Vetsulin lasts 8 hours!

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cashy

cashy

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We have been treating Cash a 16 year old Siamese mix with Vetsulin ( I think he is on his 3rd or 4th bottle.). Had first noticed his weight loss October and then he developed peripheral neuropathy mainly in his hind quarters but had a general weakness in his front legs as well. His initial blood sugar was in the 400's. We would check his blood sugar and it would be under 100 at 4-6 hours and by 10 hours it was back to 500.

By December we started treating him three times a day. We would increase or decrease each dose by 1/2 unit after a few days of dosing/testing. He was stable for a month during January.

By early February we had to decrease dosing and in a week he went from 12 units a day to 2 units. For the last 2 weeks he has slipped back and I am bringing him up to 7.5 units/day from 6 units as his last 4hr glucose was 400+. For the past month or more he has recovered much of his lost muscle coordination and his weight has returned to normal. Indeed although his sugar is higher than I want, he is clinically pretty normal. His loud siamese voice is back He rushes doors when they open. He can move very quick.

His food since the start of his treatment has been Science Diet M/D. He eats a measuring amount for weight maintenance. I weigh out 3 meals and he eats those in conjunction with his injection.

I am not really complaining about his state at this point, I really don't want to re-do his treatment.
 
Hi Cash is 12 pounds.

I feed him. Science Diet M/D, contains a minimum of 45% protein, 17% fat, 6% fiber, 8% moisture and 1.5% trace That is 76% of his food isn't carb. He gets 80 grams of it a day. less than 20 grams of it is carbs. No treats.

What assay food do you recommend?
 
cashy said:
Hi Cash is 12 pounds.

I feed him. Science Diet M/D, contains a minimum of 45% protein, 17% fat, 6% fiber, 8% moisture and 1.5% trace That is 76% of his food isn't carb. He gets 80 grams of it a day. less than 20 grams of it is carbs. No treats.

What assay food do you recommend?
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Dm is about 15% carb, so it's considered a medium carb food. Ideally diabetic cats should eat food less than 10% carb. Most of us feed fancy feast classic or Friskies pate wet food. There are only a handful of dry foods low enough for diabetic cats. One that can be found in some stores is Evo Cat and Kitten in the purple bag (about 7%). My personal favorite is Young Again Zero carb food (1%) which you can get from Youngagainpetfood.com. Another one is Natures Variety Natural Instinct which I believe is 7-8%
 
Cat insulin math. Pretty non linear. I think I am bouncing him off his glycogen storage.
cashglu.JPG

I have been measuring his glucose pretty close to when I felt he should be hitting the nadir. At 2 units TID he was gradually creeping up with BG but otherwise acting normal.

Previous glucose/insulin curves with him show 50-89:1
 
My cats nadir was always between 5-6 hours after injection. I don't know of anyone who give 3 shots a day. Is this on the advice of your vet? This much insulin just doesn't seem safe. He could very well be bouncing. I'm glad you're home testing. To know how the insulin is effecting him you should really get a reading before feeding at preshot time, then again at 4-5 hours post shot. Try running some curves of you are home tomorrow. Curves give a better picture of what's going on.
 
Yes we have run curves checking every two hours on Cash and found that he had basically no glucose control after 10 hrs. He glucose would drop to about 89/unit for a few days dropping to around 50/u as his sugar went down.

The vet is with us on treatment He is quite impressed with the clinical improvement as the cat was losing his ability to walk. Only after TID dosing has he rallied. I asked him what the highest that he has ever used on a cat. He told me 14/day, Cash took 12/day and did pretty good for a month, before his demand eased off which is where we are now.

We don't do curves often. too much stress on the animal.
 
cashy said:
Yes we have run curves checking every two hours on Cash and found that he had basically no glucose control after 10 hrs. He glucose would drop to about 89/unit for a few days dropping to around 50/u as his sugar went down.

The vet is with us on treatment He is quite impressed with the clinical improvement as the cat was losing his ability to walk. Only after TID dosing has he rallied. I asked him what the highest that he has ever used on a cat. He told me 14/day, Cash took 12/day and did pretty good for a month, before his demand eased off which is where we are now.

We don't do curves often. too much stress on the animal.
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Do you give b12 for the neuropathy?
 
cashy said:
The vet is with us on treatment He is quite impressed with the clinical improvement as the cat was losing his ability to walk. Only after TID dosing has he rallied.
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Hello and welcome to the FDMB! Happy to hear your vet is on board with testing and treatment!

Shooting TID is considered an advanced technique that can work very well when lack of duration is an issue. Although, shooting TID makes for a pretty rough schedule for the caregiver... which is why it's usually only recommended when all else has failed. That said, unfortunately, the technique has become a lost art on the FDMB. It may help other kitties if their caregivers have an opportunity to learn by seeing an illustration of the technique... if you wouldn't mind creating and using one of our spreadsheets.

Would you be interested in entering Cash's data into a spreadsheet specifically designed by member BJM for those shooting TID? The template can be found here: TID Spreadsheet. Directions for setting up a spreadsheet are here: FDMB Spreadsheet Instructions. Follow the directions except substitute the TID spreadsheet template for the templates listed in the instructions. Here's some additional information about our spreadsheets: Understanding the Spreadsheet. It's written for BID dosing, but you'll get the idea.

If you're willing to set up a spreadsheet, but find yourself needing a little help... just let us know! We have members who would be happy to help. :)
 
Thanks for your words of encouragement. Don't have tell you cat people the effort and thought it takes to even to attempt to keep the critter going with a better quality of life. TID is pretty hard on us. I give about 90% of the injections and food preparation. I have my scale set up so I can make his food consistent to within a couple of kibbles. The stress of the treatment takes it's toll on both the owner and animal. I could check sugar more often but he hates it. Early on was the hardest for us. We had to come to terms with the techniques that worked with our animal.

The whole success of TID dosing is to let the cat get less insulin at any one point and less of a swing. It is solely dependent on the owners schedule.
I lost much of my earlier spread sheet through a computer crash and have started over but a few weeks ago.

I have looked on the Vetsulin web site and and saw this graph on what they called an ideal blood sugar on a cat.
IdealBloodGlucose_cat_lg.gif

When I first looked at that curve I thought that Vetsulin doesn't look like a 12 hr insulin.

We did some curves when he was taking BID dosing found that his nadir is between 4-6 hrs and after 9 it is shooting up. Our curves were much more gradual going down and a steep slope at the end. We are not sure how much effect on the readings we are getting because we are testing. I am thinking a glucagon release.

I keep reading that a lot of cats seem to be type 1. Type 1 by definition means that their pancreas is not functional and making no insulin. Yet a lot of cats seem to go into remission, they have to be creating some insulin. Insulin dependent -Type 2.

I don't feel comfortable linking an online spreadsheet to my computer but will continue to post updates on what I have done.
 
cashy said:
Don't have tell you cat people the effort and thought it takes to even to attempt to keep the critter going with a better quality of life. TID is pretty hard on us. I give about 90% of the injections and food preparation. I have my scale set up so I can make his food consistent to within a couple of kibbles. The stress of the treatment takes it's toll on both the owner and animal. I could check sugar more often but he hates it. Early on was the hardest for us. We had to come to terms with the techniques that worked with our animal.
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I understand. We willingly take on so much, but we wouldn't have it any other way when it comes to our precious kitties.
cashy said:
The whole success of TID dosing is to let the cat get less insulin at any one point and less of a swing. It is solely dependent on the owners schedule.
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I agree. It's why the method is seldom used.
cashy said:
We did some curves when he was taking BID dosing found that his nadir is between 4-6 hrs and after 9 it is shooting up. Our curves were much more gradual going down and a steep slope at the end. We are not sure how much effect on the readings we are getting because we are testing. I am thinking a glucagon release.
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It very well could be. Others have often found Vetsulin just doesn't last a full 12 hours.
cashy said:
I keep reading that a lot of cats seem to be type 1. Type 1 by definition means that their pancreas is not functional and making no insulin. Yet a lot of cats seem to go into remission, they have to be creating some insulin. Insulin dependent -Type 2.
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It seems like we have few Type 1 diabetics and a lot of Type 2 diabetics on the board.
cashy said:
I don't feel comfortable linking an online spreadsheet to my computer but will continue to post updates on what I have done.
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Once the Google spreadsheet we use here is "published" it simply becomes a page on the web. There's nothing connecting the spreadsheet back to your computer. If there was, I wouldn't do it either! LOL! In any case, I appreciate your willingness to post updates. It's good for our members to become aware and know there are options out there for treating those kitties who haven't read the manual. :)

Thank you!


 
Hi Cashy @cashy, as Jill says above it would fab if you could enter your kitty's numbers onto our SS. (There are smart techy folks who can help you if you need assistance; just shout out...)

I am probably one of the few currently on the forum who's also given Vetsulin/Caninsulin 3 times a day... One of requirements (for safety's sake) with that dosing system is that you absolutely have to be sure, prior to each insulin shot, that the blood glucose level has peaked (dropped to lowest level) and is definitely rising.
Can I just check what the situation is currently: Are you testing your kitty's blood glucose prior to each insulin shot?
And are you also getting mid-cycle tests at some point during each cycle?
(If you haven't done this until now, that's OK. But you may wish to change things going forward, as you may be missing some valuable blood glucose data.)

Eliz
 
The main problem I have is testing. Our cat really hates it. I usually use a 16awg syringe needle slid under the skin near the peripherial main vein near the back (furry) edge of the ear. It works better than a typical human type of lance that is very short and you are limited at the angle you can get. Still there is a lot of stress and probably some glycogen release.

What technique do you use.
 
Well I got the new food (young Again Zero mature) and am mixing it 50% to the Science diet MD for his next feeding. His blood glucose has been getting higher at our once a day glucometer checks. Post 3h of 2 units he was 474. We had to be gone so gave him a unit. His pseudo remission didn't last long. He has been inched up to 7 units a day from 5 units a day 10 days ago. When his sugar goes down he clinically is better. More personable like his old prediabetic self. When sugar is high he doesn't socialize. We did this before in December, I chased his insulin up to 14 units then settling on 12 units all of January.

Any hints on glucometery lancing technique?
 
After taste test showed that he really liked the taste. We gave Cash Young Again Zero Mature food without any mix with the M/D He got his 27 grams per usual. We didn't blood test him but did get a glucostick that was clear. Kept him at 7u for the day.
 
cashy said:
After taste test showed that he really liked the taste. We gave Cash Young Again Zero Mature food without any mix with the M/D He got his 27 grams per usual. We didn't blood test him but did get a glucostick that was clear. Kept him at 7u for the day.
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Ya is much lower in carbs.... You may have to lower soon. Glad he likes the food.
 
First blood glucose since starting YAZM
cashglu2.JPG

Am I a believer of zero carb food? My skepticism has diminished a lot.
We are going to have to reconsider Insulin dosing.

If you look at the data for the past week you can see that his response to insulin is bad. I considered the amount of insulin between doses. Look at the amount of units he has had between testing on 2/27 to 2/28, he had 8.5 units and went up 120 points.

He has learned again about ear punctures. He feels the pressure of the lancing needle and becomes very rebellious.
 
cashy said:
First blood glucose since starting YAZM
cashglu2.JPG

Am I a believer of zero carb food? My skepticism has diminished a lot.
We are going to have to reconsider Insulin dosing.

If you look at the data for the past week you can see that his response to insulin is bad. I considered the amount of insulin between doses. Look at the amount of units he has had between testing on 2/27 to 2/28, he had 8.5 units and went up 120 points.

He has learned again about ear punctures. He feels the pressure of the lancing needle and becomes very rebellious.
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Great! Definitely reduce the dose!! Try a 28 gauge lancet. My cat barely feels it.
 
cashy said:
JanetNJ what food were you using before the YAZC
Gonna have to put my spreadsheet online.
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Before Yaz we had stopped letting her eat dry, so she only got fancy feast..... but before being diagnosed dry was her food of choice.
 
Cash update. He gone over 5 days on the YAZM food. We have tried testing him more frequently. We watch him carefully and because of testing difficulties we have started testing him at shot time. We should consider doing a q2h dose curve but that isn't in the plans just yet. Because he peaks overnight. We have put him on a homemade sliding scale.
Here is our data.
cashglu3.JPG

He seems alert and free of clinical symptoms.
 
Have you thought about using a milder longer lasting insulin like Lantus or Levimir? I had Smoky on vetsulin and he did terribly on it. I switched to prozinc and he has improved a lot. The vetsulin only lasted him 8 hours too.
 
Good point we have talked about to the vet. He wasn't proactive about the discussion though.

Since starting with forever young zero mature food we have seen a gradual decline in his insulin usage and more importantly in his blood glucose. The food has a lot lower glycemic index and he may well be headed to BID.

Here is my data since I last posted it.
cashglu4.JPG
 
That's great news that his BG numbers are going down.
I wish I could use the YA food but I can't since it has chicken in it. Smoky has a severe allergy to chicken which his vet thinks contributed to him getting IBD.
 
Why not try 1.5 twice a day and see how it goes. It certainly would be an easier day for the two of you.
 
Yeah we would like BID.It seems like we have to inject more total insulin for the day that way than TID. Cash seems to be definitely holding his blood sugar level longer. One reason TID works for us is his feeding schedule. He has 4 other cats and 4 dogs in the family that will eat his food if it is not picked up. Conversely he will eat any other animal food that is left out.

Cash's quality of life has improved, He has almost lost completely his leg weakness that plagued him in the late fall and early winter. He again is playing with the cats, chases the dogs and generally amuses himself. Not bad for 16. He no longer climbs onto shelves but can get himself on to furniture or the bed.

I think good medical practice would dictate that once everything is regulated the best course is to change nothing. Not the medication, or food.

We too have another cat that can't eat the YAMZ food or even the M/D science diet without gastric distress She is fat but nothing else seems wrong.
 
Well the Young Again Mature Zero food is really working.

Take a look at the last few days of Cash's blood glucose and insulin usage.

http://veloliner.com/farm/cashglucose.pdf

I hate changing him so fast as it has backfired in he past.

Even though he had a BG of 56 a few days ago He got outside and was roaming the woods behind the house in the rose bushes for 30 min before we could corral him.
 
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