Lily diagnosed today

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Hi Sally and Lily and Welcome to the FDMB!

First, yes, 2 units of Vetsulin is a high starting dose. Most cats should be started at .5 to 1 unit twice a day. It's a lot safer to start low and gradually go up as needed than to start high and risk a hypoglycemic crisis.

Vetsulin is a better insulin for dogs than cats, but some do OK on it. A lot of vets use it just because it's what they're used to using. They see more diabetic dogs than cats so when they do have a sugarcat, they just treat them like a small dog. It usually doesn't work very well.

What are you feeding Lily? A diabetic cat needs to be eating a low carb canned or raw diet (and it doesn't need to be any "prescription" food either!) Most of us feed our own cats Fancy Feast Classics, Friskies pates or 9-Lives ground because they're low carb, easy to find and affordable.

If you're not currently feeding a low carb food, be sure you learn to home test before you change the diet (If you're already giving insulin). Reducing the carbs in the diet can drastically reduce the need for insulin too!

If your vet didn't mention any sign of ketones, it's actually safer to do the diet change first (and some lucky kitties go into remission just from the diet change!). It also gives you a little time to learn to home test so if you DO end up needing insulin, you'll be ready to keep Lily safe.

Keep asking questions! The people here are very generous with their time and only want the best for you and your "extra sweet" Lily!

Here's some reading for you on How you can help us help you!
 
tiffmaxee said:
Hi and welcome. Any chance you can get Lantus for Lily instead? It works so much better for cats. I’ve never used Vetsulin as it’s more commonly used for dogs. That is too high a dose from what I have read. Most seem to start on .5 or 1.0 Hopefully someone with experience will come on to help you. I’m only experienced with Lantus and Levimar.
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I will talk to her vet about switching. Thank you very much.
 
Hi again, Sally. :)

It can take a couple of days for a cat's body to get used to receiving insulin, and sometimes they can get a bit lethargic as a consequence. Also, the action of Vetsulin can drop blood glucose (BG) levels fairly hard and fast in the early part of of each 12-hour cycle. That, too, can make a kitty feel a bit groggy. It's definitely something that needs to be monitored. It would be helpful to you and your vet to make brief notes of how Lily's energy levels vary in relation to when she gets her insulin doses. These observations can help you build up a picture of Lily's pattern of response to her Vetsulin.

I recommend keeping quite a close eye on Lily over the next few days to see how she gets on, particularly in the first 3-6 hours after giving the Vetsulin (the period of its strongest effect).

Have you started home testing Lily's BG levels yet?


Mogs
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Here's a graph of a cat's 'ideal' response to Vetsulin, to give you an idea of how this insulin typically works:


eADcxbPJ2JnNh2lSNJND0_wT4yz4A3Y71CrTNoDJfbWfCTH5m_LSx8bIqc_8XsNxdIIVibS6Rm5BUf37WIe3XPJwQjh4EPhui-nFcwaX6hNFLSfU3NpFvo8wwzZNTc1CUPzdzC--



Mogs
.
 
Critter Mom said:
Hi again, Sally. :)

It can take a couple of days for a cat's body to get used to receiving insulin, and sometimes they can get a bit lethargic as a consequence. Also, the action of Vetsulin can drop blood glucose (BG) levels fairly hard and fast in the early part of of each 12-hour cycle. That, too, can make a kitty feel a bit groggy. It's definitely something that needs to be monitored. It would be helpful to you and your vet to make brief notes of how Lily's energy levels vary in relation to when she gets her insulin doses. These observations can help you build up a picture of Lily's pattern of response to her Vetsulin.

I recommend keeping quite a close eye on Lily over the next few days to see how she gets on, particularly in the first 3-6 hours after giving the Vetsulin (the period of its strongest effect).

Have you started home testing Lily's BG levels yet?


Mogs
.
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That makes me feel much better. I gave her the insulin this morning at 8am and just now she has started playing a little with a mouse! So relieved. I am on my way to get some test strips and a meter and will test before her next dose this evening. Appreciate your support ! Sally
 
Hi Sally,

I'm glad to hear that Lily's brighter now. (((Lily)))

When you're picking up your testing bits 'n' pieces, there are suggestions in the following thread about higher carb foods and treats to grab for Lily's FD toolkit:

Hypo Toolbox

When you're getting lancets, make sure that they're 28 or 29 gauge (makes getting blood samples easier).

Here are the links you need to set up Lily's spreadsheet:

FDMB Spreadsheet Instructions

Understanding the Spreadsheet Grid

If you need assistance setting up the spreadsheet just holler and we'll find someone to help. :)


Mogs
.
 
Critter Mom said:
Hi Sally,

I'm glad to hear that Lily's brighter now. (((Lily)))

When you're picking up your testing bits 'n' pieces, there are suggestions in the following thread about higher carb foods and treats to grab for Lily's FD toolkit:

Hypo Toolbox

When you're getting lancets, make sure that they're 28 or 29 gauge (makes getting blood samples easier).

Here are the links you need to set up Lily's spreadsheet:

FDMB Spreadsheet Instructions

Understanding the Spreadsheet Grid

If you need assistance setting up the spreadsheet just holler and we'll find someone to help. :)


Mogs
.
Click to expand...
Awesome, thanks!
 
Welcome Sally & Lily.
What a beautiful coat I bet that takes some brushing!
Mac was originally on caninsulin (UK name for vetsulin) and only started on 1 iu, after the 10 days later BG curve he went up to 1.5 iu. He reacted to the shots well but as others say above had a very steep drop in the first 2 hours then a slower drop until it rose again quite early on. After the next 10 day BG curve we arranged with the vet to change to prozinc as is supposed to give a gentler curve. Started on 1 iu then went up to 1.6iu. Has just had his 10 day BG curve and vet is going to keep on that for now.
Glad your Lily is starting to seem better in herself.
Gill
 
Gill & Mac (UK) said:
Welcome Sally & Lily.
What a beautiful coat I bet that takes some brushing!
Mac was originally on caninsulin (UK name for vetsulin) and only started on 1 iu, after the 10 days later BG curve he went up to 1.5 iu. He reacted to the shots well but as others say above had a very steep drop in the first 2 hours then a slower drop until it rose again quite early on. After the next 10 day BG curve we arranged with the vet to change to prozinc as is supposed to give a gentler curve. Started on 1 iu then went up to 1.6iu. Has just had his 10 day BG curve and vet is going to keep on that for now.
Glad your Lily is starting to seem better in herself.
Gill
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Oh Mac is beautiful! I have a black panther too!! So glad he is doing well.
 
Hi Sally,

Sally and Lily said:
Hey, she is at 137 4 hours after her dosage and eating.
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So sorry I didn't get back to you till now. Being pulled in several directions today between here and looking after my own civvie, Lúnasa.

Between the preshot readings and the +4 137 you got today, it is an initial indication that Lily seems to be doing OK on her current Vetsulin dose, but as you accumulate more BG readings it will build up a fuller picture as you go along. If you can get a reading at +7 or +8 then it would give you a hint of how long the dose is lasting.


Mogs
.
 
Critter Mom said:
Hi Sally,


So sorry I didn't get back to you till now. Being pulled in several directions today between here and looking after my own civvie, Lúnasa.

Between the preshot readings and the +4 137 you got today, it is an initial indication that Lily seems to be doing OK on her current Vetsulin dose, but as you accumulate more BG readings it will build up a fuller picture as you go along. If you can get a reading at +7 or +8 then it would give you a hint of how long the dose is lasting.


Mogs
.
Click to expand...
Ok, thanks I will check her again around 3:30 and let you know.
 
Whoa! Glad I asked you to check, Sally.

The 77 is a safe BG number but it's quite low for this late in the cycle on Vetsulin. I suggest you give Lily a small feed of her regular food and test her BG again in 30 minutes.

Can I just double-check with you which meter type you're using: is it a Relion or an Alphatrak?

Also, is your vet open this afternoon for telephone calls?


Mogs
.
 
Critter Mom said:
Whoa! Glad I asked you to check, Sally.

The 77 is a safe BG number but it's quite low for this late in the cycle on Vetsulin. I suggest you give Lily a small feed of her regular food and test her BG again in 30 minutes.

Can I just double-check with you which meter type you're using: is it a Relion or an Alphatrak?

Also, is your vet open this afternoon for telephone calls?


Mogs
.
Click to expand...
Ok, will feed her and check again. No, they are only open until noon on certain Saturday’s.
 
I was hoping that your vets would be open because I wanted you to speak to them about Lily's dose because it's too high. Certainly according to the FDMB Vetsulin/Caninsulin Guide, that 77 merits an immediate dose reduction.


Some important questions:

1. Which meter are you using - Relion or Alphatrak (so that we can interpret the BG results properly). [Cross-posted! :) ]

2. Is it the Purina DM canned food that you're giving to Lily now?

3. Was Lily still eating a high carb diet when your vet did the BG tests to determine her starting dose?


Mogs
.
 
Critter Mom said:
I was hoping that your vets would be open because I wanted you to speak to them about Lily's dose because it's too high. Certainly according to the FDMB Vetsulin/Caninsulin Guide, that 77 merits an immediate dose reduction.


Some important questions:

1. Which meter are you using - Relion or Alphatrak (so that we can interpret the BG results properly). [Cross-posted! :) ]

2. Is it the Purina DM canned food that you're giving to Lily now?

3. Was Lily still eating a high carb diet when your vet did the BG tests to determine her starting dose?


Mogs
.
Click to expand...
Yes, she is on the DM food now but wasn’t when she had her blood tested initially. She was on the Royal Canin urinary SO. I used that for all my babies because one needed it and it was just easier to feed all of them the same kind. I have 6.
 
Sally and Lily said:
Yes, she is on the DM food now but wasn’t when she had her blood tested initially. She was on the Royal Canin urinary SO. I used that for all my babies because one needed it and it was just easier to feed all of them the same kind. I have 6.
Click to expand...
I did her BG after fended her a bit of food. She is at 136 now. I am do to feed her again at 7:30 and give her Vetsulin. Do you think I should cut it in half and only vice her .50?
 
Here's what the FDMB Vetsulin/Caninsulin Guide has to say about starting dose and dose adjustments:

Starting Dose
  • Usually it’s best to start with a low dose of not more than one unit (1.0u), twice a day. The manufacturer recommends a starting dose of 0.25u to 0.5u per kg body weight.
    • If your cat is on a low carbohydrate (less than 10% carb), canned or raw food diet (there are a few select dry foods that are low carb) and blood glucose is less than 380 mg/dL (or < 20 mmol/L) the starting dose should be 0.5u.
    • If your cat is on a diet that is over 10% carb and blood glucose is over 380 mg/dL (or > 20 mmol/L), you can start at 1.0u.
    • If you are transitioning your cat to a low carb diet, your starting dose should be 0.5u.
  • For those new to dealing with feline diabetes we recommend that you post and ask for help if the BG is below 200 mg/dL (11 mmol/L) on a human glucose meter. Please post both here and on the Health forum especially is you see this forum isn’t busy. (For more information on what these numbers mean see ‘Home Blood Glucose Testing’ information below.)

Changing the Dose

Hold the starting dose for at least a week UNLESS

  • your cat won’t eat or you suspect hypoglycemia
  • your kitty falls below 90 mg/dL (5 mmol/L). If kitty falls below 90 mg/dL (5 mmol/L) decrease the dose by 0.25 unit immediately.

[Emphasis mine]​


@JanetNJ, @Panic:

Considerations:

* Lily was eating high carb (RC Urinary s/o) when vet set starting dose at 2.0IU Vetsulin.
* Following FDMB input, Sally instead started on 1.0IU Vetsulin.
* Lily has been eating a low carb food (Purina DM canned) since Thursday. She started on insulin at the same time.
* 1.0IU BID dose of Vetsulin led to drop in BG to 77 at +8 today (human meter) so a dose reduction is indicated.
* For the data available, the preshot BGs are less than 380.
* No history of ketones reported to date.

Based on the above considerations and the FDMB Guidelines for Vetsulin dosing, at minimum the current 1.0IU dose should be reduced to 0.75IU but I think that a greater reduction is justified because Lily has only just started on Vetsulin, she has been switched to low carb food at the same time, and she now meets the FDMB starting dose criteria for a 0.5IU dose.

I think that a dose reduction to 0.50IU is indicated now (or maybe even 0.25IU given the diet change?). I'd be grateful if you could review my reasoning and comment on whether you would consider a dose of 0.50IU is safer (or share any other suggestions you can think of).


Mogs
.
 
Last edited:
Sally and Lily said:
I did her BG after fended her a bit of food. She is at 136 now. I am do to feed her again at 7:30 and give her Vetsulin. Do you think I should cut it in half and only vice her .50?
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Cross-posted again, Sally. :)

Couple of questions:

1. At what '+' time did you give Lily the food? (And please don't feed any more for now!)

2. How long in hours and minutes till Lily's next dose is due? (I'm in a different time zone to you.)



Mogs
.
 
Critter Mom said:
Here's what the FDMB Vetsulin/Caninsulin Guide has to say about starting dose and dose adjustments:

Starting Dose
  • Usually it’s best to start with a low dose of not more than one unit (1.0u), twice a day. The manufacturer recommends a starting dose of 0.25u to 0.5u per kg body weight.
    • If your cat is on a low carbohydrate (less than 10% carb), canned or raw food diet (there are a few select dry foods that are low carb) and blood glucose is less than 380 mg/dL (or < 20 mmol/L) the starting dose should be 0.5u.
    • If your cat is on a diet that is over 10% carb and blood glucose is over 380 mg/dL (or > 20 mmol/L), you can start at 1.0u.
    • If you are transitioning your cat to a low carb diet, your starting dose should be 0.5u.
  • For those new to dealing with feline diabetes we recommend that you post and ask for help if the BG is below 200 mg/dL (11 mmol/L) on a human glucose meter. Please post both here and on the Health forum especially is you see this forum isn’t busy. (For more information on what these numbers mean see ‘Home Blood Glucose Testing’ information below.)

Changing the Dose

Hold the starting dose for at least a week UNLESS

  • your cat won’t eat or you suspect hypoglycemia
  • your kitty falls below 90 mg/dL (5 mmol/L). If kitty falls below 90 mg/dL (5 mmol/L) decrease the dose by 0.25 unit immediately.

[Emphasis mine]​


@JanetNJ, @Panic:

Considerations:

* Lily was eating high carb when vet set starting dose at 2.0IU Vetsulin.
* Following FDMB input, Sally instead started on 1.0IU Vetsulin.
* Lily was on a high carb diet (RC Urinary s/o) when starting dose was set.
* Lily has been eating a low carb food (Purina DM canned) since Thursday. She started on insulin at the same time.
* 1.0IU BID dose of Vetsulin led to drop in BG to 77 at +8 today (human meter) so a dose reduction is indicated.
* For the data available, the preshot BGs are less than 380.
* No history of ketones reported to date.

Based on the above considerations and the FDMB Guidelines for Vetsulin dosing, at minimum the current 1.0IU dose should be reduced to 0.75IU but I think that a greater reduction is justified because Lily has only just started on Vetsulin, she has been switched to low carb food at the same time, and she now meets the FDMB starting dose criteria for a 0.5IU dose.

I think that a dose reduction to 0.50IU is indicated now (or maybe even 0.25IU given the diet change?). I'd be grateful if you could review my reasoning and comment on whether you would consider a dose of 0.50IU is safer (or share any other suggestions you can think of).


Mogs
.
Click to expand...

Hi Mogs, I definitely want to decrease her insulin to .50 and see how she does. I didn’t realize her previous food was so high in carbs. I might think about switching my other cats except for the one that needs it. Thank you for all this information, I have learned a lot since I have been on this forum.
 
Hi Sally, I agree with Mogs. On Vetsulin you do not want them falling below 90 (possibly 100 if Alphatrak, someone correct me if I'm mistaken) so I would say it's safer to go to 0.50u considering the drop + food change. We can always go back up if needed but better safe than sorry. :)
 
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