Discussion in 'Feline Health - (Welcome & Main Forum)' started by Matt & Maus, Jan 1, 2020.
I was told to do this if 1st test was under 200. It is 193. What's next?
Since there is no data on your spreadsheet to go by, I'd say do not shoot.
Don't feed, wait 30mins and test again .
He's pretty close to 200, but let's see what direction he's headed.
What is your insulin? Current dose?
Vetsulin 1 unit (U40 - 3/10 ml) 2 times a day. Will test again at 11:30
Vetsulin 1 unit (U40 - 3/10 ml) 2 times a day. Will test again at 11:30
We'll want to be conservative with vetsulin, it hits fast and can pull numbers down quickly. So if Maus isn't a lot higher at 11:30, and there is no history of ketones, I'd be inclined to skip until you have more data to work with, as Kel says. Unless a vetsulin user comes by to say different (I used lantus and levemir, so I'm much more familiar with them).
Congrats on your first test, by the way!
I wish I would have decided to do this much earlier, but better late than never! Thank you for your help!
The number is 188 now.
Well, I don't think I'd shoot this morning-- it's not a big drop (especially considering meter variance), but you don't have any info on Maus' patterns to be sure it's safe.
I say, go ahead and feed now, maybe get another test or two today to see where he goes. Definitely get a test an hour or two before what will be your normal pre-shot time, so that tonight if this happens again you'll already have an idea of what might be going on.
Not bad numbers, too! How long has Maus been on vetsulin?
She has been on Vetsulin since May 11.
Ah, "she", I realized I was saying "he" but didn't know... oops, my apologies Maus!
She says she will let it slide this time, but don't let it happen again! lol
I agree with Nan. No shot this morning.
Did you just start testing today? Do you have older tests that you can put into the spreadsheet? I'm tagging
who has more knowledge of Vetsulin.
Today is the first time that I have done any testing.
Hi and welcome to FDMB.
First of all I agree with you skipping today given you don't have any info as to what Maus has been doing up till now.
My question is what meter are you using? Can you please add that information to your signature. If you are using a human meter, then 200 is a good no shot limit for now. If you are using a pet meter, then I would raise that no shot limit to 250 until you get more tests to see how that 1u dose is working for Maus.
ReLion Premiere Compact
The next time you get a shootable pre-shot number over 200 and are able, I would suggest getting a test at +3 and +6 post shot. to see how low the insulin is dropping Maus' BG. You do not want her dropping below 90 right now due to the swift drops in BG that Vetsulin can cause in some cats. 90 gives you a good cushion of time in which to feed Maus and keep BG from falling any further. If Maus' BG falls below 90, then you should immediately reduce the dose to 0.75u (if using the pen 0.5u). If you are using the pen, I'd strongly suggest getting syringes so that you can adjust doses by 0.25u.
It is fantastic that you have started to test. It will keep your cat safe and it will help you get a good picture of how vetsulin dosage works for Maus.
Hey Matt! Glad to see you over here from the Facebook group!
Happy to see you've gotten some good advice here too! Maus is such a pretty girl...hopefully we'll be able to help keep her as happy and healthy as possible.
Thank you, I am very glad to be here! I adopted her from a local shelter 2 years ago (she's about 9), and she has been a veterinary nightmare literally since day one. It has been continually one thing after another. I won't bore you with the whole story, as it is a long one. I will say, however, that she's had a rough life and really deserves a break. I hope we are on the road to such a break. Thank you again, and thank you to all the others who have (or will in the future) given us help and advice. We really appreciate it!
How is Maus doing today? I just looked at her spreadsheet, and saw that she hit 133 yesterday. Wow! That's pretty good for no shot!
Hope you're able to shoot today, though. If she's under 200 at the next pre-shot, stall again and post here for help. The vetsulin people (like @MrWorfMen's Mom) might have other suggestions, like a reduced dose.
Those numbers are interesting. Still a little high but not bad at all. If you again get a pre-shot under 200 today, I'd suggest you skip the shot, feed Maus and then check her BG again about 3 hours later to see if BG has come down. If it has, then her pancreas is working and producing enough insulin to pull BG down which is great news.
With pre-shot BGs being just below no shot limits, and mid cycle not that high, when you can monitor Maus closely, might be an idea to lower the no shoot limit a wee bit as well as the insulin dose but let's see how the above mentioned test goes and then decide how to proceed.
I am so glad you posted this, because I literally just got on the computer to ask about almost exactly what you said. Thank you again for all your help, I will be checking again in about 2 hours.
Thank you very much for asking about her, she seems to be doing pretty well. We'll see how it goes today!
The number at 11:00 A. M. was 137.
Miss Maus is full of surprises, isn't she?
Well, I definitely wouldn't shoot 1U here! I don't know vetsulin well enough to be able to recommend anything specific here other than not shooting, but that would be three missed shots in a row... For now, I guess hold tight until someone who does know vetsulin well can weigh in. We can call this another stall and do a re-test in 30mins.
It just makes me wonder just how many times I gave her the injection when she didn't need it, or gave too much. Vets sure need to do a better job of giving information. People (I know I did) trust them and take for granted that they know what they're talking about. Oh, well.
Loving those numbers. Can you do the 3 hour post meal test today? Feed Maus her usual pre-shot meal and then test 3 hours later and see if BG is lower than the 137.
Yes, I was planning on following that advice. The only problem is is that I have to go to work shortly after that. I work 3 pm to 11 pm, but I usually can leave a bit early, so I get home at 11 pm. That is why I do 11 and 11.
If you can grab that +3 test, that's all you need to do. Leave her a bit of food to munch on while you are at work as that can "spur" the pancreas to release insulin and keep BG more level. Without a shot this AM, Maus will be fine.
The +3 number is 148. What should I do if the number is below 200 at 11 pm?
It's too early to predict what will happen by then. You might want to get a test at +11.5 so you have some time to get some advice before it's time to shoot again
Not sure what that means. I already tested and it is 157. She needs to eat now. I guess I will go without the injection again.
I see the +3 hour test today was up a wee bit but not much so I think it's likely her pancreas is working somewhat but still needs a little support. Without having any prior BGs to know how the 1u dose was working, it's difficult to know what to suggest. I definitely think the 1u dose is more than she needs at this time especially since her BG is not that high despite missing shots. Curiosity......what is her current diet?
+11.5 is 11 1/2 hours after the previous shot. Each cycle is 12 hours long, so by testing 30 minutes before the shot is due, you have 30 minutes to ask for advice on what dose to shoot (or not shoot).
I think you may want to reduce her dose down to .5 (if she's above 200 in the morning) We can always go up if we need to later.
She is very picky eater, so I use several different pates (Fancy Feast, Instinct, Wellness) and some Dr. Elsie's dry. She gets about 70% canned. She quickly tires of canned food, so I have to regularly give a different flavor. She won't eat the same kind for more than a day, sometimes not even that long.
I was just wondering if by chance there was any higher carb food that could be eliminated to try to get those numbers down a bit more. Her diet is just fine so a little more insulin support is the only option.
I agree with Chris that if you get a pre-shot of 200 or more, I'd try 0.5u. If pre-shot is between 150 and 200, and you can monitor Maus, then I think you could try 0.25u. Your aim is to get her numbers down to around 90 and you don't want her dropping much below that. I'd try this on a day when you can get a couple of tests in during the +2 to +6 hours post shot period which is generally when Vetsulin reaches peak action. If Maus drops below 90, then she earns another reduction in dose.
So if at 11 am it is 150 - 200 give 1/4. If it is lower than 150 I should give no shot again? Again, thank you and Chris very much for all the help you are giving to us.
If it's below 150, I'd skip. It's safer to experiment a bit at the higher pre-shots than to get too aggressive and if pre-shot is below 150, even though that is over optimal range, Maus will be fine as she it's well below renal threshold. The problem with Vetsulin is that it can pull BG down steeply and you need to leave yourself enough of a cushion to be able to steer her up if she starts dropping quickly.
I was thinking of talking to the vet about possibly changing the insulin type. Would you advise me to do this?
You've given the Vetsulin a good run and it's obviously taken Maus into decent range but sometimes it's hard to get over that last hump with Vetsulin because of the steep drops, lack of duration and an inability to shoot low BG numbers. A switch to Lantus might be the ticket to taking Maus down to very optimal range. A longer acting insulin like Lantus is better at holding low numbers than at pulling down high numbers and it lasts a full 12 hours through the cycle which gives kitty more time in optimal BG range which helps to rest and heal the pancreas. Certainly worth a try IMHO when you get to this point and are so close to having that little girl sitting in totally normal BG range.
Isn't Lantus over $300 for a vial? I am not sure I can swing that, at least not for few weeks anyway. I will have to try to figure something out.
Matt, there is a supply closet for members here where you can often pick up one pen of Lantus for a reduced cost and I think that would be your best bet right now given how low Maus' BG is and the small dose I anticipate she will need. You don't want a vial as you will have a lot of waste. The pens can be used as tiny vials (3ml in each vs 10ml vial). Some pharmacies will sell you one pen but you have to hunt them down. The other alternative used by a lot of folks here is to order the insulin from Canada. Our prices here are considerably less and I believe you can get a year or more of insulin (depends on dose and Maus appears to need very little) for about $200. There are a couple of well known folks selling pens in the supply closet right now.
Wow, that sounds great. Can you please point me towards the instructions on how to go about that? I would be very interested in learning more about that, thank you! By the way, this morning's test was at 118.
Good Lord! Maus is on a mission indeed. She seems to be sending a message that she doesn't want anymore insulin. Can you grab another +3 test today just out of curiosity?
The supply closet is HERE. Not sure where you are located but finding someone within reasonable distance to avoid longer mail times is sometimes best in the winter and summer months.
Given that even lower BG this AM, I'm not sure if you might be best to hold off a few days to see if BG keeps dropping before deciding to make the switch. I've experienced a few kitties where Mom/Dad got all ready to switch and kitty's BG just kept dropping and the Lantus never got used.
Maus is doing super but she isn't making decision making easy! She's being a cat! LOL!
Yes, I will do the +3 test again. As for where I live, I am in Belvidere, (North-Eastern) Illinois. As for switching the insulins, I probably won't have money to spend until next Friday anyway. Thank you so much for all of your kind words and support. I am so glad that I found my way in here. Long Live the FDMB (and all of our babies)!
Hey Matt just in case you don't find anything in the supply closet and you do decide to switch found this Discount Card called SINGLECARE just Google it and I called CVS and Walgreens and asked them do they take scripts for cats for the lantus pens here in N.J. If needed call these pharmacies and ask them print off the card and coupon, the price may change if you ever need another pen. I put in where you live in Illinois and these are the prices that came up, just google it and you can read all about them
How it works
Lantus Solostar Coupons & Prices
Lantus Solostar is available as a pen that's prefilled with a long-lasting insulin. It's used to improve blood sugar control in those with diabetes mellitus. It is used to treat both type 1 diabetes and type 2 diabetes in adults and children. Diabetes medication is often expensive. Fortunately, you can use Lantus Solostar coupons from SingleCare to save on the average price of Lantus Solostar, which could be $93.59 if not more. Pay $66.61 instead at a participating drugstore near you.
3ml of 100unit/ml
7.09 mi. away
Get free coupon
18.99 mi. away
Get free coupon
Need the lowest prices on several drugs? Use our drug basket to get the best value
Add to your drug basket
21.21 mi. away
$69.15 - OSCO
Get free coupon
7.72 mi. away
$71.74 - CVS
Get free coupon
CVS cards must be used at CVS pharmacies. Not valid at any other pharmacy.
3.9 mi. away
$72.92 - WALMART
Get free coupon
Walmart cards must be used at Walmart pharmacies. Not valid at any other pharmacy.
Prices for some drugs may be higher or vary in some states including, but not necessarily limited to, CA and MN.
Thanks a lot, I will look into that if I need to!
The +3 number was 103. Should I continue with your previous advice for tonight at 11 pm? (150 - 200 give 1/4. If it is lower than 150 nothing)
50-120 is considered the normal range for a cat. Most non-diabetic cats run on the low side of that (that's why it'd be great to give her a little more insulin support to get her in that range), but wow, look what Maus is doing all on her own!
And yes, you still don't want to shoot even 0.25U of vetsulin on these kinds of numbers, not without having any data on what it would do.
We'll see where she is at the next shot time, but.... Go Maus!!!!
Great to see that number come down from pre-shot even if only a little. I have my doubts that there will be any question about giving insulin tonight. I expect Maus will not be high enough to try any dose of Vetsulin tonight. I'd keep testing her at usual shot times and see what she does for now.
I have the ball rolling for the switch to Lantus. Do you know if there are any resources available to explain how to transition? Also, whenever you have a spare moment, can you take a peek at her chart to see whatever it is you are able to see. I have foolishly not gotten any mid-cycle PM tests the last few days, but I will get back on that during the next PM cycle. Sorry to keep bothering you, but your help has been invaluable.
When transitioning from one insulin to another we take the data from the current insulin into consideration. When switching between Vetsulin and Lantus, usually the same dose can be started with Lantus. The one caveat to that is occasionally a cat can have a strong reaction to a new insulin so it's best to the do the switch when you can monitor closely for a couple of cycles.
The nice thing about Lantus is that it is better at holding good numbers than pulling down high numbers so drops in BG tend to be slower and less steep leaving lots of time for steering to keep kitty safe.
The Lantus forum is a busy place so when posting over there, we ask everyone to put the date of their post, their kitty's name and their AMPS and any question you might have in post title. This helps ensure that anyone needing help ASAP is looked after. We can get into that nitty gritty later. In the meantime, when you have a few minutes, I'd suggest you read through the sticky's at the top of the Lantus Forum to get a feel for the differences between how it and Vetsulin work. There are 2 dosing methods and you will be asked to choose one so that folks helping can provide you with consistent and appropriate information. TR (Tight Regulation) is more aggressive and has a great track record for helping cats go into remission. SLGS (Start Low and Go Slow) is also good, can get a kitty into remission but the method is less aggressive. It's entirely up to you which you choose as long as Maus is on a strictly wet diet. If there is any dry food in her diet, then you can only use the SLGS method. The sticky describing both methods is HERE.
No apologies needed. You are not bothering us at all. We are all here because we want to help. Do try to get, at a minimum, a before bed BG reading as many if not most cats, go lower at night than they do during the day. And when you can on day cycles, grab a test between +3 and +7 to see what Maus is up to during that period which tends to be the most active for Vetsulin. Any data you can collect will help us make recommendations about what dose to start her off at with Lantus.
I have plenty of time to read the stickys. I didn't notice that it will take 2 weeks to receive the insulin from Canada, my fault for not checking. I probably would have paid full price at a local pharmacy had I noticed that, but again that is on me. Also, the PM test/shot is just before I go to bed. As for the method, SLGS it is, because dry is part of her diet. Thanks for the information!
It's usually more like a week....it says 2 on their website but in reality, it's usually less. They will give you a tracking number so you can watch it move through the postal system
Once you're an established customer, it can come even faster because they don't have to verify the script. I ordered a refill once on a Monday afternoon and it was in my mail on Friday. (I'm in Missouri)
I hope so, because in the FAQ's it says perhaps 3 weeks or more due to customs.