? Staring out with 8 Units In The First Week?!

Hi, my 1.5 year old cat was diagnosed as a diabetic on Friday 3/22. When he went to the vet after becoming lathergic they did a full blood panel and came back with high glucose (about 400). They said it could be stress related and wanted to keep him, we agreed but in the morning it was still about 400 and they said he was diabetic. So we get a dreaded phone call Saturday that our cat is 100% diabetic and needs insulin. They start him on Vetsulin and we don't hear back until Monday (they were closed on Sunday). They said his BG was barely falling and they were quick to keep giving him more and more units (twice a day). Monday it was up to 7 units and then they get a killer reading of 600ish Monday night. Tuesday (yesterday) I finally told them I would monitor him at home as I couldn't afford the vet bill while they kept giving him more and more insulin and I could just do that at home. I found this forum over the weekend and have been reading post after post getting ready for him to come home. It has really helped and I even bought a Relion prime monitor that many of you all have. Last night I took his BS for the first time at home and it was 446 on the Relion so I give him his now 8 units of insulin. This morning I woke up and the monitor just said HI (which I found out means 600+) So I once again give him 8 units of insulin which was now 3 hours ago. I have not taken his sugar again but my biggest question would be it seems the higher insulin we go the higher his numbers are going and I see many of you do not recommend going up in more insulin for days following the initial dose. Could my vet be wrong in giving him 8 units already? This just seems like a lot for a cat who has not been diagnosed for even a week yet.

 

You are right to be concerned. The starting dose and subsequent increases are FAR too high and have been made FAR too quickly. I would look for another vet immediately, and meanwhile drop the dose right down - see what the Vetsulin experts here say - and get some bg tests done during the cycle to see what numbers look like on a lower dose.

I'm glad you found this board and have posted. Keep us informed. We can talk you through each stage from now on.

 

Hi - can you please test your cat's blood glucose as soon as possible and check that your cat is OK and not hypoglycemic?

As Diana says above, you are right to be concerned. 8 units is a phenomenally high dose of Vetsulin!
The recommended starting dose of Vetsulin (according to the manufacturer) is 1 - 2 units. Then that would be held for at least a few days (but usually longer) and then the dose would be re-evaluated.
It is quite common for vets to increase the dose far too quickly, and this can be extremely dangerous for the cat. Cats do die from hypoglycemia...

If the numbers go up as the dose goes up then this is often an indication that the dose is TOO HIGH....

For your cat's safety I strongly suggest that you reduce the dose considerably and start off from a low dose, testing blood glucose at home, and raising (or lowering) the dose as appropriate.

Eliz

 

If you can possibly then test now. 8 units is a huge dose. The numbers before shots tell you little per se, mostly if it's safe to inject or not. You want the numbers from when the insulin is acting and bringing the blood glucose level down to see what the insulin is doing. Check as soon as you see this. You need to know how for your furbaby is dropping.


So your using caninsulin, did you check what the syringes say, if they say U40 then you are in fact giving 8 units, however if they say U100 on the syringe then you are giving a much smaller dose or 3.2.

I'd second considering a new vet.

I would recommend setting up a spreadsheet to chart your BG readings and you can also input what readings you have from the vet when you've had some time to breath.
Info here. http://www.felinediabetes.com/FDMB/threads/fdmb-spreadsheet-instructions.130337/

 

Hi and welcome Gage's Mommy. I just read this message and and agree with Diana&Tom's advice.
First, let's get some ducks in a row and provide the information you have so far, so that the advising Vetsulin users can review before making recommendations.

Create your signature so that Gage's information is available with each of your posts, and set up the spreadsheet with the insulin injection and testing data that you have so far. Here's how:

Signature (light grey text under a post).
click on your name in the upper right corner of this page
click on "signature" in the menu that drops down
type the following in the box that opens: kitty's name/age/date of diabetes diagnosis/insulin you're using and dosage amount /glucose meter you're using/what (s)he eats/any other meds or health issues (s)he has. You can add your name, and a geographic location (sometimes the time zone matters) Be sure to SAVE when you are finished.

Spreadsheet:
http://www.felinediabetes.com/FDMB/threads/fdmb-spreadsheet-instructions.130337/
http://www.felinediabetes.com/FDMB/threads/understanding-the-spreadsheet-grid.156606/
If you have any problems with the spreadsheet, let us know as there are members who can help or set it up for you.

Post in the Vetsulin forum HERE to get the experienced users eyes on your concerns. If you like, you can copy and paste your message here into a new thread there.

You did very well deciding to test at home, and being proactive in Gage's care. If you can, test Gage's BG during the day, so you can document how low the insulin is taking the blood sugar. Every bit of data you have is going to help.

 

Very good point, Kitty.

 

In case you are having a hard time going against the orders of your Vet please consider the following information from the Vetsulin website (p.4, column 2, paragraph \ titled "Cats")

This document from the Vetsulin website supports @Elizabeth and Bertie's information. As a caregiver to a newly diagnosed diabetic kitty myself, I am constantly having a battle with myself on how to reconcile the difference in my vets advice compared to the advice provided on this forum. So far, it has been the case that when I do my own research it backs up the recommendations that I receive here at felinediabetes.com.

Vetsulin is also sold as "Caninsulin" which is what my Mowgli was initially prescribed at 5U 2x/day, after receiving multiple recommendations here that I lower the dosage since 5U was an alarming start dosage, I did a little research... I found that Caninsulin also recommends that dosage doesn't exceed 2IU/injection in the first 2-3 weeks of diagnosis as described on their website HERE

Hope your kitty-baby is doing ok and gets well soon

 

I'm on my way home right now to test his BG I really thought this was to high of a dose and happy to see Iam right. I've studied this website up and down for days trying to understand what I was getting prepared for and I'm so happy I found it and you all are so awesome to respond so quickly.

 

It is definitely U40 syringes with 8 units. I asked about the regular U100 syringes and was told they were different and precisely remember the U40. I'm heading home to check his BS now. Thank you so much for your quick reply, I just knew I felt 8 units was high.

 

Will get this done today Heading home now to check his numbers.

 

It is overwhelming to get told your baby is a diabetic. I'm glad to see I'm not the only one that has to second guess their vet. This webpage seems amazing and I'm so happy I stumbled up on it. Heading home now for new numbers.

 

All home, his numbers are running 302 right now. I was so worried after hearing I was correct about them 8 units. So glad to see he is acting like himself. Anyone have a possible advisement on what I should do for tonight since he had so much this morning? Should I skip it, give him 1-2 units? I feel like my vet just knows nothing

 

If I were you, I'd start over at 1U and start getting more tests in when you can.

Also, what are you feeding Gage?

 

I was thinking the same thing, we are just going to have to start from scratch. I feel like I failed him by injecting him twice with 8 units. I'm just glad I caught it. The vet gave me a bag of prescription m/d food for glucose and weight control but I bought him fancy feast classic pate. I don't trust that vet or anything they say now.

 

I too would start at 1u. Get a bg reading before you shoot, and also at any intervals you can during the cycle to see how he is responding to the dose. Post your results here so we can see and talk you through what's happening. So basically, until you have a spreadsheet up and running, give us a pre-shot (PS) number and then a +2 (2 hours after shot) or whatever hourly intervals you can.

Prescription food is a waste of money. Any decent quality wet food in jelly is better.

Sorry but I would look for another vet as a matter of priority. Hopefully you are on the right road now but if there was an emergency I don't know if your current vet could handle it. Ring round a few others in your area and ask what experience they have in treating FD... you should br able to tell which ones sound ok and which ones don't!

Good luck!

 

Perfect Iam going to get some numbers going and lower his insulin tonight and go vet shopping. I just felt like she was kind of experimenting with him and now I know and we are staying as far away from her as possible.

 

I'm so sorry you had this experience; how disheartening that must be! I'm glad you found this website and are able to get on the right track.

 

You can take the MD back and get a refund....it's got a 100% guarantee. You can just tell them your cat refuses to eat it

 

If Gage runs in high numbers for a few days after you have swapped to 1 unit (thank goodness you found Fdmb!) do not be alarmed. It is possible Gage will bounce from having such a high dose of insulin and dropping low. Bounces happen when kitty drops too low, too fast or lower than his body is used to and his body panics and released glucose and regulatory hormones which send the BSL skyrocketing. This can last from 1 to 6 cycles typically. Keep posting with your numbers and questions and the great people here will get Gage onto a suitable dose.
I think I would look for another vet too.

 

I had a similar experience with my Blue kitty when his dose was increased far too quickly.

Someone with more clinical experience can correct me, but I believe that very quickly increasing doses of insulin can cause the body to react as though that insulin is a virus. Viruses can put out insulin-like proteins. With my cat, his body was attacking the insulin before it could even make it to the receptors. I had to switch to an entirely different kind of insulin before his body would respond to anything again. He was miserable.

Best of luck, friend! Take courage, you've found a good group of people.

 

This is a great idea I felt price gouged when they was like he NEEDS it

 

I just took Gage's numbers and it is reading Hi again thank goodness you posted this because I feel like such a failure, I just want him better and hope in just a few more days this huge unit change will have a great turnover

 

I'm super worried that I too will need to change to different insulin after he has had such big doses at the beginning, but hoping we can pull out of it. He is such a trooper getting his insulin shots, still not the happiest with the blood testing but we are getting there.

 

I was thrilled today to wake up and see his levels were 387... but they are now back up to Hi on the machine. I hope it is just a fluke where he was on 8 units. Thank you all for all of your support as we work through this, I started building my spreadsheet and hoping after a few days numbers start looking better.

 

This is a marathon, not a sprint. I've learned a lot about how impatient I am in the last couple of months. As I travel a lot for work DH is caregiver when I'm away.. . I once spent 20 minutes refreshing the Google sheet to see the levels..

Its going to take your baby some time to stabilise. But I would reccomend patience and reading up on here and asking questions here.

If you look at my spreadsheets (both new and old) you can see the difference a more moderate insulin dose can have. Going from red and black every Am and PMPS.. To primarily yellows and pinks. (I'm not counting the furshot and the blacks and reds surrounding.)
That's soley the difference between basing dose decisions on the lowest BG point (Nadir) and information I got on this forum. And completely ignoring my vet...

I owe my Princess Krakens life to this forum

Marathon, not a sprint! And hey! Pink AMPS! Yay!
Considering that your cat was on 8 units and didn't hypo to our knowledge its quite likely that the final dose will be higher than today's dose, but with rigorous testing (my testing is a bit overboard but I was trying to get as much info as possible before a 3 week trip when Noone is home to check the morning Nadir.) you will know what that dose does to your cat. Every cat is different!

 

Your message is truly aspiring I read it and thought we got this Gage it will just take time but we will slowly get there and then today I tested him this morning and he was out of the Hi zone and actually showed a number, then just now (6 hours post shot) he read a 260.. to many these numbers are still high. But to me I'm thrilled and call it progress and you all are the only ones that can get the feeling of accomplishment with these numbers

 

You should be thrilled!! Yellows are a lot prettier than blacks!!

Please do start getting at least a "before bed" test on the PM cycle though. If you think of your spreadsheet like it's a puzzle and you only fill out some of the pieces on the left side, there's no way to know what's on the right side of the puzzle! Is it another kitty? Or is it a flower?

 

I don't know why I never thought about running night time tests. But I will start tonight If you don't mind me asking how many cans of fancy feast do you feed your kitty? The vet was totally against can food and talked* me into buying their special m/d but i haven't even touched that as everything she said I'm going against after her 8 unit party. I have been feeding him a regular sized Friskies pate food in the morning and then the smaller sized fancy feast in the evening. I really don't know if that is enough food it worries me because he will eat EVERYTHING he has no idea when to stop.

 

Hello and welcome from me too. My kitty was also started on Caninsulin, but it took two months to get up to five units in dose. Sounds like you current vet may be more used to diabetic dogs.

For feeding, try feeding the same amount of food in the AM and PM. You want to make sure he has enough carbs on board when the insulin starts working, if you haven’t already, you should check out Dr. Lisa Pierson’s website on Feline nutrition. She has pages on diabetes and how much to feed, https://catinfo.org/

 

The rule is thumb is to calculate 20 calories (kcal) for each 1 lb of cat (indoor cat at ideal weight, outdoor is 35), so a 10 lb cat should have around 200 kcal per day.

My Blue weighs 15 lbs (at ideal weight), so I end up buying those larger cans with higher caloric value and do one in the morning and one in the evening. Each can will have a kcal number on it. The small ones are usually around 80-120 kcal and the larger one age closer to double that.