How long to wait before increasing dose?

Discussion in 'Caninsulin / Vetsulin and N / NPH' started by Tiger and the squid, Jul 25, 2018.

Thread Status:
Not open for further replies.
  1. Tiger and the squid

    Tiger and the squid Member

    Joined:
    Jul 6, 2018
    Tiger is newly diagnosed and prescribed vetsulin. He started at 1u, but when I switched vets just a few days after the diagnosis she immediately upped him to 1.5u. We did that for two weeks, but his numbers are still consistently 600+ on my human meter. We saw the vet on Monday and she upped us to 2u. We have another appointment next Monday to check his numbers.

    I've shown her my sheet and she did explain that it a) we need to increase slowly so we dont over do it and b) that it may take some time before the increase can take effect. I'm just so nervous. His legs are on occasion wobbly. Sometimes he seems fine and sometimes he leans against the wall when he walks.

    I know it's a conversation I need to really have with my vet but I'm just nervous about the long term effects on his system. I have ketone strips arriving tomorrow and I'm off the weekend so I can do a proper curve (I already have my alarm set so I can test in the middle of the night)

    I mean, she's a doctor. I can trust her, right? I definitely trust her more than my previous vet, but it's still my baby and just another patient to her. Tell me to calm down and stop staring at Tiger like hes on his death bed
     
  2. JanetNJ

    JanetNJ Well-Known Member

    Joined:
    Jun 8, 2016
    Given your super high numbers is raise 0.5 every two days until you get into better numbers, then raise 0.25 u at a time
     
  3. Kris & Teasel

    Kris & Teasel Well-Known Member

    Joined:
    Aug 17, 2016
    I agree with Janet's advice. He needs more frequent increases than your vet recommends.
     
  4. Tiger and the squid

    Tiger and the squid Member

    Joined:
    Jul 6, 2018
    I spoke to my husband about increasing before the vet visit. He is a very cautious person and knows how worried I get over Tiger. He said i should just follow the vet advice for now and ask about increasing a bit faster on his visit.

    I have decided however to follow the advice here Tiger's levels are just too high. I'm off all weekend so i can watch him just in case 2.5u is some how too much for his little system.

    I'll tell him and the vet on Monday...
     
    JanetNJ likes this.
  5. JanetNJ

    JanetNJ Well-Known Member

    Joined:
    Jun 8, 2016
    Good call. Those black numbers are scary. You'll most likely have to go quite a bit higher than 2.5 to see a significant improvement. Rarely do I suggest it but I would likely go right to 3. But I understand being cautious until you see the vet. Definitly this morning raise it to 2.5 though.
     
  6. Kris & Teasel

    Kris & Teasel Well-Known Member

    Joined:
    Aug 17, 2016
    I agree with Janet's advice. You could go safely to 3 u but you'd likely feel more comfortable going to 2.5 u. I understand your concerns but the longer he stays in those very high numbers the more "stuck" he can become. It's called glucose toxicity - a scary label for a common problem. The high level of glucose in his bloodstream impairs his ability to respond to the insulin. The way through that is by more frequent - but careful - dose increases. What can happen is that you get to a dose range that "breaks through" the toxic effects and the kitty begins to respond normally to the insulin. It can sometimes lead to doses needing to come down fairly quickly.
     
  7. Tiger and the squid

    Tiger and the squid Member

    Joined:
    Jul 6, 2018
    I'm doing (my best at) a proper curve today. I'm home and not going anywhere. I don't have the heart to stick his little ears every hour, but once every two hours is still good to get an idea, right? The thing I keep telling myself is that my meter stops at 600. Those HIs I've been getting might be much higher than 600. I just put 600 for the color coding. Two hours after his shot and he's still reading high. I'm also trying to keep aware for his potty breaks so I can try to use a ketone strip.
     
  8. Kris & Teasel

    Kris & Teasel Well-Known Member

    Joined:
    Aug 17, 2016
    A full curve involves a BG test every two hours, not hourly.
     
  9. Tiger and the squid

    Tiger and the squid Member

    Joined:
    Jul 6, 2018
    Nice, nice. I only thought an hour because the spreadsheet has hourly spots.
    Should I commit to a full 24 hours, or will 12 suffice?
     
  10. Kris & Teasel

    Kris & Teasel Well-Known Member

    Joined:
    Aug 17, 2016
    Every 2 hours between AM and PM shots is plenty. :)
     
  11. Tiger and the squid

    Tiger and the squid Member

    Joined:
    Jul 6, 2018
    He did so well on 2.5u I made the decision to jump up to 3u. I hope it's not too much too fast, but I'll keep checking him tonight.

    I mean ... Insulin ... Either just works or it doesn't right? It's either enough or it's not, right? Do I NEED to keep it the same for 3-4 cycles? (Which a cycle would be 2 shots, right?)
     
    JanetNJ likes this.
  12. JanetNJ

    JanetNJ Well-Known Member

    Joined:
    Jun 8, 2016
    It sometimes takes a few cycles for the full effect.... But in this case because he's so high that I think it's good that you went to 3 units. I'll be curious to see what happens tonight and tomorrow with the 3 unit dose.
     
  13. JanetNJ

    JanetNJ Well-Known Member

    Joined:
    Jun 8, 2016
    A cycle is a 12 hour period. So 2 cycles in a day.
     
  14. Tiger and the squid

    Tiger and the squid Member

    Joined:
    Jul 6, 2018
    At +2 he's down to 332. I'll just keep doing 3 for the rest of the weekend and see what the doctor says on Monday.
     
  15. Kris & Teasel

    Kris & Teasel Well-Known Member

    Joined:
    Aug 17, 2016
    I'm glad you did the curve today. He's responding to the insulin but all his numbers have to come down 300 points. You'll get there!
     
  16. Tiger and the squid

    Tiger and the squid Member

    Joined:
    Jul 6, 2018
    Doctor didnt seem upset that I increased his dose but wants to keep him at 3 for at least a week. I'm just so scared that it's been a month and his numbers arent really improving. Friday was pretty good but then today was all highs again. I wont be able to do another curve until Friday again. She suggested that maybe vetsulin isnt the right insulin for him. I thought this weekend was really good but now I am feeling lost again.
     
Thread Status:
Not open for further replies.

Share This Page