? New Member - gave 2 shots of caninsulin HELP

Discussion in 'Feline Health - (Welcome & Main Forum)' started by Tam & Loki, Jan 30, 2021.

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  1. Tam & Loki

    Tam & Loki Member

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    Hi, I'm currently borrowing an AlphaTrak from the vet but will have to return it soon. I'm looking into buying a human meter based on some advice on here - is there a chart somewhere that tells me how to interpret the numbers on a human one vs animal?
    Many thanks in advance :)
     
  2. Summer and Susie (GA)

    Summer and Susie (GA) Well-Known Member

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    Dec 20, 2020
    Hi Tam & Loki. You do not need to interpret the numbers on a human meter vs the AlphaTrac. Just go with what the human meter says. No coding is necessary. The ReliOn meters are a good choice. I recently switched from AlphaTrac 2 to ReliOn Prime. It is not as easy to use as the Alpha Trac but it is a suggested human meter. I am a new member but wanted to let you know that the board has been dealing with another cat that was seizing so give them some time to get back with you. It was a 911.
     
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  3. Tam & Loki

    Tam & Loki Member

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    Jan 23, 2021
    Hi Summer, thanks for replying and for the head's up. I hope the other cat's ok, it's all quite scary tbh.
    I thought I'd read somewhere that you could accept lower numbers for hypos or something on a human one, which I thought meant the number ranges must be different! I think I need to do more research!
    Thanks for the tip on which meter, I'll have a look.
     
  4. Gill & Mac (UK)

    Gill & Mac (UK) Member

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    Hi Tam
    As Susie said you do not need to worry about how to compare the numbers. I see that you have set Loki's spreadsheet up for already your alphatrak readings. Threre are different template spreadsheets availsble for pet and human readings so you just need to swap over to using the other style template and enter the new readings with the new meter on there. The sheet will then automatically colourcode them for you like before so you will still be able to tell if your new readings are green etc. I think yiu would probably put the links to both in your signature and put a note on the new spreadsheet to say that previous readings are on the old one and vice versa on the old one. That way if you need help whoever looks at your spreadsheet knows to look at both ones for the full history. There may be a clever way to link them- if so i am sure @Marje and Gracie will know it. There is a link on here somewhere for the don't shoot etc numbers based on a human meter - I'll find it and post it for you shortly.
    Finally welcome to the best help family around.
    Gill
     
    Last edited: Feb 1, 2021
    Reason for edit: Amendment
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  5. Summer and Susie (GA)

    Summer and Susie (GA) Well-Known Member

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    I heard the same thing when I first started testing with AlphaTrac 2. I heard that this meter generally tested about 20 points higher than a human meter. I think my vet even said something about that but I have since been told to try and not compare them. Confusing. Anyway, the ReliOn Prime is a good human meter but it is different. You won't get a "beep" when the testing is done and you won't be able to insert the strip half way into the meter prior to the test. You also will have to get blood from the very end of the strip and not the sides. I loved the AlphaTrac 2 testing meter but this group does not recommend it. Hopefully, you will hear from the moderators tomorrow or when this emergency is over. It is scary. I always say I just want my cat, Susie, in the low 100's because I don't want to deal with the "nail biting" low number that can help with remission but also cause hypoglycemia if we are not careful. Good luck to you and Loki!
     
  6. Summer and Susie (GA)

    Summer and Susie (GA) Well-Known Member

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    By the way, when you do want to switch to a different meter contact @Marje and Gracie. She can help show that transition on your spreadsheet.
     
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  7. Gill & Mac (UK)

    Gill & Mac (UK) Member

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    Aug 19, 2020
    Hi
    I use the alphatrak2 meter and I really like it. It is acknowledged as being very good - can put strips in halfway.tiny drop of blood only needed etc. But as you say most tend to use the human ones as the alphatrak problem is the cost of the strips. At almost £1 a :(strip if you don't have insurance that covers it then it can work out v expensive !! I bought it because the vet has that one & I didn't know any better at the time.:)
    Gill
     
    Last edited: Jan 30, 2021
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  8. Gill & Mac (UK)

    Gill & Mac (UK) Member

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    @Critter Mom
    @Elizabeth and Bertie
    @Chris & China (GA)

    Hi can one of you lovely people help with the above at some point please. I can't find the post with this info on :banghead:. I know that you're tied up with a 911 at the moment Mogs.
    Thanks
    Gill
     
    Last edited: Jan 30, 2021
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  9. Critter Mom

    Critter Mom Well-Known Member

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    Hi Tamsin,

    The feline BG reference ranges used at FDMB are as follows:

    Alphatrak meter: 68-150mg/dL | 3.8-8.3mmol/L To clarify, FDMB has no defined 'normal' reference range for users of pet meters, and vets vary in what they consider to be the normal feline BG reference range. FDMB sets 68mg/dL | 3.8mmol/L as the threshold for pet meters at which dose reductions are earned when caregivers are using Lantus/Basaglar or Levemir and following the tight regulation protocol (based on information given in the relevant study).

    Please consult your vet for guidance on the normal reference range for the Alphatrak meter.

    Human meter: 50-120mg/dL | 2.8-6.7mmol/L

    There is no direct correlation between the different ranges, you just apply the appropriate reference range for the meter you are using. The way that glucose is transported in the blood is different between cats and humans and this is why the two meter types require different reference ranges.

    NB: Contrary to some info provided in one of the earlier replies to this thread, there is no "Alphatrak meter reading = human meter +20 mg/dL" type of linear relationship between readings taken on the two meter types. If anything, a percentage relationship would be closer (but still not applicable). There is not a great deal of difference between the numbers for readings taken when 'actual' BG is in the lower part of the range, but as 'actual' BG increases the readings given by human and pet meters diverge very significantly. If actual BG is high the difference between the readings for the same 'actual' BG could be in the three figures.



    Mogs
    .
     
    Last edited: Jan 31, 2021
    Reason for edit: BG reference range comment (blue text).
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  10. Sienne and Gabby (GA)

    Sienne and Gabby (GA) Senior Member Moderator

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    Mogs is correct. You cannot directly compare readings between a human and pet meter. It's not a simple "add 20 points." In all likelihood, it's a complex mathematical equation that would take a large sample of cats who were being tested on both meters and someone with better math skills than me to figure out if there's a means to compare.

    The vet who developed the Tight Regulation Protocol for Lantus did note in the journal article that was published on the protocol that the dose reduction point on a human meter was 50 and on an AlphaTrack was 68 for cats that were a part of that study. And that's all we know.

    Since you're using Caninsulin, I would simply follow the dosing parameters that are described in the Caninsulin/Vetsulin Guide. They are based on a human meter.
     
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  11. Critter Mom

    Critter Mom Well-Known Member

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    Tamsin,

    Gill asked one of us to post the 'no shoot' limit for newly diagnosed cats who have little or no BG data gathered yet. On a human meter, it is 200mg/dL.

    We don't have a defined no-shoot limit for an Alphatrak. Best suggestion is to ask one's vet for guidance on this.


    Mogs
    .
     
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  12. Tam & Loki

    Tam & Loki Member

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    Jan 23, 2021
    Thank you so much everyone for taking the time to reply, I know you must all be so busy.
    Is there a recommendation for a human meter that is closest to the Alphatrak in terms of how much blood you need? The 0.5ml that some need seems like a lot, I definitely don't get that much most of the time, although it might come with practice x
     
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  13. Summer and Susie (GA)

    Summer and Susie (GA) Well-Known Member

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    A lot of people on this site use the ReliOn. I use ReliOn Prime but there is another ReliOn (I think it is Premier). It took me a little while to get used to it and you do need a little more blood. The Prime also requires the special CR battery (like the AlphaTrac 2). I think the Premier runs on AA or AAA batteries which most of us have at home. Also, ReliOn requires blood at the tip of the strip. With AT you can get blood from the side of the strip. I'll let the experts answer this question for you as I am a "newbie".
     
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  14. Katherine&Ruby

    Katherine&Ruby Well-Known Member

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    Oct 8, 2020
    The Freestyle Lite and Nova Max are meters that requires only .3 microliters of blood like the Alpha Trak, but the strips for the Freestyle are more expensive than the Nova Max. Many people here use the Relion because the strips are the least expensive though the blood sample size is a bit larger. I for one don't mind needing the larger sized blood sample for the meter I use as I get the amount I need from Ruby on the first poke about 98% of the time using 31 gauge lancets, but Ruby's ears are used to the poking now and bleed more easily.

    I would highly suggest you move over to the human meter as it makes conversations here about your cat's progress a little easier on this forum, plus you'll save loads of money on test strips. Good luck with it and welcome! :bighug:
     
  15. Tam & Loki

    Tam & Loki Member

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    Jan 23, 2021

    Thank you for your reply :)
    I have posted on the caninsulin forum today but I think I might have done it wrong because had nothing back. I'm concerned because Loki's BG have gone UP since his am shot. AMPS: 23 then 2units insulin. +2 = 25.5, +3 = 25.7, +4.5 =27.8. I have just given him 1.5 units of insulin, I hope that was the right thing to do
     
  16. Katherine&Ruby

    Katherine&Ruby Well-Known Member

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    Hi Tam, Did you just give another shot of Caninsulin at +5? I believe you're only supposed to dose every 12 hours as per this sticky: https://www.felinediabetes.com/FDMB/threads/beginners-guide-to-caninsulin-vetsulin.231587/

    I'm not familiar with Caninsulin, so I'm tagging @Bron and Sheba (GA) and @JanetNJ to help you.
     
  17. Tam & Loki

    Tam & Loki Member

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    Jan 23, 2021
    I did - he is starving and shouting for food - normally he has lunch because we're trying to get him to gain weight but I daren't give him anything without any insulin cover as his BG are rising so much.
    Thanks for tagging the others for me.
     
  18. Katherine&Ruby

    Katherine&Ruby Well-Known Member

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    Oct 8, 2020
    Do you have many test strips available and some high carb food, honey or kibble on hand? Would you be able to test him again in 30 minutes to see where his number is?
     
  19. Tam & Loki

    Tam & Loki Member

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    Jan 23, 2021
    Yes I was going to test him in 15 mins anyway and have a hypo kit ready.
     
  20. Katherine&Ruby

    Katherine&Ruby Well-Known Member

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    Tami, I'm newish here so I'm just trying to help before more experienced members come on board, but what I know is that one should not administer insulin more than once in a 12 hour period so having a hypo kit ready is great!

    Do you know how to change the title of your thread to "New member - gave two shots of Caninsulin HELP"

    @Sienne and Gabby (GA)
    @Critter Mom
    @Gill & George
    Are any of you around to help a potential low number situation?
     
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  21. Tam & Loki

    Tam & Loki Member

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    Jan 23, 2021

    No I don't, I barely know how to use this board at the mo x
     
  22. Katherine&Ruby

    Katherine&Ruby Well-Known Member

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    Go to the upper right corner of this screen and you should see a button "THREAD TOOLS" as per the image I have attached. Click on that and you can edit the thread title.
    Screen Shot 2021-01-31 at 7.51.08 AM.png
     
  23. Katherine&Ruby

    Katherine&Ruby Well-Known Member

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    Good job! Now test him in a few minutes and let me know what the reading is.
     
  24. Sienne and Gabby (GA)

    Sienne and Gabby (GA) Senior Member Moderator

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    Dec 28, 2009
    Katherine is correct. You should not give a shot more often than once every 12-hours. This is particularly true for an insulin like Cannsulin/Vetsulin that can drop numbers fast and hard. Even if you think you gave a fur shot, do not give more insulin since you have no idea if any was injected. (And even if you saw the needle go in and out the other side of the skin fold and shoot across the room, do not give a second shot!)

    Do not use human parameters with dosing your cat. Those rules don't apply. You don't use insulin to "cover" food in a cat.

    You are going to need to be hyperviglient and test a lot this morning. I would test in 30 min. to start.

    You may want to consider posting on Health. The Caninsulin board is not as active as Health.
     
  25. Summer and Susie (GA)

    Summer and Susie (GA) Well-Known Member

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    Tam, I also had a post on the caninsulin forum and did not get a response. I think you should post in the Main Forum (Feline Health). It seems to get more responses.
     
  26. Gill & George

    Gill & George Well-Known Member

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    Oct 27, 2015
    You don't need to with hold food just because his BG is high, he may have been high because he was bouncing of that blue he got yesterday, as Sienne already said you also don't need to 'cover' the food with the insulin, and shooting a second dose is not advisable.

    Caninsulin can make them drop hard and fast, so you will need to be especially vigilant.
    Keep us posted we will be here if you need us.

    Keeping paws crossed.

    NB the Caninsulin board doesn't get has much traffic as feline health so post here when you need help quickly or if you don't get a reply on the Caninsulin forum
     
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  27. Tam & Loki

    Tam & Loki Member

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    Jan 23, 2021
    BG now 24.9
     
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  28. Gill & George

    Gill & George Well-Known Member

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    how long after the second shot? and how many hours after the first? Do you think you could note the numbers on the SS as you get them please? Thanks.
    24.9 or 448 (in FDMB money)
    could you please quote the numbers in US figures, it's what we all use and it makes more sense so we can quickly assess them for you.
     
  29. Sienne and Gabby (GA)

    Sienne and Gabby (GA) Senior Member Moderator

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    Dec 28, 2009
    These are some general guidelines for low numbers. Even though your cat isn not currently in low numbers, this MAY happen. It could also be a non-event and I want to make sure you're prepared. Do you have a supply of test strips and high carb food or corn syrup, etc. if Loki's numbers drop?

    If your cat is testing in low numbers and you are not getting a quick response to your post, there are several things you need to do. (Low numbers are under 50mg/dL or 2.8 mmol/L.)
    • Depending on how carbohydrate sensitive your cat is, feed approximately a teaspoon or less of gravy from high carb food or high carb food only. (If you have a cat with GI issues, using a couple of drops of syrup plus low carb food is an alternative.)
    • Test again in 15 – 20 min. Depending on the numbers, give more HC food.
    • Repeat the above steps every 15 – 20 min. until your cat tests in the 50 mg/dL (2.8 mmol/L) or above range for 2 consecutive tests. Continue to feed in small amounts to keep numbers in a safe range.
    • Test in 30 - 40 min. and repeat the test and feed process until there are 2 consecutive tests where numbers are stable or rising.
    • Test in an hour and follow the same steps.
    DO NOT become complacent. If numbers have risen after one or two tests, it’s important to continue testing. Numbers may bobble up and down as the HC food and/or Karo wear off. DO NOT get one test where your cat has risen from low numbers into the 50s and go to sleep or leave the house. You are putting your cat in a risky situation. When in doubt, leave HC food out.
     
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  30. Tam & Loki

    Tam & Loki Member

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    Jan 23, 2021
    Hi, I have been putting the numbers on the SS, arethey not showing?
    Thank you all for your responses x
     
  31. Sienne and Gabby (GA)

    Sienne and Gabby (GA) Senior Member Moderator

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    They are showing. I needed to refresh the page for the newest number to appear.
     
  32. Tam & Loki

    Tam & Loki Member

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    Jan 23, 2021

    The 24.9 was 1hr after the 2nd shot, 4hrs after the 1st.
    He is currently alert and shouting at me.
     
  33. Sienne and Gabby (GA)

    Sienne and Gabby (GA) Senior Member Moderator

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    Dec 28, 2009
    It's OK to feed Loki if he's hungry. Just do not over-feed. If his numbers drop, you want him to be hungry enough that he'll eat the high carb food you give him. If he's full, he may walk away or vomit if he over eats.

    Since he's doing OK, one of the concerns with giving 2 shots is that you now have 2 nadirs to contend with. The nadir from the first shot may end up overlapping with the insulin onset from the second shot and then there's the nadir for the 2nd shot. You'll need to be testing to make sure numbers don't tank. Like I said above, we don't know if this will be a busy day or testing or a non-event.
     
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  34. Tam & Loki

    Tam & Loki Member

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    Jan 23, 2021
    So it transpires that Loki may not have got the full insulin dose 1st thing this morning as my husband said there was blood at the injection site afterwards (I don't know if this means anything)
    He then said that it is POSSIBLE that Loki could have got into the pancake mixture that was on the side because the cloth covering it had been moved - he is dreadful for stealing food at the moment. We're normally so careful. So basically it's all a complete mess :arghh:

    That's what happens when I'm upstairs with a migraine and not doing the usual routine ☹️
     
  35. Gill & George

    Gill & George Well-Known Member

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    :rolleyes: George before getting regulated was dreadful, he was forever hungry, I turned my back one morning and he was steeling my toast with blueberry jam. It's not the end of the world.

    Try not to worry, and just see how today pans out.
     
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  36. Katherine&Ruby

    Katherine&Ruby Well-Known Member

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    Tam, it seems like you have the best eyes in the biz on you and Loki today. :) They will help if you need it. Hope your migraine clears up and Loki stays safe. :bighug:
     
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  37. Tam & Loki

    Tam & Loki Member

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    Jan 23, 2021
    Can I please ask.....based on today's events, and Loki's SS, shall I give Insulin as normal tonight? He would normally get 2 units at 8pm

    Thanks
     
  38. Critter Mom

    Critter Mom Well-Known Member

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    Jun 16, 2014
    Hi Tamsin,

    I would definitely NOT give any insulin at the normal time tonight because the second dose will still be active in Loki's system.

    Please can you provide the following info:

    * Does Loki have any history of testing positive for ketones or episodes of diabetic ketoacidosis?

    * Please can you confirm that Loki got the following doses today:

    - 2.0IU Caninsulin at normal shot time (08:00).
    - 1.5IU Caninsulin at +5 hours after the first dose was administered (13:00).​

    (I've only skimmed the thread so I want to be certain I've got a proper understanding of events before making any suggestions on how you might proceed tonight.)


    Mogs
    .
     
  39. Tam & Loki

    Tam & Loki Member

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    Jan 23, 2021

    Hi, we were certainly never told that he had ketones or ketoacidosis and to be honest it was such a blur at the time that I didn't think to add it to my long list of questions!

    - 2.0IU Caninsulin at normal shot time (08:00).
    - 1.5IU Caninsulin at +4 hours after the first dose was administered (12:00).

    Also, he has just had diarrhoea. I don't know if that is related to all this, or because we are transitioning him from his LC wet pouches to raw food.

    Thanks Mogs
     
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  40. Critter Mom

    Critter Mom Well-Known Member

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    Hi Tamsin,

    Thanks for the info - you can see why I asked now! :)

    Firstly, WRT the diarrhoea either issue - or both - could potentially be affecting Loki's digestive system.

    On insulin you have the following choices:

    1. Fast Loki from 22:00 and do a preshot test at 00:00 (12 hours since the most recent dose was administered, and therefore the earliest time that you can give the next dose). If BG is high enough and he's eating OK you would have the option to give insulin. With a GI upset in progress you might want to consider going for the lower dose as a precaution. You would then need to gradually work back dose administration times over a period of several days to get back to your normal schedule (moving back 15 minutes each cycle OR by 30 minutes on only one cycle every 24 hours - you're looking at 8 days to get back to your regular slot).

    2. Skip tonight's dose and resume your normal schedule tomorrow morning at 8am.

    FYI, I asked about the ketone history because it's not a straightforward thing to skip doses for cats prone to them. (More info on ketones here.)

    My suggestion would be to skip tonight's dose because there will only be a period of 8 hours without insulin and it would save a lot of mucking about to get Loki back to his normal schedule. Also, there's a risk Loki's tummy upset might affect his appetite.

    What do you think yourself, Tamsin?


    Mogs
    .
     
    Last edited: Jan 31, 2021
    Reason for edit: Added link.
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  41. Tam & Loki

    Tam & Loki Member

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    Jan 23, 2021
    Thanks for this, my gut instinct is to skip tonight's dose and resume tomorrow.
    He hasn't eaten since 07.30, can we give him some dinner? If so, what should it consist of?
     
  42. Critter Mom

    Critter Mom Well-Known Member

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    Jun 16, 2014
    By all means give Loki some grub. If you work on the basis that the food transition may be causing the GI upset, I'd suggest backtracking a bit on the proportions and give him less of the new, more of the old food to see if things settle down. If yes, then going really slow with the changeover might help avoid further tum troubles. Probiotics sometimes help. Also feeding smaller, more frequent meals might help.


    Mogs
    .
     
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  43. Critter Mom

    Critter Mom Well-Known Member

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  44. Tam & Loki

    Tam & Loki Member

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    Jan 23, 2021
    Brilliant thanks. We already put probiotic powder in his water but will sprinkle it on his food instead so that he gets it all. And I'll split dinner into two smaller meals tonight.
    Thanks for all your help, it is appreciated x
     
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  45. Critter Mom

    Critter Mom Well-Known Member

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    Jun 16, 2014
    More than welcome! I have received so much help from other members here, it's nice to be able to pay it forward.

    Glad that the day passed without any scary developments. Have a grand evening. :)


    Mogs
    .
     
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  46. Critter Mom

    Critter Mom Well-Known Member

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    Jun 16, 2014
    Just want to give a clarification about the above.

    All preshot meals for Caninsulin/Vetsulin cats need to be quite substantial feeds. Caninsulin typically hits hard and fast at the beginning of a cycle so a kitty needs a goodly amount of food on board ready for the insulin to work on. Smaller feeds are OK later in the cycle, but it's best not to feed later than about +5 as that is when the dose may be starting to wear off. (Exception is when food is being used to raise low numbers, in which case small amounts of food (talking teaspoonfuls here) are given roughly every 20-30 minutes until the cat tests in a suitably safe range and stays up without any further food for about 2 hours.)


    Mogs
    .
     
  47. Tam & Loki

    Tam & Loki Member

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    Jan 23, 2021
    Loki's BG is 29.7 2hrs after his small LC meal :(
    Is it still ok not to give him insulin?
    I'm finding this whole situation so very confusing - he's not behaving as if he's had extra insulin
     
  48. Critter Mom

    Critter Mom Well-Known Member

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    Jun 16, 2014
    Only just seeing this now, Tamsin.

    One of the reasons we are such strong advocates of testing is that behaviour is not a reliable indicator of BG levels.

    While it is disheartening to see such high numbers, they will come down. Your options for dosing are still the same as I posted earlier. If you decide to give insulin tonight you need to wait till it's 12 hours after the SECOND dose was administered today before giving another dose, and then it will take you more than a week to get back to your normal schedule.

    I still stand by my earlier suggestion that you skip tonight and give the next dose at your normal scheduled time. It's only a wait of 8 hours. Loki is newly diagnosed and it is common to see kitties in high numbers in the early days. Regulation is a gradual process that can't be forced. You will often hear members say that management of diabetic cats is a marathon, not a sprint.


    Mogs
    .
     
    Last edited: Jan 31, 2021
  49. Critter Mom

    Critter Mom Well-Known Member

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    Jun 16, 2014
    Here's an excerpt from Saoirse's spreadsheet during the early days of her treatment when she was on Caninsulin:

    upload_2021-2-1_1-0-1.png

    (You'll need to look at the numbers because I used non-standard colour coding. The BG readings were taken using an Alphatrak 2 meter.)

    As you can see from the above, Saoirse's numbers at that time were well into the 20s (mmol/L). At time of diagnosis a few weeks beforehand her BG was so high the meter wouldn't register a number. She was in the 30s for a little while after that. Less than 5 months after she was registering the above readings Saoirse went into remission.

    High numbers are scary to see - they can make one's heart sink when they're displayed on the meter - but it takes quite some time for them to do damage. Numbers that are too low are the ones to really be fearful of.

    One of the hardest things about the process of bringing a diabetic cat into regulation is the need for patience. Lots of patience.


    Mogs
    .
     
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  50. FrostD

    FrostD Well-Known Member

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    May 27, 2020
    By all means take a look at my spreadsheet, the 2020 tab.

    I really thought I had it while we were on Vetsulin...then who knows what happened. I've yet to get him back down since July. Loki will be ok! While we don't want them in high #s too long for a number of reasons, it's better to go slowly and safely with insulin dose changes.
     
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  51. Tam & Loki

    Tam & Loki Member

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    Jan 23, 2021
    Thank you for taking the time to reply to me.
    I didn't give him any insulin and of course, as you said, he is fine this morning.
    I was in proper panic mode yesterday and it didn't help that I was dealing with it all through a full blown migraine, so my brain wasn't really functioning properly.
    This morning I'm calmer (and more rational!) and your words are really reassuring x
     
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  52. Tam & Loki

    Tam & Loki Member

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    Jan 23, 2021
    Thank you for replying - to hear about your and other cats makes me realize that this is a 'normal' journey and I think I won't freak out again like I was yesterday.
    I hope your lovely kitty gets sorted soon x
     
    FrostD and Critter Mom like this.
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