Caninsulin dosage advice needed please

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MrWorfMen's Mom said:
I'm a bit flummoxed by Josie's numbers. It looks like 0.75u is bringing numbers down a bit more mid cycle but pre-shots are mostly about the same although there have been a couple nicely lower. I'm no good at sliding scales either and would also recommend having Janet take a look and offer her opinion. I'm wondering if we are missing something in the +3 to +5 period in the cycle and would suggest getting a few more tests in that time frame to fill in a bit more data.

When you go on vacation, if you are concerned that DH won't be able to test mid cycle, you can reduce the dose slightly during your absence to keep numbers down but not necessarily optimal just for safety sake.
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Yes I've been trying to make sense of her random numbers too but can't figure out a pattern as it seem to be a bit all over the place.
Stays up when should go down but goes down when don't expect it to..?
Yes good idea, will do more +3 and +5, been focusing on +4 and +6 lately..
 
Hi Monica! Agreeing with the others here... hard to know what to say although it does seem that whatever dose you give doesn't last long enough. This is very common with Caninsulin as you know. It's tempting to suggest 1u and see what that does, and into the future you may feel it's time to ask the vet about another insulin that would give better duration... but yes, get some more data and that might help too!
 
Hello, if any of you had a minute to look at Josie's spreadsheet to tell me what you think that'd be fantastic as her numbers seem to be all over the place!?
Shall I continue with the increased 1 unit as it seem to be pushing low then high but at the other hand not every day..?!
No idea at this point how to go on about it to be honest and I definitely dislike that red number!
Thanks very much!!
 
As "unattractive" as that red number looks on the spreadsheet, it's totally expected and normal. One the hardest things about dealing with our sugar kids is to NOT get upset about or react to, any individual number (unless it's a low one) but rather to look at the trend overall. Josie got down to 9.9 and perhaps even a bit lower a little earlier in this cycle and she just isn't used to it yet, so she's bouncing back up very sharply. I'd stay the course for now and try to focus on the overall picture rather than those "one moment in time" numbers in colours you don't want. :)
 
MrWorfMen's Mom said:
As "unattractive" as that red number looks on the spreadsheet, it's totally expected and normal. One the hardest things about dealing with our sugar kids is to NOT get upset about or react to, any individual number (unless it's a low one) but rather to look at the trend overall. Josie got down to 9.9 and perhaps even a bit lower a little earlier in this cycle and she just isn't used to it yet, so she's bouncing back up very sharply. I'd stay the course for now and try to focus on the overall picture rather than those "one moment in time" numbers in colours you don't want. :)
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Was just about to post and Linda's reply popped up... very much what I was thinking, ie don't worry about one isolated number, plus we don't know if Josie went lower than 9 before you tested again so the red may well be a bounce. See what happens tomorrow and let's revisit then!
 
Thank you both for the speedy reassurance, yes will stick with the 1 unit for now. I suppose we haven't had a bounce for a while now have we so I forgot all about it..:banghead: I just didn't get why were the numbers all the way in the yellow yesterday and in the blue and red today.. Thanks again!
We're once again back in the ballroom doing the sugar dance..:cat:
 
MrWorfMen's Mom said:
As "unattractive" as that red number looks on the spreadsheet, it's totally expected and normal. One the hardest things about dealing with our sugar kids is to NOT get upset about or react to, any individual number (unless it's a low one) but rather to look at the trend overall. Josie got down to 9.9 and perhaps even a bit lower a little earlier in this cycle and she just isn't used to it yet, so she's bouncing back up very sharply. I'd stay the course for now and try to focus on the overall picture rather than those "one moment in time" numbers in colours you don't want. :)
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'Sugar kids' love it!:D
 
Remember also, Monica, that BGs can vary in response to all sorts of things, from the weather to a different food to feeling a bit poorly, etc. Hopefully all these things are transient. Josie is certainly not the only one to be "unpredictable".... newcomers here think there must be a magic formula/dose and everything will be fine - that may be the case for a lucky few, but for the rest it's a process over a period of time whilst the cat's system adjusts to different things going on.
Keep smiling!
 
Diana&Tom said:
Remember also, Monica, that BGs can vary in response to all sorts of things, from the weather to a different food to feeling a bit poorly, etc. Hopefully all these things are transient. Josie is certainly not the only one to be "unpredictable".... newcomers here think there must be a magic formula/dose and everything will be fine - that may be the case for a lucky few, but for the rest it's a process over a period of time whilst the cat's system adjusts to different things going on.
Keep smiling!
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Yes all very true Diana.
Although now I have another question if you don't mind..
I just took Josie's pmps and it dropped from 24.9 two hours ago to 21.5? Does this mean anything? Fed her last at lunchtime around 12.30. I would've thought it would stay high until next shot of insulin is given?
Was this part of the bounce and the liver kicking in pushing up then go down again?
 
MrWorfMen's Mom said:
As "unattractive" as that red number looks on the spreadsheet, it's totally expected and normal. One the hardest things about dealing with our sugar kids is to NOT get upset about or react to, any individual number (unless it's a low one) but rather to look at the trend overall. Josie got down to 9.9 and perhaps even a bit lower a little earlier in this cycle and she just isn't used to it yet, so she's bouncing back up very sharply. I'd stay the course for now and try to focus on the overall picture rather than those "one moment in time" numbers in colours you don't want. :)
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Great post, Linda....
.
 
Hello all, I'm back to this post as need dosage advice once again please. As some of you know we finally got to the bottom of the frequent vomiting and Josie was diagnosed with pancreatitis yesterday.
Since her rushed visit to the vet after the rough episode a few nights ago her PS numbers have dropped and seem to be in the yellow around 14/250 which could be down to the fact that she started receiving treatment then with a Cerenia shot and we've been giving her meds since then so maybe her pancreas is less strained and feeling more cheerful these days :)
The question is should we keep her on the current .75u or maybe start lowering dosage to 0.5u as I would prefer to keep her on the safe side whilst I'm away for 10 days from tomorrow morning and DH is unable to keep an eye on her. Unlike helicopter mummy who is hovering over her all the time.. He will be definitely doing the preshot tests twice a day and update on the spreadsheet but not sure if could/will do any more.
Or wait and see if she goes any lower?
Josie is happy and eating well at the moment. She even meowed eagerly this morning whilst waiting for me prepping her breakfast which I don't think she's done at all so far this year! She is a cat of few words/meows..:D
Thanks so much, hope you all have a lovely wknd:cat:
 
That's good news! I cant advise on dosing but I'm sure someone will pop along and help out. Or post on the vetsulin forum?
 
Very pleased to hear Josie is in such good form today, Monica! What a relief for you (and us!)

Ref the dosing, I think you've answered your own question by saying you'd prefer to stay on the safe side, so 0.5u seems reasonable. As Josie is feeling better in herself and less nauseous with the meds, that could well be contributing to her slightly lower numbers in the last couple of days, so going with 0.5u makes sense on that count. It may or may not keep her in better numbers later in the cycle but as you won't be there to test and gather that data, it's better to be cautious. We want you to go away and have a break, knowing Josie is safe in DH's hands! I would only suggest that you give him a short cribsheet with particularly important instructions, mainly not to shoot if she is under a certain number (usually 10) and in fact if she is around that at pre-shot, he may want to test again in half an hour or an hour... I guess this might be a step too far but a few basic principles would be useful with the instruction of when in doubt, don't shoot...

See what others say.
 
TempestsMum said:
That's good news! I cant advise on dosing but I'm sure someone will pop along and help out. Or post on the vetsulin forum?
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Thank you! As for posting on Vetsulin forum I'm kinda old fashioned and very fond of these ladies who are familiar with our journey so far and been helping us to get through the past few months so hopefully they won't mind advising me once again.. :)
 
Diana&Tom said:
Very pleased to hear Josie is in such good form today, Monica! What a relief for you (and us!)

Ref the dosing, I think you've answered your own question by saying you'd prefer to stay on the safe side, so 0.5u seems reasonable. As Josie is feeling better in herself and less nauseous with the meds, that could well be contributing to her slightly lower numbers in the last couple of days, so going with 0.5u makes sense on that count. It may or may not keep her in better numbers later in the cycle but as you won't be there to test and gather that data, it's better to be cautious. We want you to go away and have a break, knowing Josie is safe in DH's hands! I would only suggest that you give him a short cribsheet with particularly important instructions, mainly not to shoot if she is under a certain number (usually 10) and in fact if she is around that at pre-shot, he may want to test again in half an hour or an hour... I guess this might be a step too far but a few basic principles would be useful with the instruction of when in doubt, don't shoot...

See what others say.
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Thank you Diana.

Yes once I finally start and finish packing I was planning to make a list and stick it onto the kitchen wall with the basic important instructions. Will try to keep it short and simple!

Maybe do -

12 and above 0.5u
10-12 0.25u
10-under no insulin... ??

Will wait to see what others might suggest or maybe approve as above..

Or maybe above 12 0.5u and no shoot under 12?
 
Monica Lewis said:
Thank you! As for posting on Vetsulin forum I'm kinda old fashioned and very fond of these ladies who are familiar with our journey so far and been helping us to get through the past few months so hopefully they won't mind advising me once again.. :)
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:) Whatever you are most comfortable with is the best thing. But just so you, know the same people here are the same on there too. :bighug:
 
Honestly id stay at 0.75. You still have quite a large cushion under you. If you weren't going away I would have suggested going to 1 unit. We want to see her hitting those low blues and high double digits.
 
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JanetNJ said:
Honestly if stay at 0.75. You still have quite a large cushion under you. If you weren't going away I would have suggested going to 1 unit. We want to see her hitting those low blues and high double digits.
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I had a feeling you would say that Janet.. :)
I would've taken her up to one unit when we talked about it back then if she hadn't starting vomiting again and then the rough episode just now.. so stayed at 0.75 to see which way she was going..
 
Monica Lewis said:
I had a feeling you would say that Janet.. :)
I would've taken her up to one unit when we talked about it back then if she hadn't starting vomiting again and then the rough episode just now.. so stayed at 0.75 to see which way she was going..
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Yes I thought Janet would say that too! There will be two schools of thought here - go up in the belief that Josie can handle it and get into better numbers, or stay low for a bit longer while you can't monitor, to keep her safe... it depends what kind of person you are I guess! It's a shame you have to go away right at this point but you have to do what feels right to you.
 
Diana&Tom said:
Yes I thought Janet would say that too! There will be two schools of thought here - go up in the belief that Josie can handle it and get into better numbers, or stay low for a bit longer while you can't monitor, to keep her safe... it depends what kind of person you are I guess! It's a shame you have to go away right at this point but you have to do what feels right to you.
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You guys know me so well. I just think if she reduces the dose she will lose some traction. If her current dose was getting her into low blues is say play it safe and reduce.... But since I feel an increase is in order, staying at the current level is conservative enough. Eh either way kitty will be fine.
 
Monica, I use Lantus for Roxi and have only used Lantus for all 3 of the cats I've treated, so I can't give you specific dosing advice for Caninsulin. But, for Roxi, I reduce her dose to around 1/2 to 2/3 of her current dose if we're going to be away. Whether I use 1/2 or 2/3 for the dose really depends on how well she's been doing on her current dose (if she's been running in the 50s and 60s US for part of the day, I do half. If she's running in the 100s, I do 2/3). While the action of Caninsulin is different, there have been no problems even with a cat sitter who does not test (not because she can't, because Roxi won't allow it) in reducing a dose about that much either with any signs of hypo or with getting her back into reasonable numbers fairly quickly when we get home. However, that is based on the numbers we usually get, which are mostly blues with a few greens and an occasional yellow. Josie is running rather higher than that, so I would add in another option for the full 0.75 dose if Josie is very high at pre-shot because it doesn't seem as though the 0.75 brings her down too far. I think because you would really be looking at needing to increase her dose if you weren't going to be away, you can push that higher (but still not quite enough) dose if Josie is in very high numbers and still have her completely safe.
 
Hello everyone,
I'm back and back for dosage advice or even insulin change if needed!

Due to Josie's pancreatitis flare-ups since I'm back from hols and the complete diet change I've been reluctant to increase her dosage as we discussed previously but now I'm at crossroads as her numbers are getting really odd at times and very inconsistent lately with highs in the middle of the day or evenings and I can't figure out why..

They cannot be furshots as feeling the needle going in and been doing the same way for months...

It shouldn't be affected by the diet change as the new food Ropocat and Mac's have 0.8-1% carbs and the other posh one we tried was also lowish at 4.5% so shouldn't really change numbers that much... or should it??

Any ideas what these odd numbers could be down to?

I'm sorry about the lack of BG readings lately, we are working a lot more plus kitty is not so keen on letting us do it too often these days so we aim to do at least the PS ones every time plus whenever we can..

Shall we wait til things settle?

Shall we increase dosage?

Shall we change insulin?

I thought I had it all together but I am a bit clueless once again. Josie girl likes keeping me on my toes and presenting me with new challenging puzzles to solve...:banghead: :cat:

As always ANY advice and your thoughts are much appreciated! :)
 
Monica Lewis said:
Any ideas what these odd numbers could be down to?
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They look like bouncing to me. She might be dropping low-ish overnight on 0.75 u and rebounding the next day. Just a guess ...

Monica Lewis said:
Shall we wait til things settle?
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I suggest you leave the dose at 0.75 u for a few days and try hard to get one daytime mid cycle number and one late evening number each day. This will allow you to find out if she'll settle as well as see whether she has diving plans for the overnight hours - ie., a late evening BG that's significantly lower than PMPS.

Monica Lewis said:
Shall we change insulin?
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Maybe not yet. I know you have rules in the UK about when another insulin can be tried. If it comes to that I recommend asking for Lantus because it often helps kitties stabilize to some degree.
 
Kris & Teasel said:
They look like bouncing to me. She might be dropping low-ish overnight on 0.75 u and rebounding the next day. Just a guess ...


I suggest you leave the dose at 0.75 u for a few days and try hard to get one daytime mid cycle number and one late evening number each day. This will allow you to find out if she'll settle as well as see whether she has diving plans for the overnight hours - ie., a late evening BG that's significantly lower than PMPS.


Maybe not yet. I know you have rules in the UK about when another insulin can be tried. If it comes to that I recommend asking for Lantus because it often helps kitties stabilize to some degree.
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Yes thank you will try to get more mid cycles!

If she's bouncing would she also go higher not lower at +3 on the odd days? Is that typical? She's been fairly consistent only seem to be odd in the past week plus PS numbers seem to be creeping up as well..? Only increased back up in 0.25u instalments after she was very ill, should that have such effect?


Yes we do have rules re. insulin change according to our vet but she mentioned before that we have to try Caninsulin first but if results are not satisfying we can move onto another one.. Lantus is on the top of my list...

Thanks Kris
 
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Monica Lewis said:
Yes thank you will try to get more mid cycles!

But if she's bouncing why go higher not lower daytime on the odd days? Is that typical? She's ben fairly consistent only seem to be odd in the past week plus PS numbers seem to be creeping up as well..? Only increased back in 0.25u instalments, should that have such effect?


Yes we do have rules re. insulin change according to our vet but she mentioned before that we have to try Caninsulin first but if results are not satisfying we can move onto another one.. Lantus is on the top of my list...

Thanks Kris
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I'm a believer in consistent dosing AM and PM until things settle. In my opinion, changing dose too often can create more erratic numbers. Sliding scale dosing can work very well once things settle more. I must admit, too, that I have no expertise with sliding scale dosing. @JanetNJ could help you with that.
 
JanetNJ said:
I'd try 1 unit when the preshots are pink.
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Hi Janet,
You suggest it's ok to increase now that we are in the middle of changing her diet?
And she might be bouncing as Kris suggests above?
Wouldn't it mess up the numbers even more if we increase now on the pink days?
Thanks!
I'm actually trying to figure out first why are her readings so odd lately..?
 
Monica Lewis said:
Hi Janet,
You suggest it's ok to increase now that we are in the middle of changing her diet?
And she might be bouncing as Kris suggests above?
Wouldn't it mess up the numbers even more if we increase now on the pink days?
Thanks!
I'm actually trying to figure out first why are her readings so odd lately..?
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I only see one day of weirdness. If you wanna keep it as is for now then do that.
 
It's the two unexpected reds that are mostly weird, isn't it, and they could be down to the usual things... eg a bit of pain or other form of stress, perhaps?

It really is hard to know what to suggest and what's been said above are both viable options - keep the dose steady for a few days as Kris says, or stick with the sliding scale and increase when you get a pink as Janet says. The only way to find the best route is trial and error - sadly there is never a quick fix with FD.

Just one thing occurs to me - I can't recall exactly from your other thread when you mentioned new foods, but did the Cheshire Cat one contain cranberry or something... it's just possible that an ingredient in one of the new foods acted as a spike for BG. If you don't already, I'd start keeping a note of "weird" numbers in relation to what's been fed, just to see if there's any connection. Not saying there is but it's something to rule out - and then go for one of the options above. Or, you could try Janet's idea of 1u for a pink pre-shot, as a one-off experiment, and monitor closely what that does - one way or the other it would give useful info.

Personally, I can't help thinking that a longer-lasting insulin might be the way to go with Josie, so if after you've tried the above and got no real improvement, you'd be justified in asking the vet what she thinks.

Sorry not very conclusive but that's my two cents atm. Good luck!
 
Diana&Tom said:
It's the two unexpected reds that are mostly weird, isn't it, and they could be down to the usual things... eg a bit of pain or other form of stress, perhaps?

It really is hard to know what to suggest and what's been said above are both viable options - keep the dose steady for a few days as Kris says, or stick with the sliding scale and increase when you get a pink as Janet says. The only way to find the best route is trial and error - sadly there is never a quick fix with FD.

Just one thing occurs to me - I can't recall exactly from your other thread when you mentioned new foods, but did the Cheshire Cat one contain cranberry or something... it's just possible that an ingredient in one of the new foods acted as a spike for BG. If you don't already, I'd start keeping a note of "weird" numbers in relation to what's been fed, just to see if there's any connection. Not saying there is but it's something to rule out - and then go for one of the options above. Or, you could try Janet's idea of 1u for a pink pre-shot, as a one-off experiment, and monitor closely what that does - one way or the other it would give useful info.

Personally, I can't help thinking that a longer-lasting insulin might be the way to go with Josie, so if after you've tried the above and got no real improvement, you'd be justified in asking the vet what she thinks.

Sorry not very conclusive but that's my two cents atm. Good luck!
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Thanks Diana,
good point yes the Cheshire Cat had cranberries and green lipped mussel added, I don't have any more of them at the mo so maybe I'll hold off re-ordering it for a bit and just stick with Ropocat and Mac's which both 1% carbs with very similar content and no added ingredients apart from the vits and minerals and see if things will settle and if possible bounce stops.
Depending on what happens will have to make a decision then whether go higher with dosage or maybe change insulin...
I do realise that something has gotta change..
Thanks again everyone!
 
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