Discussion in 'Feline Health - (The Main Forum)' started by smidge&smudge, Jan 27, 2017.
Doing the 1 unit, do I still test at 20 min and 1 1/2 hours?
In going to be frank here. Your vet is ignorant in dosing and putting your cat at great risk. If you blindly follow his advice your cat will be facing a life and death situation. I'm sure of it. You don't raise insulin like that. 4.5 dose is ridiculous after 2.5 weeks. I suggest finding a new vet. Seriously.
Please take a test before you give the shot so you know what the starting point is. Then you could test at +1 hour after shot and post the readings you get. Good luck with the testing!!
ETA You may or may not see much movement at +1 hour after shot. Each kitty is different in how long it takes for the Vetsulin to start working (onset) If you don't see much movement at +1 then you could do another test at +2 hours after shot.
I suggest you test again in 2 hours. Have you been waiting 20 - 30 minutes after feeding to give Vetsulin?
I have so much to figure out, just came back from store to get more lancets, I have been giving her the shot after eating, I hadn't waited long before, should I wait a bit after? Will start the one unit this evening, will test pre shot.
The routine should be take pre-shot test, feed, wait 20-30 minutes, inject insulin. You should also make sure Smudge has not eaten for 2 hours or more before taking the pre-shot test. Then test 2 hours post shot and depending on how much and how fast Smudge's BG is dropping, you decide if another test at 4 hours post shot is ok or if you need to test sooner if the BG has dropped substantially at the 2 hour test.
The reason for the wait is that Vetsulin is fast acting insulin and you want food on board before shooting. So your sequence tonight will be test/feed/wait 20-30 min/inject insulin/ test again at +2 (2 hours after injection).
I think I may have gotten the spreadsheet worked out, will need to retest about 830
Yes, I can see it.
Great job getting the spreadsheet up. You can add the numbers and dose from earlier today to give a good comparison on how the lower dose is working.
I see you have done a +2 test and Smudge is showing a decent drop already. Vetsulin "usually" will have an onset between +1 and +2 after shot so this is looking good so far. If possible a +4 test will give a good idea how this dose is working. The nadir (lowest number) "usually" runs between +4 - +6 so she should still be dropping more
Well done Petrina, you're all set up now so if you can just get a few more readings throughout the cycle we will be able to see at a glance how the insulin is working. Starting on a low dose means you can increase in small increments as necessary - working down from the high dose the vet prescribed would have been much more difficult. The more data you can add to your spreadsheet the easier this will become. It's all falling into place so keep going!
Were you able to get a test at +4 last night? That test should have shown how the 1 unit dose was working.
If you are able home this weekend it would be useful to do some extra testing to see what sort of pattern Smudge is getting from this dose. A prehot test and then more tests at +2 and +4 hours after the shot will fill in some of the pieces of the puzzle.
Please do post after you have tested today.
Great to see you got the spreadsheet working! That +2 reading last night was a good drop in BG despite the lower dose. It's really important to get those early cycle tests at +2 and +4 to see how low the 1u is taking Smudge. Looking forward to seeing how Smudge does this weekend.
I don't have much to chime in as I'm new here but hoping for the best. And I'm learning so much from all of you!
I see you got a +2 reading today, well done. That's not such a steep drop as on the 4 units so Smudge will be feeling better for that. Can you do a +4 test as well? That will be interesting, to see if he drops further on the 1u you gave him.
These are still high readings and we want to get them down, but if the 1u proves not quite enough we can slowly work upwards until we find a dose that's right.
I hope you're beginning to see how this all works? Treating feline diabetes is an ongoing commitment, but once you've got your head round the theory and get into a routine, you will find it manageable - and Smudge will thank you for it!
Is there a 2 week correspondence course for vets that I didn't know about?
Thank you once again, since my cat is so challenging to regulate I so appreciate the support, I got the 4hr reading, seems like I should bump up the insulin just a bit?
I wish there was a diabetic cat course! ☺
Oh on my sheet, I don't know the exact morning numbers since they read as hi, on my meter that would be 600 or above.
I can't see the +4 reading, what was it? Would be good if you could update your soreadsheet as you go along, and mention the latest numbers here for easy reference.
Ooops, I put it in the wrong box, I changed it, her 4hr was 338
OK this is fine, she is still dropping slowly. This data is very important! Can you manage a +6?
I will try, she is starting to get irrated so I was going to wait for the evening preshot. But will see what her mood is like!
Good job on getting the readings. It is possible that Smudge may need to get a slightly increased dose but I would prefer to have some experienced vetsulin users weigh in on the dosing.
To get more attention on your post could you change the title to "Need dosing advice for Vetsulin" If you go up to the top right corner of this page just under the title there is a box "thread tools" if you hold your mouse over it it will give you the option of "edit title" Then you can change the title to the new one and chose the "?" icon from the left side of the title box where you are editing
@Kris & Teasel @JanetNJ
Also if you can manage to get a test at +6 that will help to show whether Smudge goes lower in the middle of the cycle or if she is just "surfing" or starting to go up. This helps to determine the duration of the insulin as far as how Smudge is reacting to it.
Exactly! And well done for changing the heading of the thread, Petrina. These little things do help us and other people reading the forum to see exactly what help is needed.
a 300 point drop is good... lets see what happens tonight. can you add info to your signature? Put date diagnosed, type of insulin and the food you are feeding.
Smudge had a good drop so far today. A +6 reading will provide some clue as to when her lowest point was today. Obviously she is getting a decent and a more controlled drop from 1u. If she really needed the 4u you were giving her, chances are you would have seen much less drop in her numbers today.
I am sure she is still in a bounce and would not advice changing the dose yet. You need to find out what her numbers look like without any influence from that huge drop yesterday and that can take up to 6 cycles to totally clear so changing the dose now would just make things worse.
I know you want to see the numbers come down but you cannot force them down because that will just make Smudge bounce more. You need to find the right dose using a controlled process not a knee jerk reaction. Slow and steady wins the race.
Agreed. We don't know how Smudge would respond to 1u if she wasn't bouncing so we need to determine that before we think about a dose change.
Petrina, are you with us so far?
I think you've been given good advice about waiting to see what BGs look like without a bounce complicating things. I'm so relieved you're doing this slowly and methodically.
@smidge&smudge well done for trusting people on here and having the bravery to go against what your vet says. I've been there and I know it is so difficult to do - we are supposed to be able to trust our vets but the way I see it is that they have a lot of knowledge about lots of conditions without necessarily being experts in all of them. The people on here have a wealth of experience geared towards diabetic cats and that can't be reproduced in books or courses.
My girl was started on a 5 unit dose of the same insulin - it was way too much for her to cope with and she had a hypo within the first week. The emergency vet was horrifed that she was on such a high dose and said she should have been started on a 1 unit and increased if needed. Even so my vet still wanted her on a 3 unit dose which I refused. Since then I've taken control of her dosing and tell them what I'm doing - at first they were shocked that I would change her dose but when I explained that I was hometesting (which again they don't recommend) they were happier for me to adjust. Now they leave me to it She is anywhere from a 0.75 to a 1.25 which is a world away from her starting dose!
My personal view is it is better to start low and build up as/when needed. I've seen hypo and I've seen how being on so much insulin changed Sky. Fortunately she got through it but she shouldn't have been put in that position.
Hopefully Smudge will start feeling better on a lower dose - and I'm sure a more gradual drop and curve will be better for him than such a massive drop.
Don't worry about the black number. Looks like bouncing still.
Should I stick with same dose this evening, last test was 501?
One thing too, she is still drinking a lot of water, but I noticed her pee is more yellow and smells more like urine than before, sorry tmi, maybe this means her body is working better? I am very familiar with her pee since she doesn't go in the box since she got sick. Hopefully this will get better too.
It has been suggested by some experienced vetsulin users that you continue with the 1 unit tonight. Since Smudge dropped a lot yesterday that would have caused a "bounce" where stored glucose is released by the body because of the big drop in glucose numbers. This can cause higher readings for a day or a few days. As the bounce clears then the numbers will start to come down. This morning there was a decent drop in numbers but not so much as to cause bouncing. It can take a few days to see the full extent of a dose. Please do test before the shot, then again at +2 and +4 hours after the shot to see how the insulin and the dose are working.
I would stick with the 1u just for now... it is quite possible that a higher dose may be needed but we have to see first what the 1u is doing. It is no surprise to see the higher number later in the cycle because the insulin had been pretty much used up...if you has got a +6 it would probably have been a better number as the insulin was still working. After +6 it's no real surprise that she was rising again.
Take heart, Petrina - the good news is that Smudge does respond to insulin so it's a matter of you doing the work now to dose appropriately.... I know you said she was getting irritated with the ear prick but this is for her own good so persevere and do more mid-cycle tests today if you can so we can see a bigger picture. Have we told you about giving her little treats at test time - freeze-dried chicken or small pieces of fresh chicken or ham? - she will come to associate test time with these and be much more amenable!
The early stages of FD treatment aren't always straightforward but you're not alone. Hang in there. Read up some more - maybe look at some other members' threads on this forum - it all starts to come together quite soon but there is no "quick fix" - you have to go through the process to work out what works for YOUR cat.
Personally I think one unit at a starting number over 450 may not cut it. 4 however was insane. I would go with 2 for a while until we see those numbers come down.
It does look as if 1u isn't doing enough... it's a difficult one, stick with 1u for another day and get more data to make sure any bounce is cleared, or up the dose a little - 1.5 or 2u - and see if that makes a difference to drop AND duration... either way it's all about more testing!
A bit of a dose increase may be a good idea, but it would be very useful to get some tests around +4 or +5 hours after the shot. That is the "usual" time when the insulin has the largest effect and gives the nadir (lowest reading). Part of adjusting the dose with Vetsulin is to know just how low a dose takes your kitty.
I agree Smudge may need a bit more insulin but she has a UTI and I believe is still on antibiotic so if she is still in a bounce, which I think is very likely, upping the dose right now is only going to muddy the waters more. If the 1u dose was that much too low, I don't think we would have seen a drop of almost 300 points yesterday. The drop we know about on Feb.3 was over 300 points only 2 hours after insulin so it's quite possible/likely Smudge dropped lower that day but we have no idea by how much. We have no idea how many times prior to Feb 3rd Smudge dropped by huge amounts so I think bouncing right now is a logical assumption. The drop on the 3rd alone might have made her temporarily more sensitive to insulin so her defences may be clicking in sooner than they normally would and upping the dose right now is just going to set off more bouncing which won't help find the right dose.
The caveat to this situation is that Smudge has high BG plus an infection which hopefully is clearing up now. I would strongly recommend checking her urine for ketones which can be done using ketone test sticks available at the pharmacy and shouldn't be too hard to do if Smudge is still peeing on the floor outside the litter box.
Petrina, how is Smudge acting? Is she lethargic or sleeping a lot? Is she eating well? Is she still having diarrhea or are her stools back to normal? Are you feeding her meals only at shot time or are you feeding her some snacks in between? Are you keeping her on wet food only or still offering some of the dry food?
You mentioned Smudge's pee is more yellow and smells like pee now. That's not TMI around here......it's good info! Diabetic pee can smell sweet. Was that the odor you noticed before?
If she was my cat, provided there are no other signs of her condition worsening, I'd hold the 1u dose at least for both shots today and get pre-shot tests as well as tests at +2, +4 , +6 and +8 today to see what her entire day cycle looks like.
The key here is testing and without more data it's impossible to be sure what the best course of action is. I would keep any insulin increases to 0.5u because we don't know if the 2u initially prescribed didn't work because of the diabetes or if the lack of improvement was also influenced by the UTI.
Great answer, Linda - Petrina, please read this carefully and digest!
I will agree with the other members here.
Scooter was diagnosed in late August 2016 and had a wild ride on Vetsulin. His dose was to high and the vet kept increasing rather than decreasing. He kept bouncing because of somogyi effect. This is when either your furbaby drops too fast or goes hypo. A failsafe in the cats body will realize its bs is too low or dropping too fast and release glucagon and hormones which will spike the next am or pm shot to be HI or 600+.
This forum helped Scooter cause when I reduced his insulin he became better regulated.
Thanks, can't wait to get her to normal. She read as high for preshot. Last night was last dose of antibiotic. Her poop is good now and she poops in litter box but still will not pee in it. She is down now to only two spots she pees in and those two are right next to the boxes, I put puppy pads down, I changed litter to dr. Elsy cat attract on friday but that hasn't made a difference. Before her pee was more diluted and didn't have much of a smell. She is still drinking lots of water, she is acting okay, still not back to normal, she is usually a very vocal, assertive kitty, she is still too laid back for her normal personality. Loves the wet food and is eating well. No ketones which os a relief I get nervous with these hi readings since I don't know how high she is. Going to test at the 2hr mark in just a little bit. Ugh, I have to drive my kiddos around today so may not get to test again until later afternoon. ☺☺☺☺
With Scooter it took a good 3 days or 6 12 hour cycles for numbers to start to stabilize. This was on a fancy feast classic only diet. The md kibble the vet recommended kept his numbers high also.
Scooter only peed outside his box when his ketones were high. When his bs is somewhat regulated the ketones will lower. This had to be his way of telling me something was wrong cause he never goes in the house ever.
It's critical to check nadir as stated in the above posts. With Scooter this was +4 or 5 hours after shot. Every kitty is different.
Reading through the posts, got a bit confused and panicked when I got the hi reading and increased to 1.5 this morning and brought her down to 234 at 2hrs. Hope this is good news, maybe if all is okay this may be a good dose? This is amazing how this low dose is working! I mean per vet I would have had her up to 4.5!!!! And this is working!
That is a big drop in only 2 hours. Since it is still early in the cycle, I would suggest testing again in about 30 minutes. "Usually" the biggest drops will occur from +1-+5 hours after shot depending on the kitty.
ETA The people on this forum live and breathe feline diabetes 24/7. There is a big difference between a vet giving advice according to what he has read and a person who deals with this every day. That is why so many people made the suggestion to drop the dose...from their own experiences.
Keep the same dose for at least 3 days to stabilize and administrator at the same time every day +-15 min.
1 unit would bring Scooter down from HI. 600+
Kept him on that for 3-5 days and when his nadir (lowest reading) was 250 after 5 days increased to 1.5 which is perfect for him bringing him to 90-100. His pancreas is kicking back in so I hope remission is in our future.
I know it's amazing how much this lower dose has an effect on her, 1.5 may have made too big of a drop, god only knows what 4.5 would have done to her!
Obviously the lower dose was the best way to go. However as I said in my other comment that is a big drop in only 2 hours so another test at +2.5 hours would be prudent. There is still 2 or more hours that the glucose levels can fall and we don;t know when the nadir (lowest number) is with Smudge yet
Also you can change your title to add "AMPS 600 +2 234" in order to get more eye on this
Petrina, I hope you will see now that the vet's dosing suggestion was far too high - so well done for trusting a bunch of strangers on a message board! The thing is, we do know what we're talking about because we have lived with diabetic cats on a daily basis, and vets too often have not.
OK so you decided on a 1.5u dose this morning which has dropped Smudge A LOT after two hours... the 234 in itself is better of course than the much higher readings you've been getting but do heed what Linda and others have said about not muddying the water with a higher dose all the while we're not sure if Smudge is bouncing and/or recovering from an infection. Please try to get a +4 and +6 today so we can be sure that the 1.5 is ok... I would urge caution at continuing until you have more readings taken DURING THE CYCLE - we really do need to see just how low Smudge is dropping on any dose before making tweaks to dosage. The other thing to remember is that Smudge will be feeling a little odd with these fluctuations in her BGs so the more you can avoid too high or too low readings, the better... eventually you will get there but for now you are still working on this...
I agree with Diana about getting more tests. However with that big a drop at +2 which is "normally" when the onset of Vetsulin is happening, I would suggest another test shortly
Also - half a unit may not seem or look a lot TO US but remember than insulin is a very potent substance so that half-unit can make a lot of difference... just saying so you are aware and can be cautious about giving an extra half-unit if pre-shot numbers are not as high in the future...
Thanks, not sure why I panicked this morning, but will not budge again! ☺ I have to run my kids around today so I won't be able to get a reading until a bit later. I'm going to get her some lunch meat chicken while I'm out too!
Could you do a reading before you leave? BTW lunch meats tend to be too high in sodium for kitties. Some boiled chicken or roast without added spices...especially onion and garlic is a better choice
Will test when I get back, again appreciate all the help! I don't know what I would do without you all!
PLEASE test before you go...Vetsulin can make the numbers drop very fast in the early part of the cycle
ETA If the numbers have dropped too much more you may need to intervene with some HC food before you leave, especially if you are not going to be around for awhile
Petrina, I don't think you are fully understanding the situation. Smudge has dropped 360+ points in just 2 hours. The insulin may continue to push her numbers down for another 3 to 4 hours. If she continues to drop at that rate, her defenses will be pushed very hard to keep up and keep her safe. Your cat could be in serious danger. PLEASE test again before you leave the house. Smudge only has so much of a reserve of glucagon to use and once it's used up, she will have a hypo episode which if not caught and dealt with immediately could be fatal.
I was giving Scooter a lunch meat treat 2 days ago and he spiked 600+. Couldn't figure it out so I narrowed it down to the lunch meat. Sure enough it was high in sugar. Uggh
DAMN!! I don't see Petrina on line any more.
I don't think she understands just how serious the situation could get. I hope Smudge will be okay
Please take note of this, Petrina... I know you're busy but can you get someone else to run the kids around so you can do what Smudge needs you to do for her today? We really don't want her continuing to drop this fast... she may not but we have to keep her safe. This is really why we suggested you stick to the 1u, which may not have had a good duration but nevertheless kept Smudge safe.
This is a marathon, not a sprint - sadly you won't find an "ideal" dose in a day or two, it's a matter of testing at least before each shot and ideally a couple of times in between, to be quite sure that Smudge doesn't veer towards hypo numbers. You wonder what would have happened if you'd given the dose suggested by the vet - well, either Smudge could have had a hypo, or she would carry on bouncing and giving you high numbers. I know you're busy but you will have to keep a close eye on things at this early stage especially.
Thank you for reminding me of that fact. Processed meats are high in both sodium AND sugar...neither of which we want out kitties to eat.
To put it in perspective, that half unit is a 50% increase from 1 u. That's huge.
I felt so bad for leaving her but I didn't know what else to do, has to run kids to some places, my mom is older and doesn't drive so had to shop to get her food and stuff for the week, Im always running crazy it seems.
retested at 9hrs and she was at 488. I am not going to give any lunch meat. I worried because tomorrow is back to work, she's all I think about when I'm gone. Will test again at 630.
We have a vet appt tomorrow and I was planning to reschedule until I got this under control, god forbid they would probably tell me to go up to 5. I'm assuming her numbers will be higher than 488, in case there is noone on the board at that time I will plan to keep at 1.5?
Just curious since she drops so much in a short amount of time even on the low dose, should I inquire about an alternate insulin? Or too soon?
With the big drop Smudge had this morning at only 2 hours after the shot there is a good chance that she may have dropped lower, maybe much lower during the early part of the cycle. A big drop or low numbers will cause a "bounce" into higher numbers later in the cycle. so you may see even higher numbers at shot time. HOWEVER you should NOT increase the dose because of higher preshot numbers. Without knowing how low Smudge got today the safest dose would be to stay with the 1 unit for a few days and try to get some extra early tests in besides the preshot test if possible. At this point it is too soon to say whether Vetsulin is the right choice in insulin. Right now it is a matter of finding a good dose and slowly working up as needed.
Using 1 unit will be a safer dose when you are not home to test more during the day. As far as the vet appointment, I would hold off for now and do more home testing with the smaller dose. You vet seems to think the answer to high numbers is always to increase, while that may be contributing to the higher numbers by causing bounces and could put Smudge at risk of a hypo. You already saw how a much smaller dose dropped the glucose numbers quite a lot. I shudder to think what the dose the vet suggested could have done. It does take some time for the body to become adjusted to having external insulin given and doing it in a safe manner is the best approach.
I vote for 1 u. You have to do what's safest I think. I agree about holding off on the vet appointment.
Totally agree, I was going to reschedule unless you thought it was worth changing insulin. They wanted me to do a curve today on the 4.5 but I told them on Friday that each time we increase she gets worse which is the truth.
It's too soon to know if you need a different insulin. Right now your goal is to find out a good dose of Vetsulin.
Petrina, how are things going with Smudge?
Doing okay, getting used to the routine ☺I was so mad at myself yesterday because I ran out of test strips but got some more, she is starting to hate the testing! I ordered some freeze dried treats from chewy.com that are supposed to be okay for dm. I have been nosing around other spreadsheets to see how other cats do. Still testing high on preshots, so just hanging in there! Thank you for asking. I feel like I'm part of a club!
You are part of a club, Petrina! Can you try to keep your ss up to date so we can see what's happening... and don't get too involved with other cats' ss for now... every cat is different and how one cat responds to one dose may be totally different to how another cat responds. Keep testing at pre-shot times and at whatever intervals in between you can, and log the numbers so we can see. Smudge will learn to associate test time with treats so carry on with those!
I couldn't agree with Diana more. Other spreadsheets can be helpful once you get a handle on how your cat reacts to insulin and you have a reasonably good understanding of all the nuances of insulin and how it works but in the early days, checking other spreadsheets is only going to add to any confusion and possibly create more anxiety for you. Different insulins behave differently and are dosed differently so checking a spreadsheet for a cat on another type of insulin is not going to be helpful at all.
While tests between 2 and 6 hours post shot are going to give you the best information for moving forward, any tests you can get are valuable so please try to test at least once during each cycle as well as pre-shot and keep the spreadsheet up to date as you go. We really want to help you get Smudge sorted out but without some testing it's very difficult to know what to suggest. I see he hasn't moved much today and that is concerning.
Have you been giving Smudge 1u or 1.5u of insulin the last couple of days? Have you checked ketones again recently? If not I would strongly recommend you do so given the high BG.
I'm close to the two of you as well! I'm in Jerseyville, IL, about an hour north of downtown. I switched from the vets office here in Jerseyville to Horseshoe Lake Animal Hospital and LOVE them there! The reason for the switch was originally because of Frannie having hacking issues and getting no answers to my questions and concerns of it and him saying it wasn't asthma or something else when it was occurring at least ever 4 weeks. After the switch to HLAH, she does indeed have asthma. Then when took her in earlier this month for her always trying to pee, she did have a urinary infection and that's when had found out she was diabetic and starting on 2U Vetslulin once a day in the AM. Yes, only once a day and she seems to be doing well that way. She has one more day of dry food and will strictly be given moist food twice daily. I had asked about if it should be just pate b/c of the high carb count, but was given a list of foods from them to check for low carbs 10% and under and there were some on it that weren't all pate and he said that it would be ok. I had emailed the vet and was given positive thoughts that it would be ok.
How is it going today?
If anyone is still follwing this thread I just wanted to shout out a big thank-you!!!! Had a really good conversation with my vet today, and I am not sure where I would be if I didn't have all the information that I had learned from here in the very short time since diagnosis.
So, have not been very good about recording on my spreadsheet (half the time my kids have my phone so I've been recording in a notebook so I wouldn't forget. Even on the lower doses she has had some drastic highs and lows that don't quite make sense.
Updated vet today on what I was doing and she actually was encouraging home testing, and said that most people don't do it, and I'm sure because I was such a hot mess she probably wasn't going to get me started on that at first. So basically after providing the info apparently I have a difficult to regulate cat, and requested that I do a curve this weekend. And I'm thinking I've read all about that ☺. Until then since she knows I can test she is on a sliding scale and I am going to do the curve on Saturday and see where to go from there.
So feeling a bit hopeful, my vet was really cool and encouraging home testing. And seriously, if it wasn't for the board I would not be doing this, and who knows where I would be. On the way home from work I stopped at one of the best places in St. Louis and got her some brisket for a special treat (no sauce of course)
And I apologize I didn't respond yesterday was feeling kinda down about the whole situation, yesterday.
Thank you so much for the update. We all know how difficult this sugar dance can be with our beloved furry kids. Don't apologize for not responding immediately. We all have lives, other responsibilities and down days. Just remember we offer emotional as well as "technical" support.
I am so glad to hear the vet is being supportive and on board with testing and letting you do the curve at home which will give you the best info. This journey is a marathon not a sprint so we all have learned to be patient and understand how difficult that can be. Ultimately, the journey does get easier and you and Smudge will both be feeling better very soon.
We'll be here for any questions, opinions or suggestions if and when you need/want them. You are part of the FDMB family now!
I was kinda depressed yesterday with her numbers, but have a bit of hope today, when vet requested the curve without me asking I felt hopeful. I am going to definitely keep her spreadsheet updated too.
We will get her better regulated. Listen two months in to her diagnosis my cat was still in the 300's and 400's. Two months later she was off the juice. So things change.
Petrina it is GREAT news that your vet is supportive about home testing... quite a few aren't so that's a huge advantage for you. You can really move forward now knowing that you have the vet backing you up and us cheering you on from the sidelines!
We'll keep an eye on your ss so we know what's going on ;-)
So good your vet is more supportive and is listening to you.
You'll get there - you'll find a dose that keeps the numbers low but it may take time. Nothing has to happen overnight - it took a while for diabetes to develop so will take a while to regulate.
Separate names with a comma.