Hello and welcome. Jasmine is one gorgeous kitty! From one slightly spicey at vet long haired tuxedo girl caregiver to another. My girl was also started on Caninsulin (Vetsulin just branded differently in the US), then we switched to Lantus. By the way, that was a good move. Vetsulin is a good insulin for dogs.... Either Lantus or Prozinc best for cats. How long ago did she switch to Lantus? And what dose of insulin is she on now?
A hypo incident means her current insulin dose is too high and needs to be lowered. What are the reasons you've been going to the ER with her?
What food are you feeding her now? Has there been any change in diet?
Short answer to both questions is she gets Tiki cat wet aloha friends about 1/2 a can twice a day and grazes a bit of Tiki cat Born Carnivore indoor health. Previously she had Tiki Cat compliments and broth twice a day and grazed on Purina cat chow naturals.
I apologize in advance for the lengthy message but I wanted to be as accurate as possible.
- 9/2019 Jasmine was diagnosed as being a diabetic and I was instructed by a small vet clinic to give 2 unites of Vetsulin twice a day (typically 10am / 10pm). No bg scanning or ketone dipsticks were mentioned. She was free fed Purina cat chow naturals because she had been a grazer all her life and I had no luck with scheduled feeding because she would only nibble and walk away. She received her insulin in the morning with tiki cat compliments which she typically only at 1/4 pouch and she would insist on 1 tsp of milk in a tiny saucer. From 9/2019 to 7/2023 she had regular checkups at the local vet. Fructosamine tests and regulation / curves were done every 6 months. during those 4 years her dosage rose from 2.0 - 2.5 which is where it remained when I moved to NYC in 9/2023. Prior to moving none of the vets I saw mentioned anything about at home testing or ketones and since she never showed any symptoms, maintained a healthy weight, was active I never thought twice about it.
- 9/01/2023 I moved from upstate NY into an apartment in Brooklyn with my girlfriend and her 4 year old heeler mix puppy who had been living there for 10 years. (we slowly introduced the 2 of them over several months and they seemed to get along without much issue.
- 9/07/2023 in the morning out of the blue (no change in diet, or insulin amounts or any other variables that I can think of other than the apartment) she exhibited concerning signs. (wobbly, confused, dialated pupils) so I rushed her to a clinic on the same block as where I live. They took her BG level and noticed they were very low (40's if i remember correctly). they gave her fluids to stabilize her and suggested to attach a freestyle libre to her to monitor her Bg level. They told me that it was relatively accurate so I agreed. He advised me not to give insulin that evening but to try and give her 2 units in the morning (instead of 2.5) based on what the Libre reading was. Also scheduled an appointment with an internist at a recommended hospital.
-9/08/2023 Jasmine ate as normal and the meter read about 256 so she received 2 units of vetsulin at 10am. By 7pm Freestyle Libre noted low BG and since the vet that treated her was closed I rushed her to the local Emergency room where she was treated for low BG. they stabilized her and advised me to discontinue insulin if the Freestyle Libre reads lower than 150-200.
-9/09/2023 - 9/10/23 are a little hazy because it was so chaotic and the digital records i received are not the greatest. (I changed her food to tiki cat wet aloha friends / grillers and her dry food to Tiki cat Borne Carnivore indoor health. She typically ate about 1/4 of the can per meal and continued to graze her dry food throughout the day and evening.) If I remember correctly she read slightly over the 200 suggestion so I gave her 1 unit of Vetsulin in the morning after she ate normally. I honestly dont remember the evening of the 9th but on 9/10 she showed little appetite but her BG were still above 200 so I believe she got 1/2 a unit of vetsulin and by 4pm showed signs of Hypoglycemia and freestyle read 63. Gave her nutrical to boost her BG and rushed her to Emergency room where she was treated again and discharged. I spoke to the vet who told me that as long as she is below 350-400 range I shouldn't worry about insulin considering her recent admissions.
At this point i was terrified of giving insulin and from 9/11 - 9/15 she received no insulin as I monitored her Libre and her physical symptoms. Her Libre typically read between 250-350 and she generally seemed ok.
-9/15/23 she showed signs of lethargy, weakness, and lack of interest in most things so I took to the ER at which point they discovered elevated ketones. They suggested monitoring in house with fluids to get the ketones back down. Jasmine remained in the ER until the evening of 9/17/23 when she was discharged and was able to return home.
-9/19/23 Finally had an appointment with an internist (different hospital) who suggested we change from Vetsulin to Lantus due to Vetsulin not being the best for cats and suggested overnight monitoring at the hospital to ensure a correct insulin dose. Tested for pancreatic cancer, chronic lung disease, heart issues... all came back negative besides a heart murmur which I was told not to be too concerned with at the moment but it would be something to have checked out by a cardiologist down the road. She remained in the hospital until the afternoon of 9/21/23 when she was discharged now receiving 1 unit of Glargine (which I was told is the generic brand of Lantus). I was also told about ketodiastix as a non invasive way to check ketones and basic BG and also a glucometer such as Alphatrak to get blood sugar readings. I purchased a tidy cats breeze litter system to be able to monitor via her urine and an Alpha Trak 3 just incase I couldn't get urine readings.
-9/21/23 - 12/10/22 Jasmine was receptive yet suspicious of the litterbox but I was able to successfully obtain readings. Ketones were negative and trace amounts of Glucose present and she appeared to be happy, active, playful ..etc. There were periods I was unable to test her due to my own health issues but I always kept a close eye on her physical condition.
- 12/11/23 Given normal routine of wet food / insulin @ 10am but around 4pm showed signs of hypoglycemia. treated her at home with a drop of Nutrical on her gums and some wet food which she ate and since I was unable to test her for a few days I tried to to use the AlphaTrak and I couldn't get the control to be within the correct range for cats. I monitored her and made plans to take her to ER but she seemed to get better after about 20 minutes. I skipped her insulin dose that evening.
- 12/12/23 She showed normal behavioral signs, mooching for food in the morning and energetic so I gave her 1/2 unit of Glargine with her breakfast and monitored her through the day and ordered a new AlphaTrak. She appeared to return to normal throughout the day however I was still unable to get a urine sample but I also didn't want her to develop ketones so I gave her 3/4 unit of glargine with her normal dinner.
-12/13/23 - 12/20/23 Jasmine received her normal dosage of 1 unit of Glargine twice a day and continued to show a healthy appetite and normal behavior. She became suspicious of the breeze pellets so I had to switch back to normal litter for fear she may withhold and cause a health problem. The AlphaTrak was delayed so all I could do was overanalyze her every behavior throughout each day.
- 12/21/23 Received 1 unit of Glargine with normal food at 10am. Exhibited signs of hypoglycemia so I took her to the ER after Nutrical and food seemed to not have much effect. They confirmed low BG, got her stable and suggested she stay overnight for monitoring.
- 12/22/23 remained in ER and I was told they suspected she was in remission so they after stabilizing her BG they slowly weened her off insulin and continued to monitor. Her sugar seemed to stabilize off insulin and I was told the wonderful news of her successful remission with the caveat that there was no guarantee she would not relapse. I was also informed that Jasmine is mildly anemic but not anything concerning. She was cleared for discharge at 5pm on 12/23/23. After bringing her home she seemed not like herself. Very weak and tired and just seemed uninterested in anything but I thought it was just fatigue from being in the ER so frequently and I figured maybe in the morning her mood will get better.
-12/24/23 She had little appetite in the morning and continued throughout the day to just be weak and uninterested in anything. She seemed to just lay next to the water bowl and continuously drank a lot of water so I called the ER and they advised to bring her in. Admitted into the ER and shown to have Ketones (1.4 if I remember correctly). More testing, checking again for pancreas issues and restarted insulin this time 1/2 unit of Glargine twice a day.
-12/26/23 She was discharged after a lengthy conversation with another vet about possible long term plans and once home I immediately saw an improvement in her behavior. She was back to mooching and had energy.
I believe most people here get them from Walmart, but I get mine from the Jewel Osco pharmacy down the street from me. For some reason, Walgreens didn't have them and seemed confused about it (about a lot of things, actually), but I think that might have been the specific clerk, and not a reflection on all Walgreens or their employees 
