AMPS: 580, +5 BG 127 PMPS: 438, +2 BG 282. Advise on dosage with new diet.

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Erica & Carter

Erica & Carter

Member Since 2016
Please let me know if it is frowned upon to make too many threads, I just don't know if that's what you're suppose to every time a new question or issue comes up.

So Carter dropped from 580 to 127 in about 5 hours. I won't be giving him his PMPS or insulin for another 3 hours. It says on other threads the rule of thumb is to not shoot if under 200.

I'm concerned however that because his dose is at 4units and he's eating the wet food that 4 units would be too much even if he is over 200. I believe she upped the dose because his dry food was keeping his BG high earlier this week.

With the canned food heavily decreasing his BG plus using a hard-hitting insulin like Vetsulin, I'm hesitant to give him the 4 units.

I called my vet but they are slammed and haven't called me back yet.
 
If the thread gets too long it's fine to start a new one, but it helps to put the link to the prior one into the new one so people can quickly go back and see what's going on. Most of us just do one new post per day and then if something changes, we edit the subject line

Here's your Post from this morning

A LOT can happen in the next 3 hours before shot time again, so it's really too early to say, but if you test, if he's under 200, you might want to hold off on feeding him for 20-30 minutes and then test again to see if he's gone above 200. If you do "stall" like that, you'll have to remember to change your shot time in the morning though since you don't want to give it more often than every 12 hours (although you can work your way back to your "chosen" shot time by moving 15 minutes per cycle until you're back where you want to be) Also, if you "stall", you'll still need to wait about 30 minutes after feeding before you shoot because of the action of Novolin

With him dropping that much on 4 units, unless he's really high, I'd probably say to shoot a smaller dose, but I don't use Novolin so I really have no experience with it.

I know @BJM has some experience with the harsher insulins, as does @Squalliesmom so hopefully they'll drop in
 
Chris & China said:
If the thread gets too long it's fine to start a new one, but it helps to put the link to the prior one into the new one so people can quickly go back and see what's going on. Most of us just do one new post per day and then if something changes, we edit the subject line

Here's your Post from this morning

A LOT can happen in the next 3 hours before shot time again, so it's really too early to say, but if you test, if he's under 200, you might want to hold off on feeding him for 20-30 minutes and then test again to see if he's gone above 200. If you do "stall" like that, you'll have to remember to change your shot time in the morning though since you don't want to give it more often than every 12 hours (although you can work your way back to your "chosen" shot time by moving 15 minutes per cycle until you're back where you want to be) Also, if you "stall", you'll still need to wait about 30 minutes after feeding before you shoot because of the action of Novolin

With him dropping that much on 4 units, unless he's really high, I'd probably say to shoot a smaller dose, but I don't use Novolin so I really have no experience with it.

I know @BJM has some experience with the harsher insulins, as does @Squalliesmom so hopefully they'll drop in
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I just fed him is dinner and then I will feed him his late food to go with his insulin in a few more hours.

I'll do his PMPS and see how high it is, I feel like it will probably be above 200 by then.

My vet told me to decrease back to 3 units given the change to the canned diet.

She also gave the OK that when this Vetsulin runs out that she is perfectly fine switching to Lantus or ProZinc, she said she didn't know as much about Levamir but could look into it. So that's great! I was hoping I didn't have to come off as pushy or rude to get that to happen.
 
Changing to a low carb canned food may reduce the glucose 100-200 mg/dL and may reduce the insulin requirement by 1-2 units.
If you're not able monitor, I'd drop the dose by 2 units for safety.

Also, check the calories of what you were feeding and what you are now feeding. If that is reducing the calories, too, that may further decrease the glucose level, plus leave the cat more hungry.
 
BJM said:
Changing to a low carb canned food may reduce the glucose 100-200 mg/dL and may reduce the insulin requirement by 1-2 units.
If you're not able monitor, I'd drop the dose by 2 units for safety.

Also, check the calories of what you were feeding and what you are now feeding. If that is reducing the calories, too, that may further decrease the glucose level, plus leave the cat more hungry.
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Yeah I figured his large drop today had a lot to due with his canned food. She said if its over 250 to do 3 units but if its under to do 2 unjts to be safe.

I still have my PMPS to do still so we'll see what we get.
 
If your vet is good to let you use Lantus, I'd go ahead and ask for a script so you can be working on getting it! It's very expensive here in the states, but if you order from Marks Marine Pharmacy in Canada, it's 1/3rd the cost it is here

It'll take about a week to get delivered, so you'd be continuing to use the Vetsulin for now. If you order from Marks, ask for the Lantus Solostar pens...they're the best deal and you'll be able to use every drop (with the vials, the insulin will lose efficacy before you can use it all up so you end up throwing half of it away). If your vet writes for the vial, you can just ask the people at Marks to send you the pens instead

As you've already seen, we have had lots of people switch and they are so much happier with the Lantus than they were with the Vetsulin and it'll give Carter the best chance at remission too.

Just tell your vet you want some time to shop around for the best price....some vets don't approve of us buying from Canada but it's the exact same thing...just a lot cheaper!!
 
Chris & China said:
If your vet is good to let you use Lantus, I'd go ahead and ask for a script so you can be working on getting it! It's very expensive here in the states, but if you order from Marks Marine Pharmacy in Canada, it's 1/3rd the cost it is here

It'll take about a week to get delivered, so you'd be continuing to use the Vetsulin for now. If you order from Marks, ask for the Lantus Solostar pens...they're the best deal and you'll be able to use every drop (with the vials, the insulin will lose efficacy before you can use it all up so you end up throwing half of it away). If your vet writes for the vial, you can just ask the people at Marks to send you the pens instead

As you've already seen, we have had lots of people switch and they are so much happier with the Lantus than they were with the Vetsulin and it'll give Carter the best chance at remission too.

Just tell your vet you want some time to shop around for the best price....some vets don't approve of us buying from Canada but it's the exact same thing...just a lot cheaper!!
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Great!

Do I need to have the actual script or can they contact the vet directly? I know on 1800 pet meds etc they can do it either way.

How does the one week delivery work when it has to be kept on ice/cold?
 
All the info is in that thread I linked above about Marks Marine Pharmacy...including a link to a video that shows how they package and ship

You can either email/fax a script, or the vet can fax one in on their own. Either way works and the people at Marks are fantastic!! They still remember the meaning of the words "customer service" and are very popular around here!!

You'll still need to contact them to make arrangement for payment, so if your vet sends the script, you can still ask them to send you the pens instead of the vial (if that's what he writes for)
 
You'll also need to make sure you get new syringes....Lantus is a U100 insulin, where Vetsulin is a U40 insulin that takes different syringes.

All these have half unit markings and are the correct syringes for the U100 insulin and are available from ADW online:
UtiCare
Monoject
Carepoint
Sure Comfort
BD Ultra Fine

They're also available at WalMart if you have one near you..Their Relion Brand 3/10ml, 3o or 31 gauge, 8mm insulin syringes all come with half unit markings (no matter what they might tell you)

This is what the Relion syringes look like:
relion syringes.png
 
Chris & China said:
You'll also need to make sure you get new syringes....Lantus is a U100 insulin, where Vetsulin is a U40 insulin that takes different syringes.

All these have half unit markings and are the correct syringes for the U100 insulin and are available from ADW online:
UtiCare
Monoject
Carepoint
Sure Comfort
BD Ultra Fine

They're also available at WalMart if you have one near you..Their Relion Brand 3/10ml, 3o or 31 gauge, 8mm insulin syringes all come with half unit markings (no matter what they might tell you)

This is what the Relion syringes look like:
View attachment 19697
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Awesome, thank you so much!

Do you need a script for the syringes? Either online or at Wal-Mart? To vets carry them? I assume but probably at a more expensive rate.

Also Carter's PMPS was @ 438. I'm feeding him now, will give him his last shot in about 20-30 minutes.
 
You will probably be okay with giving 3 units; if you want to err on the side of safety and get some sleep, you could give 2.

Vetsulin is hard on a kitty; Although my cat did very well on Vetsulin, it is still harsher on them than some of the other, longer-lasting insulins. My suggestion would be to NOT wait until you use up the Vetsulin, go ahead and do the switch as soon as you can.

ETA: If you give Carter 3 units tonight, please monitor him to head off any big drops!
 
Squalliesmom said:
You will probably be okay with giving 3 units; if you want to err on the side of safety and get some sleep, you could give 2.

Vetsulin is hard on a kitty; Although my cat did very well on Vetsulin, it is still harsher on them than some of the other, longer-lasting insulins. My suggestion would be to NOT wait until you use up the Vetsulin, go ahead and do the switch as soon as you can.

ETA: If you give Carter 3 units tonight, please monitor him to head off any big drops!
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I did go with the 3 units. Should I test him again before bed or just keep an eye on him?

He's acting normal, purring, running around playing with my other cat.

Is there anything I could do with the remaining Vetsulin and syringes? Although if I order from the site suggested for Lantus, by the time I recieve it I probably wouldn't have much left.
 
justfromerica said:
Do you need a script for the syringes? Either online or at Wal-Mart? To vets carry them? I assume but probably at a more expensive rate.
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Depends on where you live...different states have different syringe laws....Looks like you're in Alabama? According to a web search, no, you don't need a script for syringes

Vets don't usually carry the U100 syringes because they're used in human insulin's like Lantus, not most veterinary drugs

justfromerica said:
Is there anything I could do with the remaining Vetsulin and syringes? Although if I order from the site suggested for Lantus, by the time I recieve it I probably wouldn't have much left.
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Might call a shelter or rescue and see if they could use them
 
Chris & China said:
Depends on where you live...different states have different syringe laws....Looks like you're in Alabama? According to a web search, no, you don't need a script for syringes

Vets don't usually carry the U100 syringes because they're used in human insulin's like Lantus, not most veterinary drugs



Might call a shelter or rescue and see if they could use them
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Ah okay! Yeah will do. I probably won't have much left but whatever I have I'm sure some shelter could use.
 
Chris & China said:
Don't forget to keep your spreadsheet updated

What did you end up doing tonight as far as his dose?
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I can't update my spreadsheet because my internet is down and I'm only able to use the data on my phone which is verrrrryyy slow. I'm keeping it recorded though so I can put it in tomorrow when they come fix it.

I gave him the 3 units but now I'm worried that I should have given 2. Not for any particular reason but just based off of the responses I got after I already did. He's asleep on me right now, purring.

I was gonna test him again before bed just for peace of mine and give him the rest of his food he didn't finish earlier.
 
How long has it been since you shot? Have you tested at all since then? If you have, how long after the shot and where did he start and where was he then?
 
It'll help if you'll edit your subject line and keep it updated with the numbers as you get them...the people that scan the forum for problems watch those subject lines for signs that there's something going on that needs attention

Rub a dub-dub....there's a pooch in the tub!!....LOL
 
He will probably be okay with 3 units, but it can't hurt to check his BG one or two times before calling it a night, just to make sure he is staying in safe numbers. :)
 
Chris & China said:
It'll help if you'll edit your subject line and keep it updated with the numbers as you get them...the people that scan the forum for problems watch those subject lines for signs that there's something going on that needs attention

Rub a dub-dub....there's a pooch in the tub!!....LOL
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Will do.

Yeah and she hates baths!
 
Squalliesmom said:
He will probably be okay with 3 units, but it can't hurt to check his BG one or two times before calling it a night, just to make sure he is staying in safe numbers. :)
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+2 BG at 282. Just gave him the leftover of his dinner after I tested him, maybe 1/8th a can total.
 
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Yeah that's a pretty big drop, but that's Vetsulin....Good thing you did the 3u and not 4u

The worst part about those big drops is that it just sets them up to bounce again, so they end up being really high at PS, then dropping fast and bouncing back high by the next PS

He's still in totally safe numbers, but I'd plan on getting a +4 just to see how he's doing and if he's still dropping. I won't be able to stay that much longer though because I have to take my mom to physical therapy in the morning

You might want to consider (if your schedule allows it) to start shooting earlier...Looks like you're shooting pretty late which makes it that much more likely that you'll end up being up until the wee hours of the morning testing. I hate mornings, but after being up all night until 5-6am a few times testing, I decided it was better to drag my rear out of bed early (and maybe go back to sleep!) than to be up all night testing
 
Check again at +3. That's when the amorphous fraction of Vetsulin starts its period of peak glucose-lowering effect. If there's a significant drop between +2 and +3 I'd be inclined to check again at +4 to see if the drop has levelled out. If you're in any doubt about what to do, post again. (I'm in the UK so I won't be online but hopefully members from different time zones will be able to chime in.)

For info, the food change massively decreased Saoirse's insulin needs when she was on Caninsulin (same as Vetsulin - different branding in UK). She went from 3IU BID to under 1 unit in less than 48 hours. Your vigilance is appropriate. :)


Mogs
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Chris & China said:
Yeah that's a pretty big drop, but that's Vetsulin....Good thing you did the 3u and not 4u

The worst part about those big drops is that it just sets them up to bounce again, so they end up being really high at PS, then dropping fast and bouncing back high by the next PS

He's still in totally safe numbers, but I'd plan on getting a +4 just to see how he's doing and if he's still dropping. I won't be able to stay that much longer though because I have to take my mom to physical therapy in the morning

You might want to consider (if your schedule allows it) to start shooting earlier...Looks like you're shooting pretty late which makes it that much more likely that you'll end up being up until the wee hours of the morning testing. I hate mornings, but after being up all night until 5-6am a few times testing, I decided it was better to drag my rear out of bed early (and maybe go back to sleep!) than to be up all night testing
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Yeah definitely. No worries I appreciate your help! I'll need to bring it down slowly with that 15 minute interveral trick somebody mentioned previously. I had to do late because of my school schedule but the semester is ending.
 
Critter Mom said:
Check again at +3. That's when the amorphous fraction of Vetsulin starts its period of peak glucose-lowering effect. If there's a significant drop between +2 and +3 I'd be inclined to check again at +4 to see if the drop has levelled out. If you're in any doubt about what to do, post again. (I'm in the UK so I won't be online but hopefully members from different time zones will be able to chime in.)

For info, the food change massively decreased Saoirse's insulin needs when she was on Caninsulin (same as Vetsulin - different branding in UK). She went from 3IU BID to less than 1 unit in less than 48 hours. Your vigilance is appropriate. :)


Mogs
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Okay doke!

Would the fact that I also fed him shortly after checking his BG help in the case of more of a drop?
 
justfromerica said:
I'll need to bring it down slowly with that 15 minute interveral trick
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The other option if you want to make a big time change (like we went from 11am/11pm to 6am/6pm) is to skip one dose and then just start at the time you want to start at

justfromerica said:
Would the fact that I also fed him shortly after checking his BG help in the case of more of a drop?
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Yes, feeding him was good...hopefully it'll slow him down from dropping so fast
 
Chris & China said:
The other option if you want to make a big time change (like we went from 11am/11pm to 6am/6pm) is to skip one dose and then just start at the time you want to start at



Yes, feeding him was good...hopefully it'll slow him down from dropping so fast
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Would skipping not be risky, though? Just in addition to his diet change and being in the beginning stages.

I'd like to have him at 7:30am/7:30pm ideally.
 
Not necessarily....Vetsulin is an "in and out" insulin, so once it's done, it's gone from the body....with depot insulins like Lantus, it's more important that you don't miss a shot, but we occasionally will do two, 18 hour cycles if we need to (like we have to go out or for some reason just can't keep the 12 hour schedule)

Skipping once and then shooting will at least get you onto a schedule that you'll be able to get more tests in earlier in the evening and hopefully get to bed at a decent hour

This will be even more important if you switch to Lantus!!
 
Chris & China said:
Not necessarily....Vetsulin is an "in and out" insulin, so once it's done, it's gone from the body....with depot insulins like Lantus, it's more important that you don't miss a shot, but we occasionally will do two, 18 hour cycles if we need to (like we have to go out or for some reason just can't keep the 12 hour schedule)

Skipping once and then shooting will at least get you onto a schedule that you'll be able to get more tests in earlier in the evening and hopefully get to bed at a decent hour

This will be even more important if you switch to Lantus!!
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Gotcha.

Would you recommend I skip tomorrow morning? Or evening? Or wait until the day after that?
 
Chris & China said:
Vetsulin is an "in and out" insulin, so once it's done, it's gone from the body....
Click to expand...
You may get a little carryover from the crystalline fraction of the Vetsulin into the next cycle so if you skip it may stop the BG from rocketing upwards. The only way to know how Carter is using the insulin is to test. Provided Carter has no history of testing positive for ketones there should be minimal risk from skipping one dose in order to adjust the schedule to better fit your needs.

Will check back in later today.


Mogs
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Why don't you get a test in at about +11 in the morning and then post for some opinions? Just recap that you want to change your shot schedule from whatever time you're shooting now (11am/11pm?) and get onto an earlier shot schedule of 7:30am/7:30pm
 
Critter Mom said:
You may get a little carryover from the crystalline fraction of the Vetsulin into the next cycle so if you skip it may stop the BG from rocketing upwards. The only way to know how Carter is using the insulin is to test. Provided Carter has no history of testing positive for ketones there should be minimal risk from skipping one dose in order to adjust the schedule to better fit your needs.

Will check back in later today.


Mogs
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So would my next dose (in the AM) be a safe dose to skip?
 
I have to go get a last test for China and then hit the hay, so I hope you have a safe and quiet night. I asked one of our members in Australia to look in on you if she could later, and I'm going to tag @Gill & George too.....they're in Spain

They don't use Vetsulin either, but they know what to do in a crisis
 
Chris & China said:
Why don't you get a test in at about +11 in the morning and then post for some opinions? Just recap that you want to change your shot schedule from whatever time you're shooting now (11am/11pm?) and get onto an earlier shot schedule of 7:30am/7:30pm
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10:00am/10:00pm but I have to wake up at 6:30am anyways to let my dog out so I didn't know if I needed to just check his BG then, feed him a little and decide to skip or not. Or set an alarm to go back to sleep and get up at 9am and do my AMPS at my regular time.
 
I really think you could do either, but don't shoot at 7;30....either skip and start over tomorrow night at your chosen time or wait until 10am to shoot

I was just thinking that if you keep your 10am schedule tomorrow, there will hopefully be more people here to offer opinions on skipping tomorrow night's shot and starting over at 7;30 Saturday morning
 
Critter Mom said:
For info, the food change massively decreased Saoirse's insulin needs when she was on Caninsulin (same as Vetsulin - different branding in UK). She went from 3IU BID to under 1 unit in less than 48 hours. Your vigilance is appropriate. :)


Mogs
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The same thing happened with Squallie - he went from 7 units down to two almost overnight! Changing to an all-wet, low carb diet can have an incredible affect on BG.

Erica, when you get a chance could you please update your spreadsheet? Thanks! :)
 
Hmm by my calculations we're well past +3 I hope she didn't run out of data as she thought she might. I'll keep checking in for a while.
 
@justfromerica -

Hi Erica,

Hoping all is OK with you and Carter. It would be great if you could just quickly post a short message to let us know you're both OK. (We worry! :nailbiting:)


Mogs
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