Caninsulin dose increase advice

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Jen and Alfie

Jen and Alfie

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Hi everyone

My boy Alfie has just finished his first week on Caninsulin and I'm doing a 12 hours curve at home for my vet today.

He's said previously that given the numbers we're seeing, he'll probably increase both his daily shots to 2 units (he said they usually only increase the total dose by half a unit per day, so one 2u shot and one 1.5u shot, but his number are so high he thinks it's fine).

What do you guys think? Does this seems sensible at this stage given his numbers? I was hopeful last night when I saw a nice (if still high) curve developing. But today his number just seem stubbornly high. I'm going to test him every couple of hours now for the rest of today to see what's happening.

Does it usually take a few days for insulin to start taking effect?

Thanks in advance

Jen
 
Jen and Alfie said:
I'm doing a 12 hours curve at home for my vet today.
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Hurray for your vet letting you do a curve at home! That's the way it should be. Are you using an AlphaTrak pet meter?

Jen and Alfie said:
He's said previously that given the numbers we're seeing, he'll probably increase both his daily shots to 2 units
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Were these numbers from your home testing? It looks like you started on 1.5 unit twice a day - correct? The recommended starting dose from the manufacturer is 1 to 2 units twice a day. However, most cats are better off starting at 1 unit twice a day. We recommend increasing in 0.25 unit increments and keeping AM/PM doses the same at the beginning. It's possible that his numbers are higher than ideal because the dose is too high rather than too low. They can overreact to a dose that's too high by raising their own blood glucose as a protective measure.

Jen and Alfie said:
I'm going to test him every couple of hours now for the rest of today to see what's happening.
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Great idea! Has he been given 2 units this AM? As you get results please post them here for us to have a look. This is an easy to read format:

AM blood glucose reading:
AM dose:
BG at 2 hours after dose:
BG at +4:
BG at +6:
etc.
 
Are you able to see his spreadsheet from the link in my signature?

He's currently on 1.5 units twice a day. The vet wants to see the curve before increasing his dose.

He's currently +8 from his morning shot and has just tested at 28.9

I'm currently using a vet pen so can only adjust doses by 0.5 unit increments.
 
Jen and Alfie said:
Are you able to see his spreadsheet from the link in my signature?

He's currently on 1.5 units twice a day. The vet wants to see the curve before increasing his dose.

He's currently +8 from his morning shot and has just tested at 28.9

I'm currently using a vet pen so can only adjust doses by 0.5 unit increments.
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Duh! I'm sorry for not being more observant. o_O That first row of data is without insulin, correct? The insulin hasn't really made much of a difference yet except for that one yellow number the other night. The simple answer based on the spreadsheet data is that the dose needs to come up. You're using a vet pen so can do only 0.5 u increments. That might be OK until you get to a better dose range. Hard to say what that will be yet.

Other health issues can keep BG high - dental disease, bladder infection, etc. Has he been evaluated for other things?
 
Yes, the first row were taken the day before he started insulin so his numbers haven't really changed. He has improved a bit in himself though. He's more lively and has stopped drinking and peeing so much. Though that could be due to changing him to wet food.

Our vet examined him when he took blood samples and didn't find anything obvious. All his blood work came back fine. He hasn't yet managed to get a proper look at his teeth though. He's mentioned acromegaly but he only, he says, because Alfie is a big cat and they now know it's more common than previously thought. If he doesn't respond to insulin on a couple of weeks he's going to do a blood test that can apparently detect it.

We're very lucky that our vet does home visits which reduces my and Alfie's stress levels! He turns into a wild cat at the vets office! :/
 
Jen and Alfie said:
He's mentioned acromegaly but he only, he says, because Alfie is a big cat and they now know it's more common than previously thought. If he doesn't respond to insulin on a couple of weeks he's going to do a blood test that can apparently detect it.
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This is a vet who's on the ball for sure!! :):) The fact that he does home visits is wonderful as well. Has Alfie been on wet food since the insulin was started? I ask because some people transition while they begin insulin and it can have a substantial impact on numbers for some kitties.

Re your question about the time for an insulin effect to show up: if the starting dose is close to what a kitty needs, Caninsulin should show its muscle right away even if the response is erratic. If the dose is too low, as seems to be the case with Alfie, you won't likely get a good curve until it's raised. He's showing signs of feeling better and that's very good.

You have a good plan in place and a good vet. If we can help in any way going forward, please post here or on the main health forum.
 
Given the experiences of some people here we do seem to be very, very lucky with our vet.

I started him on wet food about three days before he started his insulin. So I don't know if that would affect his numbers? After doing some reasearch post diagnosis it just seemed mad to keep feeding him dry food so I wanted to swap asap. He's always loved wet food anyway so he's happy! (Though he can't graze through the day anymore so doesn't like that!)

Just spoke to the vet who has said to increase to 2 units twice a day and monitor for another week. So watch this space!

Thank you for your help :)
 
Jen and Alfie said:
Given the experiences of some people here we do seem to be very, very lucky with our vet.

I started him on wet food about three days before he started his insulin. So I don't know if that would affect his numbers? After doing some reasearch post diagnosis it just seemed mad to keep feeding him dry food so I wanted to swap asap. He's always loved wet food anyway so he's happy! (Though he can't graze through the day anymore so doesn't like that!)

Just spoke to the vet who has said to increase to 2 units twice a day and monitor for another week. So watch this space!

Thank you for your help :)
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Good plan! Starting him on wet food before insulin was a good move. I don't know UK food but I'm sure you've done your homework and found Sheba Fine Flakes to be low carb. The numbers you see now are representative of how he's doing on this food at this dose. Alfie's happy about it! :smuggrin:
 
Hi Jen, if you need any help with UK foods, just ask... one of our members has compiled a comprehensive list of what's available here. Wet food is definitely the best - I feed my cat Sainsbury's Delicious chicken in jelly which actually looks like chicken should, very palatable-looking (!) flakes of chicken not eked out with too much other stuff.

BTW do you give treats after testing BGs? We always suggest that to make sure the cats don't get fed-up but associate test time with treat time! The best ones are Thrive freeze-dried chicken treats, you can get them in tubes in some supermarkets but cheaper online in bigger tubs. Again, ask if you need and info.

Good luck!
 
Hi Diana

Thank you! I'm feeding him Sheba Fine Flakes at the minute after looking at the UK food list and finding it readily available. He was on Royal Canin Oral Care dry food with just a small amount of wet food before, and I thought I was doing the best for him! :( He's loving his new food, so although it seems a bit too processed for my liking, while we try to get his numbers under control I'm going to stick with it.

He's being so, so good with his ear pricks, I'm sure he knows we're trying to help, bless him. I've bought the thrive chicken liver and white fish flavours so far and he's ignored both I'm going to try the tuna flavour next.

In other news, he was just in the garden trying to fight one of the neighbours cats, and he's barely been out for two weeks, so I'm hoping he's feeling a bit better!
 
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