Dosage and hypo

[Drea03]

Hello, I’m needing some advice on what’s going on with my cats numbers. I haven’t had a chance to use the graph but I have pics I’ll dl of all his tests. Today is 2 weeks on vetsulin. His numbers are all over the place. He’s been getting 1 unit twice a day 20-30 minutes after eating. He is acting fine and even playing at times. His morning numbers are always 300 at least with his evening numbers much better. But yesterday he was acting weird about 3 hours after injection so I tested and his sugar was 63 So I gave dextrose. Now I’m worried to give him 1 unit and this happens and I’m not home... But then maybe 1 unit is not enough either? Any advice is much appreciated. I’m working closely with great vets but they both have different ideas of what to do so I’m confused and have anxiety. I can do a curve in a couple days. He sometimes eats half his food and an hour or so later finished it. He’s almost done with his Amoxicillin as well. (Sl high lipase).

 

[Kris & Teasel]

That 63 as measured on a pet meter is too low and calls for a reduction in dose. I'd drop his dose to 0.5 u now and leave it there in the interim and when you do the curve. I also see a 56 on 08 Feb in your notes. That verifies that 1 u is too much. He drops low and then rebounds very high, sometimes staying up there for a couple of cycles.

Please set up our spreadsheet. We need to see data at a glance if you have to come here for fast advice because of hypo, etc. We could easily miss something important if we have to look through photos of your notes.

Check out this guide to Vetsulin: http://www.felinediabetes.com/FDMB/threads/beginners-guide-to-caninsulin-vetsulin.186099/

 

[MrWorfMen's Mom]

Since Milky has had an infection and is close to finishing the antibiotics, it's safe to assume that his BG may be lowering on its own because infections often cause BG elevation. When the antibiotics start clearing the infection, the BG will also go down.

I see Kris has replied and I agree completely with her thoughts/suggestions.

 

[Drea03]

That 63 as measured on a pet meter is too low and calls for a reduction in dose. I'd drop his dose to 0.5 u now and leave it there in the interim and when you do the curve. I also see a 56 on 08 Feb in your notes. That verifies that 1 u is too much. He drops low and then rebounds very high, sometimes staying up there for a couple of cycles.

Please set up our spreadsheet. We need to see data at a glance if you have to come here for fast advice because of hypo, etc. We could easily miss something important if we have to look through photos of your notes.

Check out this guide to Vetsulin: http://www.felinediabetes.com/FDMB/threads/beginners-guide-to-caninsulin-vetsulin.186099/

Thank you for your reply. We discussed lowering the dose but did not set an exact amount. I’ll try the .5 and see how he does. I’ll be checking his lipase and another UA probably tomorrow. I have not figured out how to use the spreadsheet yet but hoping I can try it this weekend. Again, thank you.

 

[MrWorfMen's Mom]

If you need assistance setting up the spreadsheet, just let us know as there are folks here who can set it up for you.

 

[Drea03]

Thank you> I'm having a bit of trouble with the spreadsheet with my phone. I dont have much access to a computer either. Whats the easiest way from your phone to get it to work properly?

 

[MrWorfMen's Mom]

If you can be a little more specific about the issues you're having, then I'm sure we can get you the help you need. Did you get the spreadsheet set up or do you need help to do that? Or are you having trouble accessing and/or adding data to the spreadsheet? Let us know and we'll get you going.

 

[Drea03]

I apologize for the time lapse. I am able to copy the spreadsheet but it then will not allow me to hit anything to put any numbers in. I was thinking of trying to copy it on my tablet instead of phone but havent had the chance yet. I would like to share his numbers with you all soon though because he is sitting around 190-215 at almost all his readings now which is usually AM and PM. I have skipped giving him insulin a lot with these numbers because I am not able to be home to monitor him after giving the insulin. He is usually getting .5 units BID but with these numbers (using alphaTrak) I sometimes will give .25 units or none. I am not really sure what the best thing to do is. I know he can get pretty low with this insulin so I dont want to chance him being hypo and Im not there but I also dont want his pancreas to feel an extra load as well. This is def a stressful time but he is doing well. I'm hoping for remission but not sure this insulin is going to fully achieve that or if I should go to ProZinc or wait it out a bit longer....I appreciate any advice until I can get his spreadsheet up and going.

 

[Drea03]

If you can be a little more specific about the issues you're having, then I'm sure we can get you the help you need. Did you get the spreadsheet set up or do you need help to do that? Or are you having trouble accessing and/or adding data to the spreadsheet? Let us know and we'll get you going.

I apologize for the time lapse. I am able to copy the spreadsheet but it then will not allow me to hit anything to put any numbers in. I was thinking of trying to copy it on my tablet instead of phone but havent had the chance yet. I would like to share his numbers with you all soon though because he is sitting around 190-215 at almost all his readings now which is usually AM and PM. I have skipped giving him insulin a lot with these numbers because I am not able to be home to monitor him after giving the insulin. He is usually getting .5 units BID but with these numbers (using alphaTrak) I sometimes will give .25 units or none. I am not really sure what the best thing to do is. I know he can get pretty low with this insulin so I dont want to chance him being hypo and Im not there but I also dont want his pancreas to feel an extra load as well. This is def a stressful time but he is doing well. I'm hoping for remission but not sure this insulin is going to fully achieve that or if I should go to ProZinc or wait it out a bit longer....I appreciate any advice until I can get his spreadsheet up and going.

 

[MrWorfMen's Mom]

Sorry I lost track of this alert due to some kitties running low numbers. My sincere apologies.

When you say you are able to copy the spreadsheet, I'm wondering if you just downloaded it and are trying to input on the template. You download the template but then you have to go to FILE, then MAKE A COPY to create a personal copy. You cannot enter data until you make a personal copy of the spreadsheet. You'll need to rename the personal copy "Milky's SS" or something like that so it's identifiable as yours.

If this is not the problem, please let me know and we'll get someone to set the spreadsheet up for you.

As for the insulin, you've only been at this for 6 weeks which in diabetic time isn't long. I'd give the Vetsulin a bit more of a chance before deciding if a switch to something else is needed. The best insulin for your cat is the insulin that works for him and cats go into remission on Vetsulin so give it a bit of time.

Other than the BG numbers, how is your kitty behaving? How are his 5P's (playing, purring, pooping, preening and peeing)? Appetite? Amount of water intake? Our cats are more than just their numbers and often daily observations speak volumes as to how things are going.

Without data to look at it's difficult to make any suggestions regarding dosing. Your current plan seems sound based on what you are getting for pre-shot readings. Mid cycle tests are needed to see how low Milky is going so whenever you are home, grab a couple of mid cycle tests to see how low Milky's BG is going. Also we strongly recommend making it a habit of getting a before bed test to capture some night cycle data.

 

[Drea03]

Thank you for your reply. I’m still not having any luck with the spreadsheet. I thought I had copied it but now when I go back on my phone there is not even an option to copy. I’m using an iPhone and the alpha track US link for the spreadsheet. I can see the template but there’s no where to click to copy it. Sorry it shouldn’t be hard but for some reason I just can’t access it correctly.
As far as Milky goes he seems to be feeling pretty good. Eating well, drinking normally, playing, lots of purring and grooming. He hasn’t had insulin in 4 days because of his low numbers. I’ll attach a file from this week with the numbers. I’m hoping this is a good sign to remission soon. I’ve been working more so haven’t had the change to get more numbers in between. I’ll continue the vetsulin as needed. I started him back up on Cosequin because he was limping on his front leg. No limping now. It’s just a powder I add to his fancy feast twice a day. Thanks for any input

 

[MrWorfMen's Mom]

I checked on my android phone which I assume is similar. When you open the template in Google sheets, are there 3 vertical dots (lines) in the upper corner? If you tap those dots, a menu appears. Tap "Share & Export" then on the new menu, tap "Make a Copy". A box should open up to give you the option of renaming the sheet and you can then input your readings on the that version of the spreadsheet.

Looking at the readings you have so far, I would recommend you not give insulin unless Milky's pre-shot is 250 or higher. While pre-shot readings tell you if it is safe to give insulin, mid cycle tests taken between +3 and +7 post shot, will tell you how low BG is going and those are the numbers that should dictate the dose you give Milky.

If you are not able to get mid cycle tests during the week, at the very least grab a test before bed every night. Then on the weekends, get some mid cycle tests or run a curve, testing every 2 hours for 12 hours or every 3 hours for 18 hours to see what a cycle looks like.

Overall, from what I can tell, Milky's numbers are not too bad and I'd be inclined to stick with 0.25u dose when pre-shots allow until you can get some mid cycle tests to see how low Milky is going at nadir (peak insulin action...lowest BG in cycle).