My vet didn't explain this well...

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Katsallday

Katsallday

Member Since 2021
Hi all! My name is Katrina and my newly diagnosed diabetic cat is named tuna. He was diagnosed on May 13th 2021. Tuna is 18 lb and 11 years old and the insulin he is using currently is vetsulin u-40, 2x a day. I genuinely feel like my vet was too busy to explain if I should change the amount of insulin I give him based on blood testing. The day his blood was tested in the vets It was at 500. I went out and bought a human blood glucose monitor even though my vet didn't tell me if I should or shouldn't. I just tested his blood tonight and it was reading at 289. I've read some posts here and I will be creating a chart of his blood sugar every two hours throughout the day tomorrow. I'm scared I won't know what to do if he does start needing less insulin because my vet did not explain how that works. My other cat mama has been being treated by the same veterinarian every day for almost 4 weeks for pneumonia. This is the final week of treatment and then I'll be able to focus solely on tuna. I wasn't expecting him to be a diabetic when I took him to the vet, I just did a wellness exam. He's lost 2 lbs since last year so I didn't think he would become diabetic losing weight.

Yesterday I asked the vet if I would need to change the amount of insulin based on blood tests but he said that the insulin is based on weight. I have a diabetic friend and that is not how she uses insulin. Does anyone have any advice on this topic? Is it true that vetsulin only changes dose with weight? Doesn't sound right to me.
 
Hi Katrina and Tuna and welcome to the forum. I hope your other cat Mama get well soon.
Well done going out and buying a glucose meter. We have a spreadsheet here you might like to set up and enter all your data onto. Then we could help you with dosing.
Here is the link https://felinediabetes.com/FDMB/threads/how-to-create-a-spreadsheet.241706/

If you have any trouble setting it up just let us know and we will help you
While the initial dose of insulin is based on weight, the dosing moving forward is based on what the blood glucose (BG)is telling us.
What dose of vetsulin is Tuna on at the moment? It’s important we can see the BG data when offering dosing advice.

What diet are you feeding him at the moment?
Are you feeding him and waiting 30 minutes before giving the insulin?

Here is a link for new members. It has useful information in it. Make sure you have a hypo kit set up ASAP as when you need it you don’t want to be scrambling looking for things to use. There is also a link to setting up your signature to tell us all about Tuna. We look at the signature and the SS when we help you.
Link
https://felinediabetes.com/FDMB/threads/new-how-you-can-help-us-help-you.216696/

Here are 2 links to vetsulin use
https://felinediabetes.com/FDMB/threads/introduction-to-cannisulin-vetsulin-n-nph.231602/

https://felinediabetes.com/FDMB/threads/beginners-guide-to-caninsulin-vetsulin.231587/

Keep asking as many questions as you like. We are happy to help.
Bron
 
Thank you so much! I have downloaded and printed out the hypo guides and the hypo kit as well. They're up on my fridge right now. His current dose of the insulin is 4 ml twice a day. Today was my first time testing his blood glucose and it took me over an hour to gain the courage to push hard enough with the lancet is it normal for a vet to tell you that you don't have to change dosage of insulin? The only reason I even brought the blood glucose monitoring up was because I was hypoglycemic when I was younger. He didn't bring it up at all! I'll do the signature right now!

On the insulin package it says to dose the insulin 5 minutes after eating?
 
Please feed 30 minutes before the dose is given.
4 units is a huge dose to start with.
If there were no ketones mentioned at diagnosis, I would go back to 1 unit twice a day which is the normal starting dose. You can always increase the dose if needed but much better to be safe.
I am not a Vetsulin user so will tag @JanetNJ and @Deb & Wink. Hopefully they will be around soon.
Can you take a photo of where you think 1 unit is in the syringe and post it please. You will need to copy and paste it as the attachment function isn’t working atm.
***You said the current dose was 4 mls... I’m hoping you meant 4 units.
 
Katrina PMed me and asked me what number she can shot at. I said I’d answer here on the forum.
PMPS due in about 30 minutes.
Katrina, can you take a a BG reading about 10 minutes before the insulin dose is due please and post it?
With vetsulin, because you don’t have any data, I would skip the dose if the BG is under 200.
 
My glucose meter just broke the lcd went dead I am freaking out. The last number it gave me was just "hi" not even a number and he just ate and now I'm learning this is a crazy high dose. I use the 20 units syringe and pull up to the 4 line idk what that means. On the insulin bottle it says to inject 5 minutes after eating
 
Katsallday said:
My glucose meter just broke the lcd went dead I am freaking out. The last number it gave me was just "hi" not even a number and he just ate and now I'm learning this is a crazy high dose. I use the 20 units syringe and pull up to the 4 line idk what that means. On the insulin bottle it says to inject 5 minutes after eating
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Try and stay calm...we will sort it out. He can’t have the dose for 30 minutes after eating so you have time.
Could it be that the battery has fallen out of the meter?
Are you in a position to go out and get another meter if necessary?

Can you take a photo of where you draw the insulin up to please ? I am concerned about the size of the dose. I am not a vetsulin user but I thought the syringes were U40 syringes not 20.
 
Why does my vet say 5 minutes after eating to do insulin? Is he just wrong? Covid shut down all my local stores past 9pm everything is closed, lcd display is cracked and the dye is bleeding into the glass the syringe says u40 on it but the numbers stop at 20
 
Katsallday said:
Why does my vet say 5 minutes after eating to do insulin? Is he just wrong? Covid shut down all my local stores past 9pm everything is closed, lcd display is cracked and the dye is bleeding into the glass the syringe says u40 on it but the numbers stop at 20
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Yes, your vet is wrong. Vetsulin should be given 30 minutes after food.
 
The food is hills prescription diet glucosupport 1/4 a cup 2x a day, my fiance just did the insulin as I am genuinely in a panic. It's been 25 minutes since he ate dinner all of it. The BG said hi at 2am then the screen cracked stupid CVS brand I just bought it today.today at the 6hour mark between doses it said 289
 
Katsallday said:
The food is hills prescription diet glucosupport 1/4 a cup 2x a day, my fiance just did the insulin as I am genuinely in a panic. It's been 25 minutes since he ate dinner all of it. The BG said hi at 2am then the screen cracked stupid CVS brand I just bought it today.today at the 6hour mark between doses it said 289
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How long ago was the hi at 2 am ? I am in Australia and I don’t know where you are or what time it is now.
So this is the morning dose?
 
The insulin was done at 3am. Tuna so far has shown no signs of hypo but I have honey ready. I was doing the insulin since Friday without a meter because my vet told me it was fine. I bought one today after finding this forum. I will get another meter asap, 8am tomorrow. before the meter broke it read hi 30 minutes before meal and after looking it up it only reads hi if the number is above 600. At the dip today it read 289.
 
Katsallday said:
The insulin was done at 3am. Tuna so far has shown no signs of hypo but I have honey ready. I was doing the insulin since Friday without a meter because my vet told me it was fine. I bought one today after finding this forum. I will get another meter asap, 8am tomorrow. before the meter broke it read hi 30 minutes before meal and after looking it up it only reads hi if the number is above 600. At the dip today it read 289.
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How much insulin did you give?
 
Katsallday said:
The 4 units, under 1/8 a ml
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I really think that is too high a dose.
Have a read of the vetsulin information I sent you in the link. It states the starting dose is 1 unit.

I see you are only feeding Tuna twice a day. We recommend you also feed during the cycle as well as the two meals before the dose.
Vetsulin hits fairly hard and fast so by +2 (2 hours after the dose of insulin) the BG is dropping quite a bit and peaks about +4 or +4.5 so it is a good idea to give a good snack at +2 and another +4.
Be aware that by the time a cat is showing signs of a hypo, they are very very low. By home testing you are able to see the drops and feed Tuns so he doesn’t drop too much
.
I would like to talk to you about food as well as the food you are feeding is not a good diabetic food, even though I’m sure the vet sold it to you. It’s too high carb but is probably saving Tuna from dropping too low with that big dose. Don’t swap to a more suitable food until you are home testing as the BG can drop 100 points with the withdrawal of high carb food.

Please let us know how you get on with Tuna and the meter as we worry about our kitties.
 
I just gave him some of my other cats food. It's been 2 hours. I'll make sure he gets more at the 4 hour mark too. I'll take any advice, I am livid with my vet. I was blending up tikicat wet food and mixing it with the vets food because he didn't like it that much. I'll have more info tomorrow as I'm gonna have to drop off and pick up my cat with pneumonia. After this I think he's ripping me off with that too. 200 a week for nebulization, I know they only spend cents on the amount of medicine that goes into the nebulizer.
 
I’m sorry you are going through all of this and I hope your other kitty is improving.

First thing is to get another human meter. You can get a ReliOn meter from Walmart vert cheaply and they are reliable. The strips that go with them are very reasonable.
While you are there you need to get a bottle of Ketostix from Walmart or a pharmacy so you can test the urine for ketones, which can form in unregulated diabetic cats.

Once you are testing the BGs you will be able to swap over to a low carb diet which I’m sure Tuna will like. Most cats don’t like the prescription diets. They are expensive and there is nothing special in them, dispute the marketing.

When you swap over to a low carb diet you will need to reduce the dose of insulin but we can help you with that.
While at the vet tomorrow I would ask him about swapping over to Lantus. You can buy it from Marks pharmacy in Canada...they ship it....and it is cheaper than buying in the US.

I’ll look forward to hearing from you tomorrow.
 
Katsallday said:
Hi all! My name is Katrina and my newly diagnosed diabetic cat is named tuna. He was diagnosed on May 13th 2021. Tuna is 18 lb and 11 years old and the insulin he is using currently is vetsulin u-40, 2x a day. I genuinely feel like my vet was too busy to explain if I should change the amount of insulin I give him based on blood testing. The day his blood was tested in the vets It was at 500. I went out and bought a human blood glucose monitor even though my vet didn't tell me if I should or shouldn't. I just tested his blood tonight and it was reading at 289. I've read some posts here and I will be creating a chart of his blood sugar every two hours throughout the day tomorrow. I'm scared I won't know what to do if he does start needing less insulin because my vet did not explain how that works. My other cat mama has been being treated by the same veterinarian every day for almost 4 weeks for pneumonia. This is the final week of treatment and then I'll be able to focus solely on tuna. I wasn't expecting him to be a diabetic when I took him to the vet, I just did a wellness exam. He's lost 2 lbs since last year so I didn't think he would become diabetic losing weight.

Yesterday I asked the vet if I would need to change the amount of insulin based on blood tests but he said that the insulin is based on weight. I have a diabetic friend and that is not how she uses insulin. Does anyone have any advice on this topic? Is it true that vetsulin only changes dose with weight? Doesn't sound right to me.
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The recommended starting dose is 1 unit twice a day. 4 units is extremely dangerous for a newly diagnosed cat. The dosage is not determined by weight in cats.
 
Katsallday said:
I just gave him some of my other cats food. It's been 2 hours. I'll make sure he gets more at the 4 hour mark too. I'll take any advice, I am livid with my vet. I was blending up tikicat wet food and mixing it with the vets food because he didn't like it that much. I'll have more info tomorrow as I'm gonna have to drop off and pick up my cat with pneumonia. After this I think he's ripping me off with that too. 200 a week for nebulization, I know they only spend cents on the amount of medicine that goes into the nebulizer.
Click to expand...
I had a kitten with pneumonia.... I used my own nebulizer. I put her in a carrier and put a towel over it and put the nebulizer tube through the grate.
 
Hi all. Tuna is ok, my vet didn't explain why they have him on such a high dose. All I know is his blood sugar was at 500 the day they checked. I don't have his blood work results yet either. Did all your vets start you guys on a low dose at first? Did they explain how to raise and lower dose amounts according to blood glucose levels?
 
I finally got a new BG tester. Tuna is at 416 with 2 hours until food is served

Edit: I am changing tunas insulin to 2 units and putting him solely on tikicat wet food. Will update soon. I'm getting the ketone sticks right away. Thank you all I will take any advice anyone has. You all are likely saving my cats life. I've had him since he was 2 days old, I won't let a vet take him from me
 
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Hi Katrina.
I’m glad you got another meter and Tuna is ok.
We would recommend you started at 1 unit especially if you are swapping to an all low carb diet.
Make sure you test before every shot to see it is safe to give the shot. Feed 30 minutes before the dose. Then I would recommend you test at +1 and +2 the first few cycles to get an idea of how he is going with the dose. If he’s not dropping too low I would test again at +4 and +6. If at any time you are concerned you can test sooner. This will give valuable data as to how he’s handling the dose.
I’d also feed him at Preshot, +2 and +4.

Let us know how you go with the urine ketone test. That’s read exactly 15 seconds after dipping it in the urine.
 
Thank you I didn't know the timing on the ketone stick. So far today I have:

1 full can of tikicat no gravy cat food @2:30 pm


12:30 pm 416
2:12 pm 439 (preshot)
1 full can of tikicat no gravy cat food @2:30 pm
2 unit dose of vetsulin at @3 pm
3:45 on 483
4:16 pm 468
5:36 pm 400

How is that looking? I fired my vet after he pushed that insulin is based on weight today.
 
Hi Katrina
Would you mind using the + number of hours after the dose please as then we all understand. Remember I am in Australia and it’s 9am here so your times mean nothing to me. Thanks!
Don’t forget to enter the data onto the SS and in the remarks column of the SS put in the type of food, how much and when given.
 
Bron and Sheba (GA) said:
Hi Katrina
Would you mind using the + number of hours after the dose please as then we all understand. Remember I am in Australia and it’s 9am here so your times mean nothing to me. Thanks!
Don’t forget to enter the data onto the SS and in the remarks column of the SS put in the type of food, how much and when given.
Click to expand...

I apologize for the wrong setup on the info, and Thank you for reminding me about the sheet. It's been a flurry today. I've never fired anyone. Now I'm on the hunt for a feline diabetes specialist. I will cancel my wedding in December before I let this cat get sicker. No price is too high. I'm so stressed right now I don't know what I'd be doing without this forum
 
Please don’t apologise. It’s all new to you and we don’t expect you to know everything straight away. We use that terminology so that everyone in the world understands how far along your kitty is in the cycle.
As far a a new vet is concerned, you’ll be lucky to find a diabetic specialist . You just need a vet who is willing to work with you in partnership and is happy for you to home test and for you to do the dosing with the help of this forum.

You might like to start a separate thread and ask if anyone has a recommendation for a vet in your general area.

I know it’s hard but try and relax. You are on the right track now. You have the right food, are hometesting, are going to test for ketones and have the SS set up. Now we gather data while keeping Tuna safe.
Moving forward shouldn’t cost a lot of money. The cost of the strips is the main ongoing thing.

Tuna could be bouncing atm so it could be a couple of days before we see a drop in his numbers so don’t worry. Keep posting and we will look at his SS.

Keep asking questions.
You are doing a great job getting Tuna sorted out, he’s a lucky boy to have you!
 
Deep breath, hold, release, deep breath, hold, release.

Take your time. We’ll help you as much as we can.

I’m thinking that even 2U of Vetsulin is too much, especially since you switched to low carb food. I would not recommend more than 1U for now.
 
Deb & Wink said:
Deep breath, hold, release, deep breath, hold, release.

Take your time. We’ll help you as much as we can.

I’m thinking that even 2U of Vetsulin is too much, especially since you switched to low carb food. I would not recommend more than 1U for now.
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He didn't get under 200 at his nadir today, you think one unit will help that? He's still only had one can if wet food and it's been 6 hours
 
Have you entered the BGs on the SS yet Katrina? I can’t see any.
Also remember he could be bouncing still which keeps up the BG.
I’ll let @Deb & Wink comment on the dose because I don’t use Vetsulin.
Is that one can including the Preshot meal? How big is the can!
 
Bron and Sheba (GA) said:
Have you entered the BGs on the SS yet Katrina? I can’t see any.
Also remember he could be bouncing still which keeps up the BG.
I’ll let @Deb & Wink comment on the dose because I don’t use Vetsulin.
Is that one can including the Preshot meal? How big is the can!
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He's always been more of a grazer but the box says that according to his body weight he needs around 6 to 7 cans a day. I don't know how often to feed him with the insulin so that his blood glucose doesn't go through the roof? Should I feed him at nadir?
 
The best way to work it out is to decide how much food he is going to have for a cycle.... that is the 12 hours from the Preshot meal until, but not including, the next Preshot meal. We say don’t feed for the 2 hours before the Preshot BG so that the Preshot number is not food influenced.
So you have the amount you want him to eat for the cycle. Now divide that up into the main meal before the shot of insulin, and two or three snacks preferably during the first half of the cycle.
Yes a snack around nadir helps stop the BG dropping too low.
If he is a grazer you can leave the food down for him to graze on. Just take it away at +10.
How big are your cans?
 
Bron and Sheba (GA) said:
The best way to work it out is to decide how much food he is going to have for a cycle.... that is the 12 hours from the Preshot meal until, but not including, the next Preshot meal. We say don’t feed for the 2 hours before the Preshot BG so that the Preshot number is not food influenced.
So you have the amount you want him to eat for the cycle. Now divide that up into the main meal before the shot of insulin, and two or three snacks preferably during the first half of the cycle.
Yes a snack around nadir helps stop the BG dropping too low.
If he is a grazer you can leave the food down for him to graze on. Just take it away at +10.
How big are your cans?
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The thing is is I currently take care of 16 cats. I used to run a cat rescue and these cats are all the leftovers besides tuna. I can't just leave food around because all the other cats will get into it and the dog. The can size is 2.8oz. his treats are freeze dried salmon
 
Bron and Sheba (GA) said:
The best way to work it out is to decide how much food he is going to have for a cycle.... that is the 12 hours from the Preshot meal until, but not including, the next Preshot meal. We say don’t feed for the 2 hours before the Preshot BG so that the Preshot number is not food influenced.
So you have the amount you want him to eat for the cycle. Now divide that up into the main meal before the shot of insulin, and two or three snacks preferably during the first half of the cycle.
Yes a snack around nadir helps stop the BG dropping too low.
If he is a grazer you can leave the food down for him to graze on. Just take it away at +10.
How big are your cans?
Click to expand...

To confirm, +10 is 2 hours until preshot test right?
 
Oh my goodness, you are an angel to be caring for so many cats. You must share some photos of all the kitties!

With the food, an 18 lb cat would eat around 340 to 360 calories a day, if he is not overweight. You may be able to find larger low carb cans that are more economical to buy.
What are you feeding all the other cats? Is Tuna able to get into their food?

Also I still can’t see any data in the SS yet. Do you need help with that?
Are you happy with the 3am : 3pm shot times? That can be changed, if other times would work better for you.

Katsallday said:
To confirm, +10 is 2 hours until preshot test right?
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Correct.
 
Bron and Sheba (GA) said:
Oh my goodness, you are an angel to be caring for so many cats. You must share some photos of all the kitties!

With the food, an 18 lb cat would eat around 340 to 360 calories a day, if he is not overweight. You may be able to find larger low carb cans that are more economical to buy.
What are you feeding all the other cats? Is Tuna able to get into their food?

Also I still can’t see any data in the SS yet. Do you need help with that?
Are you happy with the 3am : 3pm shot times? That can be changed, if other times would work better for you.


Correct.
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oh im no angel, they all are. everyday these cats show me how much stray cats can truly love. Since tuna got his diagnosis i have taken away free feeding from everyone. they all eat 3 times a day, and tuna was supposed to be twice a day per the vets instructions. i keep the other cats food in a cupboard that requires thumbs lol. all the cats besides tuna are on the costco kirkland signature maintenance cat. it has pretty good ingredients and is well priced. tuna is most certainly overweight unfortunately. hes at 18lbs last i checked and the ex vet said he should be at 12 :(

please excuse the spelling/grammatical errors, i am on my computer to make the SS sheet right now! the shot times are the best i can do. my fiance is the one that does it as i will faint if i try to do it myself. i hate needles. he works as a server and leaves the house at 3:15pm and gets home at 2:55am so this was the only option on his work days. i truly appreciate your help and i would love to post all my kitties! what board would be a proper place to post such a thing?
 
Katsallday said:
oh im no angel, they all are. everyday these cats show me how much stray cats can truly love. Since tuna got his diagnosis i have taken away free feeding from everyone. they all eat 3 times a day, and tuna was supposed to be twice a day per the vets instructions. i keep the other cats food in a cupboard that requires thumbs lol. all the cats besides tuna are on the costco kirkland signature maintenance cat. it has pretty good ingredients and is well priced. tuna is most certainly overweight unfortunately. hes at 18lbs last i checked and the ex vet said he should be at 12 :(

please excuse the spelling/grammatical errors, i am on my computer to make the SS sheet right now! the shot times are the best i can do. my fiance is the one that does it as i will faint if i try to do it myself. i hate needles. he works as a server and leaves the house at 3:15pm and gets home at 2:55am so this was the only option on his work days. i truly appreciate your help and i would love to post all my kitties! what board would be a proper place to post such a thing?
Click to expand...
Here is a link to helping a cat lose weight. You will still need to make sure he is eating enough throughout the day and evening for the insulin he is getting. It is best to try and give the same amount each cycle.
https://www.allfelinehospital.com/getting-your-cat-to-lose-weight.pml

I still can’t see anything on the SS. Have you added any numbers yet?
If those preshot times work for you don’t change them. Do you work from home?
I think it would be fine to post a couple of photos of your kitties here on this thread.
 
Bron and Sheba (GA) said:
Oh my goodness, you are an angel to be caring for so many cats. You must share some photos of all the kitties!

With the food, an 18 lb cat would eat around 340 to 360 calories a day, if he is not overweight. You may be able to find larger low carb cans that are more economical to buy.
What are you feeding all the other cats? Is Tuna able to get into their food?

Also I still can’t see any data in the SS yet. Do you need help with that?
Are you happy with the 3am : 3pm shot times? That can be changed, if other times would work better for you.


Correct.
Click to expand...

Tunas most recent BG was 289. His preshot test is in less than an hour. Based on that should I cut back the 2 unit dose to 1?
 
Katsallday said:
Tunas most recent BG was 289. His preshot test is in less than an hour. Based on that should I cut back the 2 unit dose to 1?
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Looks like he is coming off a bounce.
See what the preshot BG is but I would reduce to 1 unit and stay at that unless he drops under 90, in which case you would reduce further.
 
Do you think he could bounce to 90 tonight? I have been taking his bg for over 12 hours now and I'm exhausted and need sleep
 
Katsallday said:
Do you think he could bounce to 90 tonight? I have been taking his bg for over 12 hours now and I'm exhausted and need sleep
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Its not a bounce to 90. it would be a drop.
I have no real idea what he might do as we really haven't seen any data yet.
What I would do is give the 1 unit if the preshot is 200 or over 30 minutes after the preshot meal.
Then I would get a +1 and a +2 to see how he's going. I will be around so post the BG and we can see when you should next post. Give him snack at +2
I used to set the alarm when I needed to test at night. Trying to stay up all night will make you exhausted. If you think you might sleep through the alarm put it further away from the bed so you have to get up.
How does that sound
 
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