Update on Biscuits

[Karen & Biscuits]

Hey Friends, just thought I'd give you a quick update on what happened with Biscuits last night and at the vet today. Last night she really scared me when she stopped responding to me. I don't know what happened to her, she was just laying on a chair and when I called to her, she didn't answer me by turning her head. Not totally unusual but when I said the word "Treat", she didn't respond to that either. I went to pick her up and she was totally listless, with this really blank stare. At that point I thought I was about to lose her. I moved her around in my arms and she made no eye contact, she didn't respond to my voice, and when I put her up against my shoulder, which is what she prefers, she didn't grab onto my shoulder as she usually does. I was starting to panic a little internally, thinking this was it and I killed my cat by not getting her sugar regulated faster. I took her to the other bedroom down the hall where the lady I take care of was, and put her on the bed, asking her to watch her while I got dressed to rush out to the vet. She says "Why?" and I said I think she's dying and I need to get her out there before that happens. She started calling Biscuits name and immediately Biscuits got up and went to her on the bed, rubbing her face against her hands and tail up high as if she was super excited to see her. I stood there in shock. Moments before she was unresponsive to me and scaring me into thinking she was dying and here she is playing with "granny" as we call her. Finally I went to her again and started petting her and she rubbed my hand with her face and was purring up a storm. What on earth was that???? It still makes no sense! I stayed up almost all night with her, keeping one eye open and watching her breathe to make sure she would hang on until we were able to get to the vet in the morning. I wasn't going to go through that mess twice!
She spent most of the day at the vet, and they did some bloodwork. Everything looked perfect except her glucose, which we expected would be high. They could not find the source of her fever, which was running at 104.5F when the vet tech took her vitals. Her weight remained steady at 12 lbs, which was good. I told the vet about this incident when she called me later in the afternoon and she said it made no sense to her etiher, other than maybe she had been in a deep sleep and when I went to her it stunned her and she wasn't really fully awake. She ruled out a seizure as there was no evidence of that at all. She said to keep an eye on her for future episodes like that but if nothing happens again, then to just chalk it up to no big deal and that she just wasn't totally alert when I woke her up. We spoke at length about her insulin and glucose levels and are FINALLY on the same page about changing her insulin. As of tomorrow morning, she is starting on Levemir, two units twice a day. I would have preferred Lantus but the lady I live with and take care of is already on Levemir and she's fine with me using it on Biscuits, so since it's free that way, I can use it indefinitely. Win-win right? I did ask the vet about dosage because what Miss Pat uses is a Flex-pen with the little pen needles and I wanted to be 100% certain that using the pen needles and just the dial on the pen would be sufficient. Dr. France said it should be fine but to do a curve test tomorrow and again on Monday and let her know what her readings are and we'll adjust it as necessary. She even gave me a bottle of test strips for my Alpha Trak meter so we can continue with accurate readings.
They also gave Biscuits a 2-week antibiotic, just as a precaution in case there was infection that they didn't find on the bloodwork. They also gave her a shot of Onsior for pain and this is where things get interesting. When I took her sugar reading tonight, she was down to 271, which is the lowest it has been in a very long time. I was pleased about that but it brings me back to my question from some time ago. Could her high sugar levels be caused by pain? I know it happens with the lady I take care of. She has chronic pain and when it gets really out of hand, her sugar readings go sky high. Could it be the same for a cat? Is her neuropathy painful and maybe that's why she's keeping her glucose levels up? The Onsior shot is for pain and inflammation, also helps to bring the fever down. Think ibuprofen for humans - same thing but for cats. Suddenly her sugar comes way down and she's happy and alert tonight. It makes sense doesn't it?
I just wonder if that's where the issue is, she's in chronic pain from the neuropathy and maybe that's something the vet needs to explore a bit more. Maybe it wasn't the Vetsulin not working but rather that the pain was working against it. It's a theory, but I don't know what to make of it. I just know that in humans chronic pain can and often does cause high glucose readings.
One of the techs that brought Biscuits to me when I picked her up later this afternoon, said that she also gave her some sub-q fluids to help with dehydration and fever, which also helps to perk her up. She's had that before and it works beautifully. Overall she is much better tonight. I only gave her 4 units of Vetsulin tonight because I didn't want her sugar to bottom out while I try to sleep. I really need sleep after last night.
So this is where things are at for now. Hopefully the Levemir will do the trick and we'll start to see a big improvement in her sugar levels over the next few days.
I am exhausted but thankful that I still have my baby girl and she's okay. I didn't need that stress but it is what it is. I'll do anything to ensure she is healthy and happy and if a trip to the vet is what it takes, so be it.
If anyone here has used Levemir on their cat, please let me know what your experience is with it, how the cat is doing on it and any advice/tips you have. I love this group and I am thankful for all the advice I've gotten so far. This has been beyond helpful to me and I am so grateful to those of you who have stepped up to help. Wishing you all a wonderful New Year's eve - keep your furries safe tonight while we endure endless hours of fireworks.
I will be holding 2 out of 4 dogs for at least 4 hours and spending the next 3 days looking for my feral cats outside because many of them will scatter for awhile. I despise NYE for that reason. I hate it for the animals but hoping it won't be too bad this time around. Guess we'll see!
Have a great night everyone!

 

[Bron and Sheba (GA)]

Thanks for the update on Biscuits.
Levemir is a very good insulin for cats. It has a a later nadir than Lantus, and nadir can be around 6 to 8 hours after the shot. Also the onset of Levemir is later around 3 to 4 hours after the shot. So you don’t need to feed Biscuits 30minutes before the shot. You can test, feed and shot one after the other with Levemir. Also give him some snacks during the first half of each cycle.

To see how the dose of Levemir is working you will need to get at least one test in during both the am and the pm cycles each day. Just getting the preshot will not tell you how the dose is working. It will just tell you is it is safe to give the dose.

As of tomorrow morning, she is starting on Levemir, two units twice a day

Two units twice a day is not going to be enough insulin for Biscuits if you have been giving 6.5 units twice a day of vetsulin. What is the current dose of insulin? Reducing it to 2 units runs the risk of ketones forming in the urine. Do you have a bottle of Ketostix to test the urine for ketones? EDIT…reading back through your posts I see Biscuits had DKA a few months ago.
I am going to tag @Wendy&Neko to see what dose she advises.

 

[Bron and Sheba (GA)]

I see on your other post you have bought a ReliOn prime meter. Are you going to swap over to it? If so we will need to adjust the SS for you.
You use it in exactly the same way as the alphatrak meter and just record the readings. You don’t need to make any adjustments at all.

I have just been reading back through your posts and I see that Biscuits had DKA. Could you put that in your signature please as it’s important when we make dosing decisions.

I also saw where you said she also had muscle spasms after she was diagnosed and they almost looked like seizures. Did you ever test the blood glucose to see if she was really low when this happened?

also you said the BG was down to 271 tonight. Was that a preshot BG or during the cycle BG?

 

[Diane Tyler's Mom GA]

Here is your previous post
https://www.felinediabetes.com/FDMB/threads/please-pray-for-biscuits.257211/#post-2894554

I guess you didn't see what I said in your previous post
Have you read about the dosing methods for Levemir? What dose will you be starting her on?
Do you have the U-100 syringes with half unit markings? We adjust doses by 0.25 units.

If your lady friend uses the Pen you can only adjust by whole units . You really need to be testing after her PMPS also just not the pre shot. You need to see how the insulin is /working and how low she is dropping. Please read what Bron wrote concerning Levimer above

If you're not sure on what dose to start with or get some advice I would post on the Lantus/ Levemir forum since you already have your signature and SS set up.
Don't forget to change your signature for Biscuits that you switched to Levemir and the Date and also on your on your SS you can put a line above the date you start Levimer and put Started Levimer
I hope the Covenia and Onisor helps

I see on your SS you haven't tested since 11-5-21 is there a reason why?
https://felinediabetes.com/FDMB/thr...-low-go-slow-slgs-tight-regulation-tr.210110

You can read more about Levimer here

https://www.felinediabetes.com/FDMB/forums/lantus-levemir-biosimilars.9/

@feralcatmama

 

[Wendy&Neko]

The last entry I see on the spreadsheet is November 5th. Any chance of updating it for the last two weeks of data? I can't comment on dose with old data.

And yes, Levemir is a much better insulin than Vetsulin. You should probably use a different pen than the one the lady you live with uses. And get some U-100 3/10cc syringes with half unit markings to use with it.

 

[Sienne and Gabby (GA)]

As several people are noting, Levemir is a MUCH better insulin than Vetsulin for any number of reasons. It's dosed the same way as Lantus despite their pharmacology being a bit different.

Please do not use the pen needles. Use U100 syringes. You cannot use your Vetsulin syringes (they are U40). We make dose changes in 0.25u to 0.5u increments. The pens will dispense insulin in 1.0u only. In addition, you need to "prime" the pen which means you are having to discard 1.0u of insulin every time you are going to give an injection. Also, I'm not sure if you're used to keeping Lev refrigerated. We recommend that you keep it in the refrigerator. (Most humans do not refrigerate. They use substantially larger doses than you will use for a cat and likely use all of the insulin in the pen in a month.)

Pain as well as any infection/inflammation can cause a rise in BG.

I want to give you a word of caution. If the vet gave Biscuits a 2-week antibiotic, it is likely that your cat was given a shot of Convenia. It is generally not a great antibiotic since if your cat has an allergic response, due to it being long lasting, your cat's in trouble. In addition, its only indication is for skin infections. Vets will use it because it means you don't have to pill your cat. In all honesty, my vet won't prescribe it.

Onsior should not be use for more than a few days. It is not meant to be used for longer term pain management, only for post-operative pain. It is a non-steroidal anti-inflammatory (NSAID) type of drug. This class of drug can cause kidney failure if used at too high of a dose or for a longer duration than indicated.

I'm also going to reiterate what several of us have asked. Please fill in your spreadsheet. You are not giving us the tools to help you. There is a good deal of experience with Levemir on the Lantus/Levemir/Biosimilar board. However, members will be very reticent to give dosing recommendations without spreadsheet data. We do not want to harm your cat.

 

[JanetNJ]

I would start at 6 u

Good luck with the new insulin. I'm glad she's doing better. If she had a fever there may be an infection. Did she get antibiotics?

 

[Noah & me (GA)]

I'm not qualified to comment on the dosing but with regards to the "sleeping" and unresponsiveness I have some cat, dog and personal experience.
First off our Daniel is as smart as any cat but falls into such a deep sleep he has to be prodded to wake up and still doesn't know where he is for 30 seconds. Daniel is a perfectly healthy normal and loving cat otherwise.
I have a long history of concussions, TIA's, an aneurysm, a few brain bleeds etc. I had the advantage of being able to describe my symptoms, cats do not. Neurology can be a long dark road that sometimes ends better than you thought (me). For Jasper the cat we put him through a spinal tap and then an MRI. The results were always inconclusive, very aggravating. I'm not suggesting you not pursue the neurological side but it can get real expensive real quick. If Biscuits is mostly happy and pain free try for now to focus on his dosing and if the antibiotics are working as they should.
About the transdermal BUPE. Noah needed all his teeth extracted but because of an enlarged heart he would never have survived the anesthesia. That was the only reason we kept him on it for over two years. It's not something I take lightly but for him it was a life and death choice, he would have been absolutely miserable with that pain and the BUPE gave him two more pain free years with no adverse effects.

 

[Karen & Biscuits]

As several people are noting, Levemir is a MUCH better insulin than Vetsulin for any number of reasons. It's dosed the same way as Lantus despite their pharmacology being a bit different.

Please do not use the pen needles. Use U100 syringes. You cannot use your Vetsulin syringes (they are U40). We make dose changes in 0.25u to 0.5u increments. The pens will dispense insulin in 1.0u only. In addition, you need to "prime" the pen which means you are having to discard 1.0u of insulin every time you are going to give an injection. Also, I'm not sure if you're used to keeping Lev refrigerated. We recommend that you keep it in the refrigerator. (Most humans do not refrigerate. They use substantially larger doses than you will use for a cat and likely use all of the insulin in the pen in a month.)

Pain as well as any infection/inflammation can cause a rise in BG.

I want to give you a word of caution. If the vet gave Biscuits a 2-week antibiotic, it is likely that your cat was given a shot of Convenia. It is generally not a great antibiotic since if your cat has an allergic response, due to it being long lasting, your cat's in trouble. In addition, its only indication is for skin infections. Vets will use it because it means you don't have to pill your cat. In all honesty, my vet won't prescribe it.

Onsior should not be use for more than a few days. It is not meant to be used for longer term pain management, only for post-operative pain. It is a non-steroidal anti-inflammatory (NSAID) type of drug. This class of drug can cause kidney failure if used at too high of a dose or for a longer duration than indicated.

I'm also going to reiterate what several of us have asked. Please fill in your spreadsheet. You are not giving us the tools to help you. There is a good deal of experience with Levemir on the Lantus/Levemir/Biosimilar board. However, members will be very reticent to give dosing recommendations without spreadsheet data. We do not want to harm your cat.

 

[Karen & Biscuits]

Hello! Thank you for all that info about the pen needles etc. I will get my hands on some u-100 syringes this weekend. Right now I don't have any so I was forced to use the pen needle this morning. I actually prefer the syringes as I can feel and see that the needle is going into her skin, unlike with the pen needle. It was very difficult to know if she actually got any insulin this morning, as 2 units is a very tiny amount. However...I have been doing a curve test today, taking her sugar every 2-3 hours and just a few minutes ago, at 6 pm, her sugar was down to 317, which is the lowest it has been in a long time. I think she got the insulin and it's working! She's been eating fine today, not a lot but she ate all of her breakfast this morning and has grazed a little on the leftovers her brothers didn't eat - all wet food. She has not eaten any m/d today that I have noticed.
Also, she did not get a Convenia shot, but rather one called Excede. I have never heard of that one but the vet seemed confident that this would deal with any infections that might have been missed during her initial exam. Hopefully that is the case. For the Onsior, I think she said it was only good for 24 hours, so it should be pretty much out of her system by now, as it's been just over 24 hours. Whatever the case, Biscuits is doing better today, and I am grateful for that. I'm not sure if Walmart is open tomorrow, but I will try my best to get there if it is, so I can get the U-100 syringes again and use those for her instead. I preferred those anyway, over the U-40's but had to switch when we put her on Vetsulin. Ironically, I had used the U-100's on Skittles for 4 years before I found out that Vetsulin required U-40's. I had no idea and nobody ever said anything until the vet that treated Biscuits put her on it as well and insisted on the U-40's. I told her then that Skittles had been using U-100's since he was diagnosed and she was horrified and surprised that his sugar was "okay" considering the dosage was incorrect. She recalculated it for me after that using the U-40's and he's been fine, thankfully.
I appreciate you telling me to keep the insulin in the fridge as well. You are correct, the lady I live with keeps it on her nightstand but she also takes 44 units twice a day, so it goes quickly. She gave me her used pen and started a new one for herself, as she has plenty to work with. I think the used one has about 30 units left in it so we should be good for awhile but I did put it back in the fridge.
I have been testing Biscuits sugar regularly but due to limited time, I haven't had a chance to update her spreadsheet. I will do my best to get that done this weekend and update everything else as well. I might be able to do that tomorrow or Sunday, depending on my ferals and how many go missing tonight during the fireworks. I will spend the next 48 hours hunting them down and coaxing them home. I dread this night of the year and 4th of July every year for that reason. Happy New Year to you and your furbabies.

 

[Karen & Biscuits]

I'm not qualified to comment on the dosing but with regards to the "sleeping" and unresponsiveness I have some cat, dog and personal experience.
First off our Daniel is as smart as any cat but falls into such a deep sleep he has to be prodded to wake up and still doesn't know where he is for 30 seconds. Daniel is a perfectly healthy normal and loving cat otherwise.
I have a long history of concussions, TIA's, an aneurysm, a few brain bleeds etc. I had the advantage of being able to describe my symptoms, cats do not. Neurology can be a long dark road that sometimes ends better than you thought (me). For Jasper the cat we put him through a spinal tap and then an MRI. The results were always inconclusive, very aggravating. I'm not suggesting you not pursue the neurological side but it can get real expensive real quick. If Biscuits is mostly happy and pain free try for now to focus on his dosing and if the antibiotics are working as they should.
About the transdermal BUPE. Noah needed all his teeth extracted but because of an enlarged heart he would never have survived the anesthesia. That was the only reason we kept him on it for over two years. It's not something I take lightly but for him it was a life and death choice, he would have been absolutely miserable with that pain and the BUPE gave him two more pain free years with no adverse effects.

That's interesting about Daniel! I'm glad he is healthy though. Maybe he just loves his sleep and that's a good thing right? Biscuits can be a deep sleeper periodically, but not on a consistent basis at all. She's usually very responsive if I call to her. She doesn't always wake up or look up, but I see the ears twitch so I know she's hearing me LOL. The other night, I think the gabapentin took hold of her and made her groggy, as usually she takes it in the morning but since she was feeling so miserable I couldn't get her to take it at the usual time so she got it later in the evening and that may be what caused her to react that way. I mentioned it to the vet, and she was kind of neutral on the issue, just told me to keep an eye on her for any further episodes and if nothing else happened then it was likely the gabapentin. Aside from her sugar, Biscuits is quite healthy. Her bloodwork came back perfect yesterday in all other areas except the glucose, she's at the perfect weight according to the vet (she's 12 lbs), and has no other underlying issues that we are aware of. She's 11 years old, so hopefully if we get the sugar issue under control, we can get several more years out of her yet.
Happy New Year to you and your furbabies!

 

[Karen & Biscuits]

I would start at 6 u

Good luck with the new insulin. I'm glad she's doing better. If she had a fever there may be an infection. Did she get antibiotics?

Hi Janet! I think the 2 units worked for Biscuits as her sugar has come down steadily today, at 316 about 30 minutes ago, which is the lowest it has been in a long time. She did get a shot of Excede, which was more of a precaution than anything because they couldn't find anything specific that was causing an infection. Her mouth/teeth looked good, ears were fine, she had not vomited or had diarrhea or anything, as she was still eating, just not as much as usual. The vet gave her the antibiotic as a precaution in case something was missed, and it's supposed to last 2 weeks, so hopefully if that's the case, it will be dealt with. She's doing a lot better today thankfully. She's been more alert and interacting with me and her brothers, so I am cautiously optimistic that she's on the upswing now. Fingers crossed! Happy New Year to you and your furries!

 

[Karen & Biscuits]

The last entry I see on the spreadsheet is November 5th. Any chance of updating it for the last two weeks of data? I can't comment on dose with old data.

And yes, Levemir is a much better insulin than Vetsulin. You should probably use a different pen than the one the lady you live with uses. And get some U-100 3/10cc syringes with half unit markings to use with it.

Hi Wendy! I will get the spreadsheet updated this weekend. I have been testing, and it's all in her meter, just haven't had time to work on the spreadsheet is all. Suffice it to say, until today her sugar has been in the 350-590 range for quite awhile. Today I gave her 2 units of the Levemir and been testing her sugar every 2-3 hours and it's come down to 316 at 6pm tonight, which is amazing! I am going to get the U-100 syringes this weekend if I can get to Walmart. I appreciate you reminding me to get the ones with half unit markings as the techs there don't always know what we need.
Happy New Year to you and your furries!

 

[Diane Tyler's Mom GA]

I'm glad Biscuits is feeling better
Our Walmart here in New Jersey is open, hopefully yours will be also
You can get syringes with half unit markings at a Walmart. Their ReliOn Brand syringes of 0.3 cc (30 unit) capacity come with half unit markings. Cost $12.58 for a box of 100
This is what the packaging looks like:

Just please try and get some tests in after his PMPS , since Levimer can have a late nadir

 

[Karen & Biscuits]

Here is your previous post
https://www.felinediabetes.com/FDMB/threads/please-pray-for-biscuits.257211/#post-2894554

I guess you didn't see what I said in your previous post
Have you read about the dosing methods for Levemir? What dose will you be starting her on?
Do you have the U-100 syringes with half unit markings? We adjust doses by 0.25 units.

If your lady friend uses the Pen you can only adjust by whole units . You really need to be testing after her PMPS also just not the pre shot. You need to see how the insulin is /working and how low she is dropping. Please read what Bron wrote concerning Levimer above

If you're not sure on what dose to start with or get some advice I would post on the Lantus/ Levemir forum since you already have your signature and SS set up.
Don't forget to change your signature for Biscuits that you switched to Levemir and the Date and also on your on your SS you can put a line above the date you start Levimer and put Started Levimer
I hope the Covenia and Onisor helps

I see on your SS you haven't tested since 11-5-21 is there a reason why?
https://felinediabetes.com/FDMB/thr...-low-go-slow-slgs-tight-regulation-tr.210110

You can read more about Levimer here

https://www.felinediabetes.com/FDMB/forums/lantus-levemir-biosimilars.9/

@feralcatmama

Hi Diane! Thank you for all that info! I will check out the Lantus/Levemir forum as I have a lot to learn. Truthfully, I was afraid to start her on Levemir today but went on faith and so far we're having good results. I have been testing her regularly since the 5th, I just haven't had time to work on the spreadsheet, but I will update it this weekend and try to keep it going from here on as much as I can. It's something I need to get in the habit of doing in order to make this work. I put a reminder on my phone so I remember to do that each day. I just get so busy with taking care of a human who is also diabetic but has a host of other issues, plus my feral colony of 30 cats and then of course my own two sugar babies. It's a lot to deal with and I have zero help from anybody, so time gets away on me frequently. I'm doing my best to make a point of checking in here daily and working the spreadsheet so everyone can see where we are at and what is happening with Biscuits. Thanks again for all the info above, I am curious and will definitely check it all out Happy New Year to you and your furries!

 

[Karen & Biscuits]

I'm glad Biscuits is feeling better
Our Walmart here in New Jersey is open, hopefully yours will be also
You can get syringes with half unit markings at a Walmart. Their ReliOn Brand syringes of 0.3 cc (30 unit) capacity come with half unit markings. Cost $12.58 for a box of 100
This is what the packaging looks like:

Just please try and get some tests in after his PMPS , since Levimer can have a late nadir

Those are the syringes I used to get for Skittles when he was first diagnosed and nobody told me about U-40 syringes, so I am familiar with them. Can you please clarify what PMPS and "nadir" mean? These are new for me, not sure what that is - thanks!

 

[Diane Tyler's Mom GA]

Hi Diane! Thank you for all that info! I will check out the Lantus/Levemir forum as I have a lot to learn. Truthfully, I was afraid to start her on Levemir today but went on faith and so far we're having good results. I have been testing her regularly since the 5th, I just haven't had time to work on the spreadsheet, but I will update it this weekend and try to keep it going from here on as much as I can. It's something I need to get in the habit of doing in order to make this work. I put a reminder on my phone so I remember to do that each day. I just get so busy with taking care of a human who is also diabetic but has a host of other issues, plus my feral colony of 30 cats and then of course my own two sugar babies. It's a lot to deal with and I have zero help from anybody, so time gets away on me frequently. I'm doing my best to make a point of checking in here daily and working the spreadsheet so everyone can see where we are at and what is happening with Biscuits. Thanks again for all the info above, I am curious and will definitely check it all out Happy New Year to you and your furries!

You do have a lot on your plate, Will be looking forward to see how Biscuits is doing on the Levimer,

 

[Diane Tyler's Mom GA]

Can you please clarify what PMPS and "nadir" mean? These are new for me, not sure what that is - thanks

Part of that process is getting a feel for basic concepts:

• Onset - the length of time before insulin reaches the bloodstream & begins lowering blood glucose
• Peak/Nadir - the lowest point in the cycle
• Duration - the length of time insulin continues to lower blood glucose

PMPS means PM Pre Shot. When you first test Biscuits at night when his insulin is due, after that you need to be getting a couple tests in after that, if you don't you are only seeing half the picture. Most cats drop lower at night, so you need to test after the PMPS to see how low he is dropping it n case you have to intervene with food to bring his BG up

Also what ever dosing method you choose to follow will tell you when increases or decreases are needed.You will read all about this when you read about Levimer .
Please when you get a chance go to your signature and add that you switched to Levimer and the date you switched for Biscuits. You can also add that to your SS for Biscuits make a line above the date you started Levimer and write started Levimer
@feralcatmama

 

[Diane Tyler's Mom GA]

It was very difficult to know if she actually got any insulin this morning, as 2 units is a very tiny amount. However...I have been doing a curve test today, taking her sugar every 2-3 hours and just a few minutes ago, at 6 pm, her sugar was down to 317, which is the lowest it has been in a long time. I think she got the insulin and it's working!

I know you are busy but don't forget to add all of the test numbers you get to your spreadsheet , what was Biscuits AMPS this morning?

 

[Diane Tyler's Mom GA]

Hi Janet! I think the 2 units worked for Biscuits as her sugar has come down steadily today, at 316 about 30 minutes ago, which is the lowest it has been in a long time.

Was 316 his AMPS?

 

[Lisa and Witn (GA)]

Hi Janet! I think the 2 units worked for Biscuits as her sugar has come down steadily today, at 316 about 30 minutes ago, which is the lowest it has been in a long time. She did get a shot of Excede, which was more of a precaution than anything because they couldn't find anything specific that was causing an infection. Her mouth/teeth looked good, ears were fine, she had not vomited or had diarrhea or anything, as she was still eating, just not as much as usual. The vet gave her the antibiotic as a precaution in case something was missed, and it's supposed to last 2 weeks, so hopefully if that's the case, it will be dealt with. She's doing a lot better today thankfully. She's been more alert and interacting with me and her brothers, so I am cautiously optimistic that she's on the upswing now. Fingers crossed! Happy New Year to you and your furries!

I am glad 2 units seems to be working. If there is an infection, as the antibiotics start working you may see a decrease in the BG levels and may need to lower the dose. As others have said, the spreadsheet needs to be updated to help you determine if the dose needs to be changed.

 

[JanetNJ]

Hi Janet! I think the 2 units worked for Biscuits as her sugar has come down steadily today, at 316 about 30 minutes ago, which is the lowest it has been in a long time. She did get a shot of Excede, which was more of a precaution than anything because they couldn't find anything specific that was causing an infection. Her mouth/teeth looked good, ears were fine, she had not vomited or had diarrhea or anything, as she was still eating, just not as much as usual. The vet gave her the antibiotic as a precaution in case something was missed, and it's supposed to last 2 weeks, so hopefully if that's the case, it will be dealt with. She's doing a lot better today thankfully. She's been more alert and interacting with me and her brothers, so I am cautiously optimistic that she's on the upswing now. Fingers crossed! Happy New Year to you and your furries!

316 is more than double what it should be. We want to aim to get it closer to 100.

 

[Bron and Sheba (GA)]

As you are just starting levemir, you need to hold the dose for at least 5 days to let the depot fill unless he drops under 90, in which case you reduce the dose.
Can you put in your signature that you are now using levemir please?
When you update the SS you will need to draw a line where you stopped vetsulin and started levemir.

Please also test for ketones daily during the transition as I think you have reduced the dose somewhat but am not sure because the SS is not up to date.

 

[Sienne and Gabby (GA)]

I could not find much information on Excede for treating cats. It seems like it's used more often with large animals.