Taking time to respond to vetsulin?

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Tiger and the squid

Tiger and the squid

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Okay. I'll go in to details below, but the gist of my question tonight is this - Is it normal for a cat not to respond to vetsulin for a month? And a half.

Tiger was diagnosed on 07/09. For the past month, we've been increasing his dose because his numbers are always very high. Finally around 4u, we were at least seeing his nadir dropping. But just over this past week, while his pre shot numbers are still high (but lower than they have been ever! If you look at his sheet, allllllllll of those 600s are actually "high" readings - my human meter stops at 600, so I dont have anything more accurate than that. ) he has started dropping quite low with his insulin.

I've been available to intervene this weekend when I've seen his numbers at their lowest, almost scary low (alright, actually scary low for me, though hes been acting fine - I have a thread in the main forum if you want to follow our weekend escapades)

I have emailed my vet, and asked her professional opinion, but I might get a faster response here - is it normal to see this kind of reaction? Where it takes a month for the insulin to start having an effect? Should I continue to reduce his dose? I know giving too much too fast is dangerous, and I know that being a little too high for a day or two is way safer than being too low for any amount of time, but are there any concerns with messing around with his dose too much?

I'm going to be switching to lantus when I'm done with this vial of vetsulin, so I dont know how much that might play in to things, if at all. My husband had also suggested the bottom of the vial of vetsulin being more potent than the beginning.

I'm sorry I got rambly. I hope this makes enough sense to someone to give me an idea where to go from here.
 
Tiger is DEFINITELY responding to Vetsulin. His recent data shows that the doses have been too high causing him to drop too low and then rebound (bounce) into the stratosphere. Until he gets more settled try to focus on how low a dose takes him and ignore the bounce inflated pre shot numbers. Your goal with Vetsulin is a nadir range in the high 90s to low 100s. That leaves enough of a cushion for safety. Last night's data suggests that 3 u is too high a dose. I see you dropped to 1.75 u this AM. Good move. Let's see how this lower dose plays out.

It's normal for Vetsulin to have a deep-ish curve because it's fast in onset and can drop the BG low. These are prime bounce creating conditions. Make sure you're rolling the vial gently before using it. The stronger response you're getting now might be from finally overcoming some glucose toxicity that had built up. That sounds scarier than it is. It means Tiger's body has been subjected to abnormally high BG and that has reduced his cells' ability to respond properly to insulin. Eventually that toxicity will be overcome and he'll respond more normally. I think that's what you're seeing.
 
Squid said:
So I see a different vet now than the one who initially diagnosed Tiger. My first vet told me to roll the insulin. My current vet said that was outdated information, and I should shake it.
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What does the instruction sheet in the box say? If it's an insulin suspension rather than a clear, colourless solution the goal is the suspend the particles to have a uniform cloudy mixture throughout the vial.
 
Kris & Teasel said:
What does the instruction sheet in the box say? If it's an insulin suspension rather than a clear, colourless solution the goal is the suspend the particles to have a uniform cloudy mixture throughout the vial.
Click to expand...
I believe suspension. When I take it out, it is clear with thick white at the bottom. I shake to mix.
 
Squid said:
I believe suspension. When I take it out, it is clear with thick white at the bottom. I shake to mix.
Click to expand...
If you shake I'd be gentle. Insulin is a protein molecule and can denature (lose its effective molecular structure) if it undergoes too much mechanical stress, heat, etc.
 
It looks like tiger is reaching his low point at about +4. Today he's already heading back up. I'll see what happens tonight, probably stick with the 1.75u maybeee go up to a full 2u

I really hope he settles in to a nice 12 hour regimen. 8 hours is impossible for my schedule.
 
+4 seems to be the common point of nadir on Novolin. That's what Rocky's is. And he starts to feel it within the first hour of injection. At +2/+3 he's usually howling for some food. It's a bit difficult to manage so I'm going to give all his data to the vet and ask for a switch to Lantus

And Novolin is a suspension so yes it does need to be gently rolled if it's separated. I wouldn't shake it though. A couple rolls or gentle rotations should be sufficient to get it mixed
 
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