Hi from me and Molly, any advice please

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When you get an unexpected low number you can stall without feeding for up to an hour. If the number is going up shoot.... If it's about the same then skip.
 
Sue @Sue Hammond, the advice to not give a shot below 11 (200) is for newcomers who are still getting comfortable with hometesting, and who don't have much data to show how their cat responds to insulin.
Once a caregiver has data to show that it may well be safe to do so it is very possible that they will give shots at lower numbers. But this depends on the cat's own response to insulin, and also on the caregiver's ability to monitor and to take any necessary action. (Trying to give shots at lower preshot numbers is always an experiment initially...)
Have you seen the new Beginner's Guide to Caninsulin/Vetsulin (put together by a group of members here)? Here's the link:
Beginner's Guide to Caninsulin (Vetsulin)

Another thing to consider maybe, if Molly's numbers don't improve, is to see if your vet would prescribe a different insulin? 'Prozinc' is also licensed for cats in the UK. .....Or it may be (though is less likely) that your vet would prescribe a 'human' insulin such as Lantus, Levemir, or Hypurin PZI.
Some kitties will get more stable numbers on insulins with longer durations.
But a change of insulin would mean using syringes rather than the pen.

Eliz
 
Elizabeth and Bertie said:
Sue @Sue Hammond, the advice to not give a shot below 11 (200) is for newcomers who are still getting comfortable with hometesting, and who don't have much data to show how their cat responds to insulin.
Once a caregiver has data to show that it may well be safe to do so it is very possible that they will give shots at lower numbers. But this depends on the cat's own response to insulin, and also on the caregiver's ability to monitor and to take any necessary action. (Trying to give shots at lower preshot numbers is always an experiment initially...)
Have you seen the new Beginner's Guide to Caninsulin/Vetsulin (put together by a group of members here)? Here's the link:
Beginner's Guide to Caninsulin (Vetsulin)

Another thing to consider maybe, if Molly's numbers don't improve, is to see if your vet would prescribe a different insulin? 'Prozinc' is also licensed for cats in the UK. .....Or it may be (though is less likely) that your vet would prescribe a 'human' insulin such as Lantus, Levemir, or Hypurin PZI.
Some kitties will get more stable numbers on insulins with longer durations.
But a change of insulin would mean using syringes rather than the pen.

Eliz
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@Elizabeth and Bertie He's already said no to changing the insulin...I've upped her dose to 2u, but her numbers are still high, but it was only increased this morning, so I'll see how it goes.. I'm not always here during the day to test, but made a point of rearranging things for today, so I can watch her....Yes I have read that about the Caninsulin xxx
 
After giving her 2u last night and again this morning, her bg today is higher than when she was on 1.5u night and morning, why is this, can anyone help
 
Hi Sue & Molly from Pat & Tut. Not experienced enough to give dosing advice -- sorry. Only wanted to share that I was also confused about the "Diabetes for Beginners' recommendations about reducing or even not shooting when BG drops. I think I now understand that is for BEGINNERS without any data. (Better safe than sorry.) I'm mostly looking at the Lantus site now and, now that I have some data, am encouraged to shoot through drops. A little scary, but it has been OK so far. I also have had what's been referred to as "bouncing" when numbers go down and then up again (so frustrating!), and am told to hang in there and let the cat do her/his internal adjustments.
It's very hard. Hang in there.
 
ppp said:
Hi Sue & Molly from Pat & Tut. Not experienced enough to give dosing advice -- sorry. Only wanted to share that I was also confused about the "Diabetes for Beginners' recommendations about reducing or even not shooting when BG drops. I think I now understand that is for BEGINNERS without any data. (Better safe than sorry.) I'm mostly looking at the Lantus site now and, now that I have some data, am encouraged to shoot through drops. A little scary, but it has been OK so far. I also have had what's been referred to as "bouncing" when numbers go down and then up again (so frustrating!), and am told to hang in there and let the cat do her/his internal adjustments.
It's very hard. Hang in there.
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Hi ]Pat & tut, I don't understand what you mean by shoot through drops?.. I'm still very ignorant about this whole thing to be honest, even when I increase the dose it makes no difference, it goes even higher, I really don't know what to do xx
 
sorry to be unclear; I meant you continue to give the decided upon insulin amount even though the Blood glusose number has dropped (as long as you are not too near the dangerous hypoglycemic area). As I read "Diabetes for Beginners' it said if there was a significant drop, you should 'back off'.

I also feel am a 'beginner' by virtually any standard -- just started insulin last month. But I found that, since I had some numbers, others did not think the "Diabetes for Beginners" sticky was the place for me to be getting advice. (I don't even have any idea how this print turned to italics!)

Really just wanted to share that I have found things confusing, but am trying to hang in. And, hope you do, too.

 
ppp said:
sorry to be unclear; I meant you continue to give the decided upon insulin amount even though the Blood glusose number has dropped (as long as you are not too near the dangerous hypoglycemic area). As I read "Diabetes for Beginners' it said if there was a significant drop, you should 'back off'.

I also feel am a 'beginner' by virtually any standard -- just started insulin last month. But I found that, since I had some numbers, others did not think the "Diabetes for Beginners" sticky was the place for me to be getting advice. (I don't even have any idea how this print turned to italics!)

Really just wanted to share that I have found things confusing, but am trying to hang in. And, hope you do, too.
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Oh I see what you mean now, it's been just over 3 months for me and Molly, but I'm still getting nowhere, hopefully we'll get there eventually, hope you do too.. nice to meet you by the way x
 
JanetNJ said:
Let's see what happens tomorrow. Stick with 2 tomorrow. I feel there is insulin resistance going on.
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Her +3 last night after 2u was 18.8.and this morning amps was 20.8, . She's lost the excess weight, she's seems perfectly well on the outside, no other issues whatsoever
 
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(@Sue Hammond , @ppp )

Just a quick note on the 'Beginner's Guide to Caninsulin/Vetsulin'. This was written by a group of folks here for several reasons:

First, it's intended to be a comprehensive source of general information for those completely new, or relatively new, to dealing with diabetes or to using Caninsulin/Vetsulin.

Second, it should be a good source of information for Caninsulin/Vetsulin users generally. And, since it's a new document, those who have been using C/V for a while might also find benefit in reading it.

Third, it has been written as a source of information for those FDMB members who are advising other members whose kitties are on Caninsulin/Vetsulin. Many members here have never used Caninsulin/Vetsulin and yet may still need to answer urgent questions from members whose kitties are on C/V. The beginners doc is an attempt to provide the basic key information that advisers might need in order to give advice that is safe.

For members using C/V the doc should also provide basic information in the event that they cannot get any responses on the forum.
For specific questions about a particular cat though the forum is probably the best place to get that information, if possible.

I would strongly suggest that all C/V users read the basic info in the Beginner's doc, and also print it out if possible. Some things are much easier to understand when read on the printed page.
Having a background understanding of 'how your insulin works' is key to getting the best out of it. And when people here answer your questions on the forum you will have some 'context' in which to better understand those answers. :bighug::bighug::bighug:

Eliz
 
Sue Hammond said:
After giving her 2u last night and again this morning, her bg today is higher than when she was on 1.5u night and morning, why is this, can anyone help
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Sue, in a situation where the numbers increase as the dose is increased bouncing/rebound should always be suspected and investigated.
Bouncing is not the only reason for higher numbers, but is a very common one.

You have a lot of data for the am cycles currently, but very little for the pm cycles. So, we only know what's going on for half of the day. And quite a few cats have lower blood glucose at night.
I strongly suggest that you routinely get some tests (or at the very least one test) during each pm cycle. This may help us to confirm whether bouncing is or is not the cause of the higher numbers. If bouncing can be confirmed - or ruled out - then it makes it easier to decide how to proceed from here.
.
 
Sue Hammond said:
He's [the vet] already said no to changing the insulin...
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Regarding change of insulin, if it turns out that Caninsulin really doesn't work for Molly then the data you've collected should ably demonstrate that fact to your vet. And there are several other insulins your vet can prescribe.
Vets in the UK vary in their willingness to prescribe alternatives. Some really want to get the best outcome for the cat (and will prescribe an alternative insulin). Some vets, for whatever reason, aren't so willing to help. But if your vet doesn't want to help then maybe you can try a different vet? Often, even vets within the same practice will have different views on prescribing.
.
 
Elizabeth and Bertie said:
Sue, in a situation where the numbers increase as the dose is increased bouncing/rebound should always be suspected and investigated.
Bouncing is not the only reason for higher numbers, but is a very common one.

You have a lot of data for the am cycles currently, but very little for the pm cycles. So, we only know what's going on for half of the day. And quite a few cats have lower blood glucose at night.
I strongly suggest that you routinely get some tests (or at the very least one test) during each pm cycle. This may help us to confirm whether bouncing is or is not the cause of the higher numbers. If bouncing can be confirmed - or ruled out - then it makes it easier to decide how to proceed from here.
.
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It's difficult getting pm tests, as she has her insulin at 9pm
 
Elizabeth and Bertie said:
That would be great. Getting data from pm cycles could really help you to help Molly.
.
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Molly's +6 is 8.2, a massive difference from the last few days, this is what's really worrying and confusing me, how can there be such fluctuations, when everything else remains the same, feeding, toilet habits etc
 
Sue Hammond said:
Only 1 test is possible, or I'm going to be up all night
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Only you can decide what is possible for you, Sue.
But in this situation (fluctuating numbers, with a lot of high 'flat' numbers) the more data you can get, the more it becomes possible to get insight into Molly's situation; and the more it becomes possible to identify how it might be resolved.
.
 
Elizabeth and Bertie said:
Only you can decide what is possible for you, Sue.
But in this situation (fluctuating numbers, with a lot of high 'flat' numbers) the more data you can get, the more it becomes possible to get insight into Molly's situation; and the more it becomes possible to identify how it might be resolved.
.
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I can do one around midnight, but that's all until morning
 
Sue Hammond said:
Molly's +6 is 8.2, a massive difference from the last few days, this is what's really worrying and confusing me, how can there be such fluctuations, when everything else remains the same, feeding, toilet habits etc
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This is why I suggested getting pm data. Bouncing is a possibility.

I also see from an earlier post that your vet hadn't entirely ruled out switching to Prozinc. So, that could also be an avenue you could try...? A slightly longer-lasting insulin may help to even out the numbers.
.
 
Elizabeth and Bertie said:
This is why I suggested getting pm data. Bouncing is a possibility.

I also see from an earlier post that your vet hadn't entirely ruled out switching to Prozinc. So, that could also be an avenue you could try...? A slightly longer-lasting insulin may help to even out the numbers.
.
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But isn't 8.2 a good number
Elizabeth and Bertie said:
I know. It ain't easy, that's for sure.. (((Hugs))) :bighug::bighug::bighug:
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Sorry but what is bouncing again, I thought her 8.2 was a good result..
 
Here's something I wrote a while ago about bouncing:

Here's how it works:
  1. BG goes low OR lower than usual OR drops too quickly.
  2. Kitty's body panics and thinks there's danger (OMG! My BG is too low!).
  3. Complex physiologic processes take glycogen stored in the liver (I think of it as "bounce fuel"), convert it to glucose and dump it into the bloodstream to counteract the perceived dangerously low BG.
  4. These processes go into overdrive in kitties who are bounce prone and keep the BG propped up varying lengths of time (AKA bouncing).
  5. Bounce prone kitty repeats this until his body learns that healthy low numbers are safe. Some kitties are slow learners.
  6. Too high a dose of insulin can keep them bouncing over and over until the " bounce fuel" runs out and they crash - ie., have a hypo episode. That's why we worry so much about kitties that have had too high a starting dose prescribed by the vet and the owner isn't home testing.
 
So @Kris & Teasel do you think giving Molly 2u twice a day is too much...There was me thinking a bg of 8.2 +6 was good after the last few days...I was told you adjust it according to by results, told to me here somewhere further up..??Thank you for that information xx
 
Should I reduce her doses then, I really don't know what I'm doing anymore, being told so many different things
 
So am I right in thinking Molly is dumping excess glucose in her blood because she's not comfortable being lower?...how do we right that situation then...Giving higher doses isn't necessarily going to be the right thing to do?
 
Sue Hammond said:
So @Kris & Teasel do you think giving Molly 2u twice a day is too much...There was me thinking a bg of 8.2 +6 was good after the last few days...I was told you adjust it according to by results, told to me here somewhere further up..??Thank you for that information xx
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It's hard to say but that blue today is very nice. Here's what I do know, though:
  • You might need to try 0.25 u dose changes. It requires some eyeballing skill but can be done relatively easily if you're willing to use U100 syringes with half unit marks. Does your Vetpen allow half unit doses?
  • Bouncing can be aggravated by too many dose changes. So far you've been very consistent and that's good.
  • Bouncy cats will bounce and there's not much you can do about it. Some bounce less as they get better regulated but some don't stop. Sometimes feeding a small snack around +2 can forestall the steep drop to nadir that can trigger bouncing. We call it "steering with food".
  • Caninsulin is known to drop BG quickly and by a lot. That can aggravate bouncing. Some kitties will settle on it eventually but some need a longer lasting, gentler depot insulin like Lantus.
 
I have some syringes, but they also only go up in .5 doses, I'm not comfortable drawing up and using syringes, as have never been shown, also I can't see the measures even with my glasses on and using a well lit magnification glass
 
Kris has given you some great advice, Sue.

Sue Hammond said:
So am I right in thinking Molly is dumping excess glucose in her blood because she's not comfortable being lower?
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It's 'possible' that Molly is bouncing, yes. ...That could be one explanation for the pattern of numbers you're seeing. That's why it would be good to get some pm data to see more of the picture.
And bouncing is very common.
Some cats are more prone to it than others.

Bouncing can be tricky to deal with.
Some folks stick with the same dose and let the cat bounce (as long as the number triggering the bounce isn't too low for the cat's safety); and the cat may (or may not) get used to lower numbers and stop bouncing.
Some folks reduce the dose a bit to see if they can get the cat used to a higher range of numbers first, and then increase the dose and take the cat down to lower numbers.

As has been said before though there are other things that can also cause higher numbers; illness, infection (esp dental and UTI), diet, food intolerance, stress, or insulin that is not suitable for the cat.

Regarding insulins in the UK, Lantus is available. Here's what I wrote to you yesterday:
"Another thing to consider maybe, if Molly's numbers don't improve, is to see if your vet would prescribe a different insulin? 'Prozinc' is also licensed for cats in the UK. .....Or it may be (though is less likely) that your vet would prescribe a 'human' insulin such as Lantus, Levemir, or Hypurin PZI.
Some kitties will get more stable numbers on insulins with longer durations.
But a change of insulin would mean using syringes rather than the pen."
.
 
Elizabeth and Bertie said:
Kris, that's a great explanation.

@Sue Hammond, maybe keep a note of this information somewhere for future reference?
.
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Elizabeth and Bertie said:
Kris has given you some great advice, Sue.


It's 'possible' that Molly is bouncing, yes. ...That could be one explanation for the pattern of numbers you're seeing. That's why it would be good to get some pm data to see more of the picture.
And bouncing is very common.
Some cats are more prone to it than others.

Bouncing can be tricky to deal with.
Some folks stick with the same dose and let the cat bounce (as long as the number triggering the bounce isn't too low for the cat's safety); and the cat may (or may not) get used to lower numbers and stop bouncing.
Some folks reduce the dose a bit to see if they can get the cat used to a higher range of numbers first, and then increase the dose and take the cat down to lower numbers.

As has been said before though there are other things that can also cause higher numbers; illness, infection (esp dental and UTI), diet, food intolerance, stress, or insulin that is not suitable for the cat.

Regarding insulins in the UK, Lantus is available. Here's what I wrote to you yesterday:
"Another thing to consider maybe, if Molly's numbers don't improve, is to see if your vet would prescribe a different insulin? 'Prozinc' is also licensed for cats in the UK. .....Or it may be (though is less likely) that your vet would prescribe a 'human' insulin such as Lantus, Levemir, or Hypurin PZI.
Some kitties will get more stable numbers on insulins with longer durations.
But a change of insulin would mean using syringes rather than the pen."
.
Click to expand...
I've heard of Prozinc, as I spoke to my vet about it a while ago, he's still not keen to change from Caninsulin though....Today her numbers after insulin have improved, and i still don't understand why it's changing every couple of days. Would it be best to carry on giving 2u depending on bg or lower it back to 1.5u.... I explained earlier that my sight isn't good enough to see syringes numbers plus I've never been shown how to use them...My Vet insists the Vetpen is the best thing to use especially with my poor eyesight....I very much appreciate your help....There has been no change in diet, daily routines, no stressful situations, she appears on the outside well, is eating, drinking normally, her coat has improved, the dandruff she had has gone, she's lost the excess weight...On the outside she's a picture of health, sadly not inside though...
 
Thank you Kris for your help too, but I'm still as muddled with all this as ever...it feels like we're getting absolutely nowhere with this treatment xx
 
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