Should we adjust the dosing?

Discussion in 'Caninsulin / Vetsulin and N / NPH' started by Toki Wartooth Jr., Aug 19, 2020.

  1. Toki Wartooth Jr.

    Toki Wartooth Jr. New Member

    Joined:
    Jul 30, 2020
    Hello, Toki has been on Vetsulin since 07/29; we started monitoring his glucose a few days later (after we found the support group on Facebook). We switched his food 08/01 from dry to FF pates. That definitely helped the levels drop. We also swithced from 2 meals and a midafternoon snack to 2 meals, midafternoon and overnight snack on 08/07. I noticed this switch, adding the overnight feed, put his numbers in the 200 range consistently.

    Of course we'd love to see his levels drop more and stay there. Aside from switching insulin (that is our plan-hopefully the vet helps us with that). Should we adjust the dose of Vetsulin based on his levels? His vet just said 2u every 12 hours. They never mentioned adjusting dosage based on glucose. I believe his spreadsheet is attached in my signature. Please advise. Thank you!
     
  2. Karen & Charlie

    Karen & Charlie Member

    Joined:
    Jul 31, 2020
    Hi Toki's human!

    Like you I'm brand new to this, and also like you, we're using Vetsulin. I've been blown over by everyone on this forum, so you'll hear from someone(s) soon who isn't a newbie like me. However, I've been warned that because Vetsulin isn't all that popular, traffic on this board can be a little slow.

    One thing I've learned in the 3 weeks I've been at this is that I believe most here would recommend testing for new sugar cats. If you're testing and not recording on your spreadhseet, you should do that. Helpers here will ask for it, as that's how they evaluate. Take a look at mine.

    Your spreadsheet indicates only AMPS--you may know this, but AMPS refers to Toki's AM, pre-shot test, but your spreadsheet would indicate that you're not testing post injection or any other time during the day, including before (and after) his PM shot.

    My very first "conversation" with the kind people here could be helpful. They gave me so much great help & info.
    https://www.felinediabetes.com/FDMB/threads/need-curve-assistance.233665/#post-2614157

    Also, here is the spreadsheet instructions, if you haven't already come across them:
    https://www.felinediabetes.com/FDMB/threads/fdmb-spreadsheet-instructions.130337/

    Hopefully somebody will be by soon to check you out. Welcome!!
     
  3. FrostD

    FrostD Member

    Joined:
    May 27, 2020
    Hello,

    I would not adjust the dose yet, because a few key pieces of information are missing.

    Like previous poster mentioned, we really do need to see the PMPS numbers.Are.you withholding food for 30 mins before the shots?

    Can you get some +3 to +6 tests in over the next few days? We need to see how low Toki is dropping. We want to see his nadir (lowest number during the day/peak insulin activity) around 90 to start with. But you need to check for a few days, because each day can be a little different. Keep in mind cats go lower at night, but I myself have trouble getting these midcycle numbers just because of schedule.

    If he isn't getting close to 90, then you can increase by 0.25U every 6 cycles (so every 3 days). If he drops below 90, that's an automatic 0.25U REDUCTION.

    Now, all this with a grain of salt! If your new insulin will be here in the next week or so I wouldn't bother tweaking doses, because you'll essentially start over on a new insulin anyway.

    Edit: if you look at my spreadsheet you'll see how I adjusted my Vetsulin dosing. The past month has been wonky, I'm not sure if the insulin went bad, he's getting resistant, has an infection, or what. So until I rule out potential underlying causes I'm just going to hold steady. The downside of that is his numbers are so high he's likely going to start peeing outside the box and losing weight. Hoping I can it resolved quickly.
     
    Last edited: Aug 19, 2020
    Reason for edit: Additional info
  4. Toki Wartooth Jr.

    Toki Wartooth Jr. New Member

    Joined:
    Jul 30, 2020
    Thank you. We test him 20-30 minutes before both his AM and PM shots. The spreadsheet has both numbers.
     
  5. Toki Wartooth Jr.

    Toki Wartooth Jr. New Member

    Joined:
    Jul 30, 2020
    Thank you.

    My spreadsheet has 2 numbers each day. One is a half hour or so before his morning shot; the 2nd number for the same date is the same before his evening shot. I believe the first date there is only a PMPS shot because we bought the glucose meter in the middle of the day.

    I had no idea about the need to test later in the day. We’ll have to try this weekend when we’re home during the day.

     
  6. FrostD

    FrostD Member

    Joined:
    May 27, 2020
    Its a lot to learn, don't worry, you're doing great! Update this thread once you get a few midday/night tests in and we can better help you.

    Vetsulin is known for dropping blood glucose very fast in cats, it's why it's not really a recommended insulin (even though vets still recommend it...).

    Do you have a hypo kit? Hypoglycemia is when the blood sugar drops too low (often around the +2 to +4 mark), and is incredibly dangerous. This post explains what to do https://www.felinediabetes.com/FDMB/threads/jojo-and-bunnys-hypo-tool-box.2354/

    I personally keep 2 cans of higher carb food (Friskies wet with gravy), and Karo syrup on hand just in case, though we've never had a hypo that I'm aware of.
     
  7. Panic

    Panic Well-Known Member

    Joined:
    Apr 10, 2019
    Hello Toki and parent!

    You've got some great advice here - I want to add that food should mainly be given before nadir (when blood sugar is at its lowest point in the cycle) and it's highly unlikely that Toki nadirs in late afternoon. We recommend a small meal about 1-2 hours after giving insulin, and a test at that time would be very useful. His pre-shots really don't look too bad considering he's on Vetsulin, and switching snack-time may improve them even more. Giving food later in the cycle "burns up" the insulin faster, which results in higher pre-shots.

    I would really love to see some mid-cycle tests. :)
     

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