High Glucose, 9 units on Vetsulin

I struggled to get a ketone test from Maury for over a week because he would come wake me up and then run downstairs to go pee before I was awake enough to realize where he went

 

We went to the vet today. Sammy's ears were fine. They tested his Ketones, nothing showed up in his blood. I got an overview printout of his medical history.

The vet was impressed with how well Sammy was doing. He took the information for this site and was excited to have it. I showed him how I tested Sammy's blood some of it was new information.

To me the results I am getting from Sammy's tests seem to be irregular. I am inclined to hold him here for a few more days too see if I get a more regular pattern.

I would be interested to hear what you think about Sammy's insulin, LMK if/ what change you suggest.

 

Hi @Sammy's G-ma, can I just ask you for a few clarifications about your SS?

How often are you giving insulin?
What does 'food#' mean?
Is the 'conversion' because you are using U100 syringes?

And what are you feeding Sammy at the moment; what % calories from carbs?

Thanks,

Eliz

 

Thank you for asking for more info.

I am giving Sammy Vetsulin every 12 hours.

I am feeding Sammy Canned Friskies. So at Food# or Snack# it is how much of a can of food I fed him. Recently he has been leaving food so I am going to start cutting back a bit.

Yes, the Conversion is because I am using U100 Syringes.

I am feeding him Canned Friskies Classics. I do not know the #'s but I will look it up.... Um... The box and the cans do not tell me % of calories from carbs.... I guess I need to research that online? I will see what I can find. Oh.. I found this Calorie Content (calculated) 1117 kcal/kg, 174 kcal/can. Rice is the 6th item on the can, the other 5 are 4 meat related products and 1 water.

 

LOL! I slept through an alarm I set to test my girl last night and then she greeted me with a much lower reading than expected this AM! All is well but they really do keep us on our toes!
I notice you had Sammy to the vet's. Was there something going on or was this just a checkup?
I love the yellow pre-shot this morning and that lovely blue mid cycle. Big improvement over those black pre-shots!

 

Sammy's G-ma, you can look up the Friskies flavours you feed on this Food Chart

 

Thank you @Yong

@Elizabeth and Bertie Looks like % calories from carbs is 3 to 6.

@MrWorfMen's Mom your girl is really taking you for some spins through the lower greens! Lots of drama! Yes the Vet was just a check up, he was impressed, and I had new information for him. He took the info about this group and planned to check it out more after work.

 

Ok I have decided to take Sammy down to 2.75 units tomorrow. Still too much of a spread between highs and lows.

 

Very nice seeing better numbers with each decrease

 

I agree the spread is still very high and setting off bouncing. Amazing to think you had Sammy on 8u of insulin at one point and are now down that low. It's much harder to back up doses than to increase slowly but slow methodical changes will get Sammy into better numbers. You're doing great G-ma!

 

I finally managed to catch the low numbers on Sammy's curve at this dose. The spread between highs and lows is still too high. But I agree with Young, overall the numbers are looking much better. I plan to go down .25 units tonight. I will now be giving Sammy 2.5 units.

 

@MrWorfMen's Mom I am sooo impressed we brought him all the way down from 9 units!! My vet was impressed too. Each time I take him down a notch in dosing my family cheers. It was nerve wracking having him that high, while the vet was telling us the numbers were wrong, while he was at risk of hospitalization! This is so much less stressful and much more successful.

 

It makes me so very happy to know you and your vet are happy and that Sammy is doing so well. We vicariously adopt all the kitties that come join us here and rejoice in every improvement! A good learning for your vet too! Those poor vets for whom I have a mountain of respect, don't get much training about feline diabetes so the vet can just chalk the different opinions about dosing up to 24/7 hands on experience.

I have a high dose kitty who was at one point on 16u twice daily due to a rare secondary related condition that my vet had never seen before and had no idea how to handle. I even had to demand testing to figure out why she was not reacting to diet or insulin dose changes. I now have my girl down to between 2 and 3u twice daily and my vet is amazed too. I learned so much from this community and will be eternally grateful to them for all that I have learned.

 

Just peaked at Sammy's SS. I might be inclined to hold that 2.75u dose for another day or so just to see if that doesn't flatten out Sammy's cycle a bit more before dropping it again. Some kitties bounce a little more than others and I think he's just coming out of one. I am so impressed with how well he is doing!

 

I like Linda's idea of holding 2.75U for another day or so. Today was kind of the first day we saw what the dose is really doing

 

Sammy has been at 2.75 for a while. We are not testing as often, and have had irregularities like fur shots. Sammy has had irregular readings too. Do you guys have enough information to make a recommendation now? Or should I get another 2 days of good testing in at this dose?

 

If I were you I'd reduce back to 2.5u for 3 to 6 cycles and see if that doesn't smooth Sammy out a bit. He's still getting a lot of really strong drops that suggest those high pre-shots are caused by bouncing. I know sometimes it's hard to get readings mid cycle but at the very least try to get a test before you turn in for the night. Any and all data is helpful. It's far harder in my opinion to back up doses to find the right dose and goodness knows Sammy needed some backing up.

Important: Have you checked Sammy for ketones lately? Just want to be sure that is not something we need to consider when reducing dose.

 

Hi @Sammy's G-ma ! Just checking in with you both . I see you got your lowest PS number last night since you started and did not share the good news . Are you going to try 2.25U next or hold 2.5U another day or two?

 

wow did you ever think 6 weeks ago that you would be down to 2.5? Now stock up on batteries. haha

 

Yes, @JanetNJ It is great to be down so low so fast!

@Yong Thanks for checking in. I noticed he was going low so I gave him extra snacks. But this morning he did not eat them all .

Tested Sammy last week and he had no Ketones. His appetite is going down for sure, I think as the insulin goes down. But, maybe sometimes I wonder if it is too low. I am going to start paying more attention to how much food he does not eat.

He is bouncing it looks like. I have filled in the numbers for today and the one late last night, to catch up. If you think it is good to go down to 2.25 Young then I will, Seems like it might be a good idea to me.

 

I think your assessment is right on and Sammy is still bouncing. Backing up doses is much harder than starting low and working up. I'd take him down to 2.25u or even 2.0 u and see if that helps. Unfortunately, you are going through a lot of trial and error trying to find that "sweet" spot dose for Sammy but you will get there!

 

He might still be bouncing today since we don't know how much lower he went last night after the 156 at just +2. Trying the next reduced dose, either 2.25U or 2.0U may help settle him. Like Linda said, going backwards can be more difficult, hang in there!

 

Thanks for your input! I am going down to 2. I do not like him going too low.

 

Ok I filled in the spreadsheet from the last several days of testing. It looks like Sammy might bounce on days when his evening snacks might be missed? His bounces coordinate with days I do not have knowledge of his evening snack being given to him. I am going to have my kids start to pay more attention to that. The other numbers are looking better. I hope that if we pay more attention to his evening snacks his patterns will become more regular.

 

It's amazing how timing of meals/snacks can sometimes effect numbers so you may be on to something! This really is a bit of a puzzle that involves a lot of trial and error because every cat is very unique. Go Sammy!

 

After you figure out if it is the snack effecting him, he might need to go to 2.25U or 1.75U since we've been decreasing. Going backwards is definitely more difficult! lol. Just to be safe, have you tested for ketones, Jeanine?

 

Ok, Sammy bounced last night and I know he had his snack.... So I am thinking I will bring him down to 1.75.

 

I think you are right. I am just wondering if it is feasible for you to get a test later into the evening cycle....say around +4 or +5. I'm wondering if he is going even lower at night leading to those high pre-shots in the mornings. I'm not trying to mess up your beauty sleep (goodness knows I like and need mine!, but a lot of kitties go lower at night and the key to figuring them out lies in getting a few evening cycle tests beyond that +3 mark. If you are early to turn in at night, you could try to grab a test if you get up to use the facilities in the night. I agree dropping down to 1.75u is worth a try because while his numbers have leveled out a lot, he's still swinging a lot.

 

I know there is not a lot of information to go on with Sammy's chart because of low testing.... But I took Sammy down to 1.75, then 1.5, then 1. Still his numbers are low enough I am tempted to bring his dosage down again.... To like .75? If you could pop in and let me know if I should hold at 1 unit or go down I would appreciate it. Thanks.

 

I know the goal was to see if the wild bounces would calm down from lowering the dose. It has helped but I think you could have left him at 1.75 u.

 

I really appreciate you popping in to give me your opinion. I guess seeing the highest numbers in the yellow is a bit disorienting to me. I am going to leave him at the last dose of 1 and give it sometime then see if I need to take him back up. I am glad you told me I could have left him at 1.75. That helps me see that the yellows at his highest points are not as much of a concern.

 

He is back in the purple now in response to the 1 unit I gave him earlier.... So we will see how it goes...

 

I think that purple is a bounce as Sammy hasn't seen a blue reading for awhile. I'd hold the 1u for a day or so to see if the pre-shot comes back down into yellow range and what his mid cycles look like. I find it interesting that Sammy's pre-shots were lower after the missed shots which suggests to me that while 1u may ultimately not be quite enough, 1.75u might have been just a tad too much. We don't have any mid cycle test for the 1.5u and it was only given once so can't really tell how that dose might have worked. If 1u is too little, I'd increase by 0.25u to make sure you don't go past the ideal dose.

 

I agree with Linda about the pink/purple and holding 1.0U for another day or so. I also think it may not be quite enough either and Sammy will probably need 1.25U or 1.5U. We'll see what the 1.0U is doing after 3 cycles, hoping he's cleared his bounce . Have you tested Sammy for ketones recently? Last test I see on the tab is 8 June. Might just be the couple cases of DKA's recently putting me on the side of caution but Sammy has been DKA before. Trying to stay safe