Starting insulin questions

After a long battle with both the vet in NY, our vet and Chewy, I finally Will have the insulin and the .5 marked syringes to start insulin tonight.

Couple of questions:
My vet wrote the script for 2units, 12h after meal.
Do I jump to the 2units or start with 1unit as his numbers have been high 200s, low 300s.

Also would my steps be test, shoot, feed or feed, test, shoot? Im reading conflicting information online.

Also should I be rotating his food flavors? I was previously told fish only was bad for mercury, etc. But that seems to be what he is happy with.

Also doing the first day of insulin tomorrow should I try to do a curve for a number of hours to see what the starting point is ? Or is that unnecessary?

 

What insulin are you using?

The sequence is test, feed, then shoot. You want to test before you feed him so that the number you get is not food influenced (it’s also recommended when you’re first starting to make sure he doesn’t have any food 2 hours before shot time for this reason as well). The timing can depend on the insulin you’re using though.

I’m not sure doing a curve on the first day of insulin would be particularly necessary but it wouldn’t hurt if you wanted to. A few tests would definitely be a good idea though, especially around the typical nadir time for the insulin you’re using

 

Like Sarah said, sequence depends mainly on the insulin. For NPH/Caninsulin it's test, feed, wait 30 min, then shoot. For ProZinc, Lantus, and Levemir it's test, feed, shoot all within 10 minutes or so.
Always test first to determine how high blood sugar is. Your conflicting information may be due to some people "stalling" before feeding/shooting. This is for if your cat is under the introductory 200 mg/dL amount. Sometimes stalling (holding back food) will allow the blood sugar to rise on its own and let you test again, then make a dosing decision.

Get him to eat food other than fish if you can, you can rotate if you like or just stick to the variety pack flavors.

You can do a curve if you like but many people agree a full curve isn't necessary. You can test every 2 to 3 hours if you like.

EDIT: Are you planning on starting insulin tonight or tomorrow morning? I wouldn't start at night as you need to be awake and alert to what he's doing, kitties tend to drop lower at night.

I would not start at 2 units if he hasn't been on insulin before. 0.5 or 1 unit is more appropriate.

 

It's always best to start low and then gradually increase as needed. Which insulin did you end up with?

Maybe try using the fish flavor as a "topper" for the other flavors? Or you can get FortiFlora (a powder that contains the same stuff they spray on kibble to make it taste good) on Amazon, Chewy, Ebay, etc. I swear China would eat sawdust if I sprinkled a little FortiFlora on it...LOL

It can't hurt, but we can give you better advice after you let us know which insulin you're using. I know you had talked about Vetsulin but you were also going to discuss it with your vet.

 

I Will be using Prozinc. I just got home. I Will be starting insulin tomorrow am as I have the whole day off to be with him

From reading the comments above, I'm going to be testing, feeding and shooting with in 10mins for prozinc it seems.
The script is written as 2units but im going to start him at 1u as I feel less is better from how everyone here seems to feel

 

I should also note his backstory
he was surrendered tothe shelter 11/12 he was diagnosed diabetic after testing. Started on 1unit insulin, then the notes vary between 1 and 2 units of,prozinc, his sugars varying, see spreadsheet tab "in shelter" for reference. Then he was placed on the euthanasia list, I ended up pulling him thru a local rescue where he was and they helped with transporting him to me. Due to an error in scripts his last dose was 11/21. (Note he was only on insulin that week or so) then he hasnt been on insulin since then but I have been home testing ( (human meter / reli on blu)
After more vet issues I finally tonight have syringes and insulin, prozinc, in,hand. I Will be starting insulin tomorrow,AM

 

Started insulin this morning, 9am. Checked him 906am at 257. I have him 1 unit prozinc. Then tested him at 1009am and he wad 286. Just checked him for tonight, at 608pm he is 66. ..... He is due for a dose at 9pm in 3 hrs. ...

 

I’ll tag some Prozinc users for dosing advice

@MrWorfMen's Mom
@FurBabiesMama

 

Any time you get a test result that doesn't make any sense, it's best to re-test immediately to make sure it wasn't just a bad strip or bad test.

It's possible that was a good test....it's just pretty unusual for the first shot at a reasonable dose like 1U.

 

I did try tp retest but got two e4 not enough blood errors so i didnt get another result. Now at 723pm he is at 132

 

728pm - 135

 

805pm - 176

 

I'd reduce the dose to 0.75u tonight provided BG is over 200 at pre-shot test. With ProZinc, anytime kitty's BG falls below 90 when you first start out, they earn a dose reduction of 0.25u. You really don't want Sir Dracula Dupree dropping much lower than 90 at this point till you get a little more data.

 

805pm - 176

 

Okay makes sense. So if he is over 200 I give him 0.75u . will that dosage stay the same from now on only giving him 0.75 each shot or is the reduction only this one time?


Does that mean I skip the shot completely if he is under 200?

 

He is at 224 906pm

 

Hold the dose at 0.75u for the next 3 days unless you get another low number or a pre-shot too low to shoot. With that pre-shot you are fine to give the 0.75u tonight.

 

He didn't eat much, he was 224 pre shot, gave him 0.75u at 925pm

 

Leave some food out so he can eat when he wants to. I take it his appetite hasn't been an issue of late?

 

No not recently, he has been having an increase in how much his appetite has been.

 

271 at 1034pm, didnt eat much, though he usually does eat and is more vocal about it

 

Unregulated diabetics can't efficiently process the food they eat so they usually need more food to keep them satisfied. Maybe he just wasn't as hungry to night because his BG has been down lower today.

 

That makes sense, he has just been very consistent since I received him 11/21. But today is first day on insulin so I am taking that into account

 

You may see higher numbers for up to 6 cycles after that lovely 66 today but that is normal. It's called a bounce and happens when BG drops quickly or to levels kitty is no longer accustomed to and Sir Dracula Dupree has had elevated BG that has become "normal" to him. Stay with the lower dose despite any higher BGs. The bounce will clear.

 

Okay I will stick with that. The vet wrote out 2units as the script but I started with the 1 unit today after advice here. Ill stick with the 0.75 for now. Thank you so much! My fiance was excited to help me tonight, I'm super happy he was glad to help even if I didnt need it this time it was nice to know he can do it!

 

He's a keeper. So many folks have "partners" who don't want to get involved. My DH loved our cats to death when it came to cuddling, playing but when I went on an out of town trip overnight, I had to write out feeding/litter cleaning instructions because he never provided "care" for the poor critters.

 

Until you get some more data and know more about how he responds to insulin and food, if you get a Pre-shot that's under 200, the best thing to do is stall, don't feed, and retest in 20-30 minutes. Use that time to post with a subject line like "HELP, STALLING!" so you get some eyes ASAP.

If the number goes up, that tells us a lot about if the last shot is starting to wear off and whether it'll be OK to go ahead and shoot. You don't want to feed when you're stalling because the food will cause the BG to go up and you won't know if it went up because of the food or because the last shot was truly wearing off.

As you gather more data, that "no shot" number can be reduced