How do you find the right dose of Vetsulin?

[Marianne M]

My kitty had an UTI and on the blood testing found out his sugar was in the 400's. I had done a strip urine test before his blood testing with the vet and the ketones where in the purple area. Vet made no mention of ketones after urine and blood testing but said everything looked normal except blood sugar. Put him on 2U of Vetsulin. Told me to increase it to 3U. He went on vacation for three weeks so we've been on our own. We are starting our third week of this new journey. Learning so much from the FDMB that I am so grateful to have found this site. I slowly increase to 3. I did so but didn't see any major changes in the reading. We get readings in the 200's had one 187 then three's and fours as well. After reading that too much insulin can be as bad as too little. Our vet didn't start him off at 1 unit as stated for Vetsulin. He said it was by weight which may be the case with the other types of insulin. We are holding at 2U had gone to 3U with not much changes. I wonder if I should decrease to 1 1/2U for a couple of days and see what the reading are. Mango is eating FF, Friskies, Tiki Cat canned as I cut out the Tiki Cat dry because the carbo's were 11% not 10. Freezes dried liver or chicken snacks. Any advice would be welcomed!

 

[CandyH & Catcat]

newbie still learning what I can about vetsulin -- -- listening to all that goes on

would be really helpful if you could put your test results in the spreadsheet, since the timing of your results would give us more info to advise you; especially since the numbers you mention are a whole lot lower than I'm getting, so I suspect you may be right about dosing -- the color coding gives a clue about what's going on with Mango too, sometimes I can understand color better than numbers

I've been told that the "insulin dose by weight" applies to dogs, not cats -- and I am furious with your vet leaving you hanging there by yourself with no referral to an interim vet, no guidelines other than here (though "here" is better than 85% of the vets, IMHO)

 

[MrWorfMen's Mom]

Hi and welcome to you and your handsome Mango.

We tend to be very data oriented here. I see you've set up a spreadsheet but there are no readings on it. If you could plot in the readings for the last couple of weeks it would help us help you sort out Mango's dosing.

The fact that you didn't see any significant difference between the 2u and 3 u dose could be indicative of too much or too little insulin and without some data to look at, it's impossible to make that determination. You are correct that too much insulin can look very much like too little but I would be hesitant to tell you to try a lower dose without more information. I am also a bit concerned about that purple reading of the ketostix and wonder if you are still testing Mango for ketones. It's very important to be sure to read the ketostix at exactly the time lapse indicated on the packaging and be sure to check it under a good lighting source. If you delay reading the strips, they keep darkening which can lead to a false alarm. Any ketone readings over trace, warrant a call to the vet as ketones can progress quickly leading to DKA and that is not only very expensive to treat but also can be life threatening. I take it Mango is not showing any signs of not feeling well.......i.e. he's eating well, interactive with you, preening etc.

 

[Marianne M]

newbie still learning what I can about vetsulin -- -- listening to all that goes on

would be really helpful if you could put your test results in the spreadsheet, since the timing of your results would give us more info to advise you; especially since the numbers you mention are a whole lot lower than I'm getting, so I suspect you may be right about dosing -- the color coding gives a clue about what's going on with Mango too, sometimes I can understand color better than numbers

I've been told that the "insulin dose by weight" applies to dogs, not cats -- and I am furious with your vet leaving you hanging there by yourself with no referral to an interim vet, no guidelines other than here (though "here" is better than 85% of the vets, IMHO)

I have the test results on a sheet but can't seem to post it here. Followed the steps etc and get a blank one. Of course I can't fill out the blank one that shows up here. Haven't figured it out yet but once I do it will be posted.

 

[MrWorfMen's Mom]

Are you by any chance accessing the spreadsheet through the link in your signature? If so, that is why you can't update the data. That link is for viewing only. To access the spreadsheet, you need to be sure you are signed on to Google, go to Google Drive and look under Sheets. Mango's spreadsheet will be there and you can edit from there to your heart's content. Let me know if you need any further help.

 

[Marianne M]

Hi and welcome to you and your handsome Mango.

We tend to be very data oriented here. I see you've set up a spreadsheet but there are no readings on it. If you could plot in the readings for the last couple of weeks it would help us help you sort out Mango's dosing.

The fact that you didn't see any significant difference between the 2u and 3 u dose could be indicative of too much or too little insulin and without some data to look at, it's impossible to make that determination. You are correct that too much insulin can look very much like too little but I would be hesitant to tell you to try a lower dose without more information. I am also a bit concerned about that purple reading of the ketostix and wonder if you are still testing Mango for ketones. It's very important to be sure to read the ketostix at exactly the time lapse indicated on the packaging and be sure to check it under a good lighting source. If you delay reading the strips, they keep darkening which can lead to a false alarm. Any ketone readings over trace, warrant a call to the vet as ketones can progress quickly leading to DKA and that is not only very expensive to treat but also can be life threatening. I take it Mango is not showing any signs of not feeling well.......i.e. he's eating well, interactive with you, preening etc.

No he is not showing signs of feeling ill. He is hunting lizards and frog, eating well, grooming, being his normal self. On the test strip the PH of his urine was normal. I tested my urine and I tested purple for ketones as well and I am not diabetic nor have a UTI. The vet did two urine tests but the blood to make sure he was diabetic. Never mentioned a word about testing his urine just his blood. Never said a world about ketones. Once I figure out how to post the results on that form it will be there. I fill the form out daily on my computer and since I can't fill it out on this site I followed the steps to do so and got the blank SS. I will figure it out. I have too!

 

[Marianne M]

Are you by any chance accessing the spreadsheet through the link in your signature? If so, that is why you can't update the data. That link is for viewing only. To access the spreadsheet, you need to be sure you are signed on to Google, go to Google Drive and look under Sheets. Mango's spreadsheet will be there and you can edit from there to your heart's content. Let me know if you need any further help.

Are you by any chance accessing the spreadsheet through the link in your signature? If so, that is why you can't update the data. That link is for viewing only. To access the spreadsheet, you need to be sure you are signed on to Google, go to Google Drive and look under Sheets. Mango's spreadsheet will be there and you can edit from there to your heart's content. Let me know if you need any further help.

I opened Google drive and have the file that I've been filling out. Now how do I get it here? If I could drag it to my desktop I could upload it as a file. Can't drag it.

 

[CandyH & Catcat]

I did same thing initially, went to SS through my signature -- didn't initially know how to get to Google Drive, but was directed to the funny checkerboard icon, top right on Google Chrome, click on that, it gives you the Apps, among which is Drive .. click on that and (cross fingers) spreadsheet will appear

 

[CandyH & Catcat]

hmmm -- I can see you have a link from blank SS to your signature, but not to the one you filled out -- check the instructions once again in Tech Support forum, could you have missed the "publish to the web" step?

 

[Marianne M]

hmmm -- I can see you have a link from blank SS to your signature, but not to the one you filled out -- check the instructions once again in Tech Support forum, could you have missed the "publish to the web" step?

I am going to start over with it and see what happens. The SS is in Google drive so just have to get it here. I also tried when I pull the file up in drive and click on the hyerlink put the link I was given setting the SS up and nothing happened. SO.....

 

[MrWorfMen's Mom]

Sounds like you perhaps have 2 spreadsheets set up? Did you set up your own Google spreadsheet (sans the colour coding etc.) to keep track of Mango's readings before you downloaded our template or did you download the template and copy it twice? Don't worry. Let us know if you can't get it sorted. We'll figure this out.

 

[Marianne M]

In the driver for Google I had two SS the one I fill out daily and the blank template. I trashed the blank one and only have the one I can work on in driver. I can't figure out a way to get it from driver to here. I am confused to say the least.

 

[Marianne M]

I just went back and took the blank out of the trash and realized I can now fill that one out and trash the other. Yippee I think I've got it!

 

[Marianne M]

Mango's SS sheets are completed and ready to view.

 

[Squeaky and KT (GA)]

ANNNNND.....I can see it just fine!!! Good job!

By chance is he eating last night's left over food shortly before you do that morning test?

 

[MrWorfMen's Mom]

Wonderful! Good job getting that all sorted so quickly. And kudos for home testing. Best tool we have to keep our little fur balls safe and healthy.

Looking at Mango's readings, it does appear his numbers are better on the 2u than on the 3u and 2u is a bit of a higher dose than we would normally recommend as a starting dose.

No he is not showing signs of feeling ill. He is hunting lizards and frog, eating well, grooming, being his normal self. On the test strip the PH of his urine was normal. I tested my urine and I tested purple for ketones as well and I am not diabetic nor have a UTI. The vet did two urine tests but the blood to make sure he was diabetic.

I'm delighted to hear Mango is active and eating well. Those everyday observations are just as important as all the numbers we collect. I'm still curious about both of you getting purple for ketones but alas, it doesn't sound like they are a problem for either of you. It is a good idea to keep an eye on ketones for a diabetic cat even though most vets don't mention it. Some cats are more prone to developing ketones than others.

Curiosity.....was the blood test done by the vet a fructosamine test or a simple test for Blood glucose? Glucose in the urine can occur even in a non-diabetic cat especially when they are under stress of any kind (vettie visit or not feeling well for instance) and kitties are notorious for elevated BG in the vet's office. A fructosamine test provides an indication of what BG has been over a period of 2 to 3 weeks prior and thus provides a much more definitive diagnosis of diabetes.

I think if you want to drop him back to 1.5u for a few cycles to see if his numbers improve, he should be fine. I'm wondering if the higher numbers today might be from a bounce (occurs as a result of BG dropping lower than kitty is accustomed to, too low or dropping a lot or quickly) from a lower BG yesterday given his pre-shot reading was lower. You've been getting mid cycle tests around +6 hours post shot many days. I'm guessing the vet may have suggested testing at that time. In any event, not all cats hit the peak action that late in the cycle. On the 28th Mango appears to have reached nadir around +4 post shot. The lowest point in the cycle (nadir) can occur as early as +3 and as late as +7 with the majority reaching nadir in the +3 to +5 time period. For that reason, if it's possible given your other commitments, it would be a good idea to check BG randomly between +3 and +6 to see how low the dose is taking Mango and determine roughly when he is reaching peak insulin action. The nadir can be fairly consistent in some cats while with others it moves around a bit which is why I'm suggesting randomly testing in that +3 to +6 time frame.

 

[Marianne M]

ANNNNND.....I can see it just fine!!! Good job!

By chance is he eating last night's left over food shortly before you do that morning test?

Hard to say as he has access to the outside and loves to catch and eat lizards so he may have had a snack before his regular breakfast. We live in Fla and have plenty in the garden. Later He was outside came in with a lizard one hour before the 6+ testing and ate it! At the beginning of this journey he didn't want to go outside but now he is felling good go out again. If I do a curve he will be staying in that night and for the next 12 hours.

 

[Marianne M]

Wonderful! Good job getting that all sorted so quickly. And kudos for home testing. Best tool we have to keep our little fur balls safe and healthy.
Simple blood test. I will start testing at 3+ or 5+ instead of 6+. And I was already thinking about dropping the Vetsulin to 1.5. Will do so tomorrow morning for a few days. Thanks for you insight. It is certainly appreciate by myself and Mango!
Looking at Mango's readings, it does appear his numbers are better on the 2u than on the 3u and 2u is a bit of a higher dose than we would normally recommend as a starting dose.



I'm delighted to hear Mango is active and eating well. Those everyday observations are just as important as all the numbers we collect. I'm still curious about both of you getting purple for ketones but alas, it doesn't sound like they are a problem for either of you. It is a good idea to keep an eye on ketones for a diabetic cat even though most vets don't mention it. Some cats are more prone to developing ketones than others.

Curiosity.....was the blood test done by the vet a fructosamine test or a simple test for Blood glucose? Glucose in the urine can occur even in a non-diabetic cat especially when they are under stress of any kind (vettie visit or not feeling well for instance) and kitties are notorious for elevated BG in the vet's office. A fructosamine test provides an indication of what BG has been over a period of 2 to 3 weeks prior and thus provides a much more definitive diagnosis of diabetes.

I think if you want to drop him back to 1.5u for a few cycles to see if his numbers improve, he should be fine. I'm wondering if the higher numbers today might be from a bounce (occurs as a result of BG dropping lower than kitty is accustomed to, too low or dropping a lot or quickly) from a lower BG yesterday given his pre-shot reading was lower. You've been getting mid cycle tests around +6 hours post shot many days. I'm guessing the vet may have suggested testing at that time. In any event, not all cats hit the peak action that late in the cycle. On the 28th Mango appears to have reached nadir around +4 post shot. The lowest point in the cycle (nadir) can occur as early as +3 and as late as +7 with the majority reaching nadir in the +3 to +5 time period. For that reason, if it's possible given your other commitments, it would be a good idea to check BG randomly between +3 and +6 to see how low the dose is taking Mango and determine roughly when he is reaching peak insulin action. The nadir can be fairly consistent in some cats while with others it moves around a bit which is why I'm suggesting randomly testing in that +3 to +6 time frame.