Need Curve Assistance

Charlie was diagnosed on 7/28/20 and 1st insulin (2u/day Vetsulin) was given 7/31/20. Per vet no BG testing until a curve tomorrow. I need help with the process! I've been reading, reading, and reading and it's not clear and very intimidating.

Can someone hold my hand and walk me through every test? The only thing I know for sure is that the first test is done after 1st meal.

• Is the first test done after meal AND after insulin?
  
• When am I giving his 2 insulin injections?
• Do the day's remaining meals need to be precisely timed to hit a specific test?
  
• What are other specifics related to each test or a particular test?
• What should I be watching for, if anything, or am I just recording data

12 hr testing cycle, 6 tests every 2 hrs

1st - after 1st meal
2nd
3rd
4th
5th
6th

Grateful thanks to anyone giving up time on their Saturday to help me!

~K

 

Have you already been to the vetslin board?
BEGINNER'S GUIDE TO CANINSULIN/VETSULIN

Theres more info there. I'm not an insulin user So not much help except to link you to pages you've probably already read.
@JanetNJ
@Elizabeth and Bertie

Hopefully one of them are available .hmmm maybe @Panic is around?

 

I read it when I first joined, won't hurt to read again -- thank you!

 

Actually that’s not correct. You need to test before the food not after. But Vetsulin acts fast and hard so you need to feed at least 30 minutes before giving insulin which means you should be testing about 30 minutes before the shot. Then feed, wait the 30 minutes and shoot. Vetsulin is also called caninsulin because it was designed for canines and it’s not always the best or most effective insulin for cats. It has a much lower rate of remission compared to Lantus or prozync so please keep that in mind.

I love ReliOn and I think it’s a great meter. Warm up the ear is key for me. Use an old sock, fill it with rice or orzo like me, and nuke it for 20-30 seconds. Apply to your cat’s ear and make sure it’s the ear gets warm to the touch. I use a few cotton ovals as a backing for the ear and I press it firmly against the ovals so I can prick it with the lancet. Here’s the spot your aiming for:

 

• Is the first test done after meal AND after insulin? I answered that above
• When am I giving his 2 insulin injections? The insulin shots should be 12 hours apart you pick a time that’s best for you and your cat. I do 7:30am and 7:30pm
• Do the day's remaining meals need to be precisely timed to hit a specific test? Cats tend to be grazers and it’s okay to give smaller meals throughout the day. It’s also easier on their pancreas. But we try to give the bulk of the meals around shot times. The important thing is that your cat needs to have food onboard prior to each insulin shot. Never give a shot if your cat hasn’t eaten especially with Vetsulin. Also, try to not give a lot of food after the insulin peaks, which with Vetsulin tends to be early on, unfortunately like +4 I believe. So then snacks after that but no large meals.
• What are other specifics related to each test or a particular test? We recommend testing before each shot every day and trying a few spot checks during the day so you can learn when your cat’s nadir sets in - lowest BG at any given 12 hour cycle. So I’d start with the 1st am preshot test then maybe try a +4 and alternate so the day after maybe try a +3 instead and then a +5 and so on, so you can gather test data about your cat
• What should I be watching for, if anything, or am I just recording data When it comes to dosing we here adjust by the nadir not the preshot numbers so that’s why it’s good go figure out when that is for your cat. Then you also want to watch for low numbers that indicate a possible hypo episode. Anything under 50 I’m ReliOn is a concern and you then need to treat it as a hypo with Karo, high carb food, etc to bring the number back up. I believe with Vetsulin the only dosing protocol is SLGS but I could be wrong, so check the forum for more info on that

 

Aleluia
So helpful! One FU question:

1. Try to not give a lot of food after the insulin peaks, which with Vetsulin tends to be early on, unfortunately like +4 I believe.

What do you mean by "early on?"
What is meant by +4 (or +X). In my reading, I've not seen (or registered that I'd seen) an explanation.
In this scenario does it refer to hours after the test?v

2. We recommend testing before each shot...and trying a few spot checks during the day so you can learn when your cat’s nadir sets in... I’d start with the 1st am preshot test then maybe try a +4 and alternate so the day after maybe try a +3 instead and then a +5 and so on, so you can gather test data about your cat.

Do you mean that I would do the preshot test, then X hrs later do another test, alternating each day?
I take if from your other comments that I wouldn't be doing only 2 tests (one preshot and then one X hrs later). So, sorry I'm still not clear on the periodic testing bit and their timing.

3. Does anyone ever test on the pad? I see little reference to it...seems it could be easier than trying to hit a "sweet spot...?"

Thanks so much for your help and your time!

~K

 

@Aleluia Grugru & Minnie

see the above

 

Exactly. So you test at 7am let’s say. Then 8am becomes your +1, 9 is +2 and it goes all the way to +11 which will be an hour before your next shot at 7pm. Makes sense? We use the + with a number because we’re all shooting at different times of the day and different time zones. This way we’re all on the same page as to when things happened. If you set up a spreadsheet using one of our templates, you’ll see that’s marked on the columns where you’d enter the BG numbers from your tests. Click on the link to my ss in my signature so you’ll see what I mean

 

Thanks Ale ! BTW I need to shut down for the night see y'all tomorrow.

 

Thank you!

 

Hi Karen about the curve

Let's say you test Charlie at 9:00 AM ( that is AMPS AM Pre- Shot)
You would then feed Charlie
Then wait 30 minutes , then inject the insulin, so that would be 9:30 AM
No feeding 2 hours before any pre shots

During the curve you can feed him small snacks as usual, and during other days, we don't just feed our cats twice a day

So 9:30 AM is when you gave him the vetsulin
11:30 AM. You would test him
1:30 PM. You would test him
3:30 PM. You would test him
5:30 PM. You would test him
7:30 PM You would test him
Now Test him at 9:00 PM
Then feed him
Wait 30 minutes then inject the insulin so that would be 9:30 PM
That would be the curve, you are testing every 2 hours after the injection time

Now for normal testing , since Vetsulin is harsh and can drop BG quickly
Let's say you test him at 9:00 AM
Feed him. Wait 30 minutes
Then inject the insulin at 9:30 AM
Do a test @+2( that means 2 hours after you inject,) so that would be at 11:30 AM
Test again @+4. ( that means 4 hours after you inject ) so that would be at 1:30 PM
Test again @+6. ( 6 hours after you inject ) that would be 3:30 PM

Night time the same thing, cats usually drop lower at night so you want to make sure you test and see how the insulin is working .
The first test is called PMPS ( PM Pre- Shot)

You want to alternate testing times for example do a test @+3 ( three hours after injecting insulin, then @+5 ( five hours after injecting the insulin, then maybe @+7 ( seven hours after injecting insulin)
You want to scatter them to see when and how low he is dropping

Depending what his BG number is you might have to test sooner if his BG drops
below 50 on the Relion meter, you would then feed him about a tablespoon of high carb food , I see you feed Friskies Pate, , you can look at the food chart and see what high carbs and medium carbs are for Friskies.
I feed Fancy Feast so I would only know what they are for Fancy Feast
I'll show you after this post
Always have some Karo or Honey on hand

It all depends if he drops low , then you would have feed medium or high carb , wait 20 minutes and test again
You want to raise his BG to safe numbers two times in a row without feeding any food.
Always post if you need help if he ever drops low and you are not sure what to do
such as. Help Low BG Need Advice, put what his BG is

Why don't you take a look at my spreadsheet and you will see what I am talking about.
You should set up a spreadsheet so you can record his numbers in case you ever need advice on dosing so members can see what his numbers have been
That is the only way they would feel comfortable giving advice

I will give you the link to set up the spreadsheet, if you have trouble doing it we have a wonderful member who will do it for you @Chris & China (GA)
Just post you need help setting it up.

Keep the numbers for the curve tomorrow so you can then fill in the spreadsheet.
I hope this helped , good luck tomorrow

 

Fancy Feast Gravy Lovers Gourmet Beef Feast in Gravy 20% High Carbs

Fancy Feast Gravy Lovers Gourmet Chicken Feast in Gravy. 15% Med Carbs

Fancy Feast Gravy Lovers Turkey Feast in Gravy. 15% Med Carbs

Fancy Feast Gravy Lovers Chicken and Beef Feast in Gravy 15% Med Carbs

So just check the food chart to see what medium and high carbs would be for what you are feeding, it's really the gravy you would need to bring his BG up, you could give him a teaspoon of food, but you don't want to fill him up on food in case you would have to keep feeding him to bring it up, hopefully it will never happen

 

Here is the link for the food :http://catinfo.org/docs/CatFoodProteinFatCarbPhosphorusChart.pdf

 

https://www.felinediabetes.com/FDMB/threads/fdmb-spreadsheet-instructions.130337/

Spreadsheet instructions

 

Hi Karen!

I want to point out some things that haven't been mentioned about Vetsulin.
Vetsulin is a harsh, fast-acting insulin in cats. It hits hard and fast and rarely lasts the full 12 hours we are aiming for (usually only 4-6). It would benefit both you and Charlie if you switched to a longer-acting insulin such as Prozinc or Lantus (Lantus especially!). Vetsulin can be difficult to work with so if you get frustrated with Charlie's data, keep that in mind. We will of course help you if you stick with Vetsulin.

Onset (the time when insulin starts to take effect) for Vetsulin can start very quickly, so it is recommended to provide food 20 to 30 minutes before giving insulin. Peak action may occur between 3 and 7 hours after the injection, though it is typically seen between 4 and 5 hours after.

Recommended protocol for Vetsulin is to test blood glucose, give food, and after 20-30 minutes administer insulin. It is important to have food already on board before the scheduled shot. It is recommended to have food available 1 to 2 hours after giving insulin due to the fast onset of insulin, and continue to have a couple extra mini meals available until your cat’s typical nadir. I really recommend giving food 1 hour after giving insulin and testing at +1 (1 hour post-shot) because that is more than likely when the drop hits. If Charlie's BG drops too fast, he will be at risk for hypoglycemia and will more than likely "bounce", which is a phenomenon the body experiences when the BG drops too low. In order to protect itself, the body dumps excess glucose into the bloodstream and raises the BG up into very, very high numbers. It looks very scary in a reading!

Vetsulin has a fair amount of “wiggle” room when administering more or less than 12 hours apart. It is considered safe to administer insulin up to two hours early or late, though the more consistent the better.

For Charlie I would recommend testing, feeding, waiting 20-30 minutes, shooting, and then testing again at +1 (for EVERY cycle, so that means night-time too!). His BG will usually have started to drop and you'll want to give him a small meal at that time. Like the others have mentioned, you can alternate testing times each day to fill in the gaps on your spreadsheet, but I always recommend a +1, unless/until we have data that proves that his BG isn't affected until +2. It depends on the cat. You can absolutely start a thread for assistance when you test so we can offer advice depending on his numbers, as we want to keep Charlie safe. Feel free to ping any of us by typing in @Panic etc to get our attention (or you can message us directly, since tags aren't going through for everyone as of late).

Friskies Pate is a fine food to be feeding. You'll want to pick up a few cans of the Fancy Feast Gravy Lovers Diane mentioned as part of your emergency kit, in case Charlie's numbers drop too low. Higher carbs will bump up BG into safer numbers in a crisis. Pick up a few medium carb and high carb cans along with a bottle of Karo Syrup. Hopefully you'll never have to use it but it's good to have on-hand in case you do.

As for paw pad testing, you can do it but I think very very few of us do. The paws can get infected when using litterboxes/walking on dirt. I think the only person I know that used the paws was because her cat's ears had frostbite.

 

Diane, thanks SO much for the step by step schedule, the great information, and the spreadsheet link (I have it all set up and ready to go)--I can't tell you how helpful you've been!

 

Elizabeth, I am so very grateful for all your help. I'm still very intimidated and nervous, mostly about Charlie's health, but also about whether I can do this . But, I have no choice.

I feel like I will want to swap out the Vetsulin at some point. I need to get these first testing steps under my belt first.

 

You're welcome! You've got this, you have decades of experienced members at your disposal. Take your time, don't feel like you need to learn everything in one night. Ask questions - ask the same ones over again if you need to.

I have used almost all insulin types with my cat and I will say switching off Vetsulin not only was better for her, but it put less stress/work on me as a caregiver. It's not always easy when you need to be there to watch the cycle but you also need to go to work/appointments/etc - the longer lasting insulins will give you some relief. Baby steps though!

 

You are welcome, I know it was a long post but I found it easier to understand for me understanding it step by step
Great job setting up the spreadsheet.
You got this, I felt the same way you did in the beginning, but you will do great.
Just keep asking questions , that's what we are here for
Good luck with the curve today
I test free hand with the 28 gauge lancets, the ears will bleed better in the beginning with the 28 gauge, they will make a bigger hole, his ears will start to grow more capillaries and bleed better, if you want to you can switch to 32 or 33 gauge lancets. I stayed with the 28 gauge.
The lower size lancet the bigger the hole, higher size lancets the smaller the hole.
Get some cotton rounds and put the behind his ear so you don't poke your finger , then press gently on his earvto stop the bleeding, about 10 seconds to stop the bleeding
If his ears get a little red you can put a thin layer of Neosporin Ointment with Pain relief, make sure its the Ointment NOT The Cream
Charlie is such a cutie

 

Here is a video that Janet NJ made
VIDEO: How to test your cat's blood sugar

 

Diane,

Okay, 1st test done! It was so stressful (for me!), but Charlie was a champ. He tested 392. I set up his spreadsheet, but haven't read instructions on entering the numbers...so I'll do that now. I used a 28 gague lancet.

I have questions about overnight eating--both cats woke me up at 3:30 to eat, I didn't feed Charlie--so I'll have to read back through all the great info from you and Elizabeth and see if you addressed that.

Thanks, again for you help and thanks for checking with me today!

 

I'll make it easy for you - snacks at night are encouraged! Cats tend to drop lower at night than during the day so it's important for night snacks. We do recommend not allowing food 2 hours before pre-shot testing, just because the food will bump up the numbers and not give you an accurate "safe shooting" number.

Good luck today!

 

Thanks, Elizabeth!

As I'm thinking about it, I'm concerned that Charlie may have eaten some of my other cat's food in the early AM hours before his test (the food I gave her when they woke me at 3:30 AM). He doesn't usually do that, but if he was hungry, as the early morning meows would indicate.... [I've transitioned Inky to the same food as Charlie, so there's no danger of him having had a high carb feast.]

I wonder if I should continue with the curve today, or do it again tomorrow.

I'd read that putting out iced food cubes before bed was a good way to provide snacks over night, but how do I know he hasn't eaten in the early AM before testing? When you were getting this under control with Tyler were you attending to him overnight?

 

The food from 3:30 AM (if he did eat any) would only affect his numbers if you did his AM pre-shot before 5:30 this morning. You're fine to continue the curve.

Most of us use autofeeders at night (Petsafe 5 is a popular favorite - and it's on sale on Amazon right now for $28, it's usually $45). It allows you to input up to 9 set times. It has 5 slots, 4 of which you can set a time for (since one is always going to be open) and what most people do is when the last/fourth slot is opened, they set the timer to go off again two hours before AMPS, so it rotates on a now-empty tray. No more food!

 

Al, thanks so much for the images, and the great info. I'm pretty sure I hit the sweet spot, blood didn't gush, so no vein. I put Neosporin on before and got a nice small drop. Still so many questions! Have a great Sunday!

 

Awesome, just ordered the feeder!

 

On more question for now. Here is the schedule so far this morning

7:45 AM AMPS
8:15 AM Feed (he wouldn't eat until then)
8:45 AM Inject

I assume my next test is always +2 from the injection...so, at 10:45?

Thank you!!

 

With Vetsulin I really recommend a +1. It hits faster than most insulin. It's possible that he won't dip until +2 but it's more likely to happen at +1.

 

So,

So, I'll be doing 12 tests instead of 6 in 12 hours, am I understanding that correctly?
Or, +1 only after injection and +2 as usual for the rest of the day?

 

Sorry no, get a +1 and then do every other hour! You can get a +2 if you want, then do +4, +6, etc. OR you can just do +1, +3, +5, etc.

 

AMPS 392
+1 352

How does this seem to you? What you would expect, or are drops more significant, usually?

Gah!

 

Not much yet. You can get a +2 if you like and see if he does anything steeper, but so far nothing alarming. Great job on the test! You can give him a snack now or in a half hour if you like.

 

He got/demanded a freeze dried snack.
As he’s snacking throughout the day, do I need to be aware of when he smacks in relation to each test? Like, can he snack and then immediately be tested? Or does there need to be a no snack space around each test?

Thank you!

 

Sorry, left for a bit.
You want this curve to be like a normal day. So feed/snack like normal, don't worry about feeding in relation to testing times during the day.
And yikes, look at that! Charlie's earned a reduction!

With Vetsulin we don't want Charlie dropping below 90. Any time below 90 (no matter what time of day it is), he earns 0.25 unit reduction. So starting tonight please only give him .75 for now on.

You also want to feed a LC snack and re-test every 20 minutes until he's above 90.

 

Thanks so much for checking back in! He's below 90. By LC food, I'm guessing you don't mean his regular low carb/high protein food? It's now been 20 minutes since I tested him...

AMPS 392
+1 352
+3 64

 

Whoops sorry, LC means low-carb. Could you please re-test him? I'll explain how to put it in the spreadsheet but right now we need to get his BG back up.

 

Hi Karen,

It's best to feed Charlie on the same schedule as any other day when you're running the curve. The purpose of running the curve is to give you an idea of how Charlie's insulin dose is working under normal circumstances. If you were to artificially alter his feeding schedule while running the curve it wouldn't give as true a picture.

It's a good idea in general to make a note in the Remarks section of Charlie's spreadsheet about the food type and time of meals/treats and it can help spot patterns or answer puzzles sometimes. For example, ingredients like beef or soy can spike some cats' numbers, even though the food in which they're contained is low carb. With the BG data in the sheet but no food info those patterns would have been harder to spot.

 

I keep cross-posting with you, Elizabeth! We'll have to stop meeting like this.


Mogs
.

 

Great minds think alike, Mogs!

 

Have you heard what they say about fools?!


.

 

I feel like I suck at this so hard!

Okay --

AMPS 392
+1 352
+3 64 (after, ate freeze dried treat + mouthful of regular LC food)
+ 30 min 221 (ate freeze dried treat after)

I'm not on any feeding schedule with him. Being newly diagnosed, I haven't changed anything about his feeding except the food itself. He pretty much was able to eat whenever he wanted. I would welcome a regular suggested feeding schedule. I think enough info has been provided here to help with me feeding on curve day.

Clarification: I'm not allowing him to feed 30 minutes ahead of injections.

 

You're doing great, Karen!

Okay awesome, no more scary numbers. He has started to bounce which is completely expected. He dropped hard and fast and that almost always triggers a bounce. He's probably going to stay high the rest of the day. You can continue the curve if you like but we'll probably only see higher numbers now.

If Charlie is a grazer and not a scarfer you can keep free feeding him like normal. Just make sure no food 2 hours before AM/PMPS. We at least want to make sure he has snacks before nadir. Right now it's too soon to tell when that is.

In your spreadsheet under +3 please input it like this: 64 (+3), 221 (+3.5). The cell will have to be manually colored if you do this, just make it that green color with white font so everyone can recognize he dropped very low.

 

Should I put a comment in each cell as to the conditions under which I tested? Can you check what I did?

 

Looks great! You'll put the food/time info in the Remarks section on the far right. That way you can list what you did and when without messing up the spreadsheet.

 

Okay, so, that's preferred over adding a comment in the applicable cell... it doesn't seem to mess anything up, but you guys are the boss of me now and I'm SO grateful!!!

 

It usually stretches the cells and messes them up, but the remarks section is there for that reason anyway. Great job today!

 

Nooo? Charlie is the boss of you.

 

Okay, .75 it is. Thank you!

 

Hahaha!!! That's a fact.

 

The sooner we ALL realize that, the world will be a better place.

 

So long as you know your place, Karen!


Mogs
.

 

I, for one, welcome our new feline overlords.


Mogs
.

 

me too

 

Charlie just tested highest so far today. I'll continue testing for the curve--this is our 1st testing of any kind, per vet, and I'll be emailing her numbers tomorrow. But, this is just stressing me out! Charlie is getting wise and growled. I've had to poke him multiple times and use 2 tests strips on each of the last 2 tests. What should I be doing differently?

AMPS 392
+1 352
+3 64 (after, ate freeze dried treat + mouthful of regular LC food)
+3.5 min 221 (ate freeze dried treat after)
+5 423 (ate lunch of FP Poultry Platter within 20 minutes of testing, got FD treat after)

 

For sure!

 

I'd call it quits for today. Charlie sounds grumpy and you're in a bounce - bouncing numbers can take up to 6 cycles to clear, but for this cycle you've got all the useful data you're going to get. Send the numbers to your vet and explain that Charlie experienced a bounce. I have no idea if most vets know what bouncing is but oh well. Charlie did good today, you don't want to push him where it's not needed.

As for the multiple pokes - totally normal. It takes a while for the ears to form capillaries that makes drawing blood easier. Warming the ear helps but in the beginning stages you just have to wait for the capillaries to develop and deal with the extra pokes. Were the test strips giving you errors? You may not have had enough blood - which brings you back to it just being part of the starting out process. You're doing exceptionally well honestly.

 

Are you giving Charlie treats after each poke? you want him to associate nummies with test and shot time.. You can start with having him in the spot you are going to test give a treat...let him go...try again with a treat and get all the supplies in front of him give a treat...let him go.. get where I'm going? eventually he will associate a little poke with nummies.
have you read here?
Hometesting Links and Tips

 

Thanks, JT...I had read the Hometesting tips a few days ago, but will peruse again. He is fed & sleeps on a counter in the laundry, so that's where I've been testing. He's in his bed, which I can sort of fold around him (which I did the last time) to contain him, without really trapping him. Plus, it's easy for me because it's counter height, easy on the knees. So, I believe his association with the spot is good--"I can get food here and TREATS here!"

 

OMG...thanks for the encouragement. I swear, though...

I'm heating his ear with a rice sock, so either I'm being a chicken and not poking hard enough (though I think Charlie would beg to differ), or it's a "new ear" problem, or both.

The times I had to use 2 strips were when there was not enough blood, and the 2nd time it seemingly wouldn't measure too much blood. I fumble pushing the strip into the meter, time spent which I'm sure Charlie doesn't appreciate. I locate it in the easiest spot for me to pick it up after drawing blood, but pushing it in one-handed...I need to practice.

Should I still go ahead and reduce injections to .75?

 

I'd wager just new ear trials! It took me like four days to consistently get tests in so you're doing better than I was!

Yep, it does that. I don't know what the Premier strips look like but the Prime strips you could "see" the blood filling up the strip. If it doesn't fill all the way then it won't read. You'll eventually be able to eyeball a blood drop and tell if it's going to be "enough" for the strip to read.

I tried doing the little trick of keeping the strip halfway in the meter but like you, sticking it in one-handed and all that was way too difficult so I just started sticking it in all the way. What I did was insert a strip and count how long it took for the meter to time out - 2 minutes. Not sure what the countdown on the Premier is, you can check, but I bet it's also 2 minutes. If a meter times out, the strip is STILL GOOD as long as you haven't put in blood in it. If you can get in the swing of drawing blood and touching the strip to the drop in under 2 minutes you won't need to play the one-handed game.

Yes, Charlie has earned that .75 reduction. Do not be tempted to give more tonight if he is still high, that's the bounce talking. I'm going to tag @Deb & Wink to ask her if she thinks, based on the very big drop today, if she recommends dropping any more than .25 units. She may say the .75u is fine, but on occasion I've seen her recommend more of a drop for new diabetics.

 

Genius advice about timing the timeout of the meter! Mine also times out in 2 minutes.
I'll do .75 unless Deb chimes in and advises otherwise. Thanks again and thanks for all your time!

 

I want to give a heartfelt thanks to each of you who has posted here, encouraging and offering advice. I'm not sure how to tag you in this forum, I hope you all see this and know what a huge help and comfort you have been. I couldn't have gotten through this without each of you! Thanks for all of the time you took to help out this nervous, stressed out fur mom!

jt and trouble (GA)
Aleluia Grugru & Minnie
Diane Tyler's Mom
Panic
Critter Mom

 

Hey we were ALL nervous stressed out fur moms! Glad to have been some comfort to you.
jeanne

 

Deb agrees with the reduction to 0.75U.

Just a quick answer for now. Need to do some things, like get dinner.

 

There simply isn't enough data to know if the dose should be lowered further.

Are you able to get a test or 2 in each cycle, after the pre-shot test?
Try to "sprinkle" those tests around at different times, like you are sprinkling jimmies on top of your ice cream. You don't want the jimmies in only one spot, but spread out so you get some with each bite of ice cream. Sort of the same idea with getting tests at different times during the 12 hour insulin cycle.

You do that, so you discover the onset, nadir, and duration for this particular insulin and this dose for YOUR cat.

p.s. Are you feeding Charlie at least 20 minutes before the insulin shot? That is important to do with Vetsulin (aka Caninsulin).

 

Deb, thanks so much for adding to the conversation. I'm brand new at this and I'm sorry, I don't know what you mean.

Getting a test or 2 in each cycle -- what's a cycle?
Sprinkle the tests around at different times -- do you mean when doing a curve I should not do testing strictly 2 hours between tests? That I should vary the time in between tests? 2 hrs one time, 4 hrs the next, etc.?

I [now] am making sure that Charlie eats 30 minutes ahead of his injection. I learned it here, not from my vet.

 

A cycle is 12 hours - it starts when you administer insulin and ends when you administer again. So if you shoot insulin at 9 AM and again at 9 PM, the entire cycle was from 9 AM to 9 PM. There's two cycles in 24 hours. Deb is wanting you to test at least a couple times in each cycle.

A curve is when you test every 2 hours in a cycle. "Sprinkling" the tests - or doing spot checks, as we call them - has you alternating your testing times. Like say one day you test at +2 and +4, and the next day you might test at +1, +3, and +5. That will fill in the gaps on your spreadsheet. Most of us actually don't even do curves at all, we do spot checks instead. Spot checks every day paint a bigger picture than doing a curve every once in a while. If you look at my spreadsheet below, you can see the "sprinkling" of tests every day.

 

Elizabeth, thanks for responding. I'm afraid I'm more confused than ever. I think I have information overload for my first testing day. I'll have to start fresh tomorrow.

But, if I understand right, tomorrow I should do random spot tests. Charlie is a grazer, not a set time eater. Earlier today, I'd asked whether I should pay attention to his food intake when doing my curve testing. You responded "feed/snack like normal, don't worry about feeding in relation to testing times during the day." I assume that advice is the same on a normal day, when not curve testing.

Do most people here still involve a vet in their cat's care on a regular basis? Or, have you all become such an educated community that it's not necessary unless something is out of control or becomes critical. Just curious.

So grateful for your help.

 

Hi Karen been reading this post about you and Charlie who is a Cutie and I just wanted to say You are doing a Great job Your really learning and trying for Charlie what a Great Mom
You can do this Karen yes it’s Overwhelming and so much to process but this forum is Amazing and as you can see you will love this bunch you just met . I can tell you they all really do care . Keep asking questions and Welcome to you and Charlie even if you just need to talk or vent we are here

 

You've done a lot today, take a step back and let yourself recharge. There's a lot to cover, but the information above isn't going anywhere. Take your time.

You are correct. Spot checks tomorrow, get an early test (between +1 and +2) to see if he's dropping noticeably. It may take him a while to "clear" the high bounce numbers so if he's still high tomorrow don't be concerned. With Vetsulin you want to focus more on the early tests (between +1 and +5) so get at least a couple then if your schedule allows. As we saw today, that's when the most changes occur.

And correct again, let Charlie do his thing, if he prefers to graze let him. A "curve day" is supposed to mimic a normal day. Feed him like normal every day, whether you're doing a curve or not.

Lol ... no. As long as kitty is happy and eating, we keep our vets out of it for the most part. Most of us just do the "smile and nod" (and maybe a bit of eyeroll) when our vets make suggestions and just keep doing our own thing. They just don't have the experience that the caregivers here do. Once I starting calling the shots for my girl's diabetes, I didn't take her back to the vet for almost a year. Just sent in spreadsheet numbers once a week and told them how she was doing. If you ever hear someone telling you to take your cat to the vet though ... it's something serious.

 

Dusty, I'm so grateful for your encouragement. I've found this to be.the most knowledgeable, caring, helpful community I've been part of. SO glad I found it! And, my helpers today are all off the chart. Above and beyond.

 

You're a saint. I feel like I've thanked you a dozen times today, and with all your responses when I needed help, I probably have.

 

Hi Karen how are you and our new boy Charlie today ? Just checking in on you

 

Morning Dusty, I just did Charlie's AMPS and it's posted. 437
Thanks so much for checking on us this morning!!

 

Insulin -- switching from Vetsulin to ???

I thought rather than a new thread, I'd ask here first, since you've been my "trusted team" so far.

1. What do you recommend I should switch to from Vetsulin? My vet suggested Vetsulin & Prozinc, at twice the price of Vetsulin.

2. I'm not able to see insulin pricing on Marks Marine Pharmacy website. Do any of you purchase from Marks?

Thank you!

AMPS 437
+2 360

PS -- Panic, I found your reply to me on Lantus. Now that I'm paying attention to changing insulin, it's valuable info. Thanks!

I recommend looking into Lantus! It's outrageously expensive here in the US but if you can get a script for it you can send it to Mark's Marine Pharmacy - the upfront cost is higher but in the long run it's actually the cheapest insulin. One box of 5 pens (they are like mini-vials) is $169 plus $25 shipping, but because they are like mini-vials, you only open one at a time, use the entire pen to the last drop before opening another which extends the expiration date. Depending on kitty's dosage a box of pens will last 9 months to 2 years! In 9 months time you'll have purchased 2-3 vials of Vetsulin ($168) and in 2 years time 5-6 vials ($336). Cats respond better to Lantus than any other insulin out there too.

 

MANY here purchase form Marks

 

I happen to be one of the members that believes keeping a good relationship going with your vet is important.
Think of us as an "adjunct" or supplemental resource to your vet.

Plus, we have links to a lot of the more current feline diabetes vet journal articles and practical day to day advice you can share with your vet.
Most vets don't have the time to give that day to day guidance that many diabetic cat owners need. We do. We share what we know with you, and you can share that with your vet.
Vets are welcome here, and we've had a few over the years.

p.s. It really is time for a new thread. Simply link this old one at the top, for reference and history.

 

Personally I spoke to my Vet about insulin and she highly recommend Lantus . It was my choice too . Is Charlie eating ? I think the rest of the crew will advise you to switch insulin too ...... your doing Great hang in there Karen Saying a prayer for Charlie’s BG to go down

 

My vet ignores the articles I send her ... can you tell why I'm switching.
I'm envious of all the members who DO have enthusiastic vets willing to learn and share. It's definitely a good thing to have a vet who will work with you.

Karen, there is this handy little guide we like to print out - 2018 AAHA Diabetes Management Guide. It's from the American Animal Hospital Association. They recommend a low-carb diet with Prozinc or Lantus for cats.

 

Hi Dusty,

Yes, Charlie is eating; he got very skinny before he was diagnosed...that was why I initially took him to the vet. Panic also recommended Lantus. Have a great evening!

 

Thanks, Panic! It remains to be seen how my vet will be when I email my numbers to her. I wanted to try to get as many tests in today--after the disaster of yesterday--before emailing her. If you have nothing better to do tonight, would you take a peek? I did his PMPS and am waiting to do a +1 and maybe a +3. +3 was where he dipped so low yesterday morning.

 

Thanks for you perspective, Deb. I will go ahead and abandon this thread where conversation is off the original topic.

 

Sure I'll stick around! It'll be interesting to see what he does tonight. Looks like he was trying to clear that bounce earlier.

 

You're probably dead to the world now; but, in the morning, if you wouldn't mind taking a look at Charlie's numbers, I'd be so appreciative. Thanks!!

 

Morning, Karen.

Looks like Charlie might be bouncing a bit after yesterday's AM cycle green.

I think it was right to reduce the dose from 1.0IU to 0.75IU of Vetsulin. It's what I would have done if Charlie were my cat. That green was a low green, there was no bit of safety cushion in it at all on the 1 unit dose. Also, most cats run lower in their night time cycles so that 1 unit dose could have potentially taken BG lower again than the 64mg/dL that you saw yesterday.

You did a great job with the testing, Karen. It shows that Charlie is giving a textbook response to Vetsulin: dropping fast in the early part of the cycle, and the dose pretty much spent by +8.

Bon chance with the vetty bean today.


Mogs
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Thanks, Mogs! Would you recommend I keep randomly testing Charlie every day, like I did yesterday? Is this how it goes? Just keep testing and injecting and hope something changes? Gah!

468 AMPS is highest since I've been testing (3 days).

I see you switched from Caninsulin to Lantus which is what I want to do! Do you syringe out of the pen or use the pen injector?

Thanks a million!

 

Amazing job Karen ! KEEP UP THE GOOD FIGHT!

 

Good job with the tests yesterday, Karen!
Keep an eye on those numbers between +1 and +5 mainly, that's where the action is for him.
You're experiencing bounce numbers AND the result of Vetsulin not acting long enough. Unfortunately he's probably always going to be unpleasantly higher at pre-shot simply because the insulin has run out a few hours before, thanks to the short duration.

We use the Lantus pens like mini vials, so you insert the syringe into the pen. When you use the pen injector it only allows full units, so you couldn't even draw Charlie's 0.75u dose. Plus you have to "prep" the pen, which means wasting 2 units every time!

 

Thank you!!

 

Gotcha, thank you!!

 

Not all that randomly with Caninsulin/Vetsulin.

When Saoirse was on Caninsulin, in textbook response to this insulin her BG dropped hard and fast early in the cycle. For her safety, I did the following tests as a matter of course:

* AMPS
* AM+3 (earlier if she showed a marked hunger uptick at onset of the dose - anywhere from +1 onwards - and then the regular +3, as she tended to nadir early).

* PMPS
* PM+3 (so I could be as sure as possible she would be safe while I was asleep.)

I would check again later in the cycle if her +3 tests were uncomfortably low.

I would do occasional curves or spot checks to cover the +6 to +8 period to track the duration of the Caninsulin dose (or rather, lack thereof). This provided evidence for my vet to be able to prescribe Lantus under UK drug cascade rules, where it must be demonstrated that a treatment licensed for use in cats is not fully effective before other non-licensed treatments can legally be pursued.

I advocate ALWAYS getting a before bed check, regardless of insulin type, especially because most cats tend to run lower at night.

One night early in Saoirse's treatment, a before bed check saved her life. It was the only symptomatic hypo she had - and she was still ABOVE the lower limit of the normal reference range.

Other than making dose adjustments as required, pretty much.

I could not have put it better myself.


Mogs
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Forgot this bit!

I used 10ml vials of both insulin types. I have PTSD and my hands get very shaky so I found the vials easier to manage. I did try the pen cartridge (as a sort of mini-vial) but I found it too fecky to use.


Mogs
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