? New DX Advice and Info Appreciated

Discussion in 'Caninsulin / Vetsulin and N / NPH' started by Fufu’s Parents, Apr 15, 2018.

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  1. Fufu’s Parents

    Fufu’s Parents New Member

    Joined:
    Apr 14, 2018
    Thank you all for sharing, I’ve read and learned more here in a day than our vet explained. Fufu was DX three weeks ago after she was ravenously hungry and losing weight. We thought she was mourning due to us having lost her partner of 16 years in February of kidney failure.

    Excessive thirst and urination clued us something was wrong. Fructosamine test was 526, started her on Vetsulin 1u q12. Did that for two weeks and took her back to vet for 5 day stay. During stay they did 5 days worth of panels every two hours and ended up at a dose of 7u q12. Put her on glycobalance also and supposedly that got her under control. She is 7 lbs, small frame cat, and now our only child. Yes read as spoiled!

    Vet did not mention home testing, but being in human healthcare (even though vet basically said they don’t translate) thought that dose seemed a big jump. Enter FDMB! About to go to pharmacy and pick up a meter, etc. we only carry human but looks like that’ll work. Fear of hypo, knowing she has bad stress from vet and a recent oral infection that required ABX, I dropped her dose to 5u q12h. She has been doing fine but have no idea of BS, so will remedy that today. I feel really stupid considering occupation, as they say “plumbers sink always drips”.

    From looking at the food charts, glycobalance has more carbs than Fancy Feast which is what we were feeding her. Am I missing something?

    Any advice appreciated, I’ll work on the spreadsheet and BS readings today. Thanks again for all the info!
     
  2. Kris & Teasel

    Kris & Teasel Well-Known Member

    Joined:
    Aug 17, 2016
    Welcome!! You've come to the best place for help and support. :) Let's get started:

    That first dose of 1 u BID is a typical starting dose for Vetsulin. However, up to 7 u BID after 5 days at the clinic?? :eek: That's an enormous dose for a newly diagnosed kitty. It's very possible that those 5 days of curves were deceiving because of elevated BG due to vet stress and/or eating Glycobalance food (14% carbs for wet). If you could clarify what you mean by "got her under control" that would be helpful.

    Many vets don't recommend home testing of BG often because they think it's too much trouble for the owners. Many/most of us here use a human meter because the cost of pet meter test strips is horrendous. Human meters read lower than pet meters but the difference is bigger at high BGs and much less at low BGs (when it really counts!). Ask for a meter that needs a very tiny blood drop to give a reading. I'm glad you dropped her dose. The infection is another factor that might have kept her from dropping too low on that high dose.

    Fancy Feast or Friskies pates are fine to feed FD kitties, Avoid the chunks in gravy versions although it's wise to keep one or two of those on hand to prop up BG if she drops low.

    Here's the new members handout I made up:
    ______________________________________________________________________________________________

    It would help us if you set up your signature (light grey text under a post). Here's how:
    • click on your name in the upper right corner of this page
    • click on "signature" in the men that drops down
    • type the following in the box that opens: kitty's name/age/date of diabetes diagnosis/insulin you're using /glucose meter you're using/what he eats/any other meds or health issues he has.
    Another thing that will help us help you now that you've started BG testing at home is to set up a spreadsheet like the one we use here. We can all see it and look at it before offering advice: http://www.felinediabetes.com/FDMB/threads/fdmb-spreadsheet-instructions.130337/

    .................................................................................................................................................................................................................................

    Here's the basic testing routine we recommend:
    1. test every day AM and PM before feeding and injecting (no food at least 2 hours before) to see if the planned dose is safe
    2. test at least once near mid cycle or at bedtime daily to see how low the BG goes
    3. do extra tests on days off to fill in the response picture
    4. if indicated by consistently high numbers on your spreadsheet, increase the dose by no more than 0.25 u at a time so you don't accidentally go right past a good dose
    5. post here for advice whenever you're confused or unsure of what to do.
    This is useful: http://www.felinediabetes.com/FDMB/threads/hometesting-links-and-tips.287/
    .................................................................................................................................................................................................................................

    Here's an explanation of what we call "bouncing". It explains why a kitty's BG can go from low to sky high:
    1. BG goes low OR lower than usual OR drops too quickly.
    2. Kitty's body panics and thinks there's danger (OMG! My BG is too low!).
    3. Complex physiologic processes take glycogen stored in the liver (I think of it as "bounce fuel"), convert it to glucose and dump it into the bloodstream to counteract the perceived dangerously low BG.
    4. These processes go into overdrive in kitties who are bounce prone and keep the BG propped up varying lengths of time (AKA bouncing).
    5. Bounce prone kitty repeats this until his body learns that healthy low numbers are safe. Some kitties are slow learners.
    6. Too high a dose of insulin can keep them bouncing over and over until the " bounce fuel" runs out and they crash - ie., have a hypo episode. That's why we worry so much about kitties that have had too high a starting dose prescribed by the vet and the owner isn't home testing.
    .................................................................................................................................................................................................................................

    Here are some tips on how to do urine ketone testing (VERY important if BG is high and kitty isn't eating well!):
    • put the end of the test strip right in his urine stream as he's peeing
    • slip a shallow, long handled spoon under his backside to catch a little pee - you don't need much
    • put a double layer of plastic wrap over his favourite part of the litter box and poke some depressions in it too catch pee.
    Most test strips have to be dipped and allowed to develop for 15 seconds before viewing the colour change in very good light.
     
    Last edited: Apr 15, 2018
  3. Fufu’s Parents

    Fufu’s Parents New Member

    Joined:
    Apr 14, 2018
    Kris,

    Thanks so much for response. As far as vet “getting her under control” I am unsure of the curve data other than they said “she was holding steady at 259”. Should have asked for curve data points but didn’t know to ask. I’ll figure that part out now with the spreadsheet + call and get chart tomorrow.

    She loves FF pate so that’s great! Probably need to be careful switching off glycobalance due to ~carbs in FF. She has no problems with appetite, I am noticing her water i/o slowing back to a more normal pace which is a good indicator of some glycemic control.

    So their bouncing would be like a human hypo getting a glucagon injection making the liver dump stored glucose?

    Fufus about to get her first ear piercing from me, this has all the potential for an America’s Funniest Home video winner!
    Thanks again!!!!!
     
  4. Kris & Teasel

    Kris & Teasel Well-Known Member

    Joined:
    Aug 17, 2016
    We'd say that's a high BG. The typical Vetsulin curve is a smile shape. Ideally, the pre shot BGs should be in the low to mid 200s and the nadir in the high double digits to low 100s. It can take a long time to get that degree of regulation.

    Yes, exactly. You have to test enough to monitor the effect on her BG as you switch back to FF. The low carb wet food can have a significant lowering effect on her BG.

    Clinical signs are also important. We can get hung up on numbers sometimes. ;)

    Yes, that's exactly what it is except it's their own glucagon mobilizing glycogen from the liver.

    You have all the credentials to do really well with this. We can certainly help. Actually, on the Lantus forum there's a member who's a small animal vet getting help regulating her own kitty. She admits she's learning a lot from FDMB lay people.
     
  5. Fufu’s Parents

    Fufu’s Parents New Member

    Joined:
    Apr 14, 2018
    Kris,

    When you have a sec can you look at my sig and see if I set the spreadsheet/ link up correctly please? Looks like it on my end. Only one recorded ESBS (ear stick blood sugar) at +9 = 316.
    Thanks again for your help!!

    Todd
     
  6. Kris & Teasel

    Kris & Teasel Well-Known Member

    Joined:
    Aug 17, 2016
    Great! Please add is what type of glucose meter you use to test and a general location for where you live because we're all over the globe.
     
  7. Fufu’s Parents

    Fufu’s Parents New Member

    Joined:
    Apr 14, 2018
    Thanks again Kris :) Will keep testing and see where the journey leads.
     
    Kris & Teasel likes this.
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