Advice with levels.... nadir all over the place

[Amanda Whitehead]

Hi All
Need some advice. My cat has been on 2 units of vetsulin for about 3 weeks. Problem is he's up and down like a yo-yo and I cannot gauge where his nadir is. Sometimes its at 3-4am but then last night he didn't drop to his lowest point until 12hrs. I'm up and down all night testing and I'm exhausted. Please can someone take a look at our chart and see what they think we should do from here. I'm starting a new job next week and I won't be able to get up all night.

Thanks in advance

 

[LuanneP]

Hi Amanda I replied to you in the FB group but couldn't help with dosing since I don't use Vetsulin. I'm commenting to bump this up in hopes that someone will jump in to give you some advice.

 

[Kris & Teasel]

You have a very bouncy kitty! I know your pain - I have one too. Have you checked to see that the carb content of the wet food is below 10%? http://www.felinediabetes.com/FDMB/threads/dr-pierson-new-food-chart.174147/

Does your kitty have any history of ketones? I ask because I think you might try lowering his dose to 1 u twice a day for 4 cycles (2 days) to see if you can't get him off his trampoline. There are some dose changes AM to PM and day to day that might be aggravating the problem. After a couple of days at a lower consistent dose you'll be better able to assess his response to Vetsulin. You're doing plenty of testing so you should be able to build a good picture of how he does at that dose. He's definitely responding to the insulin but just a little too dramatically.

 

[Amanda Whitehead]

Hi Amanda I replied to you in the FB group but couldn't help with dosing since I don't use Vetsulin. I'm commenting to bump this up in hopes that someone will jump in to give you some advice.

Thanks

 

[Amanda Whitehead]

You have a very bouncy kitty! I know your pain - I have one too. Have you checked to see that the carb content of the wet food is below 10%? http://www.felinediabetes.com/FDMB/threads/dr-pierson-new-food-chart.174147/

Does your kitty have any history of ketones? I ask because I think you might try lowering his dose to 1 u twice a day for 4 cycles (2 days) to see if you can't get him off his trampoline. There are some dose changes AM to PM and day to day that might be aggravating the problem. After a couple of days at a lower consistent dose you'll be better able to assess his response to Vetsulin. You're doing plenty of testing so you should be able to build a good picture of how he does at that dose. He's definitely responding to the insulin but just a little too dramatically.

Nice to hear I'm not alone in my struggle. No history of ketones and I check for ketones regular and he's always ok. Thing is if I lower the dose I worry we will never get him down to the normal range. I don't understand why he could be in the 300s one day then the next day below 100 its driving me crazy. We did have him on 1.75 for a while before but he never got down low enough on that. Vetsulin sometimes lasts for 12hrs then the next day it will only last for 8hrs or less. I am tempted to try a new insulin see if that helps maybe Prozinc. Yes his food is always lower than 10.

 

[Kris & Teasel]

Thing is if I lower the dose I worry we will never get him down to the normal range.

This only a temporary measure to try to settle him to see what's going on. He won't be left there. After a couple of days the dose will go up in 0.25 u increments. Another thing - just because he responded one way to a dose in the past doesn't mean he'll respond the same way now. This is a hormonally controlled ever changing situation and the dosing has to be approched accordingly. There's no "set and forget" in FD.

I don't understand why he could be in the 300s one day then the next day below 100 its driving me crazy.

His responses are volatile and the ups and downs increase the amount of bouncing he does. Some cats calm down eventually, some don't and some do better on a gentler acting insulin.

I am tempted to try a new insulin see if that helps maybe Prozinc.

ProZinc works similarly to Vetsulin in that it's (mostly) an in and out insulin. It's slower in onset and gentler in its action and that can be beneficial to a bouncy cat. The depot insulins like Lantus and Levemir are even gentler and slower. My bouncy cat lived on his trampoline when he was on ProZinc. He did better on Lantus but he was grumpy and lethargic. He's on Levemir now and feels good but still bounces to a degree.