? Preparing to dose but need some help! (Vetsulin)

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MClarke087

MClarke087

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So I promised Den's vet that I would stop testing so frequently- she thinks that by altering his dose (even slightly) I am the reason he is staying UNregulated. She asked me to stop testing him even before shooting but I refuse to do that.
He's due in 1 hour for his PM dose but his BG is only 189.
Usually his BG is in the 300-600+ range so I'm never nervous of giving him the full 5.5 units.

Obviously he's too low to get 5.5 units. I'm not sure what to do since he seems to rebound after I decrease his dose....I'm afraid of messing him up all over again. Any suggestions as to what I should do??
 
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Are you dosing him with Vetsulin? If so, I'd modify the title to mention Vetsulin. Neko was on Caninsulin almost 5 years ago, but I wasn't testing then (good for you by the way!), so can't help.
 
Wendy&Neko said:
Are you dosing him with Vetsulin? If so, I'd modify the title to mention Vetsulin. Neko was on Caninsulin almost 5 years ago, but I wasn't testing then (good for you by the way!), so can't help.
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Whoops, you're right, I should've said Vetsulin. Thank you!!
 
Whoa! That's one very low preshot value for Dennis!!

I don't comment much about dosing but if it were my cat I would not give 5.5 IU Vetsulin with that low a preshot test. (I note he had a lower mid-cycle last night, too.)

Can you contact your vet on the phone to get help there?

At minimum I suggest you don't feed, stall and test at +13 (+1 after normal dose time) to see if BG is rising or falling and then post here again to see whether other members may be able to suggest something.

If you do decide to give some sort of token dose (if the +13 test shows BG numbers rising) I'd plan to monitor closely overnight to keep your kitty safe.

Sorry I can't be of more help.


Mogs
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Critter Mom said:
Whoa! That's one very low preshot value for Dennis!!

I don't comment much about dosing but if it were my cat I would not give 5.5 IU Vetsulin with that low a preshot test. (I note he had a lower mid-cycle last night, too.)

Can you contact your vet on the phone to get help there?

At minimum I suggest you don't feed, stall and test at +13 (+1 after normal dose time) to see if BG is rising or falling and then post here again to see whether other members may be able to suggest something.

If you do decide to give some sort of token dose (if the +13 test shows BG numbers rising) I'd plan to monitor closely overnight to keep your kitty safe.

Sorry I can't be of more help.


Mogs
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Thanks for the input! I had already fed him by the time I posted this and I assume that testing the BG right after eating would skew the results anyways.....

Before I saw your post I gave him 2 units because he was a half hour past due for insulin. Looking back at when he was first diagnosed, he getting anywhere from 1-2units when his BG was in this range...that was when he was on Novolin though.

I guess it's going to be another long night of frequent testing. :(
 
Carter was on Vetsulin briefly and had to adjust his dose with a sliding scale depending on his PS number although it was almost always back in the 400s/500s by PS time - my vet advised a starting dose of 3/4 units twice daily. You testing him, especially before his shots, is definitely not the reason he can't achieve regulation - that was a very ignorant statement for your vet to say, in my opinion. You said you used Novalin previously - both Novalin and Vetsulin are harsher, in/out insulin with shorter duration periods which could be why Dennis can't get regulated. Have you thought about switching to a longer-acting insulin? (Sorry if this convo has already been had I've been a bit MIA. :P)
 
Have you considered switching to a longer-lasting insulin for Dennis? I used Vetsulin for almost 10 months, and actually had fairly good luck with it, but it doesn't seem to be doing a terrific job for Dennis. One of the longer-acting insulins might work a little better for him, and would definitely be gentler on his system.
 
Erica & Carter said:
Carter was on Vetsulin briefly and had to adjust his dose with a sliding scale depending on his PS number although it was almost always back in the 400s/500s by PS time - my vet advised a starting dose of 3/4 units twice daily. You testing him, especially before his shots, is definitely not the reason he can't achieve regulation - that was a very ignorant statement for your vet to say, in my opinion. You said you used Novalin previously - both Novalin and Vetsulin are harsher, in/out insulin with shorter duration periods which could be why Dennis can't get regulated. Have you thought about switching to a longer-acting insulin? (Sorry if this convo has already been had I've been a bit MIA. :p)
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So you changed your dose depending on the reading? If so, I'd love to hear how that worked for you. That's what the vet said is leading to Dennis being unregulated but I refuse to shoot the full dose if his BG is lower than usual....although some folks on this site have suggested that by reducing his dose too much, he actually "rebounds" by the next time he's due for insulin. Looking back at his SS I can say that this may be true.

I understand where the vet is coming from- they just want him one one dose for 2 weeks straight so they can do a curve. However, I will not give him 5.5 if his BG is below 200 because that's just asking for trouble. Ugh, this is exhausting!! lol

I have thought about switching to a longer lasting insulin but the reality is that I can't afford to.
 
Squalliesmom said:
Have you considered switching to a longer-lasting insulin for Dennis? I used Vetsulin for almost 10 months, and actually had fairly good luck with it, but it doesn't seem to be doing a terrific job for Dennis. One of the longer-acting insulins might work a little better for him, and would definitely be gentler on his system.
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I agree. I wish I could switch him, but I can't afford to. Actually, a couple of weeks ago I asked the vet about switching him to a longer lasting insulin and she said that she really doesn't think he needs to be switched- she thinks the problem is that I adjust his dose when I see fit (I try to make well informed decisions!!), and she thinks his body doesn't tolerate all the adjustments well...... I hope that's the case because it would be a simple solution, however, now I'm presented with a situation like tonight and I become very conflicted.

*slams head down on table* I had no idea how difficult diabetes would be!!
 
Just to vent (out of frustration): I don't get how my parents had a diabetic cat and never had any issues. They were told their cat had diabetes, sent home with insulin and needles and they never had a single issues. No one ever talked about glucometers, curves, ketodiastix..... They even accidentally (and severely) overdosed their little guy one time but he was fine. No ER visits, no hypo/hyperglycemia.....
Yet here I am stressing about Dennis all day every day and running myself ragged (and flat broke).

I'm wondering if there is a healthy medium between the way my parents handled their diabetic cat, vs. the way I handle mine. I'm starting to wonder if I'm doing "too much"? But I feel like a bad cat mom when I think those thoughts. I'm obsessing about Dennis, his BG, and his overall health.

No need to respond. There are no questions here......I think I just needed to write those thoughts down. :) :)
 
MClarke087 said:
I agree. I wish I could switch him, but I can't afford to. Actually, a couple of weeks ago I asked the vet about switching him to a longer lasting insulin and she said that she really doesn't think he needs to be switched- she thinks the problem is that I adjust his dose when I see fit (I try to make well informed decisions!!), and she thinks his body doesn't tolerate all the adjustments well...... I hope that's the case because it would be a simple solution, however, now I'm presented with a situation like tonight and I become very conflicted.

*slams head down on table* I had no idea how difficult diabetes would be!!
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(((Hugs))) You have my sympathy! Unfortunately, your situation is fairly common in Vetsulin dosing. I agree, I would not give 5.5 units of Vetsulin with a BG of 189! Especially when Dennis seems to frequently have considerably low, comparatively, nadirs.

As far as the cost of insulin, you can get Lantus/Levemir pens pretty reasonably from a Canadian pharmacy lots of folks here use. They are also posted for sale fairly often in the Supply Closet here.

Contrary to what your vet suggested, I would be more concerned about Dennis' body not tolerating the drastic ups and downs of Vetsulin, rather than the dose adjustments you have made.
 
Has he been checked for any infections? When my Callie had a UTI, her numbers were up like Dennis's. How are his his teeth? Needing a dental can cause the high numbers also. I would be careful about giving him his regular dose with such a low PMPS. It's better to be too high then too low. Callie is on Vetsulin amd I have to test often when her numbers are low. I have learned to set my alarm, get up, test and go back to bed in 10 minutes. In situations like yours, I would give a half dose. If his numbers were lower, I would give less.
 
Squalliesmom said:
(((Hugs))) You have my sympathy! Unfortunately, your situation is fairly common in Vetsulin dosing. I agree, I would not give 5.5 units of Vetsulin with a BG of 189! Especially when Dennis seems to frequently have considerably low, comparatively, nadirs.

As far as the cost of insulin, you can get Lantus/Levemir pens pretty reasonably from a Canadian pharmacy lots of folks here use. They are also posted for sale fairly often in the Supply Closet here.

Contrary to what your vet suggested, I would be more concerned about Dennis' body not tolerating the drastic ups and downs of Vetsulin, rather than the dose adjustments you have made.
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That's a really good point- his highs and lows are so drastic and I think that's worse! I'll have to seriously consider switching him at this point.
 
donnalea said:
Has he been checked for any infections? When my Callie had a UTI, her numbers were up like Dennis's. How are his his teeth? Needing a dental can cause the high numbers also. I would be careful about giving him his regular dose with such a low PMPS. It's better to be too high then too low. Callie is on Vetsulin amd I have to test often when her numbers are low. I have learned to set my alarm, get up, test and go back to bed in 10 minutes. In situations like yours, I would give a half dose. If his numbers were lower, I would give less.
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He has been tested as recently as 2 weeks ago and nothing odd popped up on his tests, although he did not get every test under the sun because I'm so broke lol I ended up giving him 2 units and I'll be up every few hours. Like you, I've mastered the art of getting up, testing him, and getting back to bed in record timing haha
 
I have lost track of how many nights I have slept in the recliner so I wouldn't wake DH with alarms and testing. I don't think I lost this much sleep raising our non furry kids.
 
MClarke087 said:
So you changed your dose depending on the reading? If so, I'd love to hear how that worked for you. That's what the vet said is leading to Dennis being unregulated but I refuse to shoot the full dose if his BG is lower than usual....although some folks on this site have suggested that by reducing his dose too much, he actually "rebounds" by the next time he's due for insulin. Looking back at his SS I can say that this may be true.

I understand where the vet is coming from- they just want him one one dose for 2 weeks straight so they can do a curve. However, I will not give him 5.5 if his BG is below 200 because that's just asking for trouble. Ugh, this is exhausting!! lol

I have thought about switching to a longer lasting insulin but the reality is that I can't afford to.
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If you take a look at my SS, Carter was only on Vetsulin for a few weeks - no time to really achieve regulation, so I adjusted his dose on a daily basis to a comfortable number to shoot in order to get SOME insulin into him while I waited for my Lantus prescription to be shipped and arrive. I tested him at his nadir, but when I first started testing, I didn't test NEARLY as much as I did later on... kind of became a testaholic. Which, Carter is super easy-going, so he didn't care about the tests!

Keeping him on one dose to do a curve, in my opinion, would still you allow test as much as you feel the need to. You're just gathering data, even if you didn't change the dose. However, if the vet wants you to keep him on one dose for 2 weeks straight and advises you not to test at all (which is dangerous in itself) 5.5 units is very high, especially for Vetsulin. For Carter, I did notice Vetsulin usually worked the same for Carter whether I gave him 4 units, or 2 units or 1 unit. The PS numbers were always high, so the actual amount of insulin made no difference in the duration of the insulin, but depending on the dose, his nadir would sometimes be lower.

I'm not sure if you've done the math already, so again sorry for any repeat information, but how much are you spending on Vetsulin? My bottle was $50 dollars, for example. So that's $50 dollars a month for a vile that will likely lose potency before you use the last drop. If you get an RX for Lantus or Levemir, you can buy a 5-pack of pens for around $170 with shipping from Mark's Marine Pharmacy. So yes, you'd be paying more upfront - but these pens will last you upwards of a year. So $170/12 months equals about $14.00 every month as opposed to $50. Vetsulin can work for some cats, but it appears that Dennis isn't responding as well to the faster-acting insulins.

I feel you about the money. At the time, I was unemployed and I got a small loan out in order to afford to buy the Lantus upfront - but I'm really glad I did, because Carter eventually went OTJ and has been in remission for 3 months now. ECID but I ended up saving so much more in the long run. I hadn't had him on Vetsulin for very long, but in my gut I knew he wasn't going to respond very well to it based on the data I already had.

Some people sell individual Lantus/Levemir pens on the Supply Closet for around $30 dollars. I actually some extra unopened pens myself. Just my 2 cents! :)
 
Dennis's numbers have been looking better more recently (no more 600+) but I would say you have given it a good go with vetsulin and a gentler insulin should help to even out those swings he does and help you get his numbers down. It is worth working out the costs per month for insulin as you are having to use comparatively big doses and in the long run a switch may end up costing you less, and may help soothe those shredded nerves as well!
 
looking at your chart.... i'm glad i got that mailed off to you....
just on oct 2... pm cycle..... look at how fast Dennis went down four floors.... red to blue in 4 hours....
post a new thread for a starting dose....
hopefully in the L and L forum.....
 
rhiannon and shadow (GA) said:
I mailed lantus to you on monday and the tracking number says it was delivered today.
I hope you picked it up.... it can only get warm.....
hopefully it's still nice and cool.....
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Thank you so much, my fiance picked it up yesterday. I came home from work and found it in my fridge. I haven't been on here in a few days becuase of work and school. Thank you again. I still want to send you the shipping cost, I just don't have the extra cash at the moment. I'm so sorry.
 
oh. good....
being a p.o. box worried me that it could sit there a day or two....

glad he got it on the right day....

this should really make a difference for Dennis.
 
Erica & Carter said:
If you take a look at my SS, Carter was only on Vetsulin for a few weeks - no time to really achieve regulation, so I adjusted his dose on a daily basis to a comfortable number to shoot in order to get SOME insulin into him while I waited for my Lantus prescription to be shipped and arrive. I tested him at his nadir, but when I first started testing, I didn't test NEARLY as much as I did later on... kind of became a testaholic. Which, Carter is super easy-going, so he didn't care about the tests!

Keeping him on one dose to do a curve, in my opinion, would still you allow test as much as you feel the need to. You're just gathering data, even if you didn't change the dose. However, if the vet wants you to keep him on one dose for 2 weeks straight and advises you not to test at all (which is dangerous in itself) 5.5 units is very high, especially for Vetsulin. For Carter, I did notice Vetsulin usually worked the same for Carter whether I gave him 4 units, or 2 units or 1 unit. The PS numbers were always high, so the actual amount of insulin made no difference in the duration of the insulin, but depending on the dose, his nadir would sometimes be lower.

I'm not sure if you've done the math already, so again sorry for any repeat information, but how much are you spending on Vetsulin? My bottle was $50 dollars, for example. So that's $50 dollars a month for a vile that will likely lose potency before you use the last drop. If you get an RX for Lantus or Levemir, you can buy a 5-pack of pens for around $170 with shipping from Mark's Marine Pharmacy. So yes, you'd be paying more upfront - but these pens will last you upwards of a year. So $170/12 months equals about $14.00 every month as opposed to $50. Vetsulin can work for some cats, but it appears that Dennis isn't responding as well to the faster-acting insulins.

I feel you about the money. At the time, I was unemployed and I got a small loan out in order to afford to buy the Lantus upfront - but I'm really glad I did, because Carter eventually went OTJ and has been in remission for 3 months now. ECID but I ended up saving so much more in the long run. I hadn't had him on Vetsulin for very long, but in my gut I knew he wasn't going to respond very well to it based on the data I already had.

Some people sell individual Lantus/Levemir pens on the Supply Closet for around $30 dollars. I actually some extra unopened pens myself. Just my 2 cents! :)
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You make so many good points. It's interesting to see how similar our thoughts are in this situation. I don't see how he could be on this insulin for so long and not improve...although he is improving a bit since last week.....
I pay $40 a bottle for Vetsulin and it lasts about a month. I didn't know that it expired so quickly! I wonder if that's part of the problem....

Like you said, the upfront cost of Lantus is scary, but I'd like to make the switch. I asked my vet about it 2 weeks ago and she is strongly against it..... she kept saying that I was changing the dose too much and causing the problem....but like you, it doesn't seem to matter what DOSE he gets of the Vetsulin.

If I switch insulin without the vet's approval I think she will stop seeing Dennis, and I could understand her frustration; I wouldn't normally suggest a cat mom play "Dr" and make insulin switches on their own. I'd get a new vet but mine often allows me to pay when I can and no other vet in my state does that.

Thanks for all your thoughts/ideas- it really helps to hear what others think and how others have dealt with this before. I hope to make the switch to Lantus ASAP
 
You have lots of advisors here.....

and I would say to run the experiment....
see how it goes with the lantus....
stay away from the vet for weeks, if not months....

keep a written record ( or print your ss ) to share with your vet AFTER you 've run the experiment.

She/He can't argue with progress....
let the results speak for themselves....
 
A lot of vets are not familiar with Lantus because it is a human insulin. Once I switched Carter (my vet gave me script after "researching" as she wasn't familiar with it either) said to give "x" amount of units twice daily and I nodded my head. However, from then on out, I adjusted his doses on Lantus by following the Tight Regulation Protocol and through the advice of everyone on here. He never went in for a curve, he had them done at home. He hasn't been seen for anything diabetes related since diagnosis. I adjusted the doses myself with the aid of FDMB and I think that is a big factor in him going into remission. Ultimately it is your decision but if your vet is willing to drop you as a client for wanting to explore other options, they aren't a vet that is willing to learn or gain more knowledge and that can merge into various other aspects of care as well.

I know circumstances can be tricky especially when your veterinary options are limited, but remember, they work for you, not the other way around. :P This coming from someone who worked at a vet hospital for 5 years. ;)
 
I'm lucky to have a vet that is open minded and let's me do just about anything I ask about. She was so happy will the spred sheet that she is having all her other FD patients use it. Her techs say I know more about FD then the vet does. I copy articles from the internet to educate her. The truth is that vets don't get much training in pet diabetes. We have this wonderful forum to help us.
 
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