat many many conditions and see many patients, so it’s not unreasonable that they’re not experts in every subject. Meanwhile most people on this board live and breathe diabetes every day and that’s their only focus
     
  12. Dana & Ninja

    Dana & Ninja Member

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    Thank you for your kind words. As a nurse it is hard to not follow doctor's orders but yes I want to do what's best for Ninja. I'm dropping the vet prescribed 3 units tonight down to 1 . Do you think I need to worry with the drop in the dose?
     
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  13. Sarah&Soph

    Sarah&Soph Member

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    As long as there is no history of ketones or DKA, then I don’t think there should be an issue restarting with one unit, as Linda has suggested. She is wonderful and so knowledgeable and helped me get my cat into remission :cat: One unit is a much more reasonable starting dose (this is coming from someone whose cat was started at 6 units!). If one unit is not enough, being in high numbers for a few days will not hurt him, and you can always increase.

    Is the glycobalance the vet wants you to feed dry? If so, I’m pretty sure it’s very high carb and will also contribute to keeping his numbers high
     
  14. Dana & Ninja

    Dana & Ninja Member

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    Yes it is dry food. It's only a 4 pound bag and I already ordered it. I think I will order the Dr. Elseys and perhaps mix the two and not get the glyobalance anymore.
     
  15. MrWorfMen's Mom

    MrWorfMen's Mom Well-Known Member

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    If you don't want to feed the Glucobalance, then just open the bag and then take it back to the vet and tell them Ninja won't eat it. They have a money back guarantee...your vet won't lose anything.

    Vets have so many ailments to learn about that the amount of training they get for diabetes is minimal at best and it covers all different species. Even human's have specialists. GPs only deal with one species and still look to specialists to deal with a lot of ailments so we shouldn't expect our vets to be experts in everything either. If your vet recommended home testing, they already earned points that many do not. Unfortunately, we all too often see kitties turn up here having been prescribed far too much insulin and while I still find that mind boggling, diabetes is a 24/7 proposition and your vet is never going to be there to deal with it first hand. Taking control yourself is the best and safest way to look after Ninja.
     
  16. Dana & Ninja

    Dana & Ninja Member

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    Thank you. I so appreciate your help in this. I am nurse and that might be a hinderance because I am very familiar with human diabetes but this is a whole different world. I am very thankful for your and others insight. Thank God for Google as that is how I found this site.
     
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  17. MrWorfMen's Mom

    MrWorfMen's Mom Well-Known Member

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    I am a retired R.N. and I too was a skeptic when I landed here through researching but without this site, despite having a vet I worship and wish was my GP, I never would have got my girl into remission. :)
     
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  18. Dana & Ninja

    Dana & Ninja Member

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    Thank you. It would be wonderful if he could get into remission. Hoping so. I just need to clam down and breathe. God brought me to this site for a reason.
     
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  19. Dana & Ninja

    Dana & Ninja Member

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    So I just checked his blood sugar as he due for his second shot. It was “HI”. He ate 1/2 can of fancy feast and I gave him 1 unit of the Vetsulin. . Hope he going to be ok as I had been following the vets orders for 3 units.
     
  20. MrWorfMen's Mom

    MrWorfMen's Mom Well-Known Member

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    Check him again around +2 or +3 post shot and bedtime or at least bedtime if that is roughly the same as +2 or +3. Hopefully BG will be down some.
     
  21. Dana & Ninja

    Dana & Ninja Member

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    ‘I had to go to my niece’s Christmas program and just now got home. I just checked him. So it would be +5 since the “HI”. His Blood sugar right now is 366. Not the under 200 I was hoping for but at least not 23 right?
     
  22. Dana & Ninja

    Dana & Ninja Member

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    5am this morning he was 408. He ate 3/4 can of FF. 1 unit given. Will try to get a spreadsheet set up tonight.

    I was able to check him at 9am. He was 153!! Best one yet!!
     
    Last edited: Dec 19, 2019
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  23. Deb & Wink

    Deb & Wink Well-Known Member

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  24. Dana & Ninja

    Dana & Ninja Member

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    Dec 15, 2019
    Question about glucometers. I bought a Freestyle Precision Neo to use. It’s strips cost $22.00 for 50. On the Facebook group there is mention of using a Relion Prime and it’s strips are half the cost of the Freestyle ones. I’m thinking of switching as I need to be as cost savvy as I can but still want to provide for Ninja. Any thoughts on the Relion Prime meter?
     
  25. Sarah&Soph

    Sarah&Soph Member

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    I use the ReliOn Prime. I will admit that it took me a few days to learn how to use it properly and during those few days I HATED it, but I have no issues with it now. Super cost effective ($20 for 100) and it’s also easy to get strips since they’re at Walmart
     
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  26. Dana & Ninja

    Dana & Ninja Member

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    Dec 15, 2019

    Great I think I will switch as it will be more cost effective moving forward.
     
  27. Dana & Ninja

    Dana & Ninja Member

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    Ugh!!! I’m so stupid!! I got up at 5am to check him, feed him and give him his insulin. I forgot to put the insulin back in the fridge!!! It was out for 4 hours. Major face palm!! Going to go get a new
     
  28. Red & Rover (GA)

    Red & Rover (GA) Well-Known Member

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    It has happened to us all. The insulin should be fine. Four hours is not a long time. Just keep an eye out for floating particles – that is a sign that the insulin has gone off.

    Do not start the new bottle yet (if you did go out and buy one). Just watch the numbers. A spate of higher numbers could mean that the old, left out bottle is beginning to lose its efficacy.
     
  29. Dana & Ninja

    Dana & Ninja Member

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    He’s just newly diagnosed and his numbers are all over the place. I don’t know if I will be able tell by his numbers if the insulin is good. ☹️
     
  30. Red & Rover (GA)

    Red & Rover (GA) Well-Known Member

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    just keep an eye out for floaties.
     
  31. Dana & Ninja

    Dana & Ninja Member

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    So I have switched Ninja over to the Fancy Feast Classics wet food. Still waiting for the Dr. Elsy’s kibble. Been doing A LOT of reading. Do I need to be worried about the phosphorus levels in the Fancy Feast?
     
  32. Deb & Wink

    Deb & Wink Well-Known Member

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    Does your kitty Ninja or the other 2 non-diabetic kitties have kidney disease? Lower phosphorus levels can be important if a cat has kidney issues. But, a phosphorus binder can also be used. If no kidney disease, I would not worry about the phosphorus levels in the Fancy Feast classic foods.

    The important part is to find a food all 3 of your cats like and will eat consistently (well, hopefully eat most of the time and then try another flavor for the day or hour) and go from there.
     
  33. Dana & Ninja

    Dana & Ninja Member

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    Ok, thank you. None of them have been diagnosed with kidney disease. But just yo be on the safe side the next batch I buy I will get lower phosphorus leveled fancy feast. So far they are all loving the Fancy Feast.
     
  34. Dana & Ninja

    Dana & Ninja Member

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    So before Ninja was diagnosed I had plans to go visit my sister who is 2 hours away and spend Christmas with her and her family. I have a close family friend's daughter that is going to come over and feed/water/scoop the box everyday while I am gone . Now with the new Dx that won't work for Ninja and my sister said I could bring him with me, which I think would be less stressful than boarding him at the vets clinic. I am worried that it will still stress him out some but hoping since I will be there it won't be as bad. Thoughts on how to help him with this?
     
  35. MrWorfMen's Mom

    MrWorfMen's Mom Well-Known Member

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    Your worst issue will probably be the trip there and back. You could try some Feliway spray in the carrier and take along some of his home comforts like a favourite bed and toys.
     
  36. Deb & Wink

    Deb & Wink Well-Known Member

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    Years ago, member Lisa and Leo wrote up a great google doc on traveling with kitties. I bookmarked it and was able to find it in one of my folders and here it is for you.

    Traveling with Diabetic Kitties by Lisa and Leo.

    Hope you find some helpful info in there to help with your upcoming trip with Ninja.
     
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  37. Dana & Ninja

    Dana & Ninja Member

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    THANK YOU FOR THIS!! I ended up getting these. It says 1-3 chews is the serving size. I was thinking 2?
     

    Attached Files:

  38. Deb & Wink

    Deb & Wink Well-Known Member

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    Maybe try 1 before the trip to see what effect it has on Ninja? Also, you want to make sure that Ninja will eat something new like this chew.

    There is some carb content in the brewer's yeast, but I think the calming effect you are looking for may be more important for your trip with Ninja than any possible temporary raising of BG levels. Plus hard to tell from the pictures how big the chews are, but I'm guessing the chews are pretty small so amount of carbs should be very little.

    "Better too high for a day, than too low for a moment." is one common saying on this message board.
     
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  39. Dana & Ninja

    Dana & Ninja Member

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    Thank you. He did ok with the hour car ride to the vet with no calming. Just meowed a lot. And yes I too feel better a bit high than low.
     
  40. Dana & Ninja

    Dana & Ninja Member

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    I did a few more blood sugars today. I was gonna do a 12 hour span every 2 hours but I goofed and gave him his shot 2 hours early!! Dumb dumb dumb!! But would someone mind looking at his spread sheet? From the advice I got about the vet's dose being to high I did drop the dose to 1 unit twice a day. Do I need to bump up the dose now?
     
    Last edited: Dec 22, 2019
  41. Dana & Ninja

    Dana & Ninja Member

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    @MrWorfMen's Mom. Hi Linda. Sorry to bother you. I’m really kinda feeling lost. Would you be able to look at Ninja’s spreadsheet?
     
  42. MrWorfMen's Mom

    MrWorfMen's Mom Well-Known Member

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    It does look like Ninja needs a little more insulin so I'd increase to 1.25u or 1.5u if you don't have half unit syringes yet and can eyeball that easier.

    I would strongly recommend making sure you get, at a bare minimum, a before bed test every night(and/or day if you are working overnight shifts). Curves are fine, but everyday is different and many if not most cats go lower overnight. It's how low the insulin is dropping BG rather than how high the pre-shots alone are that will dictate dosing. I would make the dose change when you can monitor and get a mid cycle test around +2/3 post shot.
     
  43. Dana & Ninja

    Dana & Ninja Member

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    Thank you sooooo mu
    Thank you sooooo much!! I will bump up his dose to 1.5. Still waiting for the new syringes but as you said I can eyeball it for now. He was 367 pre shot this morning and I will get the +3 as you suggested. I work days so on those days I will be unable to do that but I will start doing a bedtime check. Thank you so much again.
     
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  44. Dana & Ninja

    Dana & Ninja Member

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    So this morning pre shot was 219. He ate 3/4 can if FF. And I gave him 1.5 units. 3+ he was 57. Gave him a fingertip full of Karo syrup and 2 kitty treats. He was acting ok, not shakey or sleepy. Should I have not given him the insulin? I thought if the blood sugar was 200 or lower that’s when you dint give the shot? I’ll recheck him in an hour. Thought??
     
  45. Deb & Wink

    Deb & Wink Well-Known Member

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    I'd go ahead and retest now. Karo syrup can wear off quickly.

    What kind of kitty treats? Something with carbs in it to help bring the BG up?

    Does Ninja eat first after you get the pre-shot test, and before you give the insulin shot? Say 20-30 minutes between eating and shot?

    (Good thing you dropped the original vet prescribed dose down.)

    Yes, when starting, it is suggested that you do not give insulin if the pre-shot test is <200. As you gain more data it MAY be possible to lower this pre-shot number. For now, I would not give insulin if BG is <200.

    Ninja may be more sensitive to insulin after going that low (57 at +3). So less insulin for the PM or maybe even skip the shot if test is <200 for tonight.

    p.s. Hope the stay at your sisters is going well.
     
    Last edited: Dec 24, 2019
  46. Dana & Ninja

    Dana & Ninja Member

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    Ok his blood sugar right now is 159. The kitty treats gave him were 2 of the calming cat treats that I posted earlier. Should I check him again later? How soon? I have the Dr. else’s food out for him to graze on but he doesn’t seem to like it. He is actually doing fantastic at my sisters house. No alarming high blood sugars so taking that a good sign. But that low wasn’t good, should I have held his morning insulin?
     
  47. Deb & Wink

    Deb & Wink Well-Known Member

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    Ok, that's a good BG reading for now. Are you able to check again in 30 minutes? You don't want to wait more than 1 hour before another test, since the karo syrup will probably have worn off by then.

    Those calming cat treats don't have many carbs in them. Also, those treats are only meant to be given once a day per the package instructions.

    You were right to give Ninja his insulin this morning, above 200 BG this AM and you are home testing should have been ok. Looks like the 1.5 may be a bit too much though. Cats that have gone that low, that early in the 12 hour cycle, can be more sensitive to insulin. So I'd say no more than 1 unit this PM and ONLY if the BG is >200 and you are able to get a +3 and +4 test to monitor.
     
  48. Dana & Ninja

    Dana & Ninja Member

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    38 minutes later he is at 157. I gave him 1/2 can of good and he’s eating some of it. Hoping he doesn’t go back down.
     
    Last edited: Dec 24, 2019
  49. Deb & Wink

    Deb & Wink Well-Known Member

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    That's good. Ninja seems to be holding pretty steady. Maybe 1 more test at around +5 to make sure his BG numbers are still going up. The concern is that the BG levels could drop a lot lower again.

    Expect a 'bounce' to higher numbers, either this evening or tomorrow morning.

    This is from the Sticky 'The Basics: New to the Group" over in the Lantus ISG forum
    here that describes what a 'bounce' is and why it happens:
    "Bouncing - Bouncing is simply a natural reaction to what the cat's system perceives as a BG value that is "too low". "Too low" is relative. If a cat is used to BGs in the 200's, 300's, or higher for a long time, then even a BG that drops to 150 can trigger a "bounce". Bouncing can also be triggered if the blood glucose drops too low and/or too fast.The pancreas, then the liver, release glucogon, glycogen and counter-regulatory hormones. The end result is a dumping of "sugar" into the bloodstream to save the cat from going hypoglycemic from a perceived low. The action is often referred to as "liver panic" or "panicky liver". *Usually*, a bounce will clear kitty's system within 3 days (6 cycles)."

    Yes, you are using Vetsulin but bouncing can happen with all insulins.
     
  50. Dana & Ninja

    Dana & Ninja Member

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    Ugh! Guess I’ll go back to one unit twice a day. At least until I get the different syringes. Poor kitty. I hope his ears hold up!! Lol!!
     
  51. Deb & Wink

    Deb & Wink Well-Known Member

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    Make sure you withhold food for at least 2 hours before you do the BG test this evening (and before all pre-shot tests).

    Although, if there is some holiday turkey or roast beef hanging around, Ninja might let you sneak him a bit after the next BG test.

    Vetsulin is a U40 insulin but it is possible to use U100 syringes if you use a conversion chart. Can be an extra step to use the different U100 syringes. You might not want to do that right now, but if you are interested, I'll find you a link to the conversion chart.
     
  52. MrWorfMen's Mom

    MrWorfMen's Mom Well-Known Member

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    Good catch on that 57 today. Glad Deb was here to help. You handled it well. That 57 is far lower than you want kitty going when on Vetsulin so yes I would reduce the dose. It looks like a dose of 1.25u might be better so until you get syringes with half unit markings or U100 syringes to use with the conversion chart, I would try a dose of a fat 1u. By that I mean that instead of having the plunger lined up on the 1.0u line, line it up at the bottom of the 1.0u line to provide just a smidge over 1.0u. Sometimes just a little tweek is all you need.
     
  53. Dana & Ninja

    Dana & Ninja Member

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  54. Dana & Ninja

    Dana & Ninja Member

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    Perfect!!!! Thank you all so much!!!! I would be so lost without you all!!! I love my vet but he’s not available like you all!!! I’ll do the fat 1unit. My syringes have been delivered so when I get back home I can start using them.
     
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  55. MrWorfMen's Mom

    MrWorfMen's Mom Well-Known Member

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    With the half unit marked syringes, you could try a dose of 1.25u and see how that works. If it's still too much (any drops below about 90 earn a reduction) then try the fat 1.0u. Obviously trying to do in between the marks dosing is simply eyeballing best you can even with the half unit markings. Consistency is more important than absolute accuracy so you might want to draw up what you perceive to be the dose you want to use and make a sample syringe with some coloured water to use as a comparison gauge.
     
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  56. Deb & Wink

    Deb & Wink Well-Known Member

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    Ninja definitely earned a reduction with that 57 this morning!
     
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  57. Dana & Ninja

    Dana & Ninja Member

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    Ok. Thank you again sooo much!!!
     
  58. Dana & Ninja

    Dana & Ninja Member

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    Thank you soooooo much for your help!!!!
     
  59. Dana & Ninja

    Dana & Ninja Member

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    Ok at the + 5 he is 131. I’ll pick the food up at 5 two hours before his next dose. Do I need to check him anymore this afternoon before his second shot?
     
  60. Deb & Wink

    Deb & Wink Well-Known Member

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    No, I wouldn't do any more checks this afternoon. Just the PM pre-shot test (PMPS).
     
  61. Dana & Ninja

    Dana & Ninja Member

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    Ok! Thank you!!!!
     
  62. MrWorfMen's Mom

    MrWorfMen's Mom Well-Known Member

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    Actually there can be another mild drop of BG around +8 post shot so you might want to do another check around then just to see how Ninja is doing. The 2nd drop is more subtle and may not show up but with BG being lower today, good idea to check to see if Ninja has surfed through or if he drops at all.
     
  63. Dana & Ninja

    Dana & Ninja Member

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    Ok I just checked him +8 he was 182. Whew!
     
  64. Deb & Wink

    Deb & Wink Well-Known Member

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    Good +8 BG number Ninja!

    Dana, wanted to let you know that I will not be around to help this evening. I'm on the east coast US and I'm one of those people that go to bed really, really early. I'll be asleep before you even do your PMPS test tonight.

    So, some things to consider before shot/no shot decision tonight.

    1. Lots of new people on the message board. Not many experienced people around since it is a holiday for a lot of people and they are with their families.
    2. Not sure if Linda or anyone else will be available to assist.
    3. Are you comfortable handling those low numbers yourself?
    4. Being at your sister's home, do you know where the closest 24 hour emergency vet is if needed?
    5. Weather and road conditions for driving where you are.
    6. Do you know how to hand feed if Ninja won't eat for you if numbers are low and you need to bring the BG up?

    I know you are visiting your sister, and might not get to do that very often, so you need to balance that with taking care of Ninja.

    You might want to review the following Sticky in the Caninsulin/Vetsulin ISG and print a copy if at all possible. http://www.felinediabetes.com/FDMB/threads/beginners-guide-to-caninsulin-vetsulin.186099/
     
  65. Dana & Ninja

    Dana & Ninja Member

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  66. Dana & Ninja

    Dana & Ninja Member

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    Thank you so much. I will be ok. I appreciate all your help today. Have a wonderful evening and a very Merry Christmas!!
     
  67. Deb & Wink

    Deb & Wink Well-Known Member

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    Jan 31, 2013
    Took a quick peek at the SS and looks like Ninja did ok last night. Much nicer to see BG readings early in the cycle in the 90's (more normal range) then in the 50's (low and we don't want to see it drop too much lower without risk of symptomatic hypo). With BG readings in the 90's, you could have tried giving Ninja more food and not the karo syrup and done a retest as you did. Sometimes food alone is enough to bring the BG levels up sufficiently.

    Vetsulin does tend to have those fast and steep drops early and you are certainly seeing that with Ninja.

    Are you testing, feeding, waiting 20-30 minutes, then giving the insulin? Might be important to let the food digest a bit and try to balance the food getting into the bloodstream and insulin actions.

    You said Ninja did not like the Dr Elseys food. Are you still feeding some of the Glycobalance? Ok if you are not, but it would certainly contribute to the lower BG numbers you are seeing.

    What flavor of Fancy Feast is Ninja's favorite? I remember that my sugardude Wink loved the Turkey & Giblets flavor. It's what got him off the dry food after many struggles to get my "dry food addict" to eat wet food.

    Maybe an extra bit of food at +1 (another 1/4 can of the Fancy Feast) if Ninja will eat it could help balance the BG levels and even out the glucose levels a bit so Ninja doesn't have such steep drops in BG.
     
  68. Dana & Ninja

    Dana & Ninja Member

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    Thank you sooo much!! We need all the checking we can get! He was 275 at 7am this morning and I did as you suggested and let him eat first. Gave 1 unit at 7:30. So now for the +3 do I crack at 10am or 10:30?

    He seems to like all the FF classic pates. Not picky about those, just the Dr. Elsey’s. Ugh.

    I’m very sad that he doesn’t like the Dr. Elseys. I did not bring the glycobalance with me. I am hoping he will at least like that. I have to go back to work during the day strartinf Jan. 2nd ans there is no way I can leave wet food out with my other cats as I know they will eat it before Ninja does. My plan was to feed them all the same. Wet food mornings and evening then low carb dry during the day. I’ll have to see if there is another lower carb dry besides the glycobalance that he will like. Ugh, I bought 2 bags of it. Lesson learned there too.
     
  69. Deb & Wink

    Deb & Wink Well-Known Member

    Joined:
    Jan 31, 2013
    The +3 check is from the time you did the pre-shot test, not when you gave the insulin shot. So that would be 10 am your time. Any of the additional checks for a 12 hour cycle are calculated from the pre-shot test time. So +5 would be 5 hours after pre-shot test, +8 would be 8 hours after pre-shot test.

    The glycobalance dry isn't low carb. It's about 29% carb wet matter basis, 32% dry matter basis. You are looking for <10% carbs. I use this calculator to get the rough estimates of carb content for cat foods.

    Have you tried adding a bit of water to the Dr. Elsey's dry? Maybe Ninja would eat some if it's wet. Might try adding water and mashing it up so it's more like wet food.

    Yes, it's tough when you have other cats that scarf up the food as quickly as possible when they notice it's there. Maybe a timed feeder? Or putting Ninja in a room alone during the day with food, water and litter box when you are at work? Don't even know if those options would be possible for you. I used a hallway bathroom when I had a kitty that needed extra care and special feeding.

    What food was Ninja and your other cats eating before the diabetes diagnosis?

    p.s. Just add a note on your SS that you fed first, waited how ever amount of time between feeding and shot so we'll see that in future.
     
    Last edited: Dec 25, 2019
  70. Dana & Ninja

    Dana & Ninja Member

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    Ok, I’ll check him at 10. I was feeding them all Purina Cat chow complete. Been on that since they were kittens. I asked my vet when they were kittens if that was ok and he said yes. Ugh.

    I’ll try some water in the Dr. Elseys. I hate to separate them during the day because they are really bonded and love yo be with each other, but if I have too I will.

    I want you to know I so appreciate all your help!! I would be so lost without this site. Hopefully I will be able to pay it forward someday.
     
    Last edited: Dec 25, 2019
  71. Deb & Wink

    Deb & Wink Well-Known Member

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    120 is a nice safe BG number for Ninja at +3. Certainly no need for any corn syrup this time!

    If he's hungry, no problem with trying to see if he'll eat some more FF.

    I'd suggest the same test, feed, wait 30 minutes, shoot that you did this morning.
     
  72. Dana & Ninja

    Dana & Ninja Member

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    Right. I was happy with that number. He did eat a little more FF . I’m gonna check him at 3pm again. Yes, I think I will do that with testing from now on. Thank you!
     
  73. Deb & Wink

    Deb & Wink Well-Known Member

    Joined:
    Jan 31, 2013
    Looking forward to the +8.

    Hoping the delay between food and insulin continues to keep Ninja in safer numbers. At least my hope is that this will continue to work for Ninja and you will feel ok leaving for work in the morning when you start back to work on 1/2/20.

    Fast acting insulins like Vetsulin (aka Caninsulin) and the NPH insulins (Novolin N, Humulin N) can be tricky to use. Caninsulin was developed and tested for use in dogs and works better in canines (hence the name). The NPH insulins often don't give BG control for more than 6-8 hours for a cat and you need to wait even longer (45 -60 minutes used to be the suggested wait time) between food and shot back when I was using them.

    Some cats can do ok on Vetsulin and hoping that Ninja is one of them. Prozinc is another of the in and out insulins (duration usually 12 hours or less) that you might want to consider with your work schedule, but please give the Vetsulin and the adjustments in routine and dosing that we are trying time to work.

    How are Jasper and Smokey doing back at home with their substitute caregiver? Bet they are looking forward to your return.

    You have been fantastic at taking care of Ninja, from deciding to keep your plans to visit your sister for the holiday, 2 hour road trip with him, to changing the food to low carb, to testing and keeping us updated. I know it must be hard and you probably wish you had an event free visit with your sister, but Ninja had other ideas.

    I know we have been asking you to do a lot of testing and you wanted to be cost conscious but with even 1 unit of the Vetsulin dropping Ninja into really low numbers really early in the cycle, it's been important to get those tests. So thank you. Hopefully, Ninja won't always drop so low and need all these tests to keep him safe from a hypo. Maybe the Relion Prime meter is something you may want to use for testing in your future.

    Life is busy and full and Ninja has added a bit to those responsibilities, but he's worth it.

    p.s. So much information covered in this post. May be worth it to go back to reread and review.
     
  74. Dana & Ninja

    Dana & Ninja Member

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    Thank you for your kind words. This has definitely been a learning journey and I know I still have much to learn. His +8 number was 252. At least it wasn’t low. I too hope that the vetsulin will work for him. I think there is still much adjusting to be done.

    My kitty sitter is fantastic! She sent me pics and my other 2 are doing great. I go home tomorrow and am looking forward to getting this into a routine and hope things will look better when I head back to work.

    I have not minded testing Ninja at all, want him to be ok. He is definitely worth it!!! I do feel bad for his little ears but he is being a champ! I did switch to the Relion premier classic meter. I am so thankful for all the help I have been getting, would be so lost without it! Thank you!! I’m sure I will continue to ask questions but hopefully I’ll start getting a handle on it.
     
  75. Deb & Wink

    Deb & Wink Well-Known Member

    Joined:
    Jan 31, 2013
    Black ears can be so difficult to see the blood drop hiding in that dark fur. Some tips to help Ninja's poor ears.

    You can switch back and forth between ears, using different ears to test. Sometimes one ear bleeds better than the other.

    Putting a bit of pressure on the ear for a bit (30 to 60 seconds) after you get the blood sample can help to reduce bruising. Just like when you have your blood drawn at the lab, that pressure bandage helps to reduce bruising.

    Have a safe trip back home tomorrow with Ninja. Give Smokey and Jasper hugs from us when you get back. Sending hugs to Ninja too.

    You are certainly getting a crash course in Feline Diabetes at home care. Keep asking questions, it's how we learn.

    p.s. When you get a chance, would you please update your signature to reflect that you switched to the Relion Premier meter. A line inserted on the spreadsheet, between dates to show when you switched meters would be helpful too, as well as changing the spot at the top of the SS that says which meter you are using. And if you can, insert a line in the SS before the 12/13/19 tests to show you were using the Freestyle meter at the beginning.
     
  76. Dana & Ninja

    Dana & Ninja Member

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    I do alternate ears and I do hold pressure on them. I think it bothers me more than him, LOL. I have enjoyed my visit and Ninja has done great, but it will be nice to get back home. I’ll update my signature. Thank you! Ninja thanks you all too!!
     

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  77. Deb & Wink

    Deb & Wink Well-Known Member

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    Is that picture of Ninja taken at your sister's home? He looks like he's saying "Another road trip? So soon? Just got settled in here."

    Any luck with getting Ninja to eat the Dr Elseys food with some water added? Maybe if he is back home and sees his siblings eating it, that will tempt him to try it.
     
  78. Dana & Ninja

    Dana & Ninja Member

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    Dec 15, 2019
    That is Ninja last night at my sister’s house. He did so well! I’m so proud of him. We just got home. He’s eaten a little of the Dr. Elsey’s and yes I’m hoping when he sees Smokey and Jasper eat he will too. We will see. Ready to settle back in our routine and relax. Again thank you for your support and help the past few days. I really appreciate it!
     
  79. Dana & Ninja

    Dana & Ninja Member

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    I think we are doing a little better. Staying under 300 and above 90. He seems better, more like his old self these past two days. Even played yesterday with his toy. His fur is looking better and I think he looks like he is gaining some weight. Not sure if I should be adjusting his dose more or just leave it as it is. I go back to work on January 2nd so the +3 and + 8 tests will not be happening. I can check him when I get home at +9. Will that be beneficial?
     
  80. Deb & Wink

    Deb & Wink Well-Known Member

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    Jan 31, 2013
    Seeming more like his old self and playing and fur looking better are all positive signs. Even gaining a bit of weight can be good if he got too skinny.

    Could you try giving a bit more insulin, either try 1.25 or what we would call a 'fat 1' unit. A 'fat' dose would be with daylight showing over the line. A 'skinny' dose would be with daylight showing under the line. The 1.25 would be halfway between the 1 and 1.5 if you got those syringes with the 1/2 unit markings.

    A +9 in the AM cycle will likely show you that the insulin isn't lasting long enough (duration is too short). Right now, the +8 is showing us that info.
    If you are still able to get the +3 during the PM cycle, that would be good.

    With the shot done 30 minutes after feeding Ninja, it does keep him from dropping into those really low numbers below 90. That's good.

    I'm still not sure that the Vetsulin has a long enough duration. Does your vet prescribe other insulins?
     
    Last edited: Dec 29, 2019
  81. Dana & Ninja

    Dana & Ninja Member

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  82. Dana & Ninja

    Dana & Ninja Member

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    Ooof! I jinxed us! Lol! He was 301 this morning. He ate then 30 minutes later I gave him the fat unit. Will see what he is at +3. So doing a +9 would not be beneficial? I don’t know if my vet prescribes other insulin’s. Let’s see how the fat units do over the next couple of days then if I need to I’ll ask him.

    Yes him gaining a little weight makes me feel so much better. He’s never ever been overweight so when he started losing weight is what prompted me to take him to the vet. I could see his little backbone and his hips were so skinny.

    Man I wish this wasn’t so hard. Too bad they don’t do CGMs and insulin pumps for kitties! Lol!
     
  83. Deb & Wink

    Deb & Wink Well-Known Member

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    There is a continous glucouse monitor (CGM) that some people have used for their cats. The Freestyle Libre. No idea of the cost, especially since this is for a cat and Ninja probably doesn't have health insurance that would help cover the cost. Good for 14 days. Have read some comments that it falls off easily. Well, understandable since cat fur grows back fairly quickly and cats will scratch at it and try to remove it.

    This article talks about other CGMs available.

    You could do a +9 once you go back to work. All data gathering is good. It could provide more information to use with your vet, to show that the duration is not there with the Vetsulin.

    Vetsulin isn't an insulin recommended for use in cats, because the duration and control just isn't there. If Ninja was a dog, it would be the appropriate insulin. AAHA Diabetes Guidelines has lots of info. Here is the section from the guidelines about insulins for cats.

    In the UK, Caninsulin (aka Vetsulin) used to be the first insulin that vets could by law prescribe, for dogs or cats. That has changed over the years and the RVC now recommends prozinc for cats as the insulin of first choice. Some vets seem to treat cats as if they are small dogs, which we know doesn't always work.

    Some cats do become regulated on Vetsulin. Too soon to say with Ninja.

    If you're interested in more reading about insulins for cats vs dogs, here is a good article. A bit dated, 2015 but still good info. Here is a second article from 2014 about how Vetsulin is not the first choice for cats.

    Best chance of remission is with one of the longer acting insulins and low carb diet. Best chance of remission occurs in the first 6 months. Managing Feline Diabetes - Current Perspectives is from 2018, published in one of the vet journals.

    To me, knowledge is power, so I like to read some of the current thinking on treating diabetic cats and letting people know about some of the resources that are out there. Up to you if you want to read any of these articles.
     
  84. Dana & Ninja

    Dana & Ninja Member

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  85. Dana & Ninja

    Dana & Ninja Member

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    Thank you for all this information. His +3 after the fat unit was 106. I gave him 1/4 can of FF. Was that ok, or should I have just let it be?
     
  86. Deb & Wink

    Deb & Wink Well-Known Member

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    More food at +3 is fine. What you don't want to do is feed much past the time of Ninja's nadir (which seems to be right around that +3 or a smidge later). The exception would be if the BG levels continue to drop and get much under 90, than a teaspoon or 2 of wet food would help. More food after that nadir will simply make the BG levels higher later in the cycle.

    Ninja would likely have been fine with that +3 of 106 without any food. But, you said he needed to gain back some weight so a bit more food early in the cycle doesn't hurt.

    Do you think he will eat the Dr. Elseys dry food during the day when you are gone? Not sure what you were going to do to keep your other 2 cats from eating all the kibble.
     
  87. Dana & Ninja

    Dana & Ninja Member

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    Dec 15, 2019
    Well shoot. He wanted food at around 1:30 so I gave him another 1/4 can. Guess we will see what the +8 number is. I’m not sure if he will eat the Dr. Elsey’s when I’m at work, actually my other 2 cats aren’t crazy about it either. I am waiting for samples of the Young Again Zero Mature. Hopefully they will like that one if not I’m not sure what I will do.
     
  88. Deb & Wink

    Deb & Wink Well-Known Member

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    The Young Again Zero Mature (YAZM) often gives cats either diarrhea or extremely stinky, I mean clear the house stinky, poops. So don't be surprised if your cats have those issues. Sometimes the stinky gaseousness and diarrhea go away after the cats digestive system gets used to that food. Just something to be aware of.

    Still worth a try. Some cats really love that YAZM.
     
  89. Dana & Ninja

    Dana & Ninja Member

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    Dec 15, 2019
    +8 he was 377, guess I shouldn’t have given him that snack at 1:30.

    Ugh stinky diarrhea poops! Good grief. What should I do if that one doesn’t work? I am going to put out the Dr . Elsey’s while I am at work, maybe if they get hungry enough they will eat it. Tried putting water with it, they still weren’t crazy about it. Any other suggestions?
     
    Last edited: Dec 29, 2019
  90. Deb & Wink

    Deb & Wink Well-Known Member

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    Jan 31, 2013
    Well, now you know what feeding Ninja later in the cycle does to his BG numbers. Maybe next time, just a small treat, like any sort of pure meat would be good. Just a few very small pieces, thumbnail size, should be plenty.

    1. Automatic Pet feeder like the Petsafe 5. Other cats may come to recognize the sound of the compartment opening.

    Another version works on the microchip your cat has and only that cat can get to the feeder. Such as Surefeed Microchip pet feeder. There are probably others out there.

    2. Hockey pucks. By that I mean freezing some canned food in an ice cube tray and leaving a couple of frozen chunks in a dish to unthaw while you are away at work. Or you can take a can of cat food, empty the can onto a flat tray like a cookie sheet and cut into chunks, either 1/4 can or 1/2 can is a good size, and freeze. Store in ziploc type bag after frozen and take out when needed.

    3. Separate quarters for Ninja while you are away at work.
     
  91. Dana & Ninja

    Dana & Ninja Member

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    Yes, I learned a lesson, his cute little meows are very persuasive tho, but I can do tough love. I love the hockey puck idea!! I think that might work great for my cats!! Thank you!
     
  92. Dana & Ninja

    Dana & Ninja Member

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    Dec 15, 2019
    Oh boy! PMPS Tonight he was 192. So I don’t give him the insulin right? His blood sugars after the AMPS have been in the 100’s all day.
     
  93. Deb & Wink

    Deb & Wink Well-Known Member

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    Jan 31, 2013
    He's been in the low/mid/high BG levels. Not too low. Nice surfing in the lagoon.

    Are you able to get a +3 this PM cycle?

    He has some nice momentum going from the Fat 1 unit dose. Up to you to give insulin or not, this PM cycle. You are there and know how well Ninja is eating, how he reacts to the insulin.

    Options:

    1. You can always stall the shot, and recheck in 20-30 minutes to see if BG level is rising. If you have already fed, then we'll see some food influence in the next reading.

    2. You can give a token dose. 0.5 U to 0.75 U shouldn't take his BG levels too low overnight. He might be high 300's in the morning, with a bit of bouncing.

    3. You can skip the shot entirely.

    You've shot a higher dose (1.5) when Ninja was at 219 preshot test, on 12/24. I think that was before you were waiting 30 minutes between feeding and shot. At least that is what I see in the notes on your SS
     
  94. Dana & Ninja

    Dana & Ninja Member

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    Yes I can do a +3. He did eat, as I have been letting him do that then waiting 30 minutes to give him his insulin. Perhaps I should give him 1/2 a unit?
     
  95. Deb & Wink

    Deb & Wink Well-Known Member

    Joined:
    Jan 31, 2013
    So with your being able to do a +3 this PM, I think you should go ahead and give Ninja a shot of insulin this PM. You'll catch any lower number with that +3 test and know how to give food to bring that number up. 1/4 can of the FF seems to do the job nicely. Only if the BG is <90 would you want to test again at +4 and then if BG still below 90, food + a drop or 2 of honey (karo syrup, maple syrup, pancake syrup).

    You are comfortable with 1/2 unit, so why don't you go ahead and give that amount.
     
  96. Dana & Ninja

    Dana & Ninja Member

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    Ok, I did give him 1/2 a unit, I’ll check him at +3 and cross my fingers. Lol. Thank you so much!!!
     
  97. Deb & Wink

    Deb & Wink Well-Known Member

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    It was the 1.5 Unit on 12/24 where he dropped into the 50's and needed a bit of food support to bring the BG number back up.

    So both the 1 Unit and Fat 1 Unit doses (12/25 am through 12/30 am cycles), in combination with feed, wait 30 minutes, then shoot insulin has been working well. Ninja hasn't dropped too low on the insulin since 12/24.

    I think you would even be safe to give the Fat 1 Unit dose with the BG reading in the 190's range. - Next time.

    Probably not up for a pajama party.
     
  98. Dana & Ninja

    Dana & Ninja Member

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    Ok thank you. I truly appreciate all your help. I would be so lost without it!
     
  99. Deb & Wink

    Deb & Wink Well-Known Member

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    Jan 31, 2013
    Wow! Ninja did the bounce, bounce, bounce with that lower dose last PM. Saw you did a Fat 1 this AM. Good choice. Meant to check Ninja's SS earlier, but we got some sleet, rain, slush here that I had to clear this morning first. At least the power has stayed on so far.

    Have you thought about setting up your 2020 spreadsheet tab yet? Here on the instructions on how to do that new tab, written by Marje and Gracie.

    SS's can get very long and take a lot more time to load if you don't keep a tab (think Excel workbook) for each year. I did it for my Wink years ago.
     
  100. Dana & Ninja

    Dana & Ninja Member

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    Dec 15, 2019

    Yeah, guess I should have done the whole dose. Was so worried he would drop!! Ugh! I’ll have to check him at the +4 today as I’m at the airport currently waiting to pick up my son.

    Thank you for the 2020 information. I was thinking I should start a new one.

    Hope the weather improves for you. It’s cold and windy here.
     

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