? BG spiking?

[CassAndGordy(GA)]

Hello,

Gordy and I are both new to this whole thing... so bare with me with my ramblings...

So, I have been giving Mr Gord has 2U of Vetsulin twice a day as told by my Vet. I am noticing he is pretty high pre-shot and comes down much lower around the +5 mark. (A good low!) I am worried that this is too much of a bounce.

I spoke with my Vet on Monday and he suggested either upping the dose or MAYBE going to a different insulin, like Lantus. I wanted to hold off one more week to see if his numbers keep doing this (Shock... they are.)

Now I believe I did a lot of furshot in the beginning, but I am better now, so these numbers confuse me...

It looks to me that the Vetsulin isn't lasting the full 12 hours, but it working to a degree. I don't necessarily want to increase the dose because then he may go to low at nadir.

What do you guys think?

(My SS should be up to date... I entered the newest numbers earlier.)

 

[Critter Mom]

It looks to me that the Vetsulin isn't lasting the full 12 hours, but it working to a degree.

I agree. Vetsulin is definitely working in Gordy the way one would expect based on the action profile for the insulin described by the manufacturer (a sort of bucket-shaped curve). Some cats may get better duration than you're seeing on Vetsulin but to the best of my knowledge they are in the minority of all cats on Vetsulin.

A switch to a longer-acting insulin (e.g. Lantus or Levemir) is definitely worth proper consideration.


Mogs
.

 

[Alexi]

What you are seeing is a typical response to vetsulin with the smile shaped curve, it looks good, some cats do well on vetsulin once you get the dose right. Another way of managing and steering the numbers is some adjustment to the food - what are you feeding and when?

You haven't been at this very long so we don't yet know if the dose is right for Gordy and if he is a cat who will respond, we have members who have had very good results recently but it does take patience, this is true of all insulins.

 

[CassAndGordy(GA)]

What you are seeing is a typical response to vetsulin with the smile shaped curve, it looks good, some cats do well on vetsulin once you get the dose right. Another way of managing and steering the numbers is some adjustment to the food - what are you feeding and when?

You haven't been at this very long so we don't yet know if the dose is right for Gordy and if he is a cat who will respond, we have members who have had very good results recently but it does take patience, this is true of all insulins.

He gets 1/2 can of fancy feast classics before each shot, and usually the equivalent of a FF can in Wellness pate between shots. He does get a small amount of Evo dry, but I am trying to get the amount of wet better so maybe he won't want it. He seems to be pretty good with amount.... only begs first thing in the morning.

 

[CassAndGordy(GA)]

My vet just called and wants me to increase to 3units.

I've read for some of the other insulins, that sometimes doing full unit increases overshoots it. I'm worried that he will drop too low at nadir =\

@Alexi When you were doing the Caninsulin, did you increase in full units? I'm thinking maybe doing 2.5 instead and monitoring him.

 

[Alexi]

I started with 2 units, and the next increase was to 2.5 units on vet advice. Looking at his spreadsheet I'd take the dose up gradually, do a curve after a week and go from there whilst continuing with mid cycle and +2 numbers where you can. 2.5 looks reasonable to me.

ETA It goes without saying that the dose increase should be on a cycle you can monitor.

 

[Elizabeth and Bertie]

It looks to me that the Vetsulin isn't lasting the full 12 hours, but it working to a degree. I don't necessarily want to increase the dose because then he may go to low at nadir.
What do you guys think?

Hi Cassie,
I think you have a couple of options to think about at this point. You could increase the dose a tad, or you could continue on the same dose a bit longer to see if the numbers level out a bit.
Are you using syringes or a 'vetpen'? If syringes then you have the option of making much smaller increases to the dose than would be possible with the vetpen.

Was Gordy only dx a month ago ? If so it's still 'very early days', and quite a lot can change in the initial weeks/months. It may be that Gordy's body is still 'getting used' to the insulin, and you may yet see improvements on the current dose.

As to the 'bouncing', there might be more than one factor in play here. It might be that Gordy is bouncing when he is hitting blue numbers, because his body has got used to high blood glucose levels, and even those blues are a bit 'scary' for him at the moment. But the blue numbers seem to be preceded by quite fast drops in blood glucose (possibly due to him dropping out of a previous bounce, or just because the insulin happens to be dropping his blood glucose fast); and the speed of the blood glucose drop may also contribute to the bouncing. But at this point we just don't know for sure...

You are doing really well at hometesting! Great work! And it's also good to see that you are putting comments in the 'remarks' section of the SS. That's very helpful. You can also use that space to jot down any comments about Gordy's health/demeanour/appetite/behaviour (how does he seem in himself? Is he happy? Are there any times when he seems off colour?)

For this stage of the game you are doing very well indeed.

Edited to add: There is also, of course, the option of switching to a different insulin. But as yet it would seem to be a bit early to tell whether Vetsulin is going to work for Gordy. If you are considering a possible switch to Lantus then you may find it helpful to first read through some of the information 'stickies' in the Lantus forum here at FDMB.

Eliz

 

[CassAndGordy(GA)]

Are you using syringes or a 'vetpen'? If syringes then you have the option of making much smaller increases to the dose than would be possible with the vetpen.

I am using a syringe

Was Gordy only dx a month ago ? If so it's still 'very early days', and quite a lot can change in the initial weeks/months. It may be that Gordy's body is still 'getting used' to the insulin, and you may yet see improvements on the current dose.

I don't even know if its been a full month. But that's why I want to hold off adjusting the dose again.
The last 2 shots, he tested at PS 401 and 399... and then went up for the +1 and THEN started to decline. I haven't seen that before... (I don't have these in the SS right now, I'll add tonight.)

You are doing really well at hometesting! Great work! And it's also good to see that you are putting comments in the 'remarks' section of the SS. That's very helpful. You can also use that space to jot down any comments about Gordy's health/demeanour/appetite/behaviour (how does he seem in himself? Is he happy? Are there any times when he seems off colour?)

Thank you!!! He has always been cranky and lazy LOL, even when he was a kitten. He seems to be perfectly fine through all of this


Thank you guys. I think I'll leave his dose at 2 for right now. I will not be home consistently enough in the next week to monitor him closer for a dosage adjustment. I will revisit next week. Maybe he'll even out in the meantime!

 

[Tuxedo Mom]

The last 2 shots, he tested at PS 401 and 399... and then went up for the +1 and THEN started to decline. I haven't seen that before...

That is quite normal to have a higher number at +1. With many/most kitties there will be a food spike at +1. With Vetsulin it is just starting to work at this point so it will start to bring the numbers down.

 

[CassAndGordy(GA)]

That is quite normal to have a higher number at +1. With many/most kitties there will be a food spike at +1. With Vetsulin it is just starting to work at this point so it will start to bring the numbers down.

Ok, that's what I was thinking it was! I don't do a ton of +1, usually +2 and more, so it threw me for a loop.

I think I am also being extra paranoid LOL

 

[Tuxedo Mom]

Ok, that's what I was thinking it was! I don't do a ton of +1, usually +2 and more, so it throw me for a loop.

I think I am also being extra paranoid LOL

We ALL can be paranoid, especially in the early days. A lot of members here give a whole new meaning to "helicopter Mom/Dad"