Discussion in 'Feline Health - (The Main Forum)' started by Waheeda, Apr 11, 2017.
You can get them at any pharmacy.
ALWAYS get a preshot test. You have to know what you're starting with to know what to shoot. I see you wrote 2.4 units for some shots. Does that mean you are using u100 syringes and a conversion chart? I recommend you increase the dose a bit when the numbers are over 300. And even a little when under. Let's try.
200-250 shoot 2.4u
Get as many mid cycle numbers when you can, and get a curve in when you can.
We wanna start seeing more blues.
The more tests you can get, the better. Vetsulin tends to peak 4-6 hours after preshot.
Yes we only have u100 syringes here.
My vet is so worried when I wanted to increase to 2.4 units. But I'm getting better readings with it compared to 2. She said d cat's system needs time to adjust to new dose so can only chge after a week. And she said 2.4 units is already considered high. But u are even suggesting going to 3. But then ur cat is in remission so u definitely are doing it right.
I'm just worried if I increase too much he'll go into hypo state n no one is at home.
Until you have more data I understand being cautious. Times when you are home and can test I do recommend you dose a little higher on those higher starting numbers.
We wanna get him out of those pinks mid cycle. We saw one high blue but you didn't test before shooting so we don't know where he started from that day.
Keep in mind on human meter "Normal" is 50-120. We wanna start aiming to get the nadir (lowest point) at around 100-120. It may take a little time to get there.
Dosage needs change over time.
Yes I understand. I'm going for 2.4 for both day n nite jabs. N will take readings b4 shots for both. N some mid cycle if he's not too grouchy. I will try to increase on weekends when I can monitor him.
Thanks for ur advice.
So glad to meet everyone here as we "struggle" to help our babies.
2.4U isn't a really high dose, especially compared to some of the high dose kitty's here . Janet has helped many of our Vetsulin user's (and others of course) here, Waheeda . Jebat might benefit from the sliding scale dose that Janet has left you with above. Keep getting those AMPS and PMPS tests at minimum and grab extra tests when you can, including before you go to bed tests. You should still make a note for yourself about that 114 reading, so you can remind yourself to retest if that variance happens again
You can buy them at any human pharmacy.
Ya I'm grateful for Janet's help. I'm also frustrated that the current dosage does not seem to work. I will definitely try her scale next weekend as I'm not working for 3 days.
What are the chances that the cat's pancreas start to produce insulin again and we end up with too much insulin?
Hi Waheeda, I was always told when kitty's BG is under 250, their pancreas is getting some healing time. There isn't a real statistic to answer the question any better. This is what extra tests can help us identify, when the pancreas is helping .
It's actually under 150 pet meter the pancreas heals. I think 250 was in your head because that's around where the glucose spills into the urine.
It is possible and maybe it was 200 for human meter? I have not had any
Nope, defnitely lower than that. 68-150. that's when the pancreas can rest. 200 is still hyperglycemic. that's why we always aim for around 85-100 nadir.
and I'm ready for cup #2! lolol
Wow dats very low. Why are the vets always scaring me that increasing the insulin too fast will make my cat hypoglycaemic cos d pancreas will produce insulin too. My cat BG is hovering at 300+ which is so far from 100. I should ask them to learn from you.
I don't know how much extra tests I can do. He's growling at me. He only lets my sis poke him. And his legs are getting weaker. We Hv put him on vit b12 since yesterday.
He'll get used to the tests. Just make sure he gets a treat, or some extra love and attention, or whatever motivates him, every time you poke him. It helps to give a positive association. The tests are too important to skip them. Getting his BG into healthier ranges will help with the weakening of his legs. Hypoglycemia is a very real concern though, particularly on an insulin like Vetsulin, so you need the tests in order to be able to safely raise the dose to get him to those healthier numbers.
A cat is considered regulated when a typical cycle preshot is 300 and under and nadir is about 100.
As the numbers start coming down and the b12 is given it will reverse. There's another reason for trying to get your numbers down... To help with the neuropathy.
Thanks Djamila. He will get extra rubs after the tests.
I will celebrate wen dat day comes.
Hi hi, check with everyone here. I'm using freestyle freedom lite meter meant for human. Does it matter? The sales person told me many ppl bought this for their pets.
That will be fine. Most people on here use a human meter. They read lower than pet meters but as long as you know what too high, OK and too low is you'll be fine.
Ok thank you. Would u know why the AMPS n PMPS readings can be so different when the cat is eating the same food at the same interval ? The AMPS was yellow and gave me so much hope only to see a fuchsia for PMPs and not much drop +5 later.
The only way to know is to test to see what's going on in between. On your next day off you should plan on doing a full curve - test BG every 2 hours between AM and PM shots.
Ya I'm planning to this Sat.
That should give good information.
Another question. Do we need to test against any control solution? Cos d set doesn't come with any so I assumed everythg has been preset properly.
It's so strange that now at 2.4 units d readings is still so high. Last wk, it was high at 2u but much better in 2.4u but I don't see improvements wen I chge to 2.4u. I know I Hv to do d curve but I can only do that on sat n these 2 days readings r so depressing.
Without mid cycle numbers you really can't tell how effective this new dose is. You have to see how low it's going. The preshot numbers aren't going to come down much until the mid cycle numbers come down into the healing range (under 120).
I only used a control solution a grand total of two times. Once the first time I used the meter, and one other time that I got an unusual reading.
You had a nice yellow preshot on the 24th!
I Hv never used it cos it din come in d box n d sales person didnt mention about it. Is my reading still accurate? Do I need to buy d control solution ?
I did +5 last nite n it was 362! I was expecting a lower number. Will do +4 later.
I'm going to go with present dosage till fri n then increase to 2.8u on sat n do d curve. Can I just do every 3 hrs between amps n pmps?
I offered you a sliding scale recommendation a few days ago. You should try it.
You wanna get those mid day numbers down to around 80-110.
Janet I am thinking that a sliding scale may not be the best approach yet until she is able to get more mid cycle tests. Without knowing just how low a dose is taking Jebat it is hard to say whether a dose needs to be increased or decreased. Just my thoughts.
Yes will definitely do this weekend.
So far I don't even see any low number! I did +5 yesterday n it was high. I'm sure +4 tonite will b high too. Mayb this vetsulin works at +2-+3?
Ok smart to wait until the weekend. If the high units make you nervous we can go more conservative.
Ok more conservative approach...
Doing a curve will be useful, as long as Jebat is not bouncing. Some kitties can drop a lot in the first 2-3 hours with Vetsulin. others don't drop until 4 or 5 hours after, so it would be good to get a better idea how Jebat is reacting to the insulin. If Jebat does drop a lot in the early hours then it is possible that he could bounce up into higher numbers later in the cycle. Or is may be that he needs a higher dose. A curve will give better information on what is happening,
Oh 2.6 a bit tough to get accurately cos it's between 2 lines. I Hv to estimate. Ya I'm a bit nervous to go too aggressively. At the same time, I'm also getting impatient.
I Hv a feeling he drops a lot in d first few hours. Cos last sun he dropped abt 100 points in first hour. D tests I've done at +4, +5 or +6 r always high. If it drops only in first few hours then it means he's beyond d gd range most of the times.
Doing a curve will help to show if this is what is happening. If he drops too low then you may need to lower the dose, but that will need to be seen. Since each kitty reacts differently to insulin getting to know how YOUR kitty is responding is a good step to figuring out a good dose.
That wld b the somogyi effect rite?
Some people and vets call it the somogyi effect. Usually on this forum it is referred to as "bouncing". When a kitty drops too fast or too low the body releases stored glucose which causes the numbers to "bounce" up higher. If a dose takes a kitty down too low, then reducing the dose would be needed. But the more data you gather, the easier it will be able to see what is happening.
Definitely try to get a curve done on your next day off, Waheeda . Great job steadily getting the AMPS and PMPS .
Enjoy your evening!
Hi Yong, ya slowly building up the data. Amps, pmps n before bedtime. U Hv a good day too!
Hi all, can u combine the readings of a few days for d curve? Shld b ok rite as long d pmps is about d same? I did +1, +2 today n already Hv +4 n +5. So if tmr I do +3 n +6 I wld Hv at least touched the lowest point?
My readings for +1 n +2 r still high so I don't thk there's any somogyi effect.
Unfortunately, I do not think so because the dose on another day / another cycle could do something different. You want to do a test ever 2 hours after his shot, until PMPS. Readings at +1 and +2 may still be food influenced, which is why we say no food 2 hours prior to pre-test time
During the curve you will maintain feeding schedule.
So only the pre-shot will not be food influenced. Other than that it's ok ? Cos I feed him every 2 hrs so when I'm doing the curve every point will be food-influenced. Or I Hv to only feed him after taking the tests? Plse bear with my tons of questions ya. Cos I read from a website that said u can combine results over a few days to get the curve so as not to stress the cat. I didn't manage to get the pmps today cos he was growling and hissing. Bad mood today.
Do you usually feed him ever 2 hours? Pre-shot should not be food influenced, correct, to make sure he is safe to give insulin. You don't change anything in his feeding schedule when doing the curve. Like I said, I have not heard of using multiple days for a curve, maybe one of the veteran members has heard of this, I'll try to tag them @Kris & Teasel @Tuxedo Mom @Bobbie And Bubba @Chris & China . I know it's hard to get the pre-tests when they are not in a good mood but you can't give in to that. The pre-tests are sooo important
When I did curves, I made sure that one of the every 2 hour tests was right before his mid day meal. Then he had 2 hours with no food before the next test. I agree that this curve needs to be done on one day. Once you have a lot more data, scattering lots of tests at different times will work well. You're not there yet.
Thanks ! Appreciate the info. Ya I have only about 10 days of data. Hvnt done a full curve yet.
He'll ask for food around 2 - 21/2 hours. I just need to time it properly before I take the tests. I want him to eat too n not lose more weight.
Did d curve. Left one more, d pmps. Hmm it's all in red and fuschia except d amps which was yellow. Peak of vetsulin is at +6.
Looks like I Hv to increase d insulin? I gave him 2.6 according to Janet's sliding scale. Should be safe to go 2.8?
Are you feeding only pate foods? What Whiskas are you feeding? Could you for a week or two just do fancy feast classic and see if it effects those mid cycle numbers?
What's the preshot this morning?
Now he's only on burp and fancy feast. He will eat fancy feast for a few days and then he doesn't want it anymore so I have to give him burp. Today he was eating mostly burp.
What country are you in? And to answer your questiono I would say it's safe to raise. I might even try 3 for a while and see what happens.
It's strange that it goes up so much two hours after the shot..... That's why I was asking about the food. Hmmmmmm
I'm in Singapore. I'll try 2.8 tonite n take the +6 reading to see how low it goes. If it's still high, I'll do 3 tmr.
I'm also puzzled. Lately he has been mainly on burp. I guess he got bored of pate. He din wan wellness pate either. I posted the contents of burp in this thread and I thk Yong checked for me and she said the carb content is ok.
Can I ask u which of the young again dry food u giv ur cat? I just found a supplier here n am thinking of trying. They have a few types. Which is the one u feed?
I feed the regular young again zero, not the mature one only because I have two cats under the age of 2 here that can eat it. If it were just older cats eating it I might get the young again zero mature one.
What is the carb count on the burp?
On d can it says moisture 84%, protein 12%, ash 2%, fat 1%, crude fiber 0.5%. No mention of carbs.
If it's a food with gravy it's going to be high in carbs. I'm not familiar with that brand.
It's with jelly.
Ah ok. I see they have some canned in jelly and some tins and pouches with gravy.
You could probably email the company directly and ask.
I don't recall seeing any email address. I'll try to chge his food to friskies. As long as less than 10% carb shld b ok?
Majority of food companies are not required to list carb content . I did calculate an estimated carb content range for her food, Janet 0 - 3.1% dry matter.
Nice job getting the curve done Waheeda . Janet is our Vetuslin dosing expert , you are in good hands!
I'm so thankful I chanced upon this website n get to know u all. I really need all d encouragement, advice n help.
Jebat did put up a fight after some time but my sis helped so all went well. But it was so disappointing seeing the readings. And poor boy's legs r weaker today n he looks withdrawn.
When his BG numbers are better controlled the neuropathy can start to reverse. It still takes time . Don't be discouraged but the first noticeable sign with Maury happened around starting month 4. Was a small sign but I noticed it He continues to make slight improvements. Quite a few use Zobaline (not Xobaline) to help boost the progress, not sure if you can get it in Singapore. Can you order things on Amazon?
Hi Yong, I was given neuroforte by the vet which contains vit b12 cyanocobalamin. Similar to zobaline? I can order thgs from Amazon if d supplier ships to Singapore.
I increased dosage to 3 n it seems to b giving better result just now at +3. Hope to see a blue today.
Unfortunately, no they are not the same. Cyanocobalamin isn't as good for helping nerve damage as Methylcobalamin. Which is the type in Zobaline along with folic acid, which needed to help the Methyl B12 absorb properly. I mean the Cyanocobalamin won't hurt, so don't want you to worry about that. Yes this 3.0U is looking nice! Numbers permitting, hold the dose for a bit . *paws crossed for blue*!
The cyanocobalamin is giving him mild diarrhoea. I'll Chk with other clinics if they carry zobaline. Thks for d info. Testing him soon at +6. Hope for a gd one.
What happened if d pre shot reading is below 200?
Well, it hasn't happened yet but just getting ready when it does. Yesterday he gave me a blue!
Hooray for your first blue!
180-200 do 1.5
150-180 do 1
I'm cautious about you shooting lower than that for the time being until you get more data.
Get a few more days of data and as many mid cycle numbers as you can and then we will revisit the scale and adjust, because I do think you need to increase in those higher numbers.
That's a bit of a jump for 200-250 as compared to 180-200. 2.4 vs 1.5.
I'm giving him 2.8 for 250-300. I'm happy if he can stay within yellow whole day. Blue is a bonus.
I'm gonna stay within 2.8 - 3 during the next few days depending on pre-shot readings. I'll be working tmr so can only do amps, pmps n a midnite +6 test.
We usually don't recommend beginners shoot at all under 200, but given your cat takes a relatively large dose to come down I figured it was safe. You hold the needle, so what your comfortable with. It would probably be safe doing 2 units 175-200, I'm just hesitant to suggest it without data.
Perhaps if it happens I'll take the safer approach of 1.6 for few shots n increase if I don't see much results. I can see these 2 days the 2.8 is doing him good. His legs seem a bit less wobbly n he's more relaxed. But we bathed him today so the mid day shot went crazy.
I'm glad to hear there's improvement with his legs!
We like being cautious . Janet has helped many other Vetsulin users with sliding scale doses That's why I tagged her early on for you My Vetusulin go-to lady!
Thanks so much Yong! learning loads from Janet, urself n others. Now I can't giv him his shot without checking his BG. has become our routine.
Love to hear that!
Was looking at d can of burp that he luv. D active ingredients are: tuna whole meat, aloe, polysaccharide gum, enhancer, vitamins n minerals, sunflower seed oil, glucose, taurine, water.
It has glucose! Is this why he needs high insulin dose? Cos of this burp food?
Interesting . Only way to tell is if you can feed him another low carb food for a bit without glucose and see if it is really effecting him. Your SS will provide the evidence! Then let us know if it's confirmed!
Ya giving him fancy feast for whole day today. Will see if any improvement.
Do u know if Firstmate grain free dry food is suitable for diabetic cats? Wellness core also has grain free diet. There's a supplier here that sells young again that Janet feeds her cat but it comes in huge 3.6kg bag.
I'd have to look more about the Firstmate because I haven't heard of that brand but keep in mind grain-free does not mean carb-free. See if you can get a free sample from YoungAgain or the supplier that you found it at. I get the 3.6kg bag for my boy
Is your boy a fussy eater? Mine is. I bought one brand before which was recommended by the vet and he refused to eat. Tried Royal canin diabetic also but he din like it. I'm very tempted to try young again. No sample though. I thk I'll get it tmr and hopefully he eats or else the other 4 can help finish it.
I was looking through your SS. U had some fuschia for pre shots but u get some blues mid cycles! Wish I will get that soon. Mine seems to not drop a lot mid cycle.
After looking at your SS I suggest:
you keep up with the gradual dose increases of 0.2 u at a time
hold a dose only 3 cycles if it doesn't bring him down into yellow and, preferably, blue
get a test in the +5 to +7 range daily, either daytime or evening
give the same dose AM and PM until you get him into a better range
maybe try sliding scale dosing when you have better numbers more consistently.
I think this plan would get him out of pink and red sooner. His cycles are flat because the dose is probably too low.
Thanks! May I ask why take at +5 n +7? It looks like the lowest point is at +6.
how high a dose have u seen given ? I'm so worried if 3 is already high.
The nadir can move around usually from +5 to +7. By scattering mid cycle tests in that range you'll get an idea of how low he's going over many days.
There are cats here with medical conditions that cause them to need VERY high doses of insulin - 10 u plus. A kitty needs the dose he needs and 3 u is not that high. You just have to keep increasing until you reach his "good dose zone" and you'll know it when you see it: suddenly there'll be a lot more yellows, then blues and eventually dark greens on his SS. You have a way to go yet.
Also: he's probably losing weight because he's NOT regulated. His BG is consistently high which means he lacks the insulin needed to get glucose from his food into his cells in sufficient quantity to put on/keep on good weight. A very general description of regulation is BG in the low to mid 200s at PS and in the low 100s to high double digits at nadir. It's rare that one dose will keep BG that stable over time. Rather, its a case of testing to see what's going on with BG and tweaking the dose up or down a little bit to keep kitty in that regulated range. The good dose is a moving target.
Yes my journey has just started I see u guys have been doing this for months and it's getting more colourful. Will add more mid cycle range soon. Thks!
This is Sth new I learnt since joining this board. I really thought it's a fixed dose once we find it. Looking at all the SS, I realised one has to keep tweaking the dose to get it in the good range! Now I'm gaining more confident in deciding wat to giv him. I'm seeing more yellows than when I first started. Really encouraging!
You can't judge your kitty's progress against my guy's SS. Mine is an extremely complicated to dose cat - not typical.
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