new member 3/20 on vetsulin - need help

Hi, my cat was recently diagnosed with FD. He is 10 yrs old and 17.5lbs. About 2 weeks ago I noticed him drinking and voiding more than normal. He has not seen a vet since he was a baby. He is inside only cat with no other indoor pets and no obvious health problems. Needless to say, getting him in a carrier and in a vet's office was extremely stressful for us both. He also had to be sedated for the exam and all other testing. Vet did labs and urinalysis (he did not have a UTI but glucose in urine was 1000mg/dl) and made diagnosis. He was diagnosed on 3/16/21. His glucose from his blood work was 477 and the ear prick at the vet's office was 546. Vet wanted to keep him and run glucose curve. Me and him were so stressed out from the dogs barking at the office that I refused to leave him and offered to do any glucose checks at home and manage this at home. So we were sent home with Vetsulin and instructed to check glucoses every 12 hrs and give 5 units of insulin every 12 hrs. I called back 2 days later with his glucose levels and was instructed to increase to 7 units every 12 hrs. His previous food was Pruina Pro Hairball Formula (which I now know is extremely high carb). The vet gave us Hills Science diet dry W/D (which I now know isn't much better). I had already started the new vet food and giving insulin injections before I found this site. I wish I had known SO much more before our trip to the vet. He ate the new food (Hills W/D) really good for a few days but basically is refusing it today and only ate about half yesterday. Vet wanted him swapped to completely Hill's on that day, so there was no slow transition of food.

I'm not sure how to fix this mess that we are in. I would like to switch him to low carb wet food but hate to make two different food swaps in such a short amount of time. Right now the only thing I know he will eat is his old purina food and may eat some of the Hill's. I can clearly see that this 7 units is way too high and I don't understand how the vet only wanted AM and PM readings to decide to increase his dose. I wish we could just start over but I'm not sure how. Please give any advice regarding how to manage from here - do I give any insulin tonight/tomorrow? When and how can I transition to a low carb food? I'm also not sure whether to tell the vet I won't be following his plan of find another vet.
I hope this posts right as I have never used any type of forum but am desperate for help and what I have read on here seems to be more knowledgeable than my vet. Thanks in advance for any advice!

 

Hello and welcome to you and Tuko!

Great job taking control of Tuko's care, and well done on getting the testing up and running so quickly!

I'm only stopping by briefly, so hopefully others will be along to help, but very quickly: please do not switch to low-carb food without lowering the dose of insulin. You can see from your testing today that the 7U took him down to 60's, which is normal but not too far above the hypoglycemic range. You don't have much of a safety margin, and if you remove carbs from his diet suddenly, it could be very dangerous. The dry food may be what is keeping him from going hypo. If he's refusing the Hills now, I'd go back to his old food for a while-- not eating is a big problem for a diabetic cat, and it's not like the Hills was that great for him anyway. You might be able to return it to the vet for a refund, as a lot of the vet foods are guaranteed by the manufacturer. Whatever you do, though, do not change the food to low-carb just yet.

In terms of dosing tonight, you'll want to lower the dose even if you don't change the food to low-carb. A couple of points about that:

-- on Vetsulin, any time you get a BG number below 90, you reduce
-- 7U is a big dose, as is the 5U you started with. He may need that much, but it's usually better to start small (0.5-1.0U is a typical starting dose) and work your way up.

Hopefully someone who uses this insulin will be able to suggest an appropriate dose moving forward.

Don't be surprised if he has very high BG when you test this evening, he'll probably be "bouncing" from the green numbers today. That's probably also why he's been relatively high at the pre-shot numbers so far. As you discovered today, you can get a very different picture of what a dose is doing when you test between shots! In general, we try to adjust the dose to the nadir, the lowest point of BG during the cycle, not the pre-shots.

Welcome again to you and Tuko!

 

No offense, ittybitty (love the name, by the way), but I almost **** my pants when I read that as a starting dose. If I may ask, how did the vet decide on that dose to start?

 

Great job getting the spreadsheet up so quick!

I would look for a different vet ASAP.

 

Hi and welcome to you both.
Tagging @Critter Mom and @JanetNJ to help with the vetsulin dose.
I would definitely reduce the dose. 7 units is an insanely high dose to start a cat on. 1 unit is the normal starting dose.

I agree you need to be swapping to a low carb diet but need to do it under supervision while reducing the dose of insulin to prevent a hypo.
Will your kitty eat normal canned cat food?

I would buy a bottle of Ketostix from a pharmacy or Walmart and test the urine for ketones while Tuko is in high numbers. It is a good insurance policy and catching ketones early saves a lot of problems from happening. I’m not saying he has them or will get them but they are not uncommon in diabetic cats and must be treated early.

Always test before every shot of insulin and again during the cycles to see how low the dose is taking Tuko.
Keep asking questions..........you are doing a great job getting Tuko sorted out.

 

Thanks so much for ya'lls quick reply! I have read the warnings about switching to low carb and won't without more guidance (but would ultimately like to switch and I wonder how much insulin would really be required if we changed food). I would have done more frequent checks before today but we had a rough start at ear pricks (as I've read is pretty common) and I didn't want to torture either of us more than necessary. These pricks are still a work in progress though.

I also had no clue the day I left the vet with what a normal starting dose was (and was in shock a bit)..... I've learned a lot this week from this site! He basically gave me the option of glucose curve in clinic to find the starting dose or since I refused to leave him he would basically pick a number and then adjust as needed. So we started on Tuesday and he wanted an update on Thursday (where he increased us to 7U) and said to call them back with his numbers on Monday from this weekend. My only dilemma to this whole thing is I work 12hr shifts so on my work days I can't monitor him or check extra. I would rather have started slower so I didn't have to worry so much about going hypo while I'm at work. I just don't know where to go from here - drop back to 5U tonight or go even lower?

Thanks, the spreadsheet was easier than I thought once I started it.

 

I have never tried to give him canned foods. Honestly, he typically has eaten anything I fed him. He was on a plain purina dry food then transitioned to the purina pro dry hairball formula probably 2 yrs ago and then the Hill's dry now. He has grazed on the Hill's a little this afternoon but typically with the Purina Pro he cleaned the bowl and begged for more.

How often during the cycles is recommended to be testing? I don't want to prick anymore than necessary but I understand the data is needed to provide the best care for him.

 

I'll leave the dosing to the vetsulin folks, but as for testing, you don't have to do a full curve each day. You do want to do at least a pre-shot test (to make sure it is safe to shoot) and then, ideally, at least one test between shots. That may not always be possible with your work schedule, of course, but all you can do is what you can do.

If you have the time to test, the numbers today should give you a pretty good indication of when vetsulin curves are (usually) lowest. If it were me, I'd probably test at +2 or +3 (to get an idea of how the day was going to go) and then go from there on days when I was home.

Sigh. Your vet is probably used to treating diabetic dogs-- cats just don't work the same way. If you like him in general, you may be able to strike a deal where you handle the diabetes and he handles everything else.

 

His urine was negative for ketones from this vet's office. If any of the other labs (blood or urine) would be useful, I'd be happy to post more info. How would I use those ketostix?

This was the first time I had ever met this vet, since Tuko hasn't had any problems, I never took him anywhere after his initial checkup/shots as a kitten. And I picked a clinic that was recommended by multiple people. We didn't agree on much and I doubt there is any way to strike any deal with him. He strongly supported in office glucose curves and basically said any other way to treat is was just guessing. I strongly did not want my cat caged up in an unfamiliar environment hearing other animals because I didn't feel like that would give any good lab work. So he finally said he wouldn't fight with me but he didn't think what I chose was the right answer and I politely disagreed.

 

Just to be sure that you are waiting 30 minutes after he's finished eating
then giving the vetsulin.
With your work schedule leave whatever food out for him that he will eat

 

Hi just saw this tag. Omg this vet is not familiar at all with dosing a cat. My guess is he’s more familiar with diabetic dogs.
Im so so glad you found this site.

I agree with everyone else that the starting dose is crazy high. Most cats never need more than 3 units so to start at 5-7 is asking for a hypo.

if it were my cat I would pick up some fancy feast classic or Friskies pate foods and start at 1 unit. I'm so so glad you are testing at home! That is major and will be the best tool you have. If after a week or so 1 unit proves to not be enough we will recommend you raise it by 0.25-0.5 increments depending on the numbers.

Your cat is super lucky to have you to research for him and find the best way to help him.

 

The ketostix are put in fresh urine. Either the stream or catch it in a cup. When I had a diabetic cat (she died last month, not from diabetes) I used a ketone blood meter that works the same as a glucose meter. I just found it more convenient.

 

There are a couple of issues that speak to the vet being less knowledgeable about feline diabetes. First is the dose. Unless your cat is extra, extra ummmm..... "fluffy", 7u is way too big of a dose. It might be a good starting dose for a St. Bernard but not a normal size house cat.

The AAHA (American Animal Hospital Assn) recommends either Prozinc or Lantus for the treatment of feline diabetes in their guidelines. He doesn't need to take the word of the "crazy cat ladies on the internet" -- these are the guidelines from one of his professional organizations. I linked the paper so you can give it to your vet. Vetsulin was developed for dogs (it's other name is Caninsulin). It is a harsh, fast acting insulin that does not last the 12 hours necessary for a cat's faster metabolism.

Good for you for not getting a curve at the vet's office. Even if the office was serene, most cat's art stressed from a trip to the vet. Between being in a carrier, a ride in the car, and the strange sounds and smells and strange people a the vet's office, a cat's blood glucose levels will be elevated from the stress (i.e., stress hyperglycemia). This means that the numbers at the vet's office are artificially higher. As a result, the amount of insulin the vet will prescribe could result in an overdose. Doing a curve at home avoids this problem. This article from Jacqui Rand, DVM discusses stress hyperglycemia and the importance of home testing for diabetic cats. Again, it's from a veterinary website and the author is a well published diabetes researcher.

I'd encourage you to look over this information on the use of Vetsulin. It's our Beginner's Guide to Vetsulin/Caninsulin. It will give you a lot of the basics.

 

Thanks! So much good information. I have a few questions.

1. Is it worth trying to struggle through this with vetsulin or simply find a new vet and request prozinc or lantus?

2. @JanetNJ - you mentioned starting back at one unit and feeding FF classic of friskies pate... how to I go about switching food? Last night I left out half of his old Purina and half of his new Hill's. So I know my glucoses won't be great with all the high carb but I needed him to eat something. Would you leave any dry out for him or switch to all wet? Also how many times/day do ya'll feed wet? How do I know how much wet to give him? He was 17.5 lbs and I know the vet wanted him to lose weight but right now I need to get these glucoses straight first (I think is the priority, please correct me if I'm wrong.)

3. How do you catch fresh urine on a cat?

 

Also, any advice for what to do this morning for feedings and insulin dose? He was 383. I have the dry purina pro and dry Hill's and 2 cans of Hill's W/D wet. I can go pick up some FF or friskies today (just don't have it here right now).

 

I went to the store and got some friskies pate that I'm trying... so far he's licking it but I'm waiting to see if he will actually eat it. I will probably give 1U this morning and do a few ear pricks throughout the day to see where he is, does that sound appropriate?

 

1. So vetsulin. Some find it doesn't last long enough. My cat was on it when she was first diagnosed and actually did really well on it. She went into remission after 4 months. When she came out of remission a year later we tried the vetsulin again and decided we needed to switch to ProZinc. If you already have the vial you could certainly see how your cat responds to it.

2. If your cat is prone to tummy upset with a food change then I would switch to the wet gradually. Here are tips for transitioning to wet. https://catinfo.org/#Transitioning_Dry_Food_Addicts_to_Canned_Food_

If he likes the wet and doesn't seem to have a problem with it than is probably just go for it but definitly reduce that dose.

The rule of thumb is about 20 calories per pound of ideal weight. So you said your cat should lose weight. Let's say 16.5 lbs is a good weight. That means he would need about 330 calories per day. The calories will be on the cans of food. Fancy feast is about 85-90 calories per can. That means he would need About 4 cans per day. Sometimes unregulated diabetics need more so you would have to see if that satisfies him.

3. Ha ha. Well you could catch it in a cup of ladle. Or put plastic wrap where he goes. I personally just used a blood ketone meter. Totally worth it to not have the hassle.

 

Sounds great! You could put a few of his kibble on top for now to get him interested.

 

I think today has been a complete fail all the way around. He isn't eating the wet other than licking the top. He ended up hiding under the bed and wouldn't come out and I've been sick and went to a doctor's appointment so he hasn't gotten any insulin for this morning and his glucose is 443 I guess my best option now is to start fresh tonight and use wet with a little of his old purina to try and start with 1U tonight?

I just caught where you said "blood" ketone meter.... makes sense. This kitty is so tired of me messing with him, I'm not sure about trying to catch urine.

 

Sounds like a stressful day. It's a marathon so don't let one day get you down. I hope you're feeling better soon. When you do test him, give a special treat he only gets for tests. For my cat it was a few bits of cold cuts. After a few days she came to expect them and didn't struggle with tests anymore.

Ok of he's not feeling the wet food yet switch a bit more gradual. Or try a different brand like fancy feast.

The blood ketone meter I got on amazon.

 

In one of the links I read from Dr. Pierson's information it stated if you cat weighed 18lbs but should really weigh 12lbs please make sure that he is consuming ~180cal per day. With the calculation used of 12 lbs lean body mass x 15calories/pound/day = ~ 180 cal/day. I was told by the vet that Tuko should weigh about 12.5lbs and he's 17.5lbs now. So her calculation is pretty close to my situation. If I looked at her information right... it also appears the Friskies pate cans are 5.5oz and are about 170-180cal depending on the flavor. If I have not mis-read something, it appears that Tuko would need 1 can/day. This doesn't seem like enough (but he has done fine with it and isn't begging for more today). I'm not sure if I should be feeding off his current weight and stabilize glucoses first or be working toward weight loss in the process. Need advice/recs for feeding amounts. Last night I used the pate mixed with some of his old Purina dry and today I have used only the pate. I gave him 1/2 can this AM and he has been snacking on it throughout the morning and has almost finished it. He seems to be a messy eater with wet food as well. He licks it until it's either dried out into circles (and then plays with it with his paws) or he has pushed it out of the container. Any advice for best way to feed wet food?

 

Hi Krista, are you adding water to the wet food
All most all of us do
Add some water and mush it up with a fork, make it a little soupy
If he doesn't finish it all at once, when he's ready just add a little more water to it.
Maybe try putting it in a small cereal bowl with water so he doesn't fling it around
Tyler is a messy eater also
The rule of thumb is about 20 calories per pound of ideal weight as JanetNJ
stated above
So if his ideal weight should be 12.5 pounds
12.5x20 = 250 calories
So depending on the friskies pate flavors you could give him one whole can and a quarter of
of another can if he's asking for food

 

Hi, I had not added water to it, but I will now (and try a bowl)! Is there a way to determine ideal weight or just go by what the vet said? He has eaten 1/2 can since this morning and started begging so I just put out the other 1/2 can with water added and will probably put out 1/4-1/2 tonight. That may be a tad over but I don't want to leave him with nothing tonight. How do most people manage wet feedings while they are gone to work? Use twice daily feedings or timed feeders? Thanks so much for the reply! I have no idea how I would be managing this right now if it wasn't for ya'll!!!!

 

What did he weigh before diagnosis?
Was he over weight
I would say that if fine what you are feeding him.
Always add some water to his food
Yes people that work use timed feeders
They have ones where you can out a frozen ice pack in so the food stays moist
By the way Tuko sure is a cutie

 

Honestly I haven't weighed him.. I know a few years ago he was 16lb. and then 17.5 now (which vet said was overweight). He hasn't had any major gains or losses in weight. If anything it's been a constant gain from a kitten on to 10 years old.
And thanks! I think he's pretty cute too!

 

Also, any recommendations for treats, any certain brands, etc? The vet gave me "lean treats" that I've used no more than 2x/day. But I'm looking to purchase something and don't know what to buy.

 

Any freeze dried treats, you can just Google freeze dried treats for cats
such as
https://www.chewy.com/purebites-chi...MIxey2lbrG7wIVFOWzCh0IdQDfEAQYASABEgKiA_D_BwE


https://www.vitalessentialsraw.com/cat/treats-snacks/

Some members will buy the exact same treats for dogs, to save money, they just break them up into smaller pieces . you can buy a small bag for cats and see if they like them, then buy the bigger bags for dogs


Also up top right hand side there is a search area you can just type in freeze dried treats and hit search
and you will see posts that have to do with freeze dried treats that members posted.
Just go thru some of the and they will say what they use

 

Thanks for the links and advice on how to search the sight - I actually hadn't found that little search bar yet!

We quickly went from turning our nose up at the pate to waking me up for it and eating the whole 1/2 can at one time and wanting more... who would have thought?!?!?

I also got my timed feeder ordered yesterday to start trying to have ready when I'm not sick anymore and go back to work. I almost wondered if I should split the PM meal into 2. I don't know what to do if he keeps eating it all in one sitting and then there's nothing left. He will beg (and I can deal with that)- but he will also pounce on my feet/bite at the covers of my bed/jump on and off the bed, etc. non stop until I give him something (which has probably contributed to his overweight status because I had to have sleep to go to work.) Typically when he did it I just added a tiny bit, I didn't give him full extra meals.

 

Hi I'm going to tag
@JanetNJ
Since I saw she has been helping you
Can you tell her what you are exactly feeding Tuko right now
Janet can you give her some advice
She us asking if she can split the PM feedings into 2 meals
I think she said he's over weight if you can read thru some of the posts
I guess she wants to know how many hours can she set the auto feeder to open for him so he doesn't keep begging for food
Thank you Janet

 

The search bar is all the way up top in the right hand corner

 

I am using the Friskies pate chicken/seafood is the box I bought to start with. My original plan was 1/2 can in AM and 1/2 can in PM but then he wants more. So I've been giving about 1/4 can mid afternoon (2pm) and 1/4 can when I go to sleep, which has been around midnight - 1AM. I know that's about at the maximum or a little over on calories that he should have based on 12.5lb ideal weight.

I'm considering using the timed feeder for one meal/snack during the night and one meal/snack during the day. I would feed him the AM/PM meals. I just need to know the amount of the feeding. Is is better to keep the main AM/PM meals larger and use smaller meals in between. Or evenly space out 4 meals that are the same volume at each feeding? I've also been trying to add feeding notes to my spreadsheet since I know I won't remember all the details from day to day.

Thanks so much!

 

Let's see what
@JanetNJ has to say , I'm sure she will check in later, hang in there

 

I think he will be starving if you limit his calories that much in one go. Maybe do smaller weight loss goals. Plus unregulated diabetics often need more food because their bodies can not properly utilize the nutrients.we usually say to figure 20 Cal per pound of ideal weight. So let's say the first goal is to get him down to 16 lbs from the 17.5. That would be about 320 calories. That would be about 1.75 cans Friskies per day. Again though being unregulated he might need 2 cans now until his blood glucose comes down. You can break it up into as many meals as you want.

Get him exercising and moving as much as you can.

 

Okay, thanks! That sounds great!

 

I bet Tuko approves this message !

 

Thank you
@JanetNJ

 

Oh I think Tuko definately approves that message! I'm so thankful that so far he has been an easy transition to wet food.

 

oh that's good. It can be a real battle for some. You can also add a little water to the food to fill him up and hydrate him.

 

I was worried because I had read so many stories of the struggle. @Diane Tyler's Mom had suggested adding water earlier and I have been doing that and he loves it! I set my timed feeder to try an extra small feeding around 2AM in the morning (first time using it). @JanetNJ - do I just continue for 7 days with the 1 unit and then get you to look over my spreadsheet? How many extra glucose checks throughout the day would be helpful or just try to catch the nadir? I also thought about trying to do a curve on day 6 or so just to see what he was doing during the day. He jerked one time while I was pricking and it sliced a small bit of the edge of his right ear and he pretty much refuses to let me touch that ear for several days now. I feel bad to keep using the left ear so much but I don't want to fight him over the right ear. Has this happened to anybody else?

Thanks! I (as well as SO many others) have no idea what I would do without this site!!!!!

 

Hi.... Vetsulin usually peeks 4-6 hours after the shot. So random readings in there are helpful. Let's see what the numbers say Today. I'm thinking do 1.25 starting Saturday if the numbers don't go down more. I do like that 184 you saw. Getting a before bed reading is a good idea.

If you have neosporin ointment with pain relief you can put a tiny bit on his sore ear.

 

@JanetNJ - I went ahead and started the 1.25 on Saturday. When you have time please look at the latest on the spreadsheet. I'm not sure if he is bouncing or if the insulin just doesn't last 12hrs. Current feeding regimen has been 3/4 cup in AM; 1/4 2PM; 3/4 cup for PM; 1/4 for 2 AM. I may need to adjust the 2PM and make it 1PM. Sometimes he eats everything at once and sometimes he snacks and grazes and doesn't finish all of it (he always eats the majority) and may still be eating on that 2PM later than I want him to.

Also, I know it was mentioned that I should wait 30 minutes after the glucose check to give the shot. Is this just to make sure he is going to eat? Is it harmful to wait 15 min and give it or should it be a full 30 min?

I also haven't seen him drinking from his water bowl since I started adding water to his food (obviously he could have done it when I wasn't looking).... should this be a concern?

 

Vetsulin is not long lasting so it looks like it’s just wearing off. Most find they only get six to 8 hours on it. The numbers look good! I like those low 100’s.
He’s probably getting enough water in his food.

waiting 15 min is fine. It’s just to make sure he eats and keeps down the food.

 

@JanetNJ - please look over spreadsheet when you have time. I have done the 1.25u for almost a week. Not sure if I need to make any adjustments. I finally got a diagnosis and have mono (symptoms started a week before his diagnosis). As miserable as I have been for weeks - it has been nice to be home with him while I am figuring this out and I'll probably be out of work for a few more weeks while I recover.

If you have any guidance or links on giving injections please send my way. In the beginning, he didn't mind the shots at all. I have rotated between left and right side of chest (looks like shoulder areas to me). Lately, he does flinch or jerk like I've hurt him and I always go to a different spot. I'm not sure if I'm hitting old sites and need to rotate to other areas as well. He has also started jerking his head/ear at the exact second I go to prick his ear and then started the head shake and we lose our blood drop. So thankful for the easy pricks because he sure makes me work for some of these.

Thanks again for all your help along the way!!

 

@Diane Tyler's Mom @JanetNJ

If anyone is available - need advice for PM dose. PMPS was 196. This is my first PMPS <200. Right now I'm stalling and plan to recheck. Was thinking maybe decrease to 1U tonight to be safe. He does seem to eat more at night than during the day lately and he only ate about 3/4 of all food for today. Thanks!

 

Krista, sorry I can't help with dosing
I'll tag
@Deb & Wink

@Panic
Thanks Ladies

 

Thanks! Still learning everyone and who is on vetsulin! I'm so happy to finally see some better numbers but I don't want to cause a hypo for sure. Recheck 30 minutes later is 190.

 

Sorry I didn't see this last night. GOod call doing 1 U. THat's probably what I would have suggested too.

 

@JanetNJ

Advice for what to do in general? Should I continue the 1.25 or does he need a reduction? I did the 1.25u this morning but I plan to test and see how low he is going mid cycle.

Not sure today has been the best numbers to judge by. I don't think he likes the ocean whitefish/tuna pate so he has barely eaten 40% of AM meal or 2pm meal which would be at +5. I gave him 1/2 can of chicken pate at +6 since I think that's his favorite and he did eat about 1/4 of it as soon as I put it out. I'll keep checking.

 

The 71 is reason to reduce the dose. I'd go down to 1 u

 

@JanetNJ
Thanks! He has just not seemed normal today. More irritable, didn't want to eat and sleepy - not sure if that goes along with his glucose being lower than what he is used to.
Tonight's PMPS is 157 - I guess I'll stall and recheck.

Recheck at +12.75 is 160. Recheck at +13.25 is 158. Will hold tonight's dose because I'm not convinced he will eat his normal amount of food through the night.

I feel like I had a better handle on things until he started dropping into these lows. I will restart tomorrow AM with 1U as @JanetNJ recommended. What should be my number not to shoot, <200? Or how to you decide whether to hold a dose or give a lesser dose, etc?

 

AMPS is 179 and no insulin was given overnight. He ate about 85% of PM meal and then 3AM snack overnight.

Do I keep holding insulin? Or stalling and re-check?

 

AM shot held as I'm still not certain about shooting at <200. PMPS is 188. He ate about 80% of his food today. Not sure whether to continue holding insulin or give .5 or 1U. Any dosing advice is appreciated.

 

I am not a vetsulin user but I would not keep withholding the insulin.
If he is eating I would at least give 0.5 units or 0.75 units if you can monitor the cycle and feed him during the cycle.

 

Also it is my understanding that if you drop 90 on vetsulin you reduce the dose immediately by 0.25 units. He dropped under 90 on 4 occasions in the last 5 days so you should have reduced the dose to 1 unit.

 

Thanks so much for the reply. I didn't make any adjustments based off the PM checks from 3/31 since I had not been previously checking him throughout the night (that's my mistake.) In hindsight, the 84 on 4/1 - I definitely should have dropped his dose. I posted for advice but I think I was too nervous to make adjustments on my own. And then yesterday he got lower and wasn't acting like himself and wasn't really interested in eating. So then I was nervous to give him a shot if he wasn't going to eat like he normally would. This is such a learning curve. Hopefully I haven't messed up too bad so far

Plan to continue .5U and monitor.

 

Hi Krista, Tuko is a handsome boy!
No you haven’t messed up. It is a learning curve..
I would get a+1 and a +2 because you have shot a lower number than you normally do. This will be good data and if he does drop lower early in the cycle you won’t get a nasty surprise when you test later in the cycle.
If you find him dropping lower early on, you can give him a snack of ordinary low carb food to slow him down. Always post if you are unsure and change the subject line to alert us you need help

 

Thanks so much!
I have changed the subject line when I was stalling to indicate stalling several times and then changed it back once I held the dose. I think it has just happened when nobody was available. I've tried not to stall over 1-1.5hrs to try to keep a schedule (although my schedule is far from perfect). Is that correct for stalling? I just hate the point where you have stalled and have to make a decision and move on - and you hope you choose the right thing!

 

I would not stall for more than 2x20 mins as it throws the schedule out too much. Do you work from home and how flexible can you be?
When are your shot times? (In relation to the time now?)
We might be able to find someone who is online at that time to keep an eye out for you.

 

I work 12hr shifts but am currently out on medical leave with mono and have been for weeks. I have been trying to shoot around 9:30 AM/PM (2 hrs prior to now) but could adjust that as needed. I will have to adjust back to 6AM/8PM once I am working but couldn't make myself get up at 6AM while I've been so sick.

Also at some point I may need SS help. I'm not sure if I have entered all the stalling information correct. Specifically, when I held a dose - do I continue on as if 9:30 was my shot time (even though I didn't give it). If I checked it at 11:30, I would still chart that under +2?

 

I am going to ask @Bandit's Mom to have a look at your SS. She is a whizz with fixing them.
She may also be around when you shoot your PM dose so you could tag her or me for the pm dose help if needed. We have just changed times with daylight savings two days ago so I’m a bit at sea with times at the moment.
For the morning dose you might be able to tag Christie and maverick or tiffmaxee. To tag you just put a @ in front of the name ...like this @Bron and Sheba (GA) and a box will come up and it will give you a choice of who you tag. Just click on the name you want.

 

Thanks!

Just shot PM dose an hour ago and did the .5U. JanetNJ had been advising me but I know it's impossible for one person to be available at all times. I'm still learning everyone and who uses vetsulin. My AM dose would be 10 hrs from now approximately. Is there a number that's an absolute no shoot? Or if he stays >150 pre shot - continue with the .5U?

 

@Bandit's Mom

@JanetNJ

@Bron and Sheba (GA)

@Christie & Maverick

@tiffmaxee

If anyone is available for dosing help I would appreciate it. I followed @Bron and Sheba (GA) advice last night and gave .5U. Tuko did drop down to 89 but it came up on it's own with his scheduled feedings and he ate all of overnight meals. This morning AMPS is 161 @ +10.75. I'm not sure if the 89 earned him the reduction and I should give .25U. I've also never shot this low. Times are a little off since I stalled last night and was trying to allow stall time this AM if needed. Thanks is advance!!

 

I'm not familiar with Vetsulin, but a quick glance at this sticky, says you reduce by 0.25U if the BG falls below 90.
https://www.felinediabetes.com/FDMB/threads/beginners-guide-to-caninsulin-vetsulin.231587/

Have you fed? the 161 is at +10.75? So more than an hour to AMPS? Let's see where he is at AMPS.

Can you monitor if you shoot?

 

This is his "normal" shoot time.. because I stalled for an hour last night it has made his normal only be +10.75 this morning. I'm trying to learn the ropes of stalling and getting back on track, too.
Yes, can monitor.
No, have not fed yet.

 

If you can monitor, I would shoot the 0.25U

 

I don’t know enough about Vetsulin to advise you. A quick read on Vetsulin says you reduce if your cats drops under 90.

 

@Bandit's Mom - would you go ahead and shoot the .25 U at his normal time (now)?

 

You have the option of stalling and seeing if he heads up. The flip side is he could head lower without food!

165 is within meter variance of the 183 and 191 you have shot before.

 

Thanks so much!
Stalling hasn't seemed to work well with him and I would rather go ahead and get him eating while he is wanting his AM meal. He's finicky about meals lately when I keep stalling. And I would like to keep him on his schedule, if feasible.

@Bandit's Mom - also, @Bron and Sheba (GA) mentioned that you were great with spreadsheets. If you have time would you look at my stalling and see if it seems right on the spreadsheet. Also - when I held insulin but continued to check glucoses... does that get charted the same. Example - his normal shot time is 9:30 but I held the dose but then checked him at 11:30 - I would chart that under +2 even though he didn't get a shot?

 

Go ahead and shoot

All the +12 and above when stalling will go into the PS (AMPS or PMPS) cell.

Yes, that's correct!

 

Thanks!!!

 

Most welcome!

 

@JanetNJ

@Bron and Sheba (GA)

Or anyone else available - dosing advice? PMPS is 195. I think since I reduced after last night, I am supposed to hold .25U for 7 days unless I have a glucose <90, is this correct?

 

I like the 0.5 dose, but if you can't test or wanna play it safe 0.25 is fine. Why did you reduce after last night? Numbers in the high greens are good.

Edited to say I see it was because of the 89. I always assumed for numbers in the 80's, but if it makes you nervous then maybe do just below 0.5.

 

I'm fine with 0.5 and he was super happy/playful/alert last night. And yes reduced because of the 89, mainly because I didn't want to not follow the rules again. I had several times previously I should have reduced that I didn't realize that I should have. We were doing so good and then he has thrown me for a curveball the last few days. I don't understand what happened.

How long do I hold my dose? And I would reduce for lows below 90? And post for help if he starts running high again?

 

Hold it unless it goes too low. If it starts going much lower or you find you need to steer it often, I would reduce. For now maybe do a "skinny" 5... just under the line.

 

Thanks @JanetNJ I think I will have to go with a skinny .5. I did .5U this AM since .25 didn't do much yesterday and we are already down to 84 at +3. How do I chart the skinny .5u?

Also, what should my no shoot number be? I know this AM he was 153. Or I should just reduce to .25 and not skip a shot?

 

@JanetNJ @Bron and Sheba (GA)

Dosing advice please. I gave .5 as JanetNJ suggested on 4/5 PM and it looked like 86 was the lowest he went. I held that .5 yesterday AM since the .25 had not helped the day before. Yesterday 84 was my lowest so last night I gave a skinny .5 but he dropped to 78 last night. @JanetNJ I'm not sure if I should be reducing by .25 due to these lows <90 of if it is okay to see some 80-90s or if I need to adjust to a fat .25. Does anyone ever give a different dose for AM/PM? I'm trying to get all the data I can because when I go back to work I will not be able to test anywhere near as frequent. It seems like .25 doesn't help during the day but .5 maybe too much for the night OR .5 is okay if 70s-90s is okay (I know we want green numbers, just not sure how low).

Thanks so much!!

 

I am not vetsulin user so we will see what Janet says. If she doesn’t come on before your next shot, I would reduce the dose to 0.25 units, because of the 82/78.
He is looking good!

 

@Bron and Sheba (GA) thanks for the reply!! I will shoot .25 this AM and see what @JanetNJ recommends for dosing. His AMPS is now 147 (numbers just keep getting better). This forum has been invaluable - just to know there's somebody else out there and I'm not alone in this. Thanks again.

 

Oooo... loving these blues!
Do a nice full 0.25.

 

I'm using syringes that have 1/2 unit markings but that's as detailed as it gets. I'm assuming there aren't any more detailed syringes, right? I feel like .25 is such a tiny amount (and hard to see) , but I agree I'm loving the blues too!!

@JanetNJ thanks for looking at his numbers!!
I didn't get an email notification about your post so I gave a regular .25 this AM, will make it a little fuller next time.

 

Unfortunately no they don’t Come in 1/4 markings. Are the ones you are using.33cc or 0.5cc?

 

The box says 3/10cc

 

ok great. I was just checking. Those are easier to see than the .5 ones

 

New problem tonight -
He has literally refused to eat the friskies pate. I've tried multiple flavors that he has previously eaten with no problem. He is following me around the house, meowing like he wants to eat and when I put food down he smells it and walks away. I did give him a little under .25 U tonight because he has never skipped a meal. We are at 82 @ +2.5. I went ahead and gave a 3oz can of FF chicken (I think medium carb) and he is eating it. I'm not sure how much of it he will eat. Any ideas why he would suddenly refuse his normal food?? I haven't changed anything about the way I fed him tonight and he ate almost all of his AM meal and +5 small meal like normal.

Update: he ate a little over half of the can.

 

If he sniffs it and walks away, that sounds like nausea.
You did the right thing to try the medium carb if he refuses all else and you have given insulin.
I would keep testing in case he drops lower this cycle and offer him whatever he will eat.
If he still seems nauseated in the morning I would either give him some cerenia if you have any, or speak to the vet about getting some to have on hand, or taking him to the vet to see why he is nauseated.

With all the cans you have opened, I would transfer them into plastic containers or bags, mark them and freeze them for later.

 

It's just so odd because I've never seen him do this. He would eat his freeze dried treats with no problem and beg for them, but not the friskies. When I put that medium carb out he went straight to eating it like he was starving even though I've been offering food for several hours but he ate half and then tried to cover the rest up. I just rechecked and he is up to 120 but fiesty and swatted at me after ear prick (only his second time to do that). I don't have any meds for nausea but will definitely call the vet if this continues.

I mixed water in with them so they will probably just be garbage.

I guess in the future if he doesn't start eating it would have been better to just skip the dose of insulin?

I did get him a catnip banana that he has played with a few times since yesterday - do you think any correlation?

 

I would test until nadir.
I am not a vetsulin user so I’ll ask @Deb & Wink about skipping doses with vetsulin when they don’t eat.... vetsulin hits hard and fast and I know you need food aboard.
Has he ever had ketones?
I have no idea about the catnip banana.....
If he’s swatting at you it sounds as if he is not feeling 100%.

 

Ketones were negative at vet office with diagnosis. On 4/5 I did ketone strip in wet litter puddle (not sure if 100% accurate) and it was negative.
He is acting completely fine otherwise, almost like he just doesn't want to be bothered by me.

 

That is good there were no ketones at diagnosis.

 

He is 109 @ +11.5. Not sure what to do about insulin this morning. He ate all of the medium carb that I gave him last night (3oz) and a little of the friskies that I left out. I'm leaning towards skipping his shot completely this AM but I don't want to mess up.

 

@JanetNJ @Deb & Wink

Looking for vetsulin dosing help. I held this AM dose because I wasn't sure he would eat after he initially refused food last night. I gave him 3/4 can of friskies this AM and he has eaten almost all of it (in small meals throughout the day). We are at +7 right now. I don't want to make a mistake by holding insulin but I don't want to cause a hypo either. It seems like everytime I think I have him figured out he throws me another curveball.

 

I would have recommended that you skip the insulin this morning also. I see by looking at your SS that you did skip the dose. Good judgement call on your part.

You will not "mess up" if you skip the dose when he's that low.

That BG of 109 is too low to dose your kitty Tuko. You need more test data to know how your cat will react to getting a dose when the BG is that low.
We usually recommend STALLING without food, retesting and seeing if the BG is rising. It needs to rise more than meter variance (20% or more) before you would want to give a dose.

What has changed in the last 6 days? Since 4/4/21? Something has dramatically changed.

The next lower dose that you could give is 0.1U. So the syringe plunger is barely above the very first line on the syringe barrel, what we think of as the zero (0) line.

 

@Deb & Wink

Nothing has really changed that I can think of. I switched to the friskies (from high carb dry) in the beginning of this and that's the only food he has had until last night when I used FF medium carb. I've kept the same routine with feedings (3/4 can for AM and PM meals and 1/4 can around +5). I've used freeze dried treats. He was getting some "lean treats" in the beginning but that was only a few a day with testing until the freeze dried came in. Catnip banana was new starting on 4/7.
4/2 PM was where I started questing my doses because we were starting to be <200 for pre shot and seem to keep dropping from there. 4/3 he didn't eat much and then last night he refused friskies. I tried to keep up in the notes on how much he has eaten. He has slept alot today but me and him were awake all night last night so I partially feel like our sleep schedule is just off. I don't know what to do with this kitty.

 

Well, what I think you do is keep doing what you are doing. Because so far, what you are doing is fantastic!

It's possible that the switch to lower carb wet food has made a dramatic difference for Tuko. Sometimes, a change in diet with a short course of insulin is all a cat needs to turn the situation around. Keeping paws crossed here that you are headed for diet controlled remission.

p.s. Would you please start a new post, and link this old one in at the top, for some history. This thread is getting very, very long and we like to keep threads to 50 replies or less. Thanks.

 

How did he eat today