what should i give tonight

Discussion in 'Feline Health - (Welcome & Main Forum)' started by MHHCoach, Jan 17, 2021.

  1. MHHCoach

    MHHCoach Member

    Joined:
    Dec 20, 2020
    right or wrong I have been adjusting the vetsulin for based on his numbers.

    but they seem to just be climbing.

    I'm not sure if i should just stick with 1, or 1.5 or 2.

    @JanetNJ
    @Bron and Sheba (GA)
     
  2. Diane Tyler's Mom

    Diane Tyler's Mom Well-Known Member

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    Last edited: Jan 17, 2021
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  3. Bron and Sheba (GA)

    Bron and Sheba (GA) Well-Known Member

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    Feb 21, 2015
    He’s dropping during the cycle so I would stay with that dose until someone who uses vetsulin can advise further.
    I’m not a vetsulin user sorry.
     
  4. Diane Tyler's Mom

    Diane Tyler's Mom Well-Known Member

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    @Wendy&Neko Hi Wendy do you think can take a look at
    her SS #1. Just didn't want to leave her hanging
    Thank you Wendy :cat:
     
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  5. MHHCoach

    MHHCoach Member

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    Dec 20, 2020


    thank you for helping me figure this out.
     
  6. MHHCoach

    MHHCoach Member

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    Dec 20, 2020
    I endes up doing 2u, since 98% of the time 1 unit moves him 60 points.

    but I'll test at 2, 4, 6 hours to stay on top of it.
     
  7. Critter Mom

    Critter Mom Well-Known Member

    Joined:
    Jun 16, 2014
    Hi Ashley,

    Looking at the data in the spreadsheet, your cat was getting a better response on lower doses of Vetsulin. You were getting nadirs in the low 100s which is the range you should be looking at for safety as measured on the Alphatrak meter.

    Giving too much Vetsulin is likely to:

    * produce steeper drops after dose admin and steeper rises when the dose wears off.

    * increase the risk of your cat dropping too low at nadir / having a hypoglycaemic episode.

    Both of those factors are more likely to trigger bounces (as you saw with this morning's AMPS in the pinks).

    If this was my cat, I would be looking to reduce the dose. I definitely think doses of 2 units and over are likely to be too high.

    Some questions:

    1. Does your cat have a history of testing positive for ketones or any episodes of diabetic ketoacidosis?

    2. Do you have urine ketone test strips at home?

    3. Does your cat have any other current health issues that you know of or suspect might be present (infection, inflammation, other)?


    Mogs
    .
     
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  8. MHHCoach

    MHHCoach Member

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    Dec 20, 2020
    oh my gosh thank you bunches for helping me!!

    nope no ketones, I do not have any of the test strips for that.

    He had a tooth removed a month ago when he was dx. I know he has arthritis since i can hear his front joints snap. he had a mass grow at the base of his tail last April, and the ran tests and an xray. the mass wasn't bone to our surpise but way too hard to draw and test what it is. after that he had 2 episodes of urine just leaking so he had medicine for that.

    but prior to April was never sick.

    just got a lump, uti, then his fur got nasty, had a tooth rott out and was dx with diabetes in Dec.

    so I'll bring the dose back down because your explanation makes a lot of sense.

    @crittermom
     
  9. MHHCoach

    MHHCoach Member

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  10. MHHCoach

    MHHCoach Member

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    Dec 20, 2020
    okay you were exactly correct. his number tonight was even higher. I gave just 1.5 unit. should I just go straight down to 1 or stay at 1.5 for a few days?

    this definitely doesn't behave the way one would think. I would have thought as numbers went up the dose needed to go up, so seriously, thank you for this community and helping so many of us that probably would have otherwise lost our cats. When i've learned more from you ladies I hope I can pay it forward to others eventually.

    @Critter Mom
     
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  11. Critter Mom

    Critter Mom Well-Known Member

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    Hi Ashley,

    It's wise as a general safety precaution to check daily for ketones, especially for newly diagnosed cats working toward regulation.

    When reducing the dose one it's another reason to monitor for ketones so I recommend getting some test strips ASAP so that you can keep an eye on things.

    Because Tux has had a fair bit going on (recent infection, possible inflammation from the arthritis, 'mystery' lump), I'm in a wee bit of a quandary about what to suggest to you dose-wise because of the absence of ketone testing. I see you've dropped back to 1.5IU tonight. If Tux is indeed bouncing into those pinks it may take a little time for numbers to come back down but, with Vetsulin's ability to yank higher numbers down, his BG levels might go into a better range more quickly (no way to tell in advance). Would you be able to get tests at +2 and +3 tonight? Tests at +2 can give information on how fast Vetsulin drops the BG, and the +3 could give an indication of how low the dose may take Tux on the particular cycle, although BG can drop lower in the following hours while the Vetsulin is working at its strongest.

    Looking at the data, I wonder whether it might be appropriate to drop the dose down to 1.0, hold that for a few days (unless a reduction is earned) to see how Tux responds, and then review the dose efficacy, but I'd like you to be monitoring for ketones when doing that.

    I'm going to tag @Deb & Wink, @JanetNJ, and @Panic to ask them for their thoughts on dosing for Tux.

    In the meantime, can you please let us know whether Tux was treated for the UTI and whether his dental issues are now all resolved.


    Mogs
    .
     
    Last edited: Jan 19, 2021
    Reason for edit: Grammar.
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  12. Panic

    Panic Well-Known Member

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    I am thinking going back to 1u too for a few days and see how he does. He is staying mostly in the blues, and that's with an Alphatrak too. I'm very curious to know what Deb/Janet suggest because he is doing pretty well actually - I see where he went 5 days without any insulin and stayed in the blues. He may have benefited from a micro dose instead of nothing at all, but that's beyond my knowledge. i wonder if getting all the health issues out of the way won't slide him back down. I'm assuming he's on a low-carb food?
     
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  13. Critter Mom

    Critter Mom Well-Known Member

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    Jun 16, 2014
    Some helpful links:

    FDMB Guide to Vetsulin/Caninsulin

    Ketones, DKA and Ketone Meters

    Tips for Collecting Urine Samples

    In particular, I recommend familiarising yourself with the section on dose adjustment in the Vetsulin guide. It will give you a better 'feel' for what signals to look for in Tux's spreadsheet. NB: the adjustment criteria in the guide are for human meters so you need to bear in mind that Alphatrak meters normally read higher and your target range and dose reduction threshold may need to be a little higher. If you post for dosing suggestions, we can help you with that. :)


    Mogs
    .
     
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  14. Critter Mom

    Critter Mom Well-Known Member

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    @Panic -

    Thanks for your reply, Elizabeth, and your input on Tux's dosing. :)

    We seem to be thinking along the same lines. For the time when Tux was having his 'blue period' a dose of 0.25IU BID, possibly 0.1IU BID, might have been 'sweet', but because insulin needs can change and Tux isn't yet being monitored for ketones I'd be loath to drop back that far at the moment. Should it prove that Tux did need that much of a reduction, based on Tux's numbers at the moment I feel it would be better to get there with gradual decreases as and when his data show they're needed.


    Mogs
    .
     
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  15. Panic

    Panic Well-Known Member

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    That was my thought too. Hopefully the other will see it and give their input. ;)
     
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  16. MHHCoach

    MHHCoach Member

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    Dec 20, 2020
    diet- yep he is on all fancy feast & tiki wet foods
    dental- was totally great after the lose yucky tooth was extracted
    a micro dose- I'm assuming that's just filling the needle?
    ketones- tested negative, his labs are on a tab in his chart, but I'll look up the ketone info.

    dose- stay at 1u for about a week, and times he drops to ???? give a line/ just the needle worth. I did get u100 needles as well in case i need something easier to use for smaller doses.
     
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  17. MHHCoach

    MHHCoach Member

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  18. Critter Mom

    Critter Mom Well-Known Member

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    Hi Ashley,

    Great that you got the +2 and +4 on last night's cycle. :)

    By way of general info, Vetsulin has the ability to drop down higher numbers, but if it's a bouncy cycle it might not hold them down for very long. Unfortunately we only really get a view as to what might have been going on in a given cycle with hindsight. :rolleyes:

    Let's see how Tux does on the 1.0IU dose today. By way of a heads-up, we might not be able to gauge the response to the 1.0IU dose for a few cycles. It would be great if you could get AM+2 and AM+4 readings again.


    Mogs
    .
     
    Last edited: Jan 22, 2021
    Reason for edit: Grammar.
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  19. MHHCoach

    MHHCoach Member

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    His number at +2??!! what on the world

    I wish i could say I'm not freaked out by the numbers spiking, but since i don't really know what I'm watching other than them just going up and up, it's unnerving
     
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  20. Critter Mom

    Critter Mom Well-Known Member

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    Because the dosing has been so variable it makes it a bit trickier to determine what's happening, Ashley. Tux might still be bouncing, or he may need a little more insulin. It's not possible to tell with a single test result.

    Couple of questions:

    * Was Tux's UTI treated successfully (i.e. is he completely clear of it)?

    * Are his teeth all OK now?

    * Will you be able to get some ketone test strips today?


    Mogs
    .
     
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  21. MHHCoach

    MHHCoach Member

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    Dec 20, 2020
    .

    Couple of questions:

    * Was Tux's UTI treated successfully (i.e. is he completely clear of it)?
    yes that was back in the summer

    * Are his teeth all OK now? yes 100% good to go as of 12.19.20

    * Will you be able to get some ketone test strips today?
    i could order some, I'm not sure about having them today though, unless a local store has them

    Mogs
    .[/QUOTE]
     
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  22. Critter Mom

    Critter Mom Well-Known Member

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    Ta for the additional info, Ashley. :)

    You should be able to pick up the urine ketone strips at any pharmacy. The reason I'm so hot on the ketone testing is that it's a wise safety precaution when reducing the dose of insulin, particularly when we're not sure how Tux will respond. We can look at the historical data in the spreadsheet as a guide but, as I mentioned earlier, because doses have been jumping round a bit extra caution is needed when reducing in this situation because insulin needs can and do change, and we don't yet know whether his response will be similar to how it was when he was previously on the 1.0IU dose.

    When is your PMPS due, Ashley?


    Mogs
    .
     
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  23. MHHCoach

    MHHCoach Member

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    Dec 20, 2020
    mornin @Critter Mom @Deb & Wink @Panic

    thank you all for jumping in and helping me with Tux. The ketone test strips will be here tomorrow.

    How many cycles will it take before we get an idea as to how he is doing on 1u?

    Thanks a bunch ladies! I'll check in tonight and tomorrow night.
     
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  24. Critter Mom

    Critter Mom Well-Known Member

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    Hi Ashley,

    Great that the ketone strips are on their way. :)

    We need to get a better idea of how low the dose is taking Tux because adjustments need to be based on the cycle nadirs, not the preshots (latter tests can be very much affected by bouncing, plus Vetsulin typically produces 'bucket-shaped' curves at the best of times). In addition to the preshot tests, would you be able to get a +3 or +4 test on each cycle? It would help us to help you both better. :)

    Is Tux eating well?


    Mogs
    .
     
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  25. MHHCoach

    MHHCoach Member

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    Dec 20, 2020
    yes i can try to do a +3, +4 tomorrow and Saturday.

    he is being less patient about the ear pokes lol

    he was skinny and small for most of his life, at about 7lbs... he's a bit more plump lol. not quite over weight but he is about 11/12 lbs I'd guess.

    he is always hungry it seems.

    he is on fancy feast heavy and pate
     
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  26. Critter Mom

    Critter Mom Well-Known Member

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    Jun 16, 2014
    I'm not familiar with this, Ashley. Is it the same as FF Gravy Lovers or is it something else? (I'm in the UK so am not fully familiar with the foods available across the pond.)


    Mogs
    .
     
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  27. MHHCoach

    MHHCoach Member

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    that would be the phone swype autocorrect version of gravy lovers lol

    not heavy, it was supposed to say gravy lol
     
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  28. Deb & Wink

    Deb & Wink Well-Known Member

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    The FF gravy lovers is likely too high in carbs, for his regular meals.
    A picture of the can would help us to confirm which FF gravy lovers food you are feeding.
    You would be better off saving that high carb food for your hypo tool kit and giving your cat Tux only the pate style food.
    Do be aware that lowering the carbs in the food can cause the BG levels to drop significantly overall.

    So you may need to reduce the dose, if you stop feeding Tux the high carb gravy lovers food.

    So remember, don't dose based on the pre-shot test. Dosing is based on nadirs, so it's looking backward at what has happened in past cycles, and looking at trends that tell you the dosing.

    Tux was doing pretty well on the 1U dose. If you change the food to only the FF pate, you'll want to test more. So maybe only do that food change on the weekend, or when you have a couple of days to test more.
     
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  29. MHHCoach

    MHHCoach Member

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    oh my bad, I was adjusting based on preshot.
    I was wondering if the gravy FF was too high for him. to be honest i just used the last of the gravy food, i only have various pate types left.
     
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  30. Critter Mom

    Critter Mom Well-Known Member

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    :D

    Autocorrect can be rather entertaining at times! ;)

    I see Deb has given you the advice you need at this point in proceedings in her post above.


    Mogs
    .
     
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  31. Critter Mom

    Critter Mom Well-Known Member

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    Forgot to ask: which flavour(s) of FF Gravy Lovers were you feeding, Ashley? (Carb values may differ depending on flavour.)


    Mogs
    .
     
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  32. Critter Mom

    Critter Mom Well-Known Member

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    Ashley, when you post later please can you confirm what you're feeding Tux now, and also the day and time (morning or evening) when you gave him the last of the Gravy Lovers food.

    I'm really sorry but I can't offer any suggestions on dosing at the moment because there are no mid-cycle readings upon which to base them. (Several days' worth are needed in order to get a better idea of what the dose is doing.)


    Mogs
    .
     
    Last edited: Jan 22, 2021
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  33. MHHCoach

    MHHCoach Member

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    It was FF poultry and beef
    I'll work on mid cycle readings tonight/tomorrow (Sunday)/Monday
    the 18th was the last dish of gravy lovers poultry and beef.
     
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  34. MHHCoach

    MHHCoach Member

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    Dec 20, 2020
    he is now on iams pate chicken and FF pate variety pack
     
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  35. MHHCoach

    MHHCoach Member

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    Dec 20, 2020
    FYI i ran out of alpha test strips so I'm on relion again.

    I'm about to look up the how to get a urine sample
     
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  36. Critter Mom

    Critter Mom Well-Known Member

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    For info, the FF Gravy Lovers beef variety is 20% kcals from carbs. IIRC the other flavours are 15% kcals from carbs.

    I'd be grateful if you could look up the IAMS food in Dr. Lisa's food list and let us know the carb content, Ashley.

    https://docs.google.com/spreadsheet...m6PPfEUz9YmzMGMxkmcBk6uRR0/edit#gid=113878384

    If you can't find the particular food(s) on the list, try looking for the product(s) on chewy.com. If you look at the Q&A section on the product page it very often has carb content. Ideally you're looking for the value for % kcals from carbs, but dry matter carbs is better than nothing. (As fed carbs don't give information on the suitability of the food for a feline diabetic.)


    Mogs
    .
     
  37. Deb & Wink

    Deb & Wink Well-Known Member

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  38. MHHCoach

    MHHCoach Member

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