stragey help for rollie vetsulin march

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I'm so glad you're starting to see some positive results! It's exciting, isn't it?!?! It sounds, too, like you are starting to get a better handle on things and are feeling more comfortable. That's great! You're doing a wonderful job! :bighug:
 
well not so good today - i will check him at nadir tonight and see what we have but we are back up to 314 now
 
If you don't see any blues by tomorrow, I think it's safe for you to raise his dose to 3.75U. On the 3.5U dose his lowest numbers are still in very safe ranges.
 
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Looking at the spreadsheet it appears that your kitty is very bouncy. Every time he hits a blue number it takes 3 days to start to get into better numbers again. I would stay with the 3.75 units and give it a few days to see what he does.


ETA Looks like I was still typing when Kris posted basically the same thing I did. :)
 
My advice is the same as Kris and Mary Ann's, stay the course with the 3.75 for a few days and see where he ends up. I know it's frustrating; some days I felt like I might just as well have injected Squallie with water for all the good the insulin seemed to be doing him! But you ARE doing the right - and best - thing towards getting Rollie regulated. :bighug::bighug::bighug:
 
he was back up this morning but i think it may be because he went lower again last night? at +4 he was 208 so i suspect he got into the blues.....
 
We all know how frustrating these up and down numbers can be but try not to get fixated on one number. My girl surfed in some beautiful "normal" numbers most of yesterday and is now sitting higher than she has been in ages all because she is not accustomed to the lower BG she maintained for so long yesterday. I'd be much happier if those normal numbers had continued but she has other plans. All we can do is patiently follow kitty's lead. :D
 
The night of 23 March you had a similar bounce number on morning of 24 March. And night of 24 March, that nice green gave a bounce on 25 March morning. Bouncing can last a few cycles. I would think stay the course for a little bit but hopefully one of the veteran members will chime :)
 
I agree with Yong. It looks like Rollie tends to have a later nadir than some kitties usually do with Vetsulin. There have been a number of days that Rollie has hit his nadir (lowest number) at +6, so there is a good chance that he might have gone even lower last night, which could trigger the bounce into higher numbers today. When you have a day you will be home it would be good to get a curve...doing tests every 2 hours for 8-10 hours to get a better feel for how the numbers go through the whole cycle.
 
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I agree, as well. Stay the course for now, and try to get a curve when you can. I'd like to see where his numbers are during the second half of his cycles. Depending on the results of the curve, he might be up for a dose increase. :):):)
 
For Maury, because he was kept on a dose for a long period, I think, he had some temporary insulin resistance. Sorry I'm not very good at explaining things :oops:
Glucose toxicity refers to the oxidizing and hypertonic (dehydrating) properties of hyperglycemia, both of which continually stress and damage tissues in the body. But the term is also specifically used to refer to the phenomenon of temporary insulin resistance brought on by this tissue stress.

There are also high dose conditions that cause some insulin resistance: http://www.felinediabetes.com/FDMB/...-other-high-dose-conditions-what-we-know.375/

What was his starting dose?
 
when he was first diagnosed we started at 1u. the vet kept upping it until we got to 9u twice a day. he hypoed. we went down to 8 then 7 and then 6. i stil felt 6 was too much and he was getting quite low so i started all over again at 2u twice a day. i finally started the spreadsheet when i got to 4.25. i then tried a trial of TID dosing which i did not see any benefit in my opinion. so the first pat of the spreadsheet is TID and i've gone back now to BID dosing. slowly going upward again. I am just frustrated and don't know where to go and how to help him.
 
I don't think Vetsulin is any different when it comes to preferred increases, meaning by 0.25U or 0.5U. I'm wondering if jumping whole units caused Rollie's ideal dose to be skipped. @JanetNJ , can you chime in? :)
 
That drop yesterday from 539 to 174 was a HUGE drop. The nadir (lowest number) is still well within a safe area, but it was a big drop from the AMPS. This would have started another round of bouncing, which is what is showing in today's numbers. Unfortunately some kitties (one of mine for sure) are much bouncier than others. The higher numbers from a bounce can take a day or as much as 3 days to "clear" My thoughts would be to hold this dose for the time being and see where he goes when the bounce clears. Hopefully some others will weigh in with their suggestions as well.
 
I think you can stay at 3.75 u for another couple of cycles and then try 4 u. The blue probably got the bouncing started but as an indicator of how low the current dose is taking him, it shows room to drop.
 
Wow, that's a massive drop from 539 to 174! Definitely expect to see some bouncing. I would hold your current dose at least until he clears the bounce.

Something to consider: It is my personal opinion that "bouncy" cats on Vetsulin will bounce incredibly frequently and dramatically, and take several cycles (more than you would expect) to recover from it. I base this on my own experience with Vetsulin and other instances of it that I have seen occur. Vetsulin is a good insulin, but maybe a little less forgiving than some of the longer lasting insulins. Squallie is very bouncy, and uber carb-sensitive; weathering the bounces and chasing his numbers while he was on Vetsulin became an exhausting exercise in futility.
 
@Squalliesmom are you suggesting that we try a different insulin? i did ask the vet when we started this whole thing about another insulin but she basically told me no :(
 
Kris is right about those big drops being common to Vetsulin.
I am not necessarily suggesting you change insulins at this point, just bear in mind that if Vetsulin doesn't seem to be working well for Rollie there are others out there you can try.:)
 
i went to 4u this morning. I am really wondering if we are dealing with the glucose toxicity? we were all the way up to 9u twice a day because he had stopped responding and then finally it seemed that something clicked and he plummeted. that is why i am still trying to find out the right dose. i am now wondering if he is back on that same track? or if this dose is too much as it seems like he had better numbers on the 3.25 dose? or else use sliding scale? @Squalliesmom @JanetNJ @MrWorfMen's Mom @Kris & Teasel @Tuxedo Mom @Yong
 
Renee1960 said:
i went to 4u this morning. I am really wondering if we are dealing with the glucose toxicity? we were all the way up to 9u twice a day because he had stopped responding and then finally it seemed that something clicked and he plummeted. that is why i am still trying to find out the right dose. i am now wondering if he is back on that same track? or if this dose is too much as it seems like he had better numbers on the 3.25 dose? or else use sliding scale? @Squalliesmom @JanetNJ @MrWorfMen's Mom @Kris & Teasel @Tuxedo Mom @Yong
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You could call it glucose toxicity but I just call it getting "stuck". When Teasel was on ProZinc he would bounce into high numbers on a dose and stop responding to that dose. I'd have to increase a tiny bit to get him moving again. Your kitty seems to be similar in his responses. Bouncy cats are very challenging because of being so unpredictable. I suggest you try 4 u to see what happens.
 
Just make sure to monitor him, in case he starts to drop too low. I think you'll be okay, though. I went through this SO many times with Squallie! I feel your frustration!!! :bighug::bighug::bighug:
 
It would appear quite likely that Rollie's nadir (lowest point) is a bit later in the cycle then some Vetsulin kitties....but every cat is different. On April 2 he dropped from 539 at AMPS to 174 at +6. Even though the 174 was not a very low number it was still a very big drop through the cycle, which would have caused bouncing. There is a possibility that Rollie has other large drops since when you were not testing later in the cycle, which could have caused further bouncing again. If at all possible try to get a reading close to the +6 time to see how low the dose is taking him.
 
Renee1960 said:
We got into the blues last night. Not as high this morning as the past few mornings. we will see how long it lasts. thanks @JanetNJ @Squalliesmom @Yong @Kris & Teasel @Tuxedo Mom
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Renee1960 said:
We got into the blues last night. Not as high this morning as the past few mornings. we will see how long it lasts. thanks @JanetNJ @Squalliesmom @Yong @Kris & Teasel @Tuxedo Mom
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can I just offer one more suggestion that's rarely mentioned? Try to increase his activity. Get a shoelace to dangle, or a ball to chase... whatever his thing is. My diabetic cat likes shoelaces and to rip up strips of newspapers (called the rip it up game)... I found it helped with her bg levels, and made her happier... and helped her regain her muscle tone in her back legs back. when I first started she mostly laid down and just batted... after a few weeks she was up chasing the string. It was nice to see.
 
I started doing the same with Maury. Play sessions, he seems happier and I'm hoping it will help get his muscle tone back in his back legs :)

That blue looks very nice :cool:
 
Hi Renee! I think he's still bouncing from the blues yesterday :). Can last a few cycles and the 504 is within the variation so it's similar to 477. I'm still not an expert but I would hold the dose a little longer.
 
Hi Renee,

Yes, he's bouncing. Always pay more attention to the middle cycle lows than the preshots with Vetsulin. This insulin often causes highs at the end of the cycle and much lower numbers mid cycle. The dose would be too much if he was down to 50 or lower mid cycle. That's why those numbers are so important in evaluating a dose.
 
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