Vetsulin dosing advice

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Squalliesmom

Squalliesmom

Member Since 2015
Hi, all. Squallie's numbers have been all-over-the-place-crazy the last few days, and he's had two hypo episodes in two days. He was on 7 units twice daily; the vet dropped him down yesterday to 4 units 3x daily at 8 hr intervals. Well, he got his 4 units this AM, went fairly low around the +6 mark and was still low at +8 so I decided not to shoot at 8 hrs. Now we've come up on 12 hours and he's still pretty low, for him, at 226. I honestly don't know whether to give him 4 units now or not, I don't want him to go hypo again but I don't want his BG to soar way up, either!
 
Sue and Oliver (GA) said:
I always think it is better for a kitty to be high than low. If he were mine, I'd reduce to 2 units and see how he does. If after a few cycles, he is too high then increase to 2.5. If you decide to do this, be sure to check for ketones. I would not dose him every 8 hours when his numbers are so volatile and dropping.
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Seems like sound advice, I may give this a try! It's very hard to check him for ketones, he is a very "sneaky pee-er" and it's hard to catch him in the litter box, lol! I'll have to refresh my memory for symptoms, too.
 
Squalliesmom said:
Seems like sound advice, I may give this a try! It's very hard to check him for ketones, he is a very "sneaky pee-er" and it's hard to catch him in the litter box, lol! I'll have to refresh my memory for symptoms, too.
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Oliver would not let us watch him pee. We put him a room with a clean litter box (we put aquarium gravel in ours so the urine wouldn't soak in) he would have to "christen" the clean box and we'd have our sample.
 
Sue and Oliver (GA) said:
I always think it is better for a kitty to be high than low. If he were mine, I'd reduce to 2 units and see how he does. If after a few cycles, he is too high then increase to 2.5. If you decide to do this, be sure to check for ketones. I would not dose him every 8 hours when his numbers are so volatile and dropping.
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Thanks, I may try this. I'll have to refresh my memory for symptoms of ketones, he's very hard to catch in the litter box.

Right now I'm really feeling discouraged, and I'm starting to wonder if I'm doing the right thing at all. Poor Squallie is so very tired today and he doesn't want any dinner, and he just looks at me like he's trying to tell me he doesn't feel good. I don't want to keep putting him through hell and misery; I've never seen him look at me this way before. It's just breaking my heart.
 
You and Squallie have had a rough few days. Human diabetics say that bouncing from high to low numbers feels really crummy. What I am thinking is that a lower dose will give you both a break for a couple cycles without the stress of his possibly falling into ranges that are dangerously low.

Is there something he really enjoys - a special treat human or cat - that you could "dress" his food? It would be a good idea if you can get him eating.
 
Maggies Mom Debby said:
He has been on an internal roller coaster, so it's not surprising he's tired. It get's easier and better. REALLY!
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It's just killing me to see him like this. I finally tempted him to eat, with a little chicken and a tiny bite of gravy food (bad, I know), but he really only ate a few mouthfulls.
 
Sue and Oliver (GA) said:
You and Squallie have had a rough few days. Human diabetics say that bouncing from high to low numbers feels really crummy. What I am thinking is that a lower dose will give you both a break for a couple cycles without the stress of his possibly falling into ranges that are dangerously low.

Is there something he really enjoys - a special treat human or cat - that you could "dress" his food? It would be a good idea if you can get him eating.
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He likes his "vet approved" snackies, which are probably way high in carbs. I've given him a few of them. He definitely enjoyed the tiny mouthful of high carb gravy food I gave him :-\
 
His BG is at 271 now, should I give him 4 units? I think that'll be safe, but after the last couple of days I'm not so confidant any more.
 
It took CJ awhile to recover from her Novolin hypo episode. It was heartbreaking for me to watch but as others mention, Squallie has been through a rough time and this is very normal. It will get better.
 
My reasoning....he dropped almost 300 points on the 4 units. And he is lower now than he was at AM. 2 units may give him a safe surf, without worry of hypo and give you some rest!
 
If you think 2 units is too big a drop, you could do 2.5 I'd plan On getting a before bed test and maybe a nadir? As he has had some higher carb, his numbers may run a little higher.
 
Shiloh & Rhonda said:
My reasoning....he dropped almost 300 points on the 4 units. And he is lower now than he was at AM. 2 units may give him a safe surf, without worry of hypo and give you some rest!
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That makes good sense to me. I was looking back over his spreadsheet and seeing places where he was okay with a higher dose at a lower BG, but those were all before his hypo episodes. If he's more insulin-sensitive now I'd rather err on the side of caution.

I also just realized that he's 14 hours out from his last dose, not 12. Changing dosing time to accommodate a 3x daily schedule put me two hours back.
 
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That's good that he is feeling better. If his pmps was 271 at +14, he likely was in the low 200s (or lower) at +12. I hope the lower dose will help you both sleep tonight!
 
Squalliesmom said:
Thanks, I may try this. I'll have to refresh my memory for symptoms of ketones, he's very hard to catch in the litter box.

Right now I'm really feeling discouraged, and I'm starting to wonder if I'm doing the right thing at all. Poor Squallie is so very tired today and he doesn't want any dinner, and he just looks at me like he's trying to tell me he doesn't feel good. I don't want to keep putting him through hell and misery; I've never seen him look at me this way before. It's just breaking my heart.
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Does Squallie seem any tiny bit more relaxed, sociable, or any way brighter in himself when the insulin's wearing off? If yes, that's a very good indicator that the Vetsulin action is making him feel like carp. Saoirse was the very same way (on Caninsulin - UK brand name for Vetsulin). She started trying really hard to hide somewhere inaccessible come injection time. At first I thought it was me mucking up administration of the injection but it turned out to be that she hated the way the insulin made her feel. Nine or ten hours out of every cycle she was miserable and lethargic, and spent most of that time hiding behind a curtain, only coming out to get food. Caninsulin absolutely hammered her system. Before the dose kicked in and also when it was almost worn off she would be brighter and more sociable. As I said to our vet at the time, it was like having two different cats.

All of the above changed when Saoirse was switched to Lantus. It was like night and day. The harsh drops and wild swings disappeared and immediately the hiding stopped; and so did her attempts to escape from further injections. The lethargy vanished, too, to be replaced with alertness and engagement. She became brighter, healthier, and happier with every day.

Not every insulin agrees with every cat. It is a hormone, after all! Just as Caninsulin didn't agree with Saoirse, some cats can't get on at all with Lantus but positively thrive on Levemir (and vice versa). If Vetsulin isn't right for Squallie there are other insulins out there, and you will find one that is right for him.

Squalliesmom said:
I finally tempted him to eat, with a little chicken and a tiny bite of gravy food (bad, I know), but he really only ate a few mouthfulls.
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As is oft said here, sometimes the right food is the one your kitty can eat. :)

The current situation is temporary. The two of you are still working out the steps of your very own sugar dance. It does take a little time, but things will get better - for both of you. Hang in there; we'll be with you every step of the way.

:bighug: ((Lucy & Squallie)) :bighug:



Mogs
.
 
Critter Mom said:
Does Squallie seem any tiny bit more relaxed, sociable, or any way brighter in himself when the insulin's wearing off? If yes, that's a very good indicator that the Vetsulin action is making him feel like carp. Saoirse was the very same way (on Caninsulin - UK brand name for Vetsulin). She started trying really hard to hide somewhere inaccessible come injection time. At first I thought it was me mucking up administration of the injection but it turned out to be that she hated the way the insulin made her feel. Nine or ten hours out of every cycle she was miserable and lethargic, and spent most of that time hiding behind a curtain, only coming out to get food. Caninsulin absolutely hammered her system. Before the dose kicked in and also when it was almost worn off she would be brighter and more sociable. As I said to our vet at the time, it was like having two different cats.

All of the above changed when Saoirse was switched to Lantus. It was like night and day. The harsh drops and wild swings disappeared and immediately the hiding stopped; and so did her attempts to escape from further injections. The lethargy vanished, too, to be replaced with alertness and engagement. She became brighter, healthier, and happier with every day.

Not every insulin agrees with every cat. It is a hormone, after all! Just as Caninsulin didn't agree with Saoirse, some cats can't get on at all with Lantus but positively thrive on Levemir (and vice versa). If Vetsulin isn't right for Squallie there are other insulins out there, and you will find one that is right for him.


As is oft said here, sometimes the right food is the one your kitty can eat. :)

The current situation is temporary. The two of you are still working out the steps of your very own sugar dance. It does take a little time, but things will get better - for both of you. Hang in there; we'll be with you every step of the way.

:bighug: ((Lucy & Squallie)) :bighug:



Mogs
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Thank you so much for the advice and the hugs, Aine! (Do you prefer Mogs?) He is different whenthe Vetsulin wears off. But he's also different when it seems to be properly (and that's the keyword here) regulating his BG.

I only gave him 2 units last night. This AMPS was 442 so I'm giving him the 4 units and we'll just go on from there with monitoring to see how he handles it.

Hope Saoirse is doing well! Hugs back to you both!
 
Aine, question? I googled "Mogs" which I learned is British slang for cats, or can mean the equivalent of "leaving for now." What does it mean for you?
 
And of course I had to go and screw up what has been, so far, a pretty good morning. I only gave him 2 unit, don't know what I was thinking, but I immediately gave him another 2 units, for a total of 4. I hope that was okay to do! Please someone tell me I haven't done something terrible to my beloved Squallie!
 
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You should be fine. I have seen some higher dose kitties that get the shots spread into two injections at the same time. Was it your intention all along to give 4 units?
 
Shiloh & Rhonda said:
You should be fine. I have seen some higher dose kitties that get the shots spread into two injections at the same time. Was it your intention all along to give 4 units?
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Yes, it was, I don't know what I was thinking! I realized it immediately, as I gave the first 2 units, so just drew up another 2 units (but with a fresh syringe) and shot him again. Stupid of me :-(
On the bright side I did catch Mr. Sneaky Pee-er in the box, so I tested him for ketones, which were negative. He also ate all of his breakfast this morning, which was a relief!
 
@Squalliesmom - Watch him very closely this cycle, Lucy. Even though the AMPS was high this morning, the 4 units of Vetsulin could still drop Squallie's BG like a rock. Assuming that there was only a few minutes between the doses you should be able to treat it as a single dose (though I don't know whether injecting the Vetsulin into two different sites will affect its action at all - just musing to myself about this) and it should not affect your normal dosing schedule (i.e. PMPS should be 12 hours after the time you gave the second injection this morning).

I would not give 4IU Vetsulin at the moment if it was my cat. I still think it's too high. As Sue recommended last night, I think you should stick with 2IU BID to see how it suits Squallie for several cycles before adjusting again (unless, of course, the 2 unit Vetsulin dose proves to be too high, in which case you would need to reduce the dose further). @Sue and Oliver (GA) - if you're around at all before Squallie's next dose is due, it would be great if you could weigh in on this, please.

I'm delighted to hear that Squallie's appetite is better today. Good news on the ketone check as well. :)


Mogs


ETA:

Even though Vetsulin is not a depot insulin, it is still important to dose it fairly consistently. Resetting at 2 IU BID for now should be safer, kinder on Squallie's system, and it will also help you to determine whether the high PS numbers are just poor regulation alone or whether they're being influenced by bounces. I really do think that the higher doses of Vetsulin are carrying over into the following cycle. That's equivalent to giving Squallie 'known dose + X' - and there's no way of determining how large or small that X might be. (My two penn'orth.)
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Lucy, I agree with Aine and Sue. If Squallie was my cat I would not give him 4 units. I think it's too much. I think you will need to watch him very closely today to make sure he doesn't drop like a rock and get too low.
I agree with Sue and Aine to stick with 2 units for a few cycles and see how he does. For me having the cat too high is an easier thing to deal with than the stress of a cat who is too low.
 
Thank you all for your help and advice. Unfortunately I already gave him his 4 units, based on his high BG this AM. I have called the vet about yesterday's issues and she has asked me to test periodically and call with results (finally - hallelujah!), and I will post them on his spreadsheet as I get them. I will also keep updating this thread with any thing new. Thanks, folks, for sticking with me through this and providing me with such great advice and support! I don't know what Squallie and I would do without you all!
 
I think watching his numbers would be wise today. It's hard to know whether his amps was a bounce from a low overnight after your last test or whether the dose just ran out before amps. If he were mine, I'd be tempted to take the cautious approach and restart at a lower dose like 2U, increasing slowly as needed.

The diet and insulin is definitely starting to work together and he may start to gradually need less insulin. This would be great. You are getting longer cycles, which is unusual with vetsulin but great for Squallie.
 
Shiloh & Rhonda said:
Aine, question? I googled "Mogs" which I learned is British slang for cats, or can mean the equivalent of "leaving for now." What does it mean for you?
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'Moggie' is the usual slang term for cats in the UK. Although originally intended to be the feline equivalent of 'mongrel' for dogs, its use is no longer limited to refer to 'Heinz' cats and it us used to refer to any cat, pedigree or no pedigree.

Given my distinct fondness for those beings of a feline persuasion, I ended up with the nickname 'Moglet' (just changed my signature to include it), but friends variously call me Mogs, Moggers, Moggie, Mogster, Moggins, etc.


Squalliesmom said:
Do you prefer Mogs?)
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Yep. :cat:
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Just tested him again, his BG is 112 with the Relion, 165 with the AlphaTrak. I will probably check him again in another hour or so, and maybe give him some wet food if he's getting a whole lot lower. I put a call in to the vet and she will call me back as soon as she can. I really am curious to hear what she has to say this time.
 
How long after injection time is that, Lucy?

BTW, if you get any low numbers test with the Alphatrak for your vet instead of sticking to a set time in the cycle. That way she can't diss your data on grounds that a human meter isn't telling the real story. ;)
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Critter Mom said:
'Moggie' is the UK equivalent of 'kitty'. Given my distinct fondness for those beings of a feline persuasion, I ended up with the nickname 'Moglet' (just changed my signature to include it), but friends variously call me Mogs, Moggers, Moggie, Mogster, Moggins, etc.
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I knew Moggie was a kitty in the UK, so I figured that Mogs was probably your nickname, and a wonderful one, at that! I had a great aunt who was called Moggie, but it was just because her nieces and nephews couldn't pronounce Margaret when they were very little, lol!
 
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