Closing in on Wilbur's Vetsulin doses

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Kris & Teasel said:
Yes. A spike to a high number this one time won't hurt him. Have you done any urine ketone testing on him? I don't recall if that's been discussed.
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Nope. how in the world do you collect urine from a cat?

EDIT: nevermind. i found it.

the vet did one though and said it was OK. about 2 months ago
 
johnt said:
Nope. how in the world do you collect urine from a cat?

EDIT: nevermind. i found it.

the vet did one though and said it was OK. about 2 months ago
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It's easy, especially if he's not shy around his litter box use. Not sure which "how to" you found but this is one I wrote up:
  • put the end of the test strip right in his urine stream as he's peeing
  • slip a shallow, long handled spoon under his backside to catch a little pee - you don't need much
  • put a double layer of plastic wrap over his favourite part of the litter box and poke some depressions in it too catch pee.
Most test strips have to be dipped and allowed to develop for 15 seconds before viewing the colour change in very good light.

I use the spoon method for Teasel and it's a piece of cake. I have three cats but know his usual "pee times" so I grab a sample then every couple of weeks.
 
Kris & Teasel said:
It's easy, especially if he's not shy around his litter box use. Not sure which "how to" you found but this is one I wrote up:
  • put the end of the test strip right in his urine stream as he's peeing
  • slip a shallow, long handled spoon under his backside to catch a little pee - you don't need much
  • put a double layer of plastic wrap over his favourite part of the litter box and poke some depressions in it too catch pee.
Most test strips have to be dipped and allowed to develop for 15 seconds before viewing the colour change in very good light.

I use the spoon method for Teasel and it's a piece of cake. I have three cats but know his usual "pee times" so I grab a sample then every couple of weeks.
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ahh. the ones I saw said get special gravel type litter.

here's the thing, it also sai i could drip some water in the litter and put a strip in. if it doesn't change colors it will probably work if you can get it.

When wilbur pees he no longer cleans up. but he's also very messy. i had to put open front covers on the boxes because even with high boxes he was peeing right on the walls. no way I can get in there.

but when he pees he goes so much there's a huge clump in the litter with a puddle right in the middle. if the litter doesn't mess up the test i coud try that.

but the vet said they were ok when he had the last tests done. does it need checking that often?
 
johnt said:
ahh. the ones I saw said get special gravel type litter.

here's the thing, it also sai i could drip some water in the litter and put a strip in. if it doesn't change colors it will probably work if you can get it.

When wilbur pees he no longer cleans up. but he's also very messy. i had to put open front covers on the boxes because even with high boxes he was peeing right on the walls. no way I can get in there.

but when he pees he goes so much there's a huge clump in the litter with a puddle right in the middle. if the litter doesn't mess up the test i coud try that.

but the vet said they were ok when he had the last tests done. does it need checking that often?
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If a cat isn't feeling well or the BG numbers are too high for a prolonged period of time checking urine ketones is advised. They can build up in hours. Vets don't generally recommend it because they aren't aware of how easy it is or they don't want to invite any litter box avoidance issue. I only mentioned it because you were concerned about higher BG today without the AM dose.

I'm in the camp that thinks urine ketone testing is a wise precaution. It doesn't have to be weekly if the cat is doing well. Teasel had a bout of diabetic ketoacidosis two months after diagnosis and he was extremely sick. Treatment involved three days at the vet's ICU ER and was very $$$$$$.
 
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Don’t forget to make a note on your SS about last night’s late dose. For this AM put “NS” in the dose cell"
 
Kris & Teasel said:
Don’t forget to make a note on your SS about last night’s late dose. For this AM put “NS” in the dose cell"
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I did, and added a note. I checked him at what should have been +2 and he was 275. I have to leave for a bit but will check him again when i return. poor little guy.

This brings up another question. Sometimes he slips. Let's say I miss his AMPS by 15 minutes. What should I do? when it happens I adjust his next shot to match. The problem is this throws everything out of whack. it ends up, over time, moving his dose times up an hour. It's never early. but if it's only 15 minutes should I make the next shot at his normal time, or continue like i have been?
 
johnt said:
I did, and added a note. I checked him at what should have been +2 and he was 275. I have to leave for a bit but will check him again when i return. poor little guy.

This brings up another question. Sometimes he slips. Let's say I miss his AMPS by 15 minutes. What should I do? when it happens I adjust his next shot to match. The problem is this throws everything out of whack. it ends up, over time, moving his dose times up an hour. It's never early. but if it's only 15 minutes should I make the next shot at his normal time, or continue like i have been?
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With an in and out insulin like Vetsulin you have up to an hour’s flexibility in dose timing without have to worry about major effects on BG.
 
Kris & Teasel said:
With an in and out insulin like Vetsulin you have up to an hour’s flexibility in dose timing without have to worry about major effects on BG.
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Sorry I slacked on putting Wilbur's numbers in today. feeling cruddy again today. but I did get his numbers during the day and tonight and have filled it all in now)
 
Kris & Teasel said:
With an in and out insulin like Vetsulin you have up to an hour’s flexibility in dose timing without have to worry about major effects on BG.
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ok I have a problem.

I loaded up 3.5 today and gave it to Wilbur. then I noticed he's green at 4+. then it dawnd on me, it felt like i was loading more than usual.

it was then that I realized, at some point i started misreading the syringe. when it's anything over 5 i read up or down from the next 5 mark right? but when I started doing low doses, I'm pretty sure when I read 3.5 it's actually 2.5 because most times I've been counting the first mark, which is actually the 0 mark i don't always count that way.

This means my doses have been inconsistent. Sometimes I count up from the first mark, some times I count down from the 5. That means there's an entire 'u' difference depending on which way i count. there are actually 5 marks below the 5. the bottom one just doesn't say '0' next to it

this would explain those greens i think
 
johnt said:
ok I have a problem.

I loaded up 3.5 today and gave it to Wilbur. then I noticed he's green at 4+. then it dawnd on me, it felt like i was loading more than usual.

it was then that I realized, at some point i started misreading the syringe. when it's anything over 5 i read up or down from the next 5 mark right? but when I started doing low doses, I'm pretty sure when I read 3.5 it's actually 2.5 because most times I've been counting the first mark, which is actually the 0 mark i don't always count that way.

This means my doses have been inconsistent. Sometimes I count up from the first mark, some times I count down from the 5. That means there's an entire 'u' difference depending on which way i count. there are actually 5 marks below the 5. the bottom one just doesn't say '0' next to it

this would explain those greens i think
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Give this more thought. You're right that the first mark under the needle is the zero mark when you hold the syringe vertically, needle pointing upward. You can't know for sure what you did so just try a new way counting from zero and don't deviate from that. The numbers over the next few cycles should tell you whether this has been an issue.
 
Kris & Teasel said:
Give this more thought. You're right that the first mark under the needle is the zero mark when you hold the syringe vertically, needle pointing upward. You can't know for sure what you did so just try a new way counting from zero and don't deviate from that. The numbers over the next few cycles should tell you whether this has been an issue.
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oh i'm not going to change anything, except from now on i'm counting down from 5 so there's no question.

such a stupid mistake
 
Kris & Teasel said:
Give this more thought. You're right that the first mark under the needle is the zero mark when you hold the syringe vertically, needle pointing upward. You can't know for sure what you did so just try a new way counting from zero and don't deviate from that. The numbers over the next few cycles should tell you whether this has been an issue.
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by the way, i won't make that mistake again. i'm counting down from the 5 mark each time now, and I can say with certainty i was doing it the other way frequently.

Should I keep at 3.5 for now? seems like we've been here a long time
 
johnt said:
by the way, i won't make that mistake again. i'm counting down from the 5 mark each time now, and I can say with certainty i was doing it the other way frequently.

Should I keep at 3.5 for now? seems like we've been here a long time
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You can keep it another couple of cycles to see if dark green pops up. He’s been doing well on that dose.
 
Kris & Teasel said:
You can keep it another couple of cycles to see if dark green pops up. He’s been doing well on that dose.
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I agree. he seems happy here. he's also settling in without the temptations, although he still gets a little bit every couple days. i've got him almost completely weaned though.

Thanks for the reply, I'll stay the course.
 
Three choices for you:
  1. stay at 3.5 u for a few more cycles
  2. try what we call a fat 3.5 u by filling the syringe almost to but a tiny bit more than 3.5 u
  3. try 3.75 u.
Any of the above would be OK to try for now.
 
johnt said:
I think moving up .25 might be the best bet. I'lltry that starting tonight.
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Sometimes a dose can get a bit "stale" after a while and a little bump up gets the BG moving down. You might end up going back to 3.5 u. It's like a little jumpstart.
 
Kris & Teasel said:
Sometimes a dose can get a bit "stale" after a while and a little bump up gets the BG moving down. You might end up going back to 3.5 u. It's like a little jumpstart.
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Help me with something now that we're past the point.

When I was giving him 4.75 his sugar would go way down then come way back up. That means he wasn't healthy, but i don't quite understand why that happened. is it because i was giving him too much and like the vet was saying his body was fighting the low sugar off so it would climb higher by PMPS? You called it rebounding
 
Yes, exactly. We call it “bouncing” on FDMB but rebounding is another term for it. A dose that’s too high drops the BG too low and that sets off a chain of processes whereby glucose that’s stored in the liver in another form gets dumped into the bloodstream. It’s a self protective process but it can go overboard and raise BG too high. If the dose that’s too high is continued the liver’s supply eventually runs out and BG crashes into hypoglycemic territory.
 
Kris & Teasel said:
Yes, exactly. We call it “bouncing” on FDMB but rebounding is another term for it. A dose that’s too high drops the BG too low and that sets off a chain of processes whereby glucose that’s stored in the liver in another form gets dumped into the bloodstream. It’s a self protective process but it can go overboard and raise BG too high. If the dose that’s too high is continued the liver’s supply eventually runs out and BG crashes into hypoglycemic territory.
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yeah that makes sense.

I wish this stinking cold would go away so I could get on a regular schedule again. I felt awful again last night even though i was up late so I didn't get any mid-cycle readings. i'll get one today at +6 or somewhere in there.

I stayed at 3.75 again
 
Kris & Teasel said:
Yes, exactly. We call it “bouncing” on FDMB but rebounding is another term for it. A dose that’s too high drops the BG too low and that sets off a chain of processes whereby glucose that’s stored in the liver in another form gets dumped into the bloodstream. It’s a self protective process but it can go overboard and raise BG too high. If the dose that’s too high is continued the liver’s supply eventually runs out and BG crashes into hypoglycemic territory.
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phew that might have been too big a bump +4.5 and he's 65

I went ahead and gave him a few temptations because that's just too low. i dind't give him much though.

I'll check him in 30 min

At what point would you recommend karo on the gums?

FYI i waited 13 minutes and it's at 69 now. he's eating like he's starving.
 
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OK, checked him again, 30 min after the 65 and he's at 83 so he looks to be ok now. i'm relieved. whew! never sure when to panic
 
johnt said:
OK, checked him again, 30 min after the 65 and he's at 83 so he looks to be ok now. i'm relieved. whew! never sure when to panic
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Well, back to 3.5 u I guess! :) I’m sure he was going to be fine but I know you have bad memories of seizures. The “take action” number for a human meter is 50. That doesn’t mean a hypo, only that BG is low enough that a low carb snack is in order. If it had dropped below 50, then you’d dip into the Karo or Temptations.
 
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Kris & Teasel said:
Well, back to 3,5 u I guess! :) I’m sure he was going to be fine but I know you have bad memories of seizures. The “take action” number for a human meter is 50. That doesn’t mean a hypo, only that BG is low enough that a low carb snack is in order. If it had dropped below 50, then you’d dip into the Karo or Temptations.
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Actually I'm pretty comfortable that with your guidance i don't need to worry as much about seizure. You'll notice I test him a lot, and i think knowing where he is as much as possible is the best way to avoid that stuff.

As i've talked to you, my thoughts have changed completely. First I was thinking the seizures were due to overly high BG numbers because I wasn't giving him enough. Now I've learned that it's almost the opposite. They likely happened because I was giving him so much Insulin his BG dropped so low he likely went into seizure because of it. Then it would run high by the time I got him to the vet again because he was rebounding/bouncing. I believe that's what was happening now at least. maybe i'm wrong.

I just didn't remember the number I should start worrying. 65 is the lowest I've seen and it worried me. I had '50' in the back of my head as the number, but at +4 my concern was he was still on his way down and it could get much worse in the next hours. I fed him light, but wanted to make sure we didn't stay on that low number. What startled me was that he was attacking his food like he was just starving. Which iv'e read is a symptom of low BG.

Anyway, i'll stick to 50 being the worry number. Do you think if he gets to that point I should be loading him into the car on the way to the vet? or just handle it here?
 
johnt said:
As i've talked to you, my thoughts have changed completely. First I was thinking the seizures were due to overly high BG numbers because I wasn't giving him enough. Now I've learned that it's almost the opposite. They likely happened because I was giving him so much Insulin his BG dropped so low he likely went into seizure because of it. Then it would run high by the time I got him to the vet again because he was rebounding/bouncing. I believe that's what was happening now at least. maybe i'm wrong.
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That's my take on it.

johnt said:
I just didn't remember the number I should start worrying. 65 is the lowest I've seen and it worried me. I had '50' in the back of my head as the number, but at +4 my concern was he was still on his way down and it could get much worse in the next hours. I fed him light, but wanted to make sure we didn't stay on that low number. What startled me was that he was attacking his food like he was just starving. Which iv'e read is a symptom of low BG.
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Yes, 50 is the number to remember. You can do what we call "steering with food" if you find he's dropped a lot by +3 or +4. That means you give a small snack of regular low carb food and retest at the 30 minute mark afterward. Repeat snack/test if needed. It's to control the descent of the BG. If you aren't able to do that for whatever reason and you find him at 50 then bring out the big guns - Karo, wet food with gravy, Temptations, etc. You don't feed much at once because you might have to keep giving small high carb snacks over a period if time and you don't want to fill him up.

Many cats get very hungry when their BG drops a lot, even if they aren't in hypo numbers. It's a good warning sign to pay attention to.

johnt said:
Anyway, i'll stick to 50 being the worry number. Do you think if he gets to that point I should be loading him into the car on the way to the vet? or just handle it here?
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No, if he's at 50 you'd try a little high carb snack - gravy from a can of chunks in gravy wet food works. You can put a drop or two of Karo in the gravy to add more carbs or put a couple of Temptations in it. When I have to bump Teasel's BG up I just give him a couple of teaspoons of his low carb wet food with 6-8 Temptations on top.

You'd only whisk him off the the ER if you find him stumbling, yowling, seizing, etc. Karo on gums first though. Another scenario would be if you've tried hard to prop up his BG with carbs but it isn't working. Most people here who test often enough see a problem coming and are able to intervene effectively with carbs before it becomes an emergency.
 
@Kris & Teasel how many pages do you see in this thread?

to me it still shows 1. bu there are over 80 replies.

I am pretty sure we're nearing the end of the saga but i think i should start a new thread?
 
johnt said:
@Kris & Teasel how many pages do you see in this thread?

to me it still shows 1. bu there are over 80 replies.

I am pretty sure we're nearing the end of the saga but i think i should start a new thread?
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One page, 84 posts excluding this one. I think the length of the posts determines when a new page starts. You can start a new page now though.

Wilbur's SS looks really good. How is he feeling, eating, acting, etc.?
 
Kris & Teasel said:
One page, 84 posts excluding this one. I think the length of the posts determines when a new page starts. You can start a new page now though.

Wilbur's SS looks really good. How is he feeling, eating, acting, etc.?
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he's not moving faster yet, but i know it takes a long time to lose a lot of weight.

That being said, to me he seems more like 'himself'. he starting to do his post poop zoomies again (silly i know but it's cute), and he tries to scootch down and clean himself.

once he loses some weight he'll be able to do that again, and I think he'll be happier once he gets there.

He seems more happy now though.
 
johnt said:
he's not moving faster yet, but i know it takes a long time to lose a lot of weight.

That being said, to me he seems more like 'himself'. he starting to do his post poop zoomies again (silly i know but it's cute), and he tries to scootch down and clean himself.

once he loses some weight he'll be able to do that again, and I think he'll be happier once he gets there.

He seems more happy now though.
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Great news! :D
 
Elliott has been in remission so my comments do not refer to him....I am suspicious as to the stability of VETSULIN..Maybe I need to stop researching..Merck people will talk to you all day but answers are?? Maybe there's a big difference between the crystalline portion of Vetsulin and Novolin- Humulin 70/30. My point was with the vigorous shaking needed with Vetsulin. The large particles are what cause the longer lasting effects of both of these insulins. My Vetsulin does not last 12 hours..but boy, are there sudden plunges that come out of nowhere. I spoke to Merck techs frequently to get them to consult their experts if TOO vigorous of shaking, liking shaking a paint can at Lowe's, could damage the particles..."No".. No one does this with Humulin- Novolin 70/30? Another concern is sudden unexpected BG (that occurs with all insulins at times) but with Vetsulin, really strange BG appear and wonder if the fast acting + "potentially damaged" longer lasting crystals work together causing sudden drops. One researcher believes that the crystalline fraction can be damaged and does not shake it because he believes it can break up the the crystalline particles, making them smaller and therefore; work much faster adding to the effects of amorphous portion...Sorry to get into the weeds. Suzie has been on Vetsulin for one month and happens to be a dog...which is not relevant to the makeup of this insulin. Consider low BG that occur during the day before the 8 hour mark.Oh well... Again...Thanks to all for your 24/7 care that put my Elliott into remission..He is doing GREAT!!!!
 
ELLIOTT & Fran Munschauer said:
Elliott has been in remission so my comments do not refer to him....I am suspicious as to the stability of VETSULIN..Maybe I need to stop researching..Merck people will talk to you all day but answers are?? Maybe there's a big difference between the crystalline portion of Vetsulin and Novolin- Humulin 70/30. My point was with the vigorous shaking needed with Vetsulin. The large particles are what cause the longer lasting effects of both of these insulins. My Vetsulin does not last 12 hours..but boy, are there sudden plunges that come out of nowhere. I spoke to Merck techs frequently to get them to consult their experts if TOO vigorous of shaking, liking shaking a paint can at Lowe's, could damage the particles..."No".. No one does this with Humulin- Novolin 70/30? Another concern is sudden unexpected BG (that occurs with all insulins at times) but with Vetsulin, really strange BG appear and wonder if the fast acting + "potentially damaged" longer lasting crystals work together causing sudden drops. One researcher believes that the crystalline fraction can be damaged and does not shake it because he believes it can break up the the crystalline particles, making them smaller and therefore; work much faster adding to the effects of amorphous portion...Sorry to get into the weeds. Suzie has been on Vetsulin for one month and happens to be a dog...which is not relevant to the makeup of this insulin. Consider low BG that occur during the day before the 8 hour mark.Oh well... Again...Thanks to all for your 24/7 care that put my Elliott into remission..He is doing GREAT!!!!
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That's certainly way beyond my knowlege. I will say though, I don't shake it, I still roll it. habit i got into during my ProZinc days.

wonder if it really matters. All i know is Wilbur fits the profile of a cat that has an expected nadir that matches the curve Vetsulin advertises. I dont know what everyone else thinks. but for me, coming down to 3.5u versus my previous doses of 8 9 or even 10u, now expirations is something I have to watch.

Previously a vial lasted 3 weeks, now it'll b anywhere from 8 to 10
 
johnt said:
That's certainly way beyond my knowlege. I will say though, I don't shake it, I still roll it. habit i got into during my ProZinc days.

wonder if it really matters. All i know is Wilbur fits the profile of a cat that has an expected nadir that matches the curve Vetsulin advertises. I dont know what everyone else thinks. but for me, coming down to 3.5u versus my previous doses of 8 9 or even 10u, now expirations is something I have to watch.

Previously a vial lasted 3 weeks, now it'll b anywhere from 8 to 10
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I lack knowledge big time..The instructions are VIGOROUS shaking but that is why I question it because of my odd BG results....and learning about the instability in 2010 when taken off market. However, I am raising extremely slowly after leaving Lantus. Do you know why your dosage reduced so much? I bought my Vetsulin here and store appropriately. You are watching your expirations..Mine has not expired but have noticed BG rise in last couple of days. How long are you able to use the vial? I punctured vial on 2/16/2018. How did you determine that the vial lasted 3 weeks or was that because you ran out and needed more? Thanks for reading..Fran
 
ELLIOTT & Fran Munschauer said:
I lack knowledge big time..The instructions are VIGOROUS shaking but that is why I question it because of my odd BG results....and learning about the instability in 2010 when taken off market. However, I am raising extremely slowly after leaving Lantus. Do you know why your dosage reduced so much? I bought my Vetsulin here and store appropriately. You are watching your expirations..Mine has not expired but have noticed BG rise in last couple of days. How long are you able to use the vial? I punctured vial on 2/16/2018. How did you determine that the vial lasted 3 weeks or was that because you ran out and needed more? Thanks for reading..Fran
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Mine lasted 3 weeks because at the time I was giving him 10u twice per day. it ran out in 3 weeks.

I don't know how he survived for 5 years that high honeslty. he wouldn't let me test him. I just miraculously got him to allow me when I forced him becaues I was afraid he was low, and i was right. so i went to 2 u that night, and he didn't eat the next day. so i started testing him. couple days later i came back here and got help. @Kris & Teasel started helping me every day until we got him balanced.

We started moving in .25 doses until he stabilized, which seems to be where he's at right now.
 
@Kris & Teasel One question. @ELLIOTT & Fran Munschauer brought up a good question. Since I'm now able to stretch my Vetsulin over double the time from when i was injecting 10u, do I need to be aware of expiring insulin?

the way i see it now, one bottle lasted 3 weeks, even if we just double it that means one bottle would last 6 weeks. is that still safely effective?
 
He's doing fine at this dose. Ignore the pinks - they aren't much different from the high yellows. Any sense that he's lost a little weight? Easier for him to clean his back end?
 
Kris & Teasel said:
He's doing fine at this dose. Ignore the pinks - they aren't much different from the high yellows. Any sense that he's lost a little weight? Easier for him to clean his back end?
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it's hard to tell. the girlfriend says she can tell, but i think that's a little dramatic. I see changes in him and I think that's what others are seeing. his energy is changing so his actions change too and he runs and plays more

The other side of that, he is with me 24/7. He sleeps on my leg at night, if I get up to go to the restroom he nudges the door open to stand there. then he jumps back in the bed making it hard for me to get in.

When i'm working on the computer (probably 15 hours per day minimum) i have two beds on a large desk, one on each side of my monitor. he demands to lay in one of those.

point being, I see him all day, every day. so there's a good chance if hes losing weight I don't see it. I'm going to try my cheat way today.

get on the scale, weight myself, then pick him up and weigh again, deducting the difference.

he still can't scratch anywhere on his head. he tried 2 days ago, and his itch was really bugging him. his eye was closed and his left ear was flat out sideways. he came over and jammed his head into my face so i'd scratch him. he tried to do it but couldn't even get his rear leg past about mid-way up his torso.

so there's no way he can get to anything to clean yet. but like I said I'll weight him. i would bet he's lost a bit of weight though with the huge diet change
 
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