2 Low's in a week. Dosing help.

Discussion in 'Caninsulin / Vetsulin and N / NPH' started by bgiff420, Jun 2, 2020.

  1. bgiff420

    bgiff420 Member

    Joined:
    May 21, 2020
    Tonight is the second potential low he has had this week and I'm wondering if I need to adjust his insulin again. I was giving 3u and after the 1st low, it was recommended that I lower it to 2. He's been on 2u the past 2 days and tonight he's trying to go low again. His +2 was 68. I fed him another can of FF pate and a small amount of m/d kibble and rubbed some honey in his mouth and I'm currently waiting to test again in 20 min.
     
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  2. FrostD

    FrostD Member

    Joined:
    May 27, 2020
    Sorry I'm not able to help with dosing, I'm new to this. But if it were me, I wouldn't necessarily change the dose for at least another cycle or two to make sure it's not a fluke...just keep an eye on him and make sure he has food available at the times you know he goes low. Ive seen other say anytime you go below about 90, reduce by 0.25U...but I'm not sure if that's preshot numbers or at any test time.
     
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  3. Diane Tyler's Mom

    Diane Tyler's Mom Well-Known Member

    Joined:
    Sep 21, 2018
    Hi sorry I can't help you with dosing, one thing you might want to try is to feed about maybe 1 tablespoon of FF @ +1 to try and slow the drop down.
    You might want to also post this on the Feline Health forum to get some advice ,
     
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  4. Panic

    Panic Well-Known Member

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    Apr 10, 2019
    What times are you feeding Kingston? Any time he drops below 90 you want to reduce by 0.25u immediately. Possibly more still. @Deb & Wink what do you think?

    Can you update your spreadsheet for us please? :)
     
  5. Deb & Wink

    Deb & Wink Well-Known Member

    Joined:
    Jan 31, 2013
    As Elizabeth said, ANY TIME in the cycle when your cat drops < 90 mg/dL, you reduce the dose by 0.25U.

    In this case, that was a really steep drop, early in the PM cycle on 6/2/20. I think you want to reduce the dose to 1U for now.
    Did you make a food change recently by any chance? For example, from high carb dry or wet to low carb wet?

    With the steroid shot just before diagnosis, the effects of that could be wearing off. So steroid induced diabetes can resolve fairly quickly, within a couple of months.

    Are you testing for ketones? You say in your signature that Kingston had ketones on diagnosis.
    Is his appetite good? Not losing too much weight?
     
    Last edited: Jun 3, 2020
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  6. bgiff420

    bgiff420 Member

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    May 21, 2020
    I dropped it today to 1.5 today. He did much better and didn’t drop below 90 so far. His lowest was 123. I just updated his chart. As far as ketones, I haven’t been able to catch him in time. Before I realize it’s him in the box(I have another kitty) he’s almost done. I know I need to keep trying. But his appetite is doing great! He eats all the time lol. I also add water to his food to make sure he’s getting plenty of fluids. He had an infection which I think contributed to his DKA episode.
     
    Last edited: Jun 3, 2020
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  7. Panic

    Panic Well-Known Member

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    Apr 10, 2019
    I never could routinely catch my girl to test for ketones. She went outside 95% of the time and the other 5% her furry butt was blocking me from slipping a strip under her. Since he is ketone-prone maybe consider getting a glucometer that also checks for ketones to keep on hand?
     
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  8. Diane Tyler's Mom

    Diane Tyler's Mom Well-Known Member

    Joined:
    Sep 21, 2018
    That 123 was still a steep drop, 207 points.
    I would get a few more tests in tonight in case he drops further
    Cats usually drop lower at night.
    I would also drop to 1 unit tomorrow like Deb suggested
     
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  9. bgiff420

    bgiff420 Member

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    May 21, 2020
    So just so I know, do I want him to be between 100 and 200 or what is the range that I should shoot for?

    Also when should I start seeing lower AMPS and PMPS numbers? I am not seeing a trend of them coming down yet. They have a couple times but not anything steady.

    Do you think it's time I ask to switch insulins or should I just keep trying for a while?
     
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  10. Panic

    Panic Well-Known Member

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    Apr 10, 2019
    Ultimately (and this can take some time depending on the cat - sometimes weeks, others years) you want the cat in non-diabetic numbers. Diane's SS for Tyler is a wonderful example of what we always hope to achieve with our kitties - nice greens and low blues. Kingston is a very new diabetic, it could take a while. He's got better numbers now than my girl did when she was newly diagnosed and she was also on Vetsulin at that point. It just depends on the cat and how badly damaged the pancreas is.

    AMPS and PMPS numbers are the last numbers to go down. Remember that those are the times when the insulin is all "used up", especially since you're using Vetsulin and not a depot insulin.

    You can absolutely change if you want. Vetsulin is hard to work with in cats, it's causing these very steep drops and then, because Kingston's body isn't used to those numbers / because they're dropping so fast / because they're dropping so much it's causing his numbers to bounce. So you're seeing a nice low number and then a few hours later those nasty reds. It takes a long time for the body to even itself out when that's happening. It's common but frustrating.
     
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  11. FrostD

    FrostD Member

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    May 27, 2020
    Is that example achievable with Vetsulin? I'm looking at my SS thinking we're doing pretty well, but like bgiff I'm not sure what's realistic for Vetsulin
     
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  12. Panic

    Panic Well-Known Member

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    Apr 10, 2019
    Not very often, but Every Cat Is Different, and it HAS happened with kitties. I was speaking with a lady just the other day who has gotten three different cats into remission using Vetsulin, but those particular cats actually benefited from the in-and-out insulin as the depot was actually dropping them too low, making them bounce, and it was just an up and down cycle over and over. Never heard that method before so thought it was pretty neat. Those cats were already very near remission though.

    Another SS that comes to mind was from another member who joined the same time as me (haven't seen her in months, hope her and kitty are okay) and her boy CatCat actually did pretty decently on Vetsulin so she kept him on it longer than most people here do. She did ultimately switch him to Lantus though because it wasn't doing quite enough for him. Here's his spreadsheet.
     
  13. JanetNJ

    JanetNJ Well-Known Member

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    Jun 8, 2016
    Wow your cat drops FAST.
     
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  14. bgiff420

    bgiff420 Member

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    May 21, 2020
    He does and that scares me. I think tomorrow I will try 1u and see how his numbers do. He tends to drop lowest in the evenings though. Just checked him and he was at 97 at 3+ :( I think I might need to switch insulins.
     
  15. JanetNJ

    JanetNJ Well-Known Member

    Joined:
    Jun 8, 2016
    I think that's a good plan, esp when under 400.
     

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