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Hey everyone! I am so grateful to have found this group it’s such a big help.

I am the mommy of a 8 year old (almost 9) cat. His name is Poopers also known as Pooh or Pooh Bear. I just found out in January that he has diabetes ☹️ He randomly lost a lot of weight and never wanted to play with his 2 sisters. I took him to the vet and they told me he has diabetes. We right away changed his food and got him on insulin. His glucose level has been crazy. We live in Canada so there’s a conversation. Last week Pooh had a seizure and we came to find out that his blood glucose level were at 1.2mmol/L. I’m not too sure what the conversation is sorry! But we got him a monitor to check his blood instead of going to the vet and lying $400. We will still go but not as often. He is on 5 units of insulin and today we checked his blood and it was at 4.4 not too bad but we definitely have to keep an eye on him. But he’s strong. It’s very nice to meet you all and I hope all your cats and kitties are as healthy as they can be.

 

Hi Catia, welcome to you and Poopers. I'm surprised my spell check didn't try to fix his name automatically . I'm just East of the Rockies in Canada, so I know what 1.2 mmol/L is ...and it is frighteningly low. The conversion from metric to US is multiply by 18. That means he was at 22 mg/dl. Kitties who have experienced symptomatic hypo like your boy has, are quite often more sensitive to insulin, I'd be super cautious and continue to test his BG at home to see how he is reacting to insulin going forward.

That said, what insulin is he on? 5u seems like a lot of insulin if you're just fairly new, and if that was the dose that dropped him to 1.2 mmol/L (22 mg/dl), then it is clearly too much. You mentioned you picked up a BG monitor, is that a pet meter, or a human meter?

We have a really good info page here: New? How You Can Help Us Help You

Please let us know how we can help.

 

Hi Caria and Poopers.
5 units is a lot of insulin for a newly diagnosed cat. How were the increases done? In 1 unit increments?
I am really pleased you are home testing the BGs now. It is the only way to keep your kitty safe.
We have a spreadsheet you might like to set up and start recording the BGs into.
Here is the link. If you have any trouble, someone can help you.https://www.felinediabetes.com/FDMB/threads/how-to-create-a-spreadsheet.241706/

How much insulin are you giving now? Was the 4.4 reading a preshot number?
Did you reduce the dose after the seizure? If not you definitely need to!!
As Christie said, cats who have had symptomatic hypos are often very sensitive to insulin moving forward.
Can you tell us the type of insulin you are using please?

Do you have a hypo kit set up in case of low numbers? There is a link within the link Christie sent you.
When you swap to a low carb diet that can drop the BGs significantly and unless you are testing the BGs, you run the risk of hypo numbers.

Please let us know how things are going. We can help you find a safe dose for Poopers.

 

Hi omg thank you for your reply! We started his insulting at 3 units back in January but his levels kept a getting higher. We increased from 3 to 4 (for one day) and the following day to 5. His glucose level was still too high it was around 24mmol/L (around 432mg/dl). So the next day we did 6 units and the following 7. When he had his seizure he was on 7 units which is WAY too much. He is back on 5 units for now.

His insulin is called “Caninsulin”

The monitor i got is for humans it’s the “Contour next EZ”

Thank you so much for your help

 

Hi thank you for your reply!

We started his insulting at 3 units back in January but his levels kept a getting higher. We increased from 3 to 4 (for one day) and the following day to 5. His glucose levels were still too high and the vet was getting worried.

When he had his seizure he was on 7 units which is WAY too much. He spent 1 days on 6 and changed to 7 right after (vets orders) He is back on 5 units for now.

His insulin is called “Caninsulin”

The monitor i got is for humans it’s the “Contour next EZ”

Thank you so much for your help I will definitely check out that link!

 

Yikes! That dose is far too high!!!
And increased far too quickly!
Can you tell me what dose you are giving now please?

I think you would be far better changing over to lantus insulin which is a longer acting and more gentle insulin and far better for cats. If you live in Canada, you don’t need a script for it.

 

The 7units? Right, when we took him to the emergency vet they said that it was WAYYY to high that the highest they would recommend would be a 5 (which he is on) we took him to a specialist as well he said 5 units as well. I sent all of them his previous glucose results and all of them agreed with 5 units.
I felt horrible giving him 7 units I had a feeling it was too much but at first he didn’t react to it only about a 20-30 days later.
He seems fine on 5 units. I just finished taking down notes on the HYPO Toolbox. So grateful for this group!

 

Just rereading your posts. I see you are at 5 units now. That is still an incredibly high dose for a newly diagnosed cat.
Would you like to set up a spreadsheet so we can see the numbers? I will ask @Bandit's Mom to help you as we really need to see theses numbers quickly so we can sort out a safe dose for Poopers

 

Are you testing before every shot and testing during the cycles?
Are you feeding 30 minutes before the shot?

Here is a link to using caninsulin.....which is really a dog insulin and not a cat insulin.....please think about swapping to Lantus.

Beginners guide https://www.felinediabetes.com/FDMB/threads/introduction-to-cannisulin-vetsulin-n-nph.231602/

Dosing with caninsulin https://www.felinediabetes.com/FDMB/threads/beginners-guide-to-caninsulin-vetsulin.231587/

 

Yes please I would love all the help I can get!

 

@Bandit's Mom should be along before too long...she lives in India and I live in Australia so we are often online after the US goes to bed.
Blooma (bandits Mom) will send you a PM which you can access in the top right hand corner under conversations. She will need some details to set up the SS. Keep an eye out for it!

 

I just got the glucose monitor 2 days ago. The day I got it I tested him after his insulin because that was the time I bought it at it was at 7.5 mmol/L (135mg/dl). Today I tested him 2 hours before his food and insulin and it was at 4.4 mmol/L (79mg/do).

do you recommend I test him everyday ? For some reason my vet told me not to...

Also we feed him at 8am & 8pm and give him his insulin around 8:20-8:30

 

Thank you so much! You are amazing! I definitely will keep an out out for that message. It’s 1am here in Canada so I will most likely check back in the morning.

 

You need to test him before every dose of insulin and again during the cycle to see how low the dose is taking him.
Read the information I gave you on caninsulin and it will tell you when you should and should not give the dose.
Caninsulin is a fast acting and fairly harsh insulin and drops the blood glucose fast in the first three to four hours.
Are you giving snack of food during the cycle as well? I would feed a main meal 30 mins before the shot then give another snack at +2 and +4 at least to help him keep the numbers up during the cycle and for the food to work with the insulin.

Many Vets for some reason, don’t think testing is necessary. But it is the only way to keep your kitty safe and to know when to increase or decrease the dose. Once a cat has hypo symptoms, the cat is very very low. If you are testing you can feed him to prevent a hypo.
We can teach you this.
I really think that the 5 units is too much, so please be careful.
Hopefully we will see some date tomorrow in the SS and can help you with the dose
Bhooma will be around off and on for about the next 10 hours so look for the Message from her as soon as you get up in the morning so you can connect before she logs off.
Feed Poopers before you go to sleep p,ease!
See you tomorrow. Bron

 

Thank you so much and yes I have him a snack.
Also, I use the Caninsulin U-40 syringes (1cc). Does that make a difference. I’m tryingto do some research on it but I’m getting a bit confused
Thank you for caring!

 

You use the U-40 syringes with caninsulin.
I am not a caninsulin user so I can’t tell you the finer details but read the links I sent you, that has a lot of information in them.

If you decide to swap to Lantus you will use a different syringe.

 

Hi Catia!

I will send you a PM with the details I need to set up your spreadsheet and signature block. If you go to "Inbox" in the menu at the top of the page, you should see a new message from me in just a minute!

Bhooma

 

Thanks Bhooma!

 

@Poopers and Catia i can see you have your SS up. Are you able to fill in some of the data you have since you started to test the zbG?
How are things going today.?

 

I filled in starting April 25, 2021 because that’s when we started doing the testing at home. Let me know if you see it.
Things today are okay Poopers ate but threw up, he might have eaten too fast. But he ate more after and we gave him his insulin.

we will be doing another test around 1Pm in 4 hours and tomorrow I’m going to call the vet to switch insulin.

 

Since you are in Canada and have follow the mmol/l system for BG measurement, I have set-up the non-US format of the SS for you.

You can enter data in the World mmol tab. The data in the US mg/dl tab is automatically calculated based on that.

 

I did both sheets, I believe they should be there. Let me know if you see both

 

Yes I can. You needn't take the trouble of doing both. Doing any one is fine. People outside the US are used to mmol and prefer to enter it the data in the World sheet. Those of us used to the US nomenclature look at the US sheet

Btw, that's a good start today. Please do get a test at +2 (2 hours after the shot).

 

Will do! And i’ll put it in the sheet! Thank you!

 

Yes I can see the data thank you.
Am I reading it correctly that you gave 5 units with a preshot of 4.1 (74)?
That is a low preshot to be giving that much caninsulin insulin, especially as you have no data and Poopers had the seizure last week.
Please make sure you test during the cycle and feed snacks.
I think you need to reduce the dose. I am not a caninsulin user and I know you are hoping to swap over to Lantus tomorrow but I am going to tag @JanetNJ and @Deb & Wink to look at the dose in the meantime.
I am really pleased you are seeing the vet tomorrow and changing the insulin.
It is my understanding you can buy Lantus over the counter in Canada.
I’m just heading to sleep.
Will watch for news in the morning.

 

Hi and welcome. SO glad you found this place. I'm in Ontario. Butters's vet put her on Caninsulin and I switched her to Lantus a couple of weeks later with help from this wonderful group of people here.
You can indeed buy Lantus without a prescription. I bought some from my local pharmacy when I was first starting out, along with syringes. Prices vary wildly, I found, so you may want to shop around. If you have a Costco membership, I think some people buy insulin there. The best price on Lantus that I've found personally has been from https://diabetesexpress.ca/ They also have the best prices on insulin syringes and all other supplies you need. A few members besides me get their supplies here. Unless Poopers is a high dose kitty, most of us find that buying the cartridges ends up being better value, because you will use up the insulin to the last drop.

Just a word of caution about switching insulin: Lantus is a u-100 insulin, which means it measures 100 units of insulin/mL. Caninsulin is a u-40 insulin, so it measures 40 units of insulin/mL. It is critically important when switching your insulin to Lantus that you purchase u-100 syringes to use with it. These syringes will have an orange cap. Do not use your u-40 Caninsulin syringes (red cap) with Lantus insulin, or you will end up giving Poopers too much insulin.

Get a syringe that has half unit markings. These are the ones that I like:
https://diabetesexpress.ca/collections/syringes/products/bd-uf-ii-syringe-3-10cc-31g-8mm

If you haven't seen it yet, here is a great thread on storage of insulin and what syringes are recommended, etc:
https://felinediabetes.com/FDMB/thr...info-proper-handling-drawing-fine-dosing.151/

 

Great info @Butters & Lyla

 

yes that’s correct. I honestly didn’t know too much about insulin and about cat diabetes at all. I see that most people give low units and sometimes different amounts. Our vet has been telling us to stay on 5 units that it would be good. I’m not sure I’m going to talk to him tomorrow and maybe call a different vet to get another opinion as well.

 

This is perfect! Thank you so much for the both websites! Did you personally see a difference when you switched from Caninsulin to Lantau?

 

A lot of vets don’t know much about Feline Diabetes and they tend to treat them like dogs with diabetes which just doesn’t work. Cats have a much faster metabolism and don’t react to insulin like dogs do.
If I were you, I would just get the Lantus insulin and we can help you with the dosing. I don’t think you even have to go though the vet to get Lantus in Canada.
I am sure you will find it a much better insulin for Poopers. I have seen cats go into much much better numbers after they swapped over to Lantus from Caninsulin.

 

Really I thought they would know about it. That’s unfortunate! But thank you for your help you all are amazing! I definitely will be buying the Lantus insulin

 

Yes I sure did. Not just with Butters but many others on the board.
What happened pretty quickly was that Butters no longer had those quick hard drops in her numbers, similar to what you're currently seeing with Poopers. Those were so scary to manage. Her numbers came down gradually as she spent more time on Lantus. I am thrilled that I made the switch.

 

That’s amazing to hear! If you don’t mind me asking what was Butters Caninsulin units and what is it now with Lantus

 

i am definitely changing insulins. This morning at 8AM he was at 4.1mmol/L (74mg/dl) and now that it is 12PM he dropped to 1.1mmol/L (20mg/dl) he had no symptons he was actually playing with his sisters. It could be that he didnt eat all of his food today before giving the insulin. Not sure but im glad i was sent the link to the HYPO toolbox, i gave him high carb wet food and a bit of maple syrup. Will check again in an hour.

 

Please do not wait for an hour to check him. That's a really low number. Please check right away? Thanks!

ETA: I think 5U is too high a dose for him. I am not experienced with Caninsulin but you may want to reduce his dose significantly starting tonight.

 

I agree with @Bandit's Mom – 1.1 is far too low. Not all cats give warning signs of a hypo and by then it can be too late.
As you can see from below, Poopers is very low. It is imperative that you start the hypo protocol.

Can you tell us how far away from the nearest emergency vet clinic you are?

TREATMENT

During treatment for hypoglycemia, try to test every 15 - 20 minutes until you see the bgs begin to rise. Then continue to test until you are satisfied that the cat is out of danger.

VERY LOW NUMBERS – WITHOUT SYMPTOMS
Retest glucose using a large blood sample to make certain you have enough blood, and if you still get a very low number (under 40 mg/dL or 1.9 – 2.2 mmol/L) administer a teaspoon of corn syrup, liquid glucose, pancake syrup or honey, or INSTA-GLUCOSE and follow with food until the blood glucose numbers rise to acceptable levels. The syrup can be mixed with wet food or poured over dry if the cat will eat the mixture. If using liquid glucose, dilute with water for a thinner consistency.
​

Waving from central Ontario.

 

His glucose level went up to 3.5mmol/L (63mg/dL) which is best but im still not comfortable. i called the Emergency they told me to continue doing what im doing feeding him high carbs and maple syrup as much a possible. i fed him again and gave him mire maple syrup. will check back in 45 minutes

 

Carbs and maple syrup only last so long. Can you take another test 30 minutes after the 3.5 please?

 

In future, if you encounter a number below 8mmol (150 mg/dl), please post here and ask for advice before shooting?

When you can, if you could also input the test data that you have for the last week or 2 weeks into the SS, that would be very helpful!

 

lately all results have been under 8 mmol/L but yes i will post every time. i will be doing another test in about an hour

 

yes of course!

 

Omg this dose is way too high. I would drop to 2 units and only if the number at preshot is over 200

 

How do you know what to drop it to? Im very new to this and i get confused when i see people changing the insulin. How do you know what to change the units to. I definitely trust this group a bit more then my vet at the moment because you guys in 1 day have giving me more info then he has in 4 months...

 

I just know that what your on is a high dose... Most cats never need more than 3 units. I would rather drop it lower than he needs and need to raise the dose in tiny increments rather than give too much. Having him at 20 you are honestly lucky he didn't start having seizures. Even 2 units may prove to be more than he needs.

Normal on a human meter is 50-120.

 

So 5 units is bringing his glucose level down too much at a faster pace, if i drop to 2 units it'll bring it down slower and not too down. Correct? I'm just trying to understand as much as i can.
If i give him 2 today he should be fine right? with the big change ?

 

Update: i just checked him glucose level and it went down to 2.2mmol/L (40mg/dl)
I did one at 1:20PM and it was at 3.5mmol/L (63mg/dL).

I think we might not give him any insulin today. i dont understand why its going up and down and im starting to get really worried.
Would you recommend not giving anything tonight and tomorrow morning to allow his levels to go up? I already tried feeding him high carbs food again but hes full :/

 

Swipe a fingerfull of maple syrup along his gums.

 

Yeah i just did that thank you!

 

You are back to testing every 20 minutes until Pooper's numbers are above 2.8 (50).

Important question – how many strips do you have on hand?

The good news is that Caninsulin usually does not last the full twelve hours and he should start rising on his own at some point.

Some cats become insulin sensitive after a hypo or low numbers experience. I'd bet that Poopers has been too low numerous times but was showing no physical signs. Because of this and erring on the side of caution, 2 units is a good starting point to establish a baseline.

Caninsulin is not the best insulin for cats. It was designed for dogs who have a different metabolism. The name says it all.

You can get Lantus over the counter in Canada. Humans need a prescription, cats do not. Just tell your pharmacist that it is for your cat. You also need U100 syringes with half unit markings.



Some reading for your vet:

• (2018) Managing Feline Diabetes: Current Perspectives
• (2018) Whats New In Canine And Feline Diabetes Mellitus .pdf
• (2018) AAHA Diabetes Management Guidelines for Dogs and Cats

 

This is very helpful thank you so much. i will see what his numbers are later tonight before he eats and i will give him 2 units if its not too low

 

Catia, can you please get another test? You want him comfortably above 50, and when you intervene with syrup, numbers wobble around a little, as the syrup wears off quickly.

 

yes i will do one right now and put it on the spreadsheet

 

@Poopers and Catia is everything okay? Please post an update when you are able, we worry when a kitty is in low numbers and no update.

 

In going to wait a little bit I tried to get the test but there wasn’t enough blood and he was getting very mad about it. I’m giving him a little time to cool off ! Will update soon

 

Okay, I might be worrying for nothing, but if you can give him either some more syrup, or a little HC food just to be on the safe side. When Maverick gets to low numbers, I often have a hard time getting a proper blood drop, so I'm just a bit worried that Poopers is still hanging in lower numbers.

 

I will give him more syrup I don’t think he’ll take the food but i’ll put the syrup on his gums

 

That's the key is make sure he's not too low before shooting. You may need to skip tonight. They can be very insulin sensitive after a major hypo event.

 

I’m just awake and catching up.
I agree with Janet.
I would skip the dose tonight.

 

Just like everyone said when you are not sure what to do, post it
Something like this AMPS then his BG Need help with dose!
and PMPS then his BG Need help with dose!

 

Hey guys so sorry for the late update Poopers got very upset with me unfortunately he still isnt used to it. Ive updated the spreadsheet i just did his glucose test and it is at 6.7mmol/L (121mg/dl). i will check again soon and i will let you guys know! i will definitely need your advice on if i should give him insulin and if so how many units.

 

What about tomorrow morning? What level should he be at that you would recommend giving him insulin?

 

i got his kevels to work earlier. i am going to check now again and i would probably need your advice to see if i should give him any insulin or not today

 

If you reread post 57 @JanetNJ, who uses caninsulin, said not to shoot if the BG is under 200 (11). We suggest this, at least until you have more data on how Poopers reacts to the dose of insulin given.

 

i just checked and hes at 9.4mmol/L (169.2mg/dl)

 

Hey just updated my spreadsheet. Poopers is at 9.4mmol/L (169.2mg/dl). Do you think we should give any insulin at all? If so how many units would you recommend?

 

Oh looks like nobody is around but I hope you followed the advice here and didn't shoot. @JanetNJ said not to shoot if Poopers is <200 (11), which he is. @Bron and Sheba (GA) mentioned this just above in post 63.

 

I would skip the dose as @JanetNJ recommended as he is under 200. It won’t hurt him to miss one dose

 

I agree, I would skip.

 

For tomorrow morning, would you recommend we skip as well if its under 200 or just give him 2 units as well?

 

Let’s see how he goes this cycle with no insulin. If you could get a couple of tests in during the cycle that would be very helpful.
Then I would get a +11 so we can see what the BGs is for the morning coming up to AMPS and post and ask for help. How does that sound?
Keep feeding him the snacks and meals as normal.

 

For tomorrow morning, would you recommend we skip as well if its under 200 or just give him 2 units as well?

OK that sounds great! Thank you for your help. I will update you in the morning

 

Just to add...don’t feed him for the 2hours before the AMPS in the morning so the BG isn’t food influenced.
If he is close to 200 at AMPS you might be advised to stall, dont feed and test again in 20 minutes to see if the BG is rising. Does that make sense?

 

We usually feed him at 8AM so we would check his levels around 7:40AM to see what its at. So if he is close to 200 i should just test him again after 20 minutes and then feed him afterwards? A little bit confused, just trying to understand it

 

Yes you can check him at 7.40am and then stall, don’t feed and see if he has come up to 200 by 8 am. I would post and ask advice. You may need to stall a bit longer so don’t feed until you can talk to someone. When a decision is made you can feed him. Hopefully once you get him on Lantus everything will settle down.

 

Ok i will definitely do that. Thank you for your help. Would you recommend i post it here or make a new thread about it?

 

I think Bron sent you the Beginner's Guide info page on Vetsulin, where it is suggested until you get enough data on how your cat responds to the insulin, you can always stall (don't feed) and retest in 20 minutes. You typically want to see the number rising up to 200. This can continue, (stalling and not feeding) another 20 minutes, and perhaps again, if schedule allows. If the number still isn't rising after multiple times stalling, and your schedule doesn't allow for more stalling, then it is usually safer to skip. As Bron said, if you can get at least a test or two tonight so you can see what he's doing without insulin that would be good information.

 

Probably good to start a new thread as this is getting long. Link this thread to the new thread for continuity please. Then we can go back and check things if needed.