New from Wyoming, Should I Inject?

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New diabetic kitty Artemis went to new vet for curve on Tuesday. Was on 2U every 12 hrs prescribed by another vet. New vet switched Artemis to 6U every 12 hrs.

On Wednesday he went into extreme hypo (29 on human meter). I gave honey on gums and he was going back to fairly quickly and by evening was 300. I changed it to 4U that night and called vet. He said go with 5U every 12. So I did that. His sugars stayed at 250-296 Thursday all day. Today he's been between 200-250 but tonight is 176.

Should I inject or wait until he goes higher?
 
That’s a big dose and some big increases. What insulin is he on and what type of food is he eating?

with anything below 200 for a new diabetic cat, we say either skip the dose or give a token dose which shouldn’t be more than 20% of the actual dose. You could also have stalled without feeding and retested in 20 minutes but it’s been longer than that.
 
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Going from 2 units to 6 is crazy to me and honestly I can’t understand how any vet would recommend that. I’m not surprised you ended up with a hypo in your hands. Anything under 50 is a take action number and you saved his life with honey so good job! It also sounds like you’re home testing which is great. Your instincts were correct in reducing the dose and it may be safer to go back all the way down to 2 units because 5 is looking like too much as well. Unfortunately most vets do not know a lot about feline diabetes….they have many animals to look after and they all have different diseases and treatments. Would you be able to transfer the data you have into our spreadsheet template so we can beta advise you on dosage?

With a diabetic cat you need

  • A low carb wet diet that is 10% carbs or under. Most of us use around 4-7% carbs
  • A suitable insulin such as Lantus or Prozinc which are long acting, more gentle insulins than the old insulins.
  • We recommend hometesting the blood glucose with a human meter…it is not necessary to use a pet meter which is expensive to run and is no better. It will keep your kitty safe and you will know how the dose is working for your kitty. Only testing every so often will not tell you what is happening in between those times and an awful lot can happen in even a day.
  • HELP US HELP YOU has information about the spreadsheet, signature and hypo box which you will need to be able to look after your beloved kitty properly
A word of warning though…don’t change the food you are feeding at the moment over to the low carb food until you are testing the blood glucose because a change over can drop the BGs by up to 100 points and we don’t want you to have another hypo on your hands.

We are happy to help you with setting up the spreadsheet, sorting out what food to buy, how to transition safely to a low carb diet, how to learn to home test and much more.
 
One prat thought, he may have been bouncing the last two days due to the hypo. I really think it’s safer to keep him at 2 units until we can see some of your data.

It's a kitty's self defense mechanism. Here is the description:

Bouncing is simply a natural reaction to what the cat's system perceives as a BG value that is "too low". "Too low" is relative. If a cat is used to BGs in the 200's, 300's, or higher for a long time, then even a BG that drops to 150 can trigger a "bounce". Bouncing can also be triggered if the blood glucose drops too low and/or too fast.The pancreas, then the liver, release glucogon, glycogen and counter-regulatory hormones. The end result is a dumping of "sugar" into the bloodstream to save the cat from going hypoglycemic from a perceived low. The action is often referred to as "liver panic" or "panicky liver". *Usually*, a bounce will clear kitty's system within 3 days (6 cycles).
 
Welcome to the best group you could have ever joined, they helped me get Tyler into remission taking their advice. He's been in remission since 1-24-21
Food controlled. We adjust the dose by how low our kitties go, not the pre shot and we only adjust the dose by 0.25 units at a time
If you can take a look at the link Ale gave you Help Us Help You that would be great.
In that link it will ask you to give us information about Artemis and also setting up our spreadsheet were we enter in the BG numbers for our Kittie
If you need help setting it up just ask. We have a member who will contact you
Glad you had honey in your house

Hypo kit
Med and High Carb food and some honey



Fancy Feast Gravy Lovers Gourmet Beef Feast in Gravy 20% High Carbs

Fancy Feast Gravy Lovers Gourmet Chicken Feast in Gravy 15% Med Carbs

Fancy Feast Gravy Lovers Turkey Feast in Gravy 15% Med Carbs

Fancy Feast Gravy Lovers Chicken and Beef in Gravy 15% Med Carbs

Good idea to mark the cans with magic marker how many carbs

Or any on the food chart. Doesn't have to be Fancy Feast just an example about the med and high carb foods

https://felinediabetes.com/FDMB/threads/dr-pierson-new-food-

Between 11% and 17% is medium carbs.

18% and over is high carb.
 
Hi and welcome to the forum.
I agree, going from 2 to 6 units of insulin is very bad advice.
Why did the vet want you to go from 2 to 6 units?
It does sound as if your kitty could be bouncing from the very low BGs. He will drop down to lower numbers after the bounce finishes.

Were ketones in the urine mentioned at diagnosis?
If not, I would go back to 2 units unit you can set up a spreadsheet and we can see what is happening.
Would you like some help setting up the spreadsheet?
If you can give us a bit more information, that would be helpful.
When was he diagnosed?
When did he start insulin?
What food are you feeding him?
 
Ale & Bobo & Minnie (GA) said:
That’s a big dose and some big increases. What insulin is he on and what type of food is he eating?

with anything below 200 for a new diabetic cat, we say either skip the dose or give a token dose which shouldn’t be more than 20% of the actual dose. You could also have stalled without feeding and retested in 20 minutes but it’s been longer than that.
Click to expand...

He's on Vetsulin. 296 is low? I thought that was high and would require at least some kind of action, just wasn't sure how much. Anyway I gave 4U and he did well. He was at 157 last night. I'm unable to do frequent testing more than 4x daily. 4x daily we both can handle. I have a physical disability and he suffers from prior trauma. So testing is pretty difficult for both of us.
 
Ale & Bobo & Minnie (GA) said:
Going from 2 units to 6 is crazy to me and honestly I can’t understand how any vet would recommend that. I’m not surprised you ended up with a hypo in your hands. Anything under 50 is a take action number and you saved his life with honey so good job! It also sounds like you’re home testing which is great. Your instincts were correct in reducing the dose and it may be safer to go back all the way down to 2 units because 5 is looking like too much as well. Unfortunately most vets do not know a lot about feline diabetes….they have many animals to look after and they all have different diseases and treatments. Would you be able to transfer the data you have into our spreadsheet template so we can beta advise you on dosage?

With a diabetic cat you need

  • A low carb wet diet that is 10% carbs or under. Most of us use around 4-7% carbs
  • A suitable insulin such as Lantus or Prozinc which are long acting, more gentle insulins than the old insulins.
  • We recommend hometesting the blood glucose with a human meter…it is not necessary to use a pet meter which is expensive to run and is no better. It will keep your kitty safe and you will know how the dose is working for your kitty. Only testing every so often will not tell you what is happening in between those times and an awful lot can happen in even a day.
  • HELP US HELP YOU has information about the spreadsheet, signature and hypo box which you will need to be able to look after your beloved kitty properly
A word of warning though…don’t change the food you are feeding at the moment over to the low carb food until you are testing the blood glucose because a change over can drop the BGs by up to 100 points and we don’t want you to have another hypo on your hands.

We are happy to help you with setting up the spreadsheet, sorting out what food to buy, how to transition safely to a low carb diet, how to learn to home test and much more.
Click to expand...

Thank you for the information and guidance.
Artemis was diagnosed 6 weeks ago. He has been on recommended low carb, 4-7% using the formula for each can for several months as I was trying to get him to lose some weight months prior to his diagnosis. Always wet food and pate - FF. Before that he has been on "lower" carb (9-12% wet pate for at least 10 years. He has stomach issues and no teeth so we went to wet food with lower carb and "grain free" (we know there's no such thing in wet commercial food) years ago. Still, he became diabetic.

I use a Bayer Contour EZ human glucometer. I ordered a ReliOn but it didn't come with solution so had to order directly from company and that takes a week.

His vet won't prescribe human insulin. I live in very rural Wyoming and domestic vets who see cats are hard to find. I'd prefer Lantus but getting vets (or human doctors) to do anything outside the norm is nearly impossible. Do you know alternative options for getting it?

When a different vet diagnosed him 6 weeks ago she started him on 2U twice daily. His BS was not controlled. He'd spike to 500. So 2U was clearly not enough. That's also what the new vet saw, BS 500 and over, hence the 6 U. But still I felt it was too much. I reduced to 5 yesterday....is 296 too low? I thought it was high. I gave 4U and he came down to 157. I thought that was good. Maybe I need to understand the reference range better. From the range I'm using, 296 is high and I should have injected at least something. I will remember the 20% rule if that happens again.

Thanks for the information and support!
 
Ale & Bobo & Minnie (GA) said:
One prat thought, he may have been bouncing the last two days due to the hypo. I really think it’s safer to keep him at 2 units until we can see some of your data.

It's a kitty's self defense mechanism. Here is the description:

Bouncing is simply a natural reaction to what the cat's system perceives as a BG value that is "too low". "Too low" is relative. If a cat is used to BGs in the 200's, 300's, or higher for a long time, then even a BG that drops to 150 can trigger a "bounce". Bouncing can also be triggered if the blood glucose drops too low and/or too fast.The pancreas, then the liver, release glucogon, glycogen and counter-regulatory hormones. The end result is a dumping of "sugar" into the bloodstream to save the cat from going hypoglycemic from a perceived low. The action is often referred to as "liver panic" or "panicky liver". *Usually*, a bounce will clear kitty's system within 3 days (6 cycles).
Click to expand...
Thank you:) I read up on the bounce. I was trying to do TR but opted out. It's too much stress for both of us.
 
Bron and Sheba (GA) said:
Hi and welcome to the forum.
I agree, going from 2 to 6 units of insulin is very bad advice.
Why did the vet want you to go from 2 to 6 units?
It does sound as if your kitty could be bouncing from the very low BGs. He will drop down to lower numbers after the bounce finishes.

Were ketones in the urine mentioned at diagnosis?
If not, I would go back to 2 units unit you can set up a spreadsheet and we can see what is happening.
Would you like some help setting up the spreadsheet?
If you can give us a bit more information, that would be helpful.
When was he diagnosed?
When did he start insulin?
What food are you feeding him?
Click to expand...


Thank you for your response. See my response/description to Ale and Bobo explaining why the vet went to 6U, which I thought was a huge jump.
 
Twinkleboots said:
I was trying to do TR but opted out. It's too much stress for both of us.
Click to expand...
TR is not meant to be done with vetsulin.
I will give you the vetsulin guide below for you to follow.
The vet could have been testing on a day your kitty was bouncing and that could have been why the BG was over 500.
vetsulin is a fast acting harsh insulin for cats and I am concerned about you giving such a high dose when he was only diagnosed 6 weeks ago.
Are you testing, then feeding and then waiting 30 minutes before giving the insulin?
With vetsulin, your kitty needs to have some food aboard before the insulin hits.
I would test abut 4 hours after the dose to see how low the insulin is taking him.
Would you consider setting up one of our spreadsheets and adding your data. We can then help you with dosing.
I can ask @Bandit's Mom to set the spreadsheet up for you.

In regards to giving the dose when the BG is under 200.
Until we can get more data, I would not give the dose if the BG is under 200.
I would stall, don’t feed and test again in 20 minutes to see if the BGis rising. You can also post and ask for help.
If the BG drops under 90, you need to reduce the dose.
BEGINNERS GUIDE TO VETSULIN
Keep asking questions
 
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@Twinkleboots
Hi don't mean to keep bugging you about setting up your signature ,just so we don't have to keep asking you the same questions
To set up your signature which you will see is at the end of everyone's post in gray, click on your name up top and then tap on the word signature and add this information
  • Add info we need to help you:
    • Caregiver & kitty's name
    • DX: Date
    • Name of Insulin (do not include dose or frequency)
    • Name of your meter
    • Diet: "LC wet" or "dry food" or "combo"
    • Dosing: TR or SLGS or Custom (if applicable)
    • DKA or other recent health issue (if applicable)
    • Acro, IAA, or Cushings (if applicable)
    • Spreadsheet link. Please put the signature link on the bottom line of your signature information, on its own, so it is easy to find.
    • Please do not put any information about your location in the signature for security reasons. If you wish to add your country location, please add it to your profile.
Be sure to click the 'Save Changes' button at the bottom. If you need help urgently it is important we know these things at a glance. We don’t want to waste valuable time finding out information.

Take a look at mine
 
Diane Tyler's Mom said:
@Twinkleboots
Hi don't mean to keep bugging you about setting up your signature ,just so we don't have to keep asking you the same questions
To set up your signature which you will see is at the end of everyone's post in gray, click on your name up top and then tap on the word signature and add this information
  • Add info we need to help you:
    • Caregiver & kitty's name
    • DX: Date
    • Name of Insulin (do not include dose or frequency)
    • Name of your meter
    • Diet: "LC wet" or "dry food" or "combo"
    • Dosing: TR or SLGS or Custom (if applicable)
    • DKA or other recent health issue (if applicable)
    • Acro, IAA, or Cushings (if applicable)
    • Spreadsheet link. Please put the signature link on the bottom line of your signature information, on its own, so it is easy to find.
    • Please do not put any information about your location in the signature for security reasons. If you wish to add your country location, please add it to your profile.
Be sure to click the 'Save Changes' button at the bottom. If you need help urgently it is important we know these things at a glance. We don’t want to waste valuable time finding out information.

Take a look at mine
Click to expand...

I'm sorry. Just to fully disclose...I deal with some challenges related to brain injury. I'm trying to get to all of these tasks I've been asked to do by the board as quickly as I can along with trying to care for my kitty. I may be a bit slower than others and may struggle a bit more to get through all of this. It's important for me to share this since I don't want anyone to think I'm careless or just unresponsive. If things get to stressful it can really cause me to have serious issues. Then Artemis would really be in a bad situation. I'm asking that people understand this. I'm really feeling pressured. But I understand why all of this information is needed
 
Twinkleboots said:
I'm sorry. Just to fully disclose...I deal with some challenges related to brain injury. I'm trying to get to all of these tasks I've been asked to do by the board as quickly as I can along with trying to care for my kitty. I may be a bit slower than others and may struggle a bit more to get through all of this. It's important for me to share this since I don't want anyone to think I'm careless or just unresponsive. If things get to stressful it can really cause me to have serious issues. Then Artemis would really be in a bad situation. I'm asking that people understand this. I'm really feeling pressured. But I understand why all of this information is needed
Click to expand...
My Apologies , take your time , I didn't mean to pressure you at all :bighug::bighug::bighug:
When Bhooma
@Bandit's Mom sets up your spreadsheet for you she can do your signature also
Again I'm sorry I made you feel pressured :bighug::bighug::bighug:
@Twinkleboots
 
Bron and Sheba (GA) said:
TR is not meant to be done with vetsulin.
I will give you the vetsulin guide below for you to follow.
The vet could have been testing on a day your kitty was bouncing and that could have been why the BG was over 500.
vetsulin is a fast acting harsh insulin for cats and I am concerned about you giving such a high dose when he was only diagnosed 6 weeks ago.
Are you testing, then feeding and then waiting 30 minutes before giving the insulin?
With vetsulin, your kitty needs to have some food aboard before the insulin hits.
I would test abut 4 hours after the dose to see how low the insulin is taking him.
Would you consider setting up one of our spreadsheets and adding your data. We can then help you with dosing.
I can ask @Bandit's Mom to set the spreadsheet up for you.

In regards to giving the dose when the BG is under 200.
Until we can get more data, I would not give the dose if the BG is under 200.
I would stall, don’t feed and test again in 200 minutes to see if the BGis rising. You can also post and ask for help.
If the BG drops under 90, you need to reduce the dose.
BEGINNERS GUIDE TO VETSULIN
Keep asking questions
Click to expand...

Yes I test, wait 20 minutes after feeding to give insulin.

I'm sorry vetsulin is a harsh insulin It makes me feel really bad like I'm hurting my kitty! What is your solution? Do I continue giving him a horrible, harsh drug? Do I stop the drug? How can I get Lantus? Ugh. I feel so bad for him that I'm putting something so terrible in him.

I didn't have questions about BS under 200. I had questions about the 296 range. I will look at the guide thank you.

I'm confused though. I thought I feed 20 minutes after? You mentioned 200 minutes after maybe you meant 20?

Yes I will try to do the spreadsheet. Where can I find it? Is it a template?
Thank you for your help, guidance and time.
 
Diane Tyler's Mom said:
My Apologies , take your time , I didn't mean to pressure you at all :bighug::bighug::bighug:
When Bhooma
@Bandit's Mom sets up your spreadsheet for you she can do your signature also
Again I'm sorry I made you feel pressured :bighug::bighug::bighug:
@Twinkleboots
Click to expand...


It's ok really, how were you to know? That's why I tossed out the SOS.... sometimes I have to disclose so others understand. I don't like to but sometimes I have to

I can go do my signature now and if someone would start/setup the spreadsheet that would be so great! Really helpful! Thank you.
 
Diane Tyler's Mom said:
@Twinkleboots
Hi don't mean to keep bugging you about setting up your signature ,just so we don't have to keep asking you the same questions
To set up your signature which you will see is at the end of everyone's post in gray, click on your name up top and then tap on the word signature and add this information
  • Add info we need to help you:
    • Caregiver & kitty's name
    • DX: Date
    • Name of Insulin (do not include dose or frequency)
    • Name of your meter
    • Diet: "LC wet" or "dry food" or "combo"
    • Dosing: TR or SLGS or Custom (if applicable)
    • DKA or other recent health issue (if applicable)
    • Acro, IAA, or Cushings (if applicable)
    • Spreadsheet link. Please put the signature link on the bottom line of your signature information, on its own, so it is easy to find.
    • Please do not put any information about your location in the signature for security reasons. If you wish to add your country location, please add it to your profile.
Be sure to click the 'Save Changes' button at the bottom. If you need help urgently it is important we know these things at a glance. We don’t want to waste valuable time finding out information.

Take a look at mine
Click to expand...


Hi, I set up my signature but it only allowed me a few lines. I couldn't get all that information on there. I also completed the personal details section. Could you look at the signature line for me and maybe suggest what I might be doing wrong? It kept telling me I was over until I got to the current lines I have. Then it accepted.
 
Date of DM diagnosis: June 19, 2023. Insulin: Vetsulin. Not by choice. Meter: ReliOn
Diet: Fancy Feast pate, 6-9% carbs since Feb 2022. He's always been on pate.
Try "Diagnosis 06/19/23 Vetsulin (Not by choice) Meter ReliOn
Diet Fancy Feast pate 6-9% carbs since Feb 2/22 (always been on pate)
 
Twinkleboots said:
He's on Vetsulin. 296 is low? I thought that was high and would require at least some kind of action, just wasn't sure how much. Anyway I gave 4U and he did well. He was at 157 last night. I'm unable to do frequent testing more than 4x daily. 4x daily we both can handle. I have a physical disability and he suffers from prior trauma. So testing is pretty difficult for both of us.
Click to expand...
I was giving you advice on what to do last night when you got 176. That’s what you were asking about. Anything below 200, less than 200 :cat:
 
You already got great info about Vetsulin. I think we all agree it’s not a good insulin for cats. It’s actually also called caninsulin because it was made for canines who have a slower metabolism than cats. In addition to being a harsh insulin, it’s also short lasting so your cat is not protected the entire 12 hours. It hits fast and it wears off fast too.
 
Twinkleboots said:
Hi, I set up my signature but it only allowed me a few lines. I couldn't get all that information on there. I also completed the personal details section. Could you look at the signature line for me and maybe suggest what I might be doing wrong? It kept telling me I was over until I got to the current lines I have. Then it accepted.
Click to expand...
Looks good :cat:
 
Twinkleboots said:
I'm confused though. I thought I feed 20 minutes after? You mentioned 200 minutes after maybe you meant 20?
Click to expand...
I think Bron just made a typo yes it's 20 minutes
Oh one other thing you need to withhold food 2 hours before you test first thing in the AM and the PM because you don't want the BG to be influenced by the food
That's the only time you have to withhold it after that you can feed small snacks during each 12 hour cycle
@Twinkleboots
 
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Twinkleboots said:
Yes I will try to do the spreadsheet. Where can I find it? Is it a template?
Thank you for your help, guidance and time.
Click to expand...
Here is the link to set up your spreadsheet if you wantbto give it a try, We have tagged Bhooma one of our members to do it for you, she lives India so it's probably night time for her, she usually comes on tonight
https://felinediabetes.com/FDMB/threads/how-to-create-a-spreadsheet.241706/
@Twinkleboots
About the spreadsheet
AMPS - means AM Pre Shot the first test you take in the AM ,you need to withhold food 2 hours before testing so it's not food influenced

Units is where you would put how much insulin you gave
+1 is one hour after giving insulin if you were to test then that's where you enter his _BG number
+2 two hours after giving insulin. ditto
+3 and so on until you get to PMPS - PM pre shot withhold food 2 hours before testing

+1 same as you do for AM cycle

We don't give times because we are all in different time zones that's why we use the + numbers
 
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Diane Tyler's Mom said:
I think Bron just made a typo yes it's 20 minutes
Click to expand...
2 separate things. You test, feed and wait 20-30 minutes to give the Vetsulin injection.

when you get a lower than 200 bg value like you did last night, you want to stall 20 minutes without feeding, then retest to see if the bg is going up on its own and it’s safe to shoot his regular dose. Bron had a typo it should be 20 not 200 minutes.
 
Ale & Bobo & Minnie (GA) said:
2 separate things. You test, feed and wait 20-30 minutes to give the Vetsulin injection.

when you get a lower than 200 bg value like you did last night, you want to stall 20 minutes without feeding, then retest to see if the bg is going up on its own and it’s safe to shoot his regular dose. Bron had a typo it should be 20 not 200 minutes.
Click to expand...


Ok, got it. Thank you so much.

1. Is there a chart I can use?
2. Are you saying that 200 is the point I shouldn't go under?
3. All of this is with a human monitor?

Sorry for all the questions, just want to get it right.
 
Ale & Bobo & Minnie (GA) said:
You already got great info about Vetsulin. I think we all agree it’s not a good insulin for cats. It’s actually also called caninsulin because it was made for canines who have a slower metabolism than cats. In addition to being a harsh insulin, it’s also short lasting so your cat is not protected the entire 12 hours. It hits fast and it wears off fast too.
Click to expand...


Ok, I get it. It's terrible. I have the vetsulin guide now. If someone has some actual advice on how I can get something else please let me know. But I get it and understand it's awful. Is it so awful that I should stop? Or is it better than not treating him? I would guess it's better than not treating.

I've explained that I live in rural Wyoming where it's difficult to find vets who treat felines and are open-minded. Most are large animal vets. I've been to two in the last month, one being two hours away and the other one hour away. Neither would prescribe Lantus. I have done so much reading and research since he was diagnosed 6 weeks ago. That is why I asked the vets for Lantus. I can keep trying.

So please let me know if you have an actual option that I've overlooked or I'm unaware of. Thank you for your time and responses.
 
Twinkleboots said:
Ok, got it. Thank you so much.

1. Is there a chart I can use?
2. Are you saying that 200 is the point I shouldn't go under?
3. All of this is with a human monitor?

Sorry for all the questions, just want to get it right.
Click to expand...
Yes, all human meter numbers. Unfortunately, there’s no chart because every cat is different, but have you had a chance to review the info on the Vetsulin forum? I believe Bron linked it for you above. If not, I can find it for you. There should be some guidelines about lower preshot numbers.
 
Twinkleboots said:
Ok, I get it. It's terrible. I have the vetsulin guide now. If someone has some actual advice on how I can get something else please let me know. But I get it and understand it's awful. Is it so awful that I should stop? Or is it better than not treating him? I would guess it's better than not treating.

I've explained that I live in rural Wyoming where it's difficult to find vets who treat felines and are open-minded. Most are large animal vets. I've been to two in the last month, one being two hours away and the other one hour away. Neither would prescribe Lantus. I have done so much reading and research since he was diagnosed 6 weeks ago. That is why I asked the vets for Lantus. I can keep trying.

So please let me know if you have an actual option that I've overlooked or I'm unaware of. Thank you for your time and responses.
Click to expand...
We’re just giving you the facts. This is not meant to make you feel bad at all. I understand your situation. The best advice I can give you is what Red already said. Share the
guidelines from the American Animal Hospital Assn some vets are more flexible than others and willing to work with you. Would the 1st vet you went to perhaps be more flexible? I don’t know either and you’re the only one who knows how much you can push them and how much you can advocate for your cat without upsetting them.

Any insulin is better than no insulin
 
Ale & Bobo & Minnie (GA) said:
Yes, all human meter numbers. Unfortunately, there’s no chart because every cat is different, but have you had a chance to review the info on the Vetsulin forum? I believe Bron linked it for you above. If not, I can find it for you. There should be some guidelines about lower preshot numbers.
Click to expand...

Yes, I have reviewed the guide and shared it with my son. He will be doing the spreadsheet for me. Thank you for your help!
 
Ale & Bobo & Minnie (GA) said:
We’re just giving you the facts. This is not meant to make you feel bad at all. I understand your situation. The best advice I can give you is what Red already said. Share the
guidelines from the American Animal Hospital Assn some vets are more flexible than others and willing to work with you. Would the 1st vet you went to perhaps be more flexible? I don’t know either and you’re the only one who knows how much you can push them and how much you can advocate for your cat without upsetting them.

Any insulin is better than no insulin
Click to expand...


Yes, I think the first vet might be more receptive. She was very honest about not knowing much about details regarding feline diabetes. I will ask my 2nd vet once again and also provide the information guide from the AAHA. I will fax him the info and ask if he will reconsider Lantus. If he says "no" I will ask the first vet. I won't stop advocating for him.
 
Twinkleboots said:
Yes, I think the first vet might be more receptive. She was very honest about not knowing much about details regarding feline diabetes. I will ask my 2nd vet once again and also provide the information guide from the AAHA. I will fax him the info and ask if he will reconsider Lantus. If he says "no" I will ask the first vet. I won't stop advocating for him.
Click to expand...
That sounds like a good plan. I think a less knowledgeable but more flexible vet may be the best choice because she would be willing to work with you and you can even direct her to this forum. Lots of vets find the info here very helpful. The ones that think they know it all, not so much lol.

just one more fact for you, if he tries to argue that Vetsulin is cheaper, it’s not really true. There are affordable generic versions of Lantus and since it’s a human insulin, also lots of discount online coupons you can use for it. That was always another plus for me. I knew if anything happened and I ran out I could get it at any human pharmacy any day of the week while the pet insulins are only sold at vet offices or online pet pharmacies like Chewy.
 
I just peaked at the Vetsulin page. There are guidelines for dose adjustments, but until you have a spreadsheet setup, I wouldn’t be adjusting the dose unless you get a lower than 90 number, so less than 90. What dose did you give this morning?

here’s the other bit of info about lower preshot numbers again:
  • 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.)
 
Ale & Bobo & Minnie (GA) said:
I just peaked at the Vetsulin page. There are guidelines for dose adjustments, but until you have a spreadsheet setup, I wouldn’t be adjusting the dose unless you get a lower than 90 number, so less than 90. What dose did you give this morning?

here’s the other bit of info about lower preshot numbers again:
  • 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.)
Click to expand...


Oh, thank you! Ok, this morning his BG was 249 at 8am. His BG was 99 at noon. How long should I wait to re-test him as this is approaching 90?

I now know that I should have tested again 2 hours later. I'm home all day so it's not like I can't do it. My son is helping me today. I just need to organize all the information in one place so I know what I'm doing for the schedule.

For instance, my kitty doesn't have access to food during the night as he is on wet pate. So I test him when I get up and then feed him. Inject 20-30 minutes after feeding. From there, I'm sketchy on the time intervals for testing. I know it's in this MB somewhere but haven't had a chance to search.

I will post here and in the Health forum if his numbers go below 200. So I will also post on that forum now since he's at 99....
 
Ale & Bobo & Minnie (GA) said:
I just peaked at the Vetsulin page. There are guidelines for dose adjustments, but until you have a spreadsheet setup, I wouldn’t be adjusting the dose unless you get a lower than 90 number, so less than 90. What dose did you give this morning?

here’s the other bit of info about lower preshot numbers again:
  • 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.)
Click to expand...

I thought this was the Health forum?
 
This is the heath forum. I copied the above from the Vetsulin forum that’s why :)

can you retest him now please if you haven’t already? We want to make sure he stays in safe numbers. Also anytime you start getting into the 90’s, go ahead and give him a bit of wet food to slow down the drop
 
Vetsulin peaks earlier so I’d suggest in addition to the preshot tests - for these btw in case we haven’t already mentioned, you shouldn’t withhold food for at least 2 hours prior so you’re getting the true bg not influenced by food, for the other tests, it doesn’t matter - 2 more tests at day at least. I’d try to test at about +2 or +3 to start to see how early his nadir is happening - lowest point in a cycle. I think it’s great you tested again and got the 99 as that may have been his nadir. We’ll see when you retest. When you get a lower number, it’s a good idea to give a bit of food to slow down the drop and try to test again in 30 minutes or so. For that 4th test is good to do it in the evening cycle so after the evening shot at about +2 so you can get a sense of how he’s going to do overnight.

generally speaking, it’s better for diabetic cats to have 3-4 smaller meals or snacks a day in addition to the 2 feedings at shot time. Any dried freeze treats are good low carb options. I have an auto feeder I set up so Bobo gets an overnight snack when I’m asleep. I think you may want to consider that as well.
 
Twinkleboots said:
I'm confused though. I thought I feed 20 minutes after? You mentioned 200 minutes after maybe you meant 20?
Click to expand...
Yes, sorry! That was a typo. It was meant to be 20. Sorry to confuse you.

You can’t worry if the only insulin the vet will give you is vetsulin. It isn’t ideal but it is better than not giving insulin.
Just be aware you need to feed 30 minutes before you give the insulin and it is strongest in the first 4 to 5 hours after you give it. So give a couple of snacks during that first 5 hours and do your other mid cycle test then.
You are doing a really good job getting sorted.:)
 
My cat actually did good on vetsulin. She even got into remission for a year. When she came out of remission I switched to prozinc because I couldn’t get her regulated. Turns out she had acro and that’s why. Prozinc is a better insulin but some cats do ok on vetsulin.
 
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