Hi Lisa,
I gave him a fur shot again but this time I didn't give him another one since I don't know if he got much of it.
Never, never, NEVER give a second injection if you think you've done a fur shot or have had any other problem with an injection. ALWAYS wait till the next dose is due before giving any more insulin.
Smoky has been very difficult to give shots to lately.
Also, smoky doesn't seem to feel well and is hiding under the coffee table in my bedroom.
With the hiding and also fighting the injections Smoky is trying to tell you something is wrong, Lisa. (Other members, myself included, have observed similar behaviours when treating their cats with Vetsulin/Caninsulin.)
Also, my vet keeps wanting to up his dose every five days.
If you look at his SS he has dropped 300 to 400 points in four hours.
Those drops of over 300 - 400 points are
HUGE, even by Vetsulin standards. If I saw them in my cat I would consider them to be highly dangerous. These data should have been a massive red flag to your vet that the dose is too strong.
Based on what data you've managed to gather plus Smoky's problematic clinical signs my thoughts are that Smoky is on
too high a dose of Vetsulin already.
My thinking is that the really high BG numbers are coming from Smoky's body trying to compensate to protect itself from the effects of too strong a Vetsulin dose. If he's dropping down into double figures that's too low for comfort on Vetsulin (you need a bigger safety buffer).
Thank goodness you didn't follow your vet's recommendation to aggressively increase the dose. If it were me, I'd be shopping for a vet who fully understands that regulation of a newly diagnosed diabetic is a slow and gradual process; it can't be 'forced' by increasing the dose. Indeed, that approach tends to lead to overdosing - as we so often see here. Note that some vets only look at making Vetsulin dosing adjustments based on preshot BG. This is not adequate. For safety weight should also be given to the nadir BG because Vetsulin can drop BG so hard and fast - especially when any given dose is completely tanking BG between preshot and nadir, and even more so when the Vetsulin nadir is in double figures (mg/dL) - as is the case with Smoky. I think that Smoky may very well be feeling awful at least in part due to those wide swings (human diabetics report that wide BG swings make them feel very unwell) but if, as it appears, the dose is too high that is also likely to be putting his little body under enormous strain as it tries to compensate to keep his BG levels up.
Unless Smoky is making it completely impossible to test him, Lisa, to protect Smoky you
need to test before EVERY dose to see if it's actually safe to give any insulin at all. Just because some PS BG values are high doesn't mean that
all PS BG levels will be safe - especially in a cat whose BGs are swinging as wildly as Smoky's. Thank goodness that you have managed to get some data to show just how low Smoky is going. I strongly recommend you test at +2 and +3 on every cycle if possible but definitely on the PM cycle. (Smoky's data suggests he has a tendency to run lower during the PM cycle; many, many cats do.)
I
strongly recommend that you speak to your vet ASAP about reducing Smoky's Vetsulin dose immediately. Highlight that drop from over 500 down to double digits by +3 on the PM cycle of 2 October - and that was on 2.0 IU Vetsulin. Now you're giving him 2.5IU Vetsulin (and you got another huge drop on 8 October PM cycle). There is no way of knowing for sure without test data but given the data you have there is the possibility that Smoky is going low at times when you're not testing.
Are you testing for ketones? If not, get some urine test strips today (e.g. Keto-diastix) and check them today. You should check ketone status regularly as a matter of course as part of Smoky's monitoring routine. You need to establish Smoky's ketone status now because that will have a direct influence on any dosing decisions that you and your vet make for him. If Smoky tests positive for ketones you need to immediately seek veterinary attention. If you are looking to reduce the dose you need to be especially vigilant about checking for ketones (recommend daily testing for the time being).
Mogs
.
