Advice for Tigger

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Rachel & Tigger

Member Since 2016
Hello everyone,

Tigger is 15yo, and was diagnosed with FD in Aug2015. He had lost over half his body weight (about 16-17 Lbs down to 6.5Lbs) and had pretty bad neuropathy in the hind legs (this is almost all the way better). He has been on Vetsulin since diagnosis, first at 2U, twice a day, and now prescribed 3U, twice per day. His current fructosamine (after the dosage increase) put him in the "fair control" range. Our current vet is closing, and I have a new vet in mind, however we are having some issues with regulation on the Vetsulin and instances of hypo setting in. He has been eating Friskies shreds, which I know are higher in carbs, but we only had one issue with hypo early on when his dosage was upped from 2 to 3U on this food. I switched him back to the Friskies Pate last week, and he has had two issues with hypo (twitching, disorientation, uncontrolled urination, stumbling around) since. Because of the hypo, I have been slowly decreasing his insulin from the 3U to around 2.25U, because I feel like the massive drops are coming from too much insulin, and the change to lower carbs in his food. I am looking to switch him from Vetsulin to Lantus or Levemir, but just need to get into the new vet first to make sure I'm on the right track. This particular vet used to treat my neighbor's kitty for years, and he was diabetic, as well. I'm not worried about her getting on board with the switch.

Today, his AMPS was 357 @6:08am, he got 5.5oz of Friskies pate @6:10am, and since he needs food in his system a bit before his shot, he got 2.25U of Vetsulin @6:40am. When I checked on him at 12Noon, I could see he was acting weird and then he just started peeing, so I knew he was low needed food. I gave him some Friskies shreds and a little Karo on the gums. About an hour later, at 1pm, his BG was at 72, so I knew it was coming back up. We skipped his evening shot to give him some rebound time, and tonight at 10pm, he was at 494, which is too high, I know. He had 5.5oz of Fr.pate at 6pm, and his regular small snack at 10pm tonight. I will test in the morning, feed, and then shoot accordingly. We use a Freestyle Precision Neo human meter to test.

My question is this: Until I get him on a new insulin, and given his instances of hypo, should I keep him on the higher carb food with small meals through the day (we do this already), and should I try to lower the dosage to get him better regulated? I hate this Vetsulin insulin with a passion---it's just too hard on him.

I have a spreadsheet that I started two days ago, but just haven't linked it yet to my profile.

Thank you in advance!
 
If he's going so low that he's having symptomatic hypo's, he needs less insulin!!

Have you gotten any tests when he's been acting like he's too low?

Going from a high carb food to a low carb one can drop the blood glucose numbers 100 points or more, so I'm sure that's part of what's going on

A symptomatic hypo is a dangerous thing and can also make the cat even more sensitive to insulin afterwards, so please decrease his dose!
 
If he's going so low that he's having symptomatic hypo's, he needs less insulin!!

Have you gotten any tests when he's been acting like he's too low?

Going from a high carb food to a low carb one can drop the blood glucose numbers 100 points or more, so I'm sure that's part of what's going on

A symptomatic hypo is a dangerous thing and can also make the cat even more sensitive to insulin afterwards, so please decrease his dose!
Thank you Chris! That's what I'm working towards. Unfortunately, my current vet knew nothing really, so I'm just recently learning about how harsh Vetsulin is for him now. I only gave him 2.25U this morning, instead of 3U, so would you suggest going lower? If so, how much lower? We also skipped this evening's shot since he would likely be more sensitive to the insulin after a hypo event.

Thanks!
 
If he's going so low that he's having symptomatic hypo's, he needs less insulin!!

Have you gotten any tests when he's been acting like he's too low?

Going from a high carb food to a low carb one can drop the blood glucose numbers 100 points or more, so I'm sure that's part of what's going on

A symptomatic hypo is a dangerous thing and can also make the cat even more sensitive to insulin afterwards, so please decrease his dose!
I didn't take the time to test him during his hypo event this morning because I was too worried about getting his BG back up. I will make sure to do so next time.
 
Without seeing a spreadsheet and knowing how low he's been going (especially when he's acting wonky), it's really impossible to advise you too much.

If he were my cat, I'd probably drop back to maybe 1 or 1.5 unit and get at least 4 tests per day (Pre-shot test in the morning, mid-cycle somewhere between +4 and +7 on the AM cycle, then PMPS and at least a "before bed" test at night

It won't take long if you can get those 4 tests in and shoot only 1 or 1,5 for us to be able to help you a lot more

I'd concentrate on getting a script for Lantus so you can email it off to Marks Marine Pharnacy
 
Without seeing a spreadsheet and knowing how low he's been going (especially when he's acting wonky), it's really impossible to advise you too much.

If he were my cat, I'd probably drop back to maybe 1 or 1.5 unit and get at least 4 tests per day (Pre-shot test in the morning, mid-cycle somewhere between +4 and +7 on the AM cycle, then PMPS and at least a "before bed" test at night

It won't take long if you can get those 4 tests in and shoot only 1 or 1,5 for us to be able to help you a lot more

I'd concentrate on getting a script for Lantus so you can email it off to Marks Marine Pharnacy

I know you can't give me exact advice....just looking for general direction from people who have more experience than me. I will start fresh in the morning, and try 1.5U to see how he does. I usually test as you have suggested, AMPS, PMPS, and the in betweens, but just started keeping the spreadsheet when I found it on the forum a couple days ago. I will try to link to my profile tomorrow. Thank you for your advice!
 
Welcome to the sugardance!!!

The people here are great about helping a new pet parent and you have the chance to set up something very special

What time do you shoot in the morning?
 
Usually, we shoot around 6am and 6pm. I usually try for 2-3 testings after the morning shot, as well as the evening shot. I'm up until at least midnight most nights, so I can test late in the evening too.
 
Without seeing a spreadsheet and knowing how low he's been going (especially when he's acting wonky), it's really impossible to advise you too much.

If he were my cat, I'd probably drop back to maybe 1 or 1.5 unit and get at least 4 tests per day (Pre-shot test in the morning, mid-cycle somewhere between +4 and +7 on the AM cycle, then PMPS and at least a "before bed" test at night

It won't take long if you can get those 4 tests in and shoot only 1 or 1,5 for us to be able to help you a lot more

I'd concentrate on getting a script for Lantus so you can email it off to Marks Marine Pharnacy
Chris, I linked up Tigger's spreadsheet. There's not much on it yet, as I started in at the PMPS a couple of days ago, but you can see what I have going on. Hope it all makes sense. Thanks again!
 
Your spreadsheet may indicate that Tigger's dose is too high. The higher BG numbers you are seeing are likely a "bounce," when the liver panics at the very low numbers and tries to compensate by releasing more glucose. I wouldn't want to say for sure that's what is happening without more spreadsheet info, but that is what I would suspect.

http://www.felinediabetes.com/FDMB/threads/what-is-a-bounce.108796/
Thank you for your input! I was reasonably sure that was what was going on, but it's good to hear validation on this. We are starting fresh this morning with a lower insulin dosage, so we will see how he does. Thanks so much!
 
Thank you for your input! I was reasonably sure that was what was going on, but it's good to hear validation on this. We are starting fresh this morning with a lower insulin dosage, so we will see how he does. Thanks so much!
Hope it all goes well for you and Tigger! :):):)
 
Your spreadsheet may indicate that Tigger's dose is too high. The higher BG numbers you are seeing are likely a "bounce," when the liver panics at the very low numbers and tries to compensate by releasing more glucose. I wouldn't want to say for sure that's what is happening without more spreadsheet info, but that is what I would suspect.

http://www.felinediabetes.com/FDMB/threads/what-is-a-bounce.108796/
Question:
He is acting hungry this morning, but is not liking his food for some reason. How much food should he actually have in order to shoot the Vetsulin? I know he has to have food in his system, but I don't want to give him the shot if he's not had enough to eat. He's slowly eating, but not a considerable amount, as of yet. I'm thinking he doesn't like the pate much, and prefers the Friskies filets and shreds. It seems to be a texture thing, maybe? Maybe I could get him the shreds/filets and just rinse the gravy off of it? Do you know of another food that is chunky like that but with no gravy? Figures he'd decide to be a picky eater now, when he's never been before! LOL
 
Figures he'd decide to be a picky eater now, when he's never been before! LOL
Lol, he's a cat, fickle is their rule to live by! I have never tried them but Fancy Feast has Chunky and Flaked varieties that are under 10% carbs.

http://catinfo.org/docs/FoodChartPublic9-22-12.pdf

I have a civvie with IBD who never likes anything I feed her, she only wants the foods that tear up her stomach and give her horrible diarrhea. Cats! :rolleyes:
 
Lol, he's a cat, fickle is their rule to live by! I have never tried them but Fancy Feast has Chunky and Flaked varieties that are under 10% carbs.

http://catinfo.org/docs/FoodChartPublic9-22-12.pdf

I have a civvie with IBD who never likes anything I feed her, she only wants the foods that tear up her stomach and give her horrible diarrhea. Cats! :rolleyes:
Ah geez! I will get some of that FF today! I have looked at Dr. Lisa's food list extensively, and I don't know how I missed the low carb FF you suggested! Couldn't see the forest for the trees! lol Hopefully it will make him happy.
I'm sure he's not feeling well because his BG is elevated still.

He did eat some, maybe 1 oz or so. Is it safe to shoot with that little food in? I was going to start at 1.5U this morning, but maybe I should drop down to 1U instead?
 
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Lol, he's a cat, fickle is their rule to live by! I have never tried them but Fancy Feast has Chunky and Flaked varieties that are under 10% carbs.

http://catinfo.org/docs/FoodChartPublic9-22-12.pdf

I have a civvie with IBD who never likes anything I feed her, she only wants the foods that tear up her stomach and give her horrible diarrhea. Cats! :rolleyes:
Awww yes! He's up and eating a bit more! I will shoot 1U, and see how he does. Woohoo!
 
Awww yes! He's up and eating a bit more! I will shoot 1U, and see how he does. Woohoo!
Are you able to monitor him today? I would check his BG frequently and try to get him to eat as much or as often as possible. I used to use Vetsulin, too, and it is SO harsh, you want to make sure he gets plenty of food on board to buffer those big drops!
 
Are you able to monitor him today? I would check his BG frequently and try to get him to eat as much or as often as possible. I used to use Vetsulin, too, and it is SO harsh, you want to make sure he gets plenty of food on board to buffer those big drops!
Yes, I'll be able to watch him today =) I have to run some errands later, but I can do the +2 spot check, and then I should be back in time for the +4, +6, etc. I will leave his food out for him to graze on while I am gone, as he usually gets a snack to combat the rapid drop in BG, due to the Vetsulin. I only gave 1U, so I'm hoping the lower dose will be much better for him. Vetsulin is TERRIBLE! I cannot wait to switch him over to Lantus or Levemir. They look to be so much gentler on the system.

Thank you again! You've been the biggest help this morning! =)
 
Looks like Tigger either didn't eat enough or you still need to reduce the dose even more!!

That's quite a dive from 480 to 32 in 3 hours!!!
 
Looks like Tigger either didn't eat enough or you still need to reduce the dose even more!!

That's quite a dive from 480 to 32 in 3 hours!!!
I know....such a big curve. It's so distressing. I only gave him 1U this morning, and I waited until he had more food in his system. I bought him a different kind of food, still low carb, in the hopes that he will eat more. I'm determined, though. About to check him at the moment, and will update his spreadsheet.

Thank you for checking in, Chris!
 
Lol, he's a cat, fickle is their rule to live by! I have never tried them but Fancy Feast has Chunky and Flaked varieties that are under 10% carbs.

http://catinfo.org/docs/FoodChartPublic9-22-12.pdf

I have a civvie with IBD who never likes anything I feed her, she only wants the foods that tear up her stomach and give her horrible diarrhea. Cats! :rolleyes:
The FF food you mentioned here is a hit! Thank you so very much! I feel so relieved to find something he likes and enjoys eating! Thank you!
 
Looks like Tigger either didn't eat enough or you still need to reduce the dose even more!!

That's quite a dive from 480 to 32 in 3 hours!!!
Chris, I just checked his BG and he's back up to 380. Would this be considered a bounce? And what is your thoughts on his PM shot? It's not due until around 7, however should I lower again and see how he does or maintain on the 1U such as this morning? We are trying out the FF flaked food right now, and he likes it, so I shouldn't have a problem getting him to eat again.

I hope I don't sound like I don't know what I'm doing. I just know that if I don't ask the questions, then I won't know.
 
Yes, that would be a bounce!

He went too low and his liver released stored sugars and hormones to bring him back up

I've never used Vetsulin, so I'm really not that comfortable with dosing advice....I'll tag @Squalliesmom too since I know she used to use it and see what she thinks

I'd suggest reducing down to .75 tonight though since the 1 unit dropped him into the 30's...if he ends up needing a higher dose, we can always go back up, but right now, we need to keep him safe
 
Yes, that would be a bounce!

He went too low and his liver released stored sugars and hormones to bring him back up

I've never used Vetsulin, so I'm really not that comfortable with dosing advice....I'll tag @Squalliesmom too since I know she used to use it and see what she thinks

I'd suggest reducing down to .75 tonight though since the 1 unit dropped him into the 30's...if he ends up needing a higher dose, we can always go back up, but right now, we need to keep him safe
Thank you so much, Chris! I appreciate your input so much!
 
Yes, that would be a bounce!

He went too low and his liver released stored sugars and hormones to bring him back up

I've never used Vetsulin, so I'm really not that comfortable with dosing advice....I'll tag @Squalliesmom too since I know she used to use it and see what she thinks

I'd suggest reducing down to .75 tonight though since the 1 unit dropped him into the 30's...if he ends up needing a higher dose, we can always go back up, but right now, we need to keep him safe
So, I took Tigger's Vetsulin down to .75 at dinner time, he ate a good meal, and had a good snack tonight, and his levels have been maintaining in the upper 300's. Not great, but at least it's not the huge swings he's been having, which I feel like is better at this point. What are your thoughts on the dosage now? Should we stay at the .75 for tomorrow and see how he does all day, or should we bump back to 1U? My gut tells me to hold off for one more day to see how the .75U does for him tomorrow since we just came off this huge bounce, but I'm always open to suggestions.

Thank you again, @Chris & China ! I sure appreciate your help! You, too, @Squalliesmom ! You guys are awesome! Much love from Tigger and I!
 
Hi, Rachel, sorry I missed you question yesterday, I have been sick and not spending as much time online as I usually do.

I would keep him on the .75 dose for at least a couple more cycles to see where his BG is going. I will always err on the side of caution - once the insulin is in them, you can't take it back out, if you know what I mean. 480 to 32 in three hours is a HUGE drop, even for Vetsulin! The high numbers you are seeing now are probably still part of a bounce; it can take 2 or 3 days to clear a bounce, sometimes.

Squallie and I wrestled for about 9 months with Vetsulin before switching to Lantus. Squallie was one of those rare cats that did reasonably well on Vetsulin, but it's just so harsh, I wanted to go to something that would not be as hard on his system. You can undoubtedly get Tigger regulated to some degree on Vetsulin, but to save him, and yourself, the scares and stresses of it, I would recommend switching to one of the longer-acting insulins.

BTW, glad to hear the food worked for him! :):):)
 
Hi, Rachel, sorry I missed you question yesterday, I have been sick and not spending as much time online as I usually do.

I would keep him on the .75 dose for at least a couple more cycles to see where his BG is going. I will always err on the side of caution - once the insulin is in them, you can't take it back out, if you know what I mean. 480 to 32 in three hours is a HUGE drop, even for Vetsulin! The high numbers you are seeing now are probably still part of a bounce; it can take 2 or 3 days to clear a bounce, sometimes.

Squallie and I wrestled for about 9 months with Vetsulin before switching to Lantus. Squallie was one of those rare cats that did reasonably well on Vetsulin, but it's just so harsh, I wanted to go to something that would not be as hard on his system. You can undoubtedly get Tigger regulated to some degree on Vetsulin, but to save him, and yourself, the scares and stresses of it, I would recommend switching to one of the longer-acting insulins.

BTW, glad to hear the food worked for him! :):):)
Thank you! I just checked him and it's +4 post shot and he's at 158! Which is a wonderful number to see! He's having a small snack now, so that should keep him from bottoming out. Vetsulin is hard to manage, for sure. After July 4th, I'm going to call and get his appt. set up with the new vet and then get him on something better.

Sorry you have been ill =( I sure hope you feel better soon! Hugs!
 
Thank you! I just checked him and it's +4 post shot and he's at 158! Which is a wonderful number to see! He's having a small snack now, so that should keep him from bottoming out. Vetsulin is hard to manage, for sure. After July 4th, I'm going to call and get his appt. set up with the new vet and then get him on something better.
I'm glad he's in good numbers! Hope he stays there for you! :)

Sorry you have been ill =( I sure hope you feel better soon! Hugs!
Thanks!
 
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