? Stable numbers with no insulin and token dosing?

I’ve skipped my kitty’s AM shot the last two days and her numbers are pretty low and steady. This morning she was at 126 for her AM preshot so I skipped. Now her PM pre shot is only 131. Is a token dose of .25 even a good idea or should I skip tonight as well? Last insulin I gave her was a .25 unit dose 24 hours ago.

 

https://felinediabetes.com/FDMB/threads/consistent-readings-under-200.241412/

Previous post for continuity

Tagging
@Deb & Wink

@JanetNJ

@Panic

@Bron and Sheba (GA)

Thank you ladies

 

Can you get any tests in before you leave for work after giving insulin? Like a +1
What time do you get home from work?

 

Vetsulin usually hits is peek 4-6 hours after injection. (Some sooner some later). That would be when you will see how low it goes.

You need to get some more tests in during the night cycle


Learn how YOUR kitty is responding to insulin:

• Onset - the length of time before insulin reaches the bloodstream & begins lowering blood glucose
• Peak/Nadir - the lowest point in the cycle
• Duration - the length of time insulin continues to lower blood glucose
• How to do a Curve - a simple explanation

 

What are the benefits for giving her more feeding times? She usually eats as well as my other cat at their meal times. I leave 45 minutes after the time I usually try to give her a shot (8:30) and I get home at about 7:45 PM. I’ll be able to do AM post shot testing this weekend.

I did end up giving her another .25 shot tonight.. I got a +5 last night, and I’m either going to get a +4 or +6 tonight.

 

Tip: For yer average Vetsulin kitty, nadir can occur from round +3 onwards. If the kitty's a fast metaboliser of insulin and gets early onset, it is possible for nadir to occur from can be hit round the +2 mark, sometimes a little earlier.


Mogs
.

 

Thank you Mogs I'll remember that

 

Hi Samantha , disregard about the auto feeder, I didn't mean to type it here,
I have been going back on so many different posts.
Glad you can test him more this weekend
@squeecat

 

At what blood glucose reading do I 100% skip insulin? Or is it not that simple?

 

https://felinediabetes.com/FDMB/threads/consistent-readings-under-200.241412/

Previous post for continuity

Tagging
@@Deb & Wink

@@JanetNJ

@@Panic

@@Bron and Sheba (GA)

Thank you ladies see #9

 

She was at 98 at +6 last night, and her preshot today is 86.. so definitely skipping again.

Im really confused about how to proceed with these numbers other than getting more tests in.

 

Hi Samantha,

Does Sansa have any history of testing positive for ketones or episodes of diabetic ketoacidosis? Also, do you have urine ketone test strips at home?

From your first thread:

Did the vets determine whether Sansa had an infection, and was it treated? (Asking because BG levels can improve when an infection clears.)

Also, did the vets run a fructosamine test as part of Sansa's diagnostic work-up when they suspected she had diabetes?


Mogs
.

 

Another question:

What other clinical signs did Sansa show prior to the diabetes diagnosis, e.g:

- excessive thirst and urination.
- excessive hunger.
- unexplained weight loss.
- poor hair coat condition.
- lethargy.
- subdued/depressed.


Mogs
.

 

She basically had all of the symptoms you listed, I’m gonna copy paste your checklist and add notes:

- excessive thirst and urination. yes, I mostly noticed the drastic increase if urine in the litter boxes

- excessive hunger. Yes, she would even ravenous go for the dogs food

- unexplained weight loss. Yes, she lost a couple pounds without me changing anything

- poor hair coat condition. yes, before the vet ran tests he talked to be about her dandruff, skin irritation, and poor coat condition.

- lethargy. - no

subdued/depressed. After treating her I do think she indeed had these symptoms. I just thought she was getting lazier with age and didn’t come upstairs to bed with us because our new dog was sleeping in the bed.

The only other persistent health issue she’s had for the past couple years besides these recent changes was her anal glands were leaking a thick sludge, she was brought in multiple times for it. They would express the glands, say they didn’t seem impacted and nothing would change. This condition would get better and worse by itself and her stool was always firm. She actually ripped out the hair around her entire rear end area and that was one of the other reasons for the vet trip at time of diagnosis.

She has had no history of diabetic ketoacidosis and I’m not aware of her peeing ketones. I don’t have tests but I could certainly get some. Do human strips work for cats? How do I go about getting her urine on the test strip?

They found no infections or other conditions, only diagnosed her as a diabetic cat at the appointment.

I’m going to go through the paper work and check if they tested for ketones or did fructosamine test.

 

I guess I’m not sure if what a fructosamine test is? I’m just going to attach all the numbers they ran I hope that’s okay. She has another appointment on Monday that I think was to check her glucose levels? This uploaded really oddly and I don’t know how to fix it, I do see she was positive for ketones at the appointment.

 

Hi Samantha,

Sorry for not getting back to you till now.

Ketone monitoring is a general safety precaution for any diabetic cat, but some cats seem to be more prone to generating ketones than others. Since Sansa has tested positive in the past then it's wise to be that little bit extra careful when it comes to reducing or skipping insulin doses. Human ketone strips are what's used. Helpful info:

Tips for collecting urine samples

I couldn't see a fructosamine test on the lab report. The gives an indication of average BG level for the previous couple of weeks and for that reason it's valuable as a diagnostic aid since the results aren't influenced by temporary stress hyperglycaemia the way that a serum glucose test might be. Also, clinical signs are also considered when making a diagnosis, and Sansa indeed seems to have checked a lot of those boxes.

Did you change Sansa's diet from high to low carb after she was diagnosed, Samantha?

On dosing, with Vetsulin it can get really tricky to administer when a cat is in very good but still diabetic numbers on a tiny dose because there isn't much room to tweak anything.

With the numbers Sansa's starting to see, she looks like a good candidate for possible remission. The normal feline BG reference range is 50-120 as measured on a human meter. Ideally it's good for a cat to spend time in the 50-100 range, (better still the 50-80) range for a while before stopping insulin but, as you're seeing, that can be a bit tricky with Vetsulin because of how it works. If her numbers hover in the blues and only see occasional greens without insulin, I'd suggest considering switching Sansa to Lantus for a while. With adequate testing and an appropriate feeding schedule it should be possible to to give Sansa that little extra bit of support she might need to get her the rest of the way (hopefully) to remission.

The best I can suggest to you at the moment is that if Sansa's too low at preshot to give insulin then continue to monitor her BG and also check her urine daily for ketones (you can get strips at any pharmacy), then contact your vet on Monday to review Sansa's status and determine your next steps. Obviously if Sansa's numbers were to drift upwards in the meantime then you'd need to give insulin. Be sure to post for any help you need.


Mogs
.

 

Thank you for all the advise. She has actually dipped into the greens today, and had no insulin since her .25 dose Thursday evening!

I did switch her to low carb food at time of diagnosis. I’m going to pick up the ketone strips tonight.

What makes Lantus safer than Vetsulin? After a quick google I see Lantus is $300 a vial. Do people typically pay that much or is there a way to make it more affordable?

 

Hi Samantha,

Ooooh! Pretty numbers.

Sansa's doing great. Your little Queen in the North may be one of the lucky kitties who only need the diet change and a very short time on insulin. Anti-jinx, fingers and paws crossed!

On Lantus v. Vetsulin, the former is gentler in action overall. For cats in good numbers, an effective dose of Lantus can produce very shallow curves; smile-shaped cf. Vetsulin's typical bucket-shaped ones. Lantus is overall better at holding down low numbers, whereas Vetsulin tends to be better at yanking down higher ones. Those characteristics mean that one can give Lantus at lower preshot levels and BG is less likely to drop very far at nadir.

Great that you're picking up some ketone strips. It's a wise safety precaution to monitor for them when you've had to suspend insulin treatment. Here's more info:

Ketones, DKA, Ketone Meters

If your girl stays in these numbers for 14 days without insulin, she would be considered a diet-controlled diabetic. Keep testing every day at your normal AM and PM preshot times. Ideally you're looking for her to stay under 100 with only the occasional reading in the blue range. If you do get a blue reading, once she's eaten her food check her BG at +1, +2 and +3 hours (ideally) to see whether there's a food bump and how quickly numbers drop back down again. If her numbers start trending upwards post for help, as she might need a little more insulin support before another remission trial.


Mogs
.