? vetsulin advice?

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Renee1960

Renee1960

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my boy rollie was diagnosed about 2 months ago. we started vetsulin. at first it seemed to work. then we kept upping his dose until we hit 9u twice a day! then something happened and he did not need as much. backed him down to six. his preshot numbers were 400's but on the six he got down to 31 which scared me but the vet seemed to think it was alright since he was acting ok. since then i backed it down to 4.5 u but preshot remained in 400's. It did get him down to 142 at +5 but was told that was too big of a drop. I have been trying the 3 doses a day for about a week now. started at 2u tid. preshot came down to 300's and mid numbers were 200's. have upped it to 3 tid and today is 3d day. did a curve this morning. preshot was 437 (!), +2 416, +309, +4 268, +5 326, +6 267. missed +7. His preshot number this afternoon was 362 which is better than this morning. I don't seem to be making much progress at all. I am thinking about going back to the 12 hour schedule? Any suggestions? I also posted this on the vetsulin forum and it was suggested to also post here. Also update on his sheet...tonight i am seeing the best numbers in awhile.
 
now after seeing some good numbers tonight he was way high this morning. i don't have a clue what to do? any advice would be appreciated?
 
Sorry there are not always a lot of people on earlier in the morning. With having dropped into the blues numbers last night the higher numbers could very well be from the insulin wearing off AND/OR from hitting lower numbers than Rollie's body is "used" to. When a kitty drops too fast, too low OR into lower numbers than they usually do it can cause the body to do a counter-regulatory process (bouncing) which release stored glucose since the body sees this as am "emergency" situation (even without dropping into hypo numbers) and tries to raise the glucose levels. Bounces can cause higher glucose levels for a few cycles (time between shots) and as much as three days. If you can try to get readings at +2 and +3 or +4 to see how this cycle is going.
 
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i did get one at +2 and is went from 488 to 418. i have to leave here for work so i won't be able to get anymore but i will try tonight. thanks for the response!!
 
There is a chance that the numbers may stay higher this morning. You can leave a bit of your regular food out while you are at work. :bighug:
 
Tuxie is my little (haha) baby boy 16 1/2 years old and the tortie is his litter mate sister Maxie. They are my two babies :)
 
they are beautiful! i've had a couple tuxedo's and just one tortie in my life. your picture makes me smile!
 
I have never dosed three times a day with Vetsulin. My former vet suggested it, but she already had him on way too high a dose so I opted out - shortly thereafter I found a new vet.

What was Rollie's initial dose at diagnosis, and how much does he weigh? What does he eat? It's difficult to tell, at this point, if he's just bouncing madly from too much insulin, or if he actually needs more. I tend to lean toward the idea that he may be getting too much and bouncing because there are not a whole lot of high-dose kitties - although there definitely are some, and he could be one of them, I just can't tell.
 
We went for two months of high 275/600 bs with our cat He started on Vetsulin 6u/day quickly going to 8u. What helped us initially was to measure all of his food. He is 12 pounds and eats about 80 grams/ per day. We were content as long has his urine was clear. We went from Science diet M/D for several months He went into remission for a week after using 12u TID a day for a month. After a few days he pushed back up to 8/8 u a day. For the past week he has been taking Young Again Zero Mature. We don't have great stablity as I think the new food has created a lot longer curve.
 
Thank you all for responding! His initial dose at dx was 2u twice daily. vet wanted it lower so we went to 3. Then he didn't seem to respond and vet kept upping it. We got up to 9u twice a day. Then something clicked and it was too much. we lowered and lowered until we got to 6u twice a day. vet was happy with that but he was 600 preshot and would drop to 31. She said as long as he acted ok at 31 it was alright. I didn't agree with that so i went lower. I went back to 2 then got back to 4.5u twice a day. It was then suggested to me to try the tid dosing. i did 3u tid. his numbers were smoother but not getting down where they needed to be. I did this for a week and yesterday I went back to the bid dosing at 3u. I don't know if the changes have him all over the place or what. I did see some blue numbers but then it went red. I did ask the vet about a different insulin and she told me that this was the insulin of choice. I feel like i am failing him.
 
forgot to mention the food. vet recommended purina dm. he likes it but i think it may be too high in carbs so i have been feeding him weruva paw lickin chicken which he loves.
 
Renee1960 said:
Thank you all for responding! His initial dose at dx was 2u twice daily. vet wanted it lower so we went to 3. Then he didn't seem to respond and vet kept upping it. We got up to 9u twice a day. Then something clicked and it was too much. we lowered and lowered until we got to 6u twice a day. vet was happy with that but he was 600 preshot and would drop to 31. She said as long as he acted ok at 31 it was alright. I didn't agree with that so i went lower. I went back to 2 then got back to 4.5u twice a day. It was then suggested to me to try the tid dosing. i did 3u tid. his numbers were smoother but not getting down where they needed to be. I did this for a week and yesterday I went back to the bid dosing at 3u. I don't know if the changes have him all over the place or what. I did see some blue numbers but then it went red. I did ask the vet about a different insulin and she told me that this was the insulin of choice. I feel like i am failing him.
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You are not failing Rollie, please don't think that you are! However, I'm not convinced that your vet isn't failing both Rollie and you! A blood glucose number of 31 is NOT okay for a diabetic cat on insulin. Ever. On the contrary, it can be extremely dangerous. Your vet should know this! Additionally, dropping so far, from 600 to 31, is incredibly hard on a cat's system, and can make them feel quite ill. Vetsulin is not what I would necessarily call the insulin of choice; it is one of the insulins used. Some cats do very well on Vetsulin, others don't; this is true with any insulin. Vetsulin can be harsh with the steep, quick drops, and some people (and it sounds like you may be one of them) find that it doesn't have a full 12-hour duration. There are several other insulins available for cats with FD; ProZinc, Lantus, Levemir are probably the most widely-used. I can't speak for ProZinc or Levemir from personal experience, but I switched from Vetsulin to Lantus and it has worked much better for my cat. If the Vetsulin is not working for Rollie I would definitely ask the vet for a Rx for a different one. If she won't give you one, you might want to consider finding a new vet!

The canned Purina DM is around 6% carbs. We recommend feeding a diet of canned or wet food under 10% carbs. The Weruva you are using is somewhere around 3%, I think. HERE is a link to a newly updated food chart that will tell you the amounts of protein, fat and carbs in many different cat foods.

I generally don't like to give dosing advice but, if Rollie was my kitty, I would probably hold him at his current bid dose for several days and see where his numbers go.
 
thank you so much! i will go on with what we are doing then. should i see some improvement or will it take awhile?
 
Kris & Teasel said:
That's certainly a possibility. I was going by how low the 3 u got him when those blues showed up at night, not by the bounce numbers.
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I just figured holding him at 3U for a few days would help clear the bounce, and I don't want her to miss finding the right dose for Rollie. He may well need more insulin, but I thought it would be good to get a sort of base-line, if you know what I mean.
 
Squalliesmom said:
I just figured holding him at 3U for a few days would help clear the bounce, and I don't want her to miss finding the right dose for Rollie. He may well need more insulin, but I thought it would be good to get a sort of base-line, if you know what I mean.
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I agree.
 
ok. i work during the day so it is difficult to get a lot of readings during the day. saturday will be the first chance i have to get quite a few. i am going to try to sneak home today to try to get a reading around nadir. thank you!
 
Those two readings this AM are within the 20% variance allowed for meters so don't worry about them. It's hard to get lots of data when you work all day but some evening tests, or at least one before bed test, would give good information on how this dose is working. The pre shot numbers don't tell the whole story. If you can do a curve on Saturday that would give the full picture. I suspect the dose might have to go up but do a curve first.
 
I agree with Kris; if you can do a curve on Saturday that should give us the best idea of how Rollie is handling the 3U bid dosing. If he's still in higher numbers you can increase his dose by 0.25 and see how he does with that. :):)
 
ok thanks ladies! i am worried with the high reading this morning. another question - should i be worried about ketones? i've been told with that high number he may have them? how do they treat that? can that cause the high numbers?
 
his pmps tonight is 467 :( some things have come up and now it appears it will be sunday for the curve. do you think delaying it a day is horrid?
 
Renee1960 said:
ok thanks ladies! i am worried with the high reading this morning. another question - should i be worried about ketones? i've been told with that high number he may have them? how do they treat that? can that cause the high numbers?
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It's wise to add urine ketone testing to your routine. You can buy the test strips (not expensive) at a human pharmacy. The brand I use is Bayer Keto-Diastix. There are some different ways to get a urine sample:
  1. Put the strip into the urine stream.
  2. Catch a little urine in a shallow, long handled spoon that you hold under kitty's backside.
  3. Put a couple of layers of plastic food wrap over the favourite part of the litter box and poke a few depressions in it.
 
Tomorrow will be three days since Rollie saw yellow, four since he saw blue. I think you can safely raise his dose by 0.25U if he still doesn't see either yellow or blue tomorrow. :)
 
Renee1960 said:
his amps was better this morning 329. we will see what happens. last night i got a +4 and +5 reading. 246 and 245.
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Hold this 3.25 u dose tonight and tomorrow to see where it takes him. You might need to increase if you don't see any blues. You might well get back near 4 u but it'll be systematically and there's less chance of missing a good dose along the way. I'm sure you're finding the BID dosing easier to fit into your schedule. :)
 
Glad he's starting to see better numbers! Unfortunately that fairly big drop is not uncommon with Vetsulin, and one more reason why you want to increase doses slowly, in small increments. We'll see in another couple of days if Rollie needs another increase. Are you still planning on doing a curve on Sunday?
 
When you get a chance can you add some info to your signature with insulin, date diagnosed, health concerns, and food being fed?
 
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