No regulation since crash

I am at a complete loss.

We started Zoe on Vetsulin back in August. We followed directions and thought we were doing what we should be. Spot checks only at vet's and following her guidance, we did 2 weeks 1 unit 2x daily (no change); 2 weeks 2 units 2x daily (no change); 2 weeks 3 units (showed marked decrease of BG to 200's); very next day Zoe crashed. Emergency vet visit, two night's stay, and slow, slow recovery since.

Following that crash on Sept 12th, we've been on and off again w/ injections because of Zoe's intermittent throwing up. Visited internist, ultrasound etc, and diagnosed w/ pancreatitis, possible IBS, dietary sensitivity....

Has been eating Royal Canin PV mostly w/ some Weruva for treats. He doesn't like eating at 12-hour intervals, and with his throwing up, that goes out the window as we try to get him to eat.

Yesterday afternoon I gave him 1/2 dose of nausea med. He hasn't thrown up since.

We've begun checking Zoe's blood sugar at home now - WHY WEREN'T WE INSTRUCTED ON THIS IN THE BEGINNING?! - and this morning's was 112, which we thought was too low to give him even 1/2 unit of insulin.
I fed him about 1/4 can, and we've checked BG twice since, after four hours BG only went up to 233.

Anyone have any ideas at all? We feel like our beloved Zoe has become a science experiment.

 

So glad you are home testing Zoe now! It's frustrating how Vet's say it is unnecessary. We wouldn't let a doctor tell us not to test a small human child receiving insulin, why should it be different for our fur babies?

Good call on skipping insulin shot with a PS test of 112. Could you setup your Signature and Spreadsheet with Zoe's BG history? You can use the SS moving forward too .

Sounds like a classic case of a Vet raising a dose in whole increments, which is too much for a kitty. Also, the 2x feedings is an old school of thought and doesn't work well for most of our sugar kitties. There are some tips if you don't want to or can't afford a timed feeder .

Apologies if my post is a bit scattered, it's bed time but I wanted to at least check on my main 2 forums. I hope Zoe starts feeling better and as the flare settles, she may just need a tiny bit of insulin to help and may head towards a remission. Paws crossed! Will be checking in

 

Congratulations on starting home testing. This is SO SO important to keep our kitties safe. Every time I see another post about a vet saying it is not necessary it makes my blood boil. EVERY human diabetic is told to ALWAYS test before shots and in between shots and it should be no different with our kitties. Maybe even more important, since our kitties cannot "tell" us when something is off. One of the most important things you can do, besides regular home testing, is to set up a spreadsheet to log the readings. Instructions can be found at this link:

http://www.felinediabetes.com/FDMB/threads/fdmb-spreadsheet-instructions.130337/

Vetsulin is a faster acting insulin than others such as Prozinc, Lantus and Levemir. Some information on Vetsulin can be found here:

http://www.felinediabetes.com/FDMB/threads/vetsulin-caninsulin-user-guide.302/

It is VERY important to test before each shot and then again at +3-+5 hours after the shot, which is the "usual" time for the main effects to be seen. By testing before Zoe's shot you were able to get that reading of 112, which was too low to give a shot. The high dose of insulin your vet suggested could very well have put Zoe into another serious hypo, so your home testing saved him from that. As Yong said the dose has been raised by too much of an increase each time. Dose increases are usually done by 1/4 or possibly 1/2 unit increments with regular testing to see how the dose works.


ETA With Vetsulin you need to have a decent amount of food given about 20-30 minutes before the shot. However in between a number of small meals will be easier on the system than only feeding twice a day. My other kitty had chronic pancreatitis and had fewer problems when I fed him 2 bigger meals and about 4 smaller meals each days...plus a treat or so when he had his glucose tests.

 

Sorry but your vet sucks at dosing advice, and raised her too quickly and withought enough information. Good call skipping. Go back to one unit when the bg is over 200 at preshot. ALWAYS take a preshot, and get mid cycle numbers when you can. Record your readings and check back in here throughout the week so we can see. If it is not enough we will have you raise in 0.25-0.5 increments.


I would make the weruva his main food. Stop feeding the dry. Most of us feed fancy feast classic or Friskies pate foods.

 

Thank you everyone for all the help! I'll complete the profile on Zoe and other info as soon as I can. Right now internist says no Weruva, feed only the RC PV. Only gotten one BG over 200 (234) in last three days, no Vetsulin since 1/2 unit on Sunday morning before he began intermittently throwing up. Has anyone had this kind of reaction to Vetsulin/overdose of insulin?

 

Oh, and Zoe hasn't had any dry food since 9/23. Prior to that, he was eating mostly canned Proplan DM. Vet and emergency clinic both prescribed dry formulas.

 

Just know that that dry p/v food is about 38% carb.... So basically you are feeding him donuts. If there's a wet version it may be a better option. With numbers in the low 200's I am fairly sure changing to a diet under 10% carb could be the answer. Your cat may be able to be controlled through diet alone.

Throwing up may have been a sign of hypoglycemia.

 

He's been on mostly wet food since diagnosis, and exclusively since 9/23. That's something I learned from this forum, along w/ most of the info I've acquired. I'm so grateful this exists - my cat would be dead, I'm sure, w/o my having found it.

 

He's been on mostly wet food since diagnosis, and exclusively since 9/23. That's something I learned from this forum, along w/ most of the info I've acquired. I'm so grateful this exists - my cat would be dead, I'm sure, w/o my having found it.

 

Ok glad to hear it's the wet version. That one is 15-16% and so still higher than recommended but not nearly as bad as the dry.

In not sure where I would be without the information I learned in this site as well. Amazing resource.

 

Zoe's now off insulin, as per internists' suggestions, and we're cautiously optimistic. We'll be monitoring urine for glucose and ketones, and I'll be looking for info about this on the forums. Also have a new RX for a different insulin so will start a link there. Thank y'all for your help!