Fluctuations in BS this am

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Kelly Ballard

Member Since 2022
My sugarcat Nessie is currently on Vetsulin 2.5 units at 8:00 am and pm. She started on 2 unit twice a day.

Since going up on her insulin (and switching to the AlphaTRAK, her sugars have ranged 97 to 607

For example, today: AMPS 417, 97 at +3, 107 at +4, 201 at +5, 410 at +7, and PMPS 607. I'm letting her eat her dinner and then will give her the Insulin.

If someone can let me know if I can post my spreadsheet on here, could you please walk me through it.

I have an appointment on Friday and I am going to ask to change her to Lantus.

My question is: how can I find the protocol(s) on managing BS when they are low? And what is considered low in sugarcats. I've read so much that my head is full of I don't know. I'm going through all of the files and printing them off and putting them in a binder for easier access.

Thank you...Nessie and her human
 
Hi Kelly! Hooray! Your post worked ;)

Nice to see you here from FB, welcome to the FDMB!

Here’s a link to help you get a few more things to help the experts here get to know you and kitty better. Main thing to focus on is to get your signature created (see mine for example) and attach your spreadsheet to the signature
https://www.felinediabetes.com/FDMB/threads/how-to-use-the-fdmb-the-basics.130682/

ETA: I see Chris has already given you some direction, so I’ll let her continue

@FrostD is our Vetsulin Guru here, she’ll be able to help out with your questions
 
Kelly Ballard said:
If someone can let me know if I can post my spreadsheet on here, could you please walk me through it.
Click to expand...

Click on your name on the top right and choose "Signature".
upload_2022-4-26_22-14-43.png


A new box will pop up for you to add information so we don't have to keep asking the same questions (you'll see my Signature under my post here). Info like:

Your name/Cats name, age, sex, date of diagnosis, type of insulin, type of meter, type of food, any other health problems or medications? and then paste the link to your spreadsheet at the end. Then hit "save" and you're done!
 

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Hi there!

Can you post a link to your spreadsheet if you have one?

I suspect she's overdosed given the numbers and the size of that dive, but spreadsheet is really the way for me to tell.

We can slow those dives by strategically feeding some food (again spreadsheet data would help me there) but realistically it's probably not going to do a whole lot. Definitely try to get the Lantus (there are generics now that are much cheaper, definitely get pens instead of a vial, do not get the pen needles as they're useless for the small doses we need). If you do switch, remember you'll need new syringes (U100, 0.3cc, half unit markings). We can help you pick the right ones if you need it.

Here is a link for handling low numbers - https://www.felinediabetes.com/FDMB/threads/how-to-treat-hypos-they-can-kill-print-this-out.15887/

And info about what to putting hypo kit - https://www.felinediabetes.com/FDMB/threads/jojo-and-bunnys-hypo-tool-box.2354/

Managing low numbers is a bit of an art and a science. So while that document handles pretty low, hypo numbers - there's intervention you can do well before that point if your tests catch something odd (like that drop from 417 to 97).

If you are around to test, I would start getting some +1s and +2s to see when exactly she starts to drop. Are you feeding, then waiting half an hour before giving the shot? That's what we recommend, so that way there is food on board to help slow the drop.

Please reduce your standard dose by 0.25U just to be cautious. I suspect she went under 90 between the two tests.

Any recent ketone tests?
 
Hi FrostD. I was initially testing, Insulin, and feeding but someone else had brought up the correct way to do it so I am checking BS, feeding, Insulin 20-30 minutes later. Thank you for the resources for treating hypoglycemia and the hypoglycemia kit (surprisingly I have most of the stuff. I need to get a small syringe in case I have to give something rectally). Her last urine was checked this morning...no ketones. I have tested her urine 4 times and no ketones. I have to catch her in the act so get her urine dipstick done.

I really appreciate you and the other members immensely

Kelly and Nessie
 
Never a problem, happy to help! Glad on the ketones.

Again, whenever you get a spreadsheet set up or posted I'll be happy to take a look and see if we can help manage her Vetsulin curves a little better while she's still on it.
 
FrostD said:
Can you post a link to your spreadsheet if you have one?
Click to expand...

She has one https://docs.google.com/spreadsheet...wH2mO_sjQpyMd3962eI09b4U_o/edit#gid=361360320

Kelly, what happened today was the Vetsulin hit hard and fast (which is common for Vetsulin) which drove Nessie's blood glucose (BG) too low and now, not only has that shot worn off, she's bouncing.

Bounces happen when 1. they drop too low, 2. they drop too fast, 3. they drop into numbers their body isn't used to anymore (or any combination of all 3). In this case Nessie dropped very fast and her body hasn't been in normal numbers for probably a long time so her liver released stored sugars and hormones to bring the BG up quickly.

Bounces can take up to 6 cycles to clear so you don't want to give a higher dose because of a "bounce".
 
Chris & China (GA) said:
Click on your name on the top right and choose "Signature".
View attachment 64135

A new box will pop up for you to add information so we don't have to keep asking the same questions (you'll see my Signature under my post here). Info like:

Your name/Cats name, age, sex, date of diagnosis, type of insulin, type of meter, type of food, any other health problems or medications? and then paste the link to your spreadsheet at the end. Then hit "save" and you're done!
Click to expand...

Nessie is a 7 year old spayed DSH. She was diagnosed on 4/14/22 after I noticed she was losing weight and extreme thirst. My vet ran a cbc with diff, electrolyte panel and Liver function panel. Thats when she was diagnosed. She was started on Vetsulin on 4/18/22 on 2 units twice a day. She was increased to 2.5 units on 4/19/22. I originally was checking her with an Accucheck but my vet said the AlphaTRAK was better and gave me a starter kit. I did notice that her numbers increased, which I read was to be expected. She refuses to eat wet food (I have tried 40 plus favors)...she's never been a fan of wet food. I am currently waiting on the samples from the 3 recommended dry foods. In the mean time, I am feeding her lean turket and hamburger, egg, and will be trying to find an appropriate fish. I am waiting on a supplement to come in as I know she is getting her macronutrients but I'm worried about the micronutrients.

She is other wise healthy and not on any medications.

Again, I can't figure how to post my spreadsheet to this forum. You informed me how to get it to the facebook group...Now I need help getting it here. TY for all of your help

Kelly and Nessie
 
Chris & China (GA) said:
She has one https://docs.google.com/spreadsheet...wH2mO_sjQpyMd3962eI09b4U_o/edit#gid=361360320

Kelly, what happened today was the Vetsulin hit hard and fast (which is common for Vetsulin) which drove Nessie's blood glucose (BG) too low and now, not only has that shot worn off, she's bouncing.

Bounces happen when 1. they drop too low, 2. they drop too fast, 3. they drop into numbers their body isn't used to anymore (or any combination of all 3). In this case Nessie dropped very fast and her body hasn't been in normal numbers for probably a long time so her liver released stored sugars and hormones to bring the BG up quickly.

Bounces can take up to 6 cycles to clear so you don't want to give a higher dose because of a "bounce".
Click to expand...


Thanks Chris. Do I need to post my spreadsheet here? Can't figure it out
 
It does take time for cats to settle into insulin, so we do usually say give insulins like Vetsulin and ProZinc 2-3 months to work.

That said, anecdotally from what I've seen, the cats that do well on Vetsulin are fairly low numbers to begin with (think 200s) and have fairly gentle curves to begin with (so maybe a 50% drop at maximum). With how she's reacting, I'm pretty comfortable saying Vetsulin is just going to be a waste of time for you and her (plus it's no longer recommended for cats anyway).

Just know that if/when you do switch, it's not going to be like some magical miracle right off the bat. The depot insulins also take time, largely because they are better at keeping low numbers low vs bringing down high numbers. We've had some cats that switch see a really nice difference in 1-2 weeks, some take a month or so (assuming you stay on top of increases and decreases as needed). But long term it is much better for her.
 
Hi can you add your signature , @Chris & China (GA) posted how to do this above post #3 , numbers are to the right of each post
  • Add info we need to help you:
    • Caregiver & kitty's name
    • DX: Date
    • Name of Insulin (do not include dose or frequency)
    • Name of your meter
    • Diet: "LC wet" or "dry food" or "combo"
    • Dosing: TR or SLGS or Custom (if applicable)
    • DKA or other recent health issue (if applicable)
    • Acro, IAA, or Cushings (if applicable)
    • Spreadsheet link. Please put the signature link on the bottom line of your signature information, on its own, so it is easy to find.
    • Please do not put any information about your location in the signature for security reasons. If you wish to add your country location, please add it to your profile.
Be sure to click the 'Save Changes' button at the bottom. If you need help urgently it is important we know these things at a glance. We don’t want to waste valuable time finding out information.

You then need to link your spreadsheet to your signature, if you can't you can tag
@Chris & China (GA) to help you do that
 
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