Worried Vetsulin user - food switch in progress - need help

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Sooooo my little kitty project throws yet another surprise. I expected Radars BG number to be a little higher tonight at preshot time, but instead it dropped to 175 on my AlphaTrak. I'm thinking about his vigorous romp this afternoon with DaBird -his most favorite toy in all the world and thinking that perhaps this is what helped him drop. He hasn't asked to play that game in months. Watching him today it was plain to see, he was totally into his game and the normal happy spunky guy we love so much had returned.

He prowled in the kitchen and stalked the refrigerator asking for dinner so after I tested I gave him some grub. He ate 2/3 of a can of lc chicken. I will test again in a little bit and see what his numbers say. The vet said to give him 1 unit if he's above 190. We'll see...
 
With numbers that good, I'd be more inclined to do the smallest drop, or 0.5 units max (and only if I could monitor BG closely).

It's wonderful hearing how much better Radar's doing, Jan. :)
 
So 1 hour after eating his BG is 224. I feel good about a half unit. My math is as follows. 224 take away 75 puts him at an approximate BG of 149. I subtracted 75 because that is half as much as he dropped per unit given last time he had insulin injected. We will be monitoring closely as needed...
 
It's not quite as straightforward as that, Jan. The 224 is food-influenced and the BG may very well drop back again after a little while. (If there's any function in the pancreas beta cells they will pulse insulin in response to the feed.) The recommendation is to have a 2-hour fast before a preshot test because it reduces the likelihood of the reading being influenced by the previous meal. Working from the fasting BG, you get a better idea of which point to 'guestimate' the drop from. Also, the time in better numbers may be allowing Radar's pancreas to recover a little, particularly as it's not dealing with the heavy carb load now. Just look at the steady stream of reductions Radar has needed. It is possible that the 0.5 unit dose may take him lower than your rough estimate.

In general, if a preshot value is too low you can elect to stall (i.e. don't give the injection at the regular time), DON'T FEED, then retest in 30-60 minutes to see if the BG is rising without any food influence since that makes it easier to see whether the last insulin dose is wearing off.
 
All That information makes lots of sense and is good to know going forward. I guess we will see just what his pancreas might be doing as we monitor. I can test as needed tonight. Will let you know how he does :)
 
Have a look at Saoirse's spreadsheet values for the last week of July last year to see just howmuch variation there can be on exactly the same dose; and also how big a drop even 0.5 units is capable of producing.
 
I wanted to let you, Aine, especially,... but anyone else out there following the micro dosing at my house needs to know that Radar has done well tonight. His +3 reading was 219 which I'm pretty sure I steered successfully with food for the first time. It's a project that will still need tweaking but I'm glad to have a little success in that arena of the cooking show. I'm of course continuing to monitor.
 
Hi Jan,

Just had a gander at Radar's spreadsheet comments. Looks like you caught the 'appetite uptick' at +2 on yesterday's PMPS cycle.

I do wonder whether Radar's getting a little carryover on the Caninsulin (see the blue on the PM cycle of 25/7). The numbers on yesterday's AM cycle look promising as well, since Radar's BG lowered after meals - could very well be signs of his little pancreas helping out. Fingers and paws crossed ... :)

Are you planning to stick with the 0.5 IU for the next dose?
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I'm also thinking that Radars little pancreas may be coming out to dance with us. :). I've been watching the litter box closely for any signs that he's peeing more since we've reduced his dose soooo much and last nights cleaning revealed slightly bigger portions than we've had. The combination of that along with the numbers in the 200s last night made me think that his pancreas needs more support. I don't know if that's correct and only time and testing will tell the tale. We started this morning at 275 so I gave him 1 unit and am crossing my toes and paws.
 
His +3 is 88 which suggests that things are moving in the right direction. It seems like it's been forever since I've had a +3 reading that didn't involve honey. In the meantime, I'm continuing to practice micro dosing with water in case my roller coaster cat wants to dip closer to zero. :)
 
We are keeping fingers, toes, paws and eyes crossed that Radar's pancreas is indeed coming out to play!

Go Radar!!!
 
That appetite uptick at +6 this evening may be the crystalline fraction of the Vetsulin starting to kick in. Or it could just be that Radar's hungry (he is, after all, a cat!). Are you going to snag a +7 or +8 test, Jan?
 
I had errands to run so no testing this afternoon. I did just test the little guy and he's at 164. This is not food influenced I don't think because I picked up all the food before I left the house Several hours ago. I'm stalling at the moment....
 
Thank you :) for the reassurance that my education is proceeding well. I just tested again and it's down to 154. Does that mean the mornings dose is still working or are we doing a jig with the pancreas?? Or is there some other complex process working??
 
He seems to get a real bang for his buck from the Caninsulin a lot of the time. Meter variance is usually around +/- 20% - so in essence the 164 and 154 could in theory be around about the same as each other.

If he were mine, I'd be a bit cautious about the PM dose. Radar has shown he can run quite low at night.

@BJM - If you're around, BJ, is there any chance you could look at Radar's spreadsheet numbers and dosing, please? (I've got to head for the leaba - about to pass out again.)
 
Thank you, BJ.

Glad to do a little to help, Jan. Hope you and Radar have an uneventful and restful evening. Catch you on the morrow, DV.
 
Thanks, @BJM, for your assistance. I've just tested him again 2 hours after eating and his number is 180. I don't know what that might mean but I'm feeling reluctant to give any insulin. I don't know what any of this might mean but the vet is thinking his pancreas might be starting to work again.
 
I'd be hesitant to give any tonight. Maybe go with mini-meals to spread out the impact on the pancreas and see how morning is.
 
Agreed. He has always been a grazer and seems to be responding well to the small meals I've been giving him recently. Thank you for peeking at Radars ss. I appreciate your time and opinion. :)
 
If he's higher in the morning, maybe go with 0.5 units and note what kind of drop he gets on that. He's really running down the dosing scale.
 
This roller coaster ride is going straight down to 0. My nose is in danger of being smashed into the ground in cartoon fashion as we fall. Radar on the other hand is doing better than he has in months. I'm in complete awe of the power of a diet change.
 
This mornings preshot number was 170. He ate 4 hours prior to that test. Yacked up a big hairball overnight too. It's all that bathing he's been doing. At this point I'm feeding him every couple of hours as he asks and holding off on the insulin. I'm waiting to hear back from the vet. Stay tuned for the next adventure on our way to zero.
 
Hi Jan,

That's a pretty good AMBG this morning. A bit early to be sure, but it looks like Radar may need a little more support from insulin. I'd be looking at a gentler, longer-acting insulin if he doesn't get all the way on the diet change. Granted, there's the option of using U100 syringes and a conversion chart, then drop dosing; but at the rate Radar's leaping down the dosing scale I think even that might be too much Vetsulin for him. Saoirse hit the Vetsulin dosing wall like that, too, but she couldn't hold the low numbers. The extra bit of support she got from her time on Lantus made a huge difference. I don't think she'd have achieved diabetic remission without it.

Looking forward to hear how your discussionings go with your vetty bean. :)



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