? "Caninsulin dosing advice needed"

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That was a big drop, but still in the safe zone although with the recent hypo I am sure it was a scary drop for you. There is a good chance that the numbers will be higher for the next preshot because of the big drop.

It is hard to say whether changing insulins is the best approach. Even on the long lasting insulins some kitties are prone to having big spreads between the nadir and the preshot.

I am going to tag a couple of people and see if they can offer some more insights.

@Kris & Teasel @JanetNJ @Squalliesmom
I agree. It was a safe number, but I could see why with time to still drop there was concern, but I think there was an over-correction. A little bit of low carb food rather than high carb treats would have kept her in those nice healing numbers longer giving her pancreas a rest.
 
Just scanned through this thread to get caught up a bit. I don't really have anything to add, I agree with the information and advice you've gotten so far, it's what I would have recommended, too. Unfortunately, those big drops are fairly typical of Vetsulin.
 
Hmm that is quite a big drop, although the 4.4 is actually a nice number, just scary I know when you're used to so much higher ones. It is looking as if Shelley somehow uses insulin in an unpredictable way... I'd say you're not far off the time now when it would be worth showing your vet your spreadsheet and asking if another insulin might be in order... it does seem difficult to determine a dose or doses that follow the pattern you'd expect on Caninsulin. It is a tricky call though, when there are various factors to take into account - the different foods she eats being perhaps the main one, and the cost of other insulins which are dearer (not that that's insurmountable when it comes to our kitties!)

This whole issue of unpredictability is probably why Shelley hypo'd in February - the dose at the time was consistent, I think (?) and maybe she did have a little bit of build-up in her system.

It may be that if you hadn't given her Dreamies she would have stayed in the greens a while longer and ended up at pre-shot this morning slightly lower than her usual... that's the situation we're aiming for but it is certainly easier said than done. See what others say, and perhaps consider callling the vet to ask if you can email a link to your ss and ask his opinion.. I know he's not the most experienced in FD but this is just the sort of thing he should be able to address if he wants to become more knowledgeable in his profession, so he might take it upon himself to do some research.

Sorry I can't actually say anything useful but I do sympathise and I do wish you the best of luck!

hello Diana,
That is all helpful, thank you. Sorry I have been a while but I had a visitor.
The vet actually said that due to possible inaccuracies with the Alpha Track, that I should take Shelly in if the number fell below 5.
From what I have seen on the internet I think the Alpha Trak is a lot more accurate than that. But when I saw the 4.4, I just didn't want it to go any lower. Shelley had been eating Gourmet Pate prior to this, that's why I thought I needed some higher carbs but perhaps I over-reacted.
I did speak to the vet last Thursday and he had the spreadsheet up to the previous Monday and he was adamant I should stick to 1u.
Whether I would have had a more serious problem if I had I don't know.
But I will speak to him again and see how things go today but I have only injected 0.5 this morning.
Thanks once more!
 
That was a big drop, but still in the safe zone although with the recent hypo I am sure it was a scary drop for you. There is a good chance that the numbers will be higher for the next preshot because of the big drop.

It is hard to say whether changing insulins is the best approach. Even on the long lasting insulins some kitties are prone to having big spreads between the nadir and the preshot.

I am going to tag a couple of people and see if they can offer some more insights.

@Kris & Teasel @JanetNJ @Squalliesmom
Thank you Mary Ann,
I just explained my thinking in reply to Diana but perhaps if I was more use to the lower numbers I would not have worried. Perhaps this is where Shelley should be more often.
 
hello Diana,
That is all helpful, thank you. Sorry I have been a while but I had a visitor.
The vet actually said that due to possible inaccuracies with the Alpha Track, that I should take Shelly in if the number fell below 5.
From what I have seen on the internet I think the Alpha Trak is a lot more accurate than that. But when I saw the 4.4, I just didn't want it to go any lower. Shelley had been eating Gourmet Pate prior to this, that's why I thought I needed some higher carbs but perhaps I over-reacted.
I did speak to the vet last Thursday and he had the spreadsheet up to the previous Monday and he was adamant I should stick to 1u.
Whether I would have had a more serious problem if I had I don't know.
But I will speak to him again and see how things go today but I have only injected 0.5 this morning.
Thanks once more!
Alphatrak is quite accurate.... Moreso than a human meter with only a 15% variance.
 
I agree. It was a safe number, but I could see why with time to still drop there was concern, but I think there was an over-correction. A little bit of low carb food rather than high carb treats would have kept her in those nice healing numbers longer giving her pancreas a rest.

Hi JanetNJ,

Thank you for your comments. I have explained my thinking in my reply to Diana but I am sure you are right. Over reaction!
 
Just scanned through this thread to get caught up a bit. I don't really have anything to add, I agree with the information and advice you've gotten so far, it's what I would have recommended, too. Unfortunately, those big drops are fairly typical of Vetsulin.
Thank You!
 
Vetsulin/Caninsulin will often create high pre shot/low nadir situations. That's why your dosing should be based more on how low Shelley goes and less on the pre shot number, barring any bouncing. I see from your SS that you've changed doses often in the last 3 or 4 days and that can lead to erratic BG behaviour in sensitive kitties (and your girl is one). My suggestion is to stay at 0.75 u consistently both AM and PM for a few days. Sliding scale dosing is a useful tool in some instances and in others it makes things more complicated. If you're uneasy giving 0.75 u, try a "fat" 0.5 u instead.
 
Vetsulin/Caninsulin will often create high pre shot/low nadir situations. That's why your dosing should be based more on how low Shelley goes and less on the pre shot number, barring any bouncing. I see from your SS that you've changed doses often in the last 3 or 4 days and that can lead to erratic BG behaviour in sensitive kitties (and your girl is one). My suggestion is to stay at 0.75 u consistently both AM and PM for a few days. Sliding scale dosing is a useful tool in some instances and in others it makes things more complicated. If you're uneasy giving 0.75 u, try a "fat" 0.5 u instead.

Hi Kris,
Thank you, that's very helpful and an alternative approach, I will try that.
Kind regards,
 
Hi Kris,
Thank you, that's very helpful and an alternative approach, I will try that.
Kind regards,
You're welcome, Anthony. Make sure you can monitor and have high carb food if you need to steer. Try not to overreact if you see green numbers. Easier said than done, I know!
 
Hi Kris,
Thank you, that's very helpful and an alternative approach, I will try that.
Kind regards,
Yes that does seem a good plan and definitely worth a try. It IS easy to panic though when you see low numbers, we do understand that. Next time you get a lower than expected number (but still a "good" one), take a deep breath and remind yourself that this is in fact what you're aiming for to keep Shelley in healthier numbers...
 
Yes that does seem a good plan and definitely worth a try. It IS easy to panic though when you see low numbers, we do understand that. Next time you get a lower than expected number (but still a "good" one), take a deep breath and remind yourself that this is in fact what you're aiming for to keep Shelley in healthier numbers...

Thank you Diana, that is good advice!
 
I'm with you Anthony, I know the dark greens are good but I don't like them! Must have been a real shock to see it! The only thing I would have done differently is feed normal food rather than a high carb treat and try and steer it a bit gentler.

God bless sensitive cats!

@Kris & Teasel Sky is similar in sensitivity! I do my best to stay at a 0.5 but find it impossible at the moment to get a consistent dose for her. How is best to go about trying to get a regular consistent dose? Should I stick at the 0.5 regardless of AM and PM numbers for 3 cycles to try and stop the shifting numbers and then just increase slowly? I always seem to react to the numbers at shot time rather than have a long term view.

Sorry to highack Anthony!
 
I'm with you Anthony, I know the dark greens are good but I don't like them! Must have been a real shock to see it! The only thing I would have done differently is feed normal food rather than a high carb treat and try and steer it a bit gentler.

God bless sensitive cats!

@Kris & Teasel Sky is similar in sensitivity! I do my best to stay at a 0.5 but find it impossible at the moment to get a consistent dose for her. How is best to go about trying to get a regular consistent dose? Should I stick at the 0.5 regardless of AM and PM numbers for 3 cycles to try and stop the shifting numbers and then just increase slowly? I always seem to react to the numbers at shot time rather than have a long term view.

Sorry to highack Anthony!
As the owner of an extremely volatile FD kitty, I've learned that I have to keep things as simple and consistent as possible to maintain as much stability as I can. And he still shifts like quicksand. In my opinion these kitties become very erratic if you change doses too often by too much. There's no way a sliding scale approach works for Teasel and many of my dose changes when he was on ProZinc were on the order of 0.1 u. And, yes, taking the long view is the way to go.
 
I stand by my suggestion in post #58 to give 0.75 u consistently for a couple of days. I don't think it's too high a dose. It might give you some manageable greens and Shelley needs the stability of same dose AM and PM.
 
I'm with you Anthony, I know the dark greens are good but I don't like them! Must have been a real shock to see it! The only thing I would have done differently is feed normal food rather than a high carb treat and try and steer it a bit gentler.

God bless sensitive cats!



@Kris & Teasel Sky is similar in sensitivity! I do my best to stay at a 0.5 but find it impossible at the moment to get a consistent dose for her. How is best to go about trying to get a regular consistent dose? Should I stick at the 0.5 regardless of AM and PM numbers for 3 cycles to try and stop the shifting numbers and then just increase slowly? I always seem to react to the numbers at shot time rather than have a long term view.

Sorry to highack Anthony!

No problem Karen, I appreciate your comments. I will be interested to see how Sky responds. Prior to all this Shelley's dose was only adjusted perhaps once or twice a year after the Fructosamine test. I injected her twice a day and didn't worry about it in between times. As you know, this worked fine for 6 years.
Regards!
 
How's Shelley getting on (and Herbie)? You seem to be getting good mumbers in the middle of the cycle- are those +6 numbers when she eats? She is still high at preinjection though which i would expect to be lower now. I suppose as long as she is low for a lot of the time it's doing it's job :)
 
I've been wondering too, Anthony... am guessing you think that there's nothing new to ask as there have been various suggestions that you've tried...? It is definitely the pre-shot numbers that need to come down but how to achieve that is the question when you don't want to be too aggressive with dosing... very hard call I know. It would be nice to see some more blues though so keep trying and maybe one day Shelley will surprise us all...
Keep smiling!
 
I too have been checking in on Shelley's spreadsheet but since you haven't posted in a few days I haven't commented. However, from my point of view I am wondering if you might be open to increasing the dose a bit. Shelley has not hit any blue numbers for a few days now and it would be more healing to get her spending some time in the "healing blues". Just a thought, but it is always up to you what you choose. :bighug: :bighug:
 
Hello everyone, thank you for your comments.
I have been following Kris's advice and trying to keep the doseage consistent and see if things stabilise. Today's numbers seem a bit better but I know they should be lower. Shelley seems quite well and seems to have a burst of hunger and activity about 2 hours after her injection. But she is not as bright as she was when her diabetes was under tight control. I think her numbers do spike after food especially Felix Agail. I don't usually give her that but I have used a little a couple of times to encourage her appetite.
I am concerned that the poor control will affect her but when I have increased the dose I seem to get a big drop or a low number that worries me. I do plan to speak to the vet again this week.
Herbie has had a good week. He has been his normal self really, quite active and eating well. He has been having more wet food but I don't know if this is anything to to with it?
It's very good of you to catch up, thanks again!
 
Hello everyone, thank you for your comments.
I have been following Kris's advice and trying to keep the doseage consistent and see if things stabilise. Today's numbers seem a bit better but I know they should be lower. Shelley seems quite well and seems to have a burst of hunger and activity about 2 hours after her injection. But she is not as bright as she was when her diabetes was under tight control. I think her numbers do spike after food especially Felix Agail. I don't usually give her that but I have used a little a couple of times to encourage her appetite.
I am concerned that the poor control will affect her but when I have increased the dose I seem to get a big drop or a low number that worries me. I do plan to speak to the vet again this week.
Herbie has had a good week. He has been his normal self really, quite active and eating well. He has been having more wet food but I don't know if this is anything to to with it?
It's very good of you to catch up, thanks again!
Hi Anthony,
You could try raising the dose a little. Those blues today were nice but there some room to go down. Maybe try 0.7 u? 0.75 u? 0.8 u?
 
How are things, Anthony...? I see Shelley is getting some decent drops from the different doses but is still very high at pre-shot. You were going to speak to the vet this week, you said - what was the outcome of that I wonder?
No pressure to update us here if you don't feel up to it, but we're here to listen if you do!
 
How are things, Anthony...? I see Shelley is getting some decent drops from the different doses but is still very high at pre-shot. You were going to speak to the vet this week, you said - what was the outcome of that I wonder?
No pressure to update us here if you don't feel up to it, but we're here to listen if you do!

Hello Diana,
Thank you for your message. I have been trying to keep to 1u and Shelley does seem more her usual self on that dose.
After a month without a car I have finally got some transport again, so I decided to put off seeing the vet until next week as using taxis makes it a bit more stressful.
So, not much to add at this stage. I will let you know how I get on at the vets and I very much appreciate you keeping in touch.
Kind regards, Anthony
 
Hello,
I had a vet's appointment with Shelley yesterday. The vet had look at the spreadsheet and said that her diabetes is not regulated. He does not agree with me adjusting her dose and said I need to inject 1.0u consistently for 10 days and then review her results. He is aware of my worry about hypos but said even at a pre-shot number of 14, that is too high and 1.0 u should be OK. He said constantly changing her dose is messing with her pancreas.
Asked about a different insulin but he said the Caninsulin is working but needs to be injected consistently and there was no reason to change at this stage.
Thank you for reading, I would be grateful for any comments.
 
Anthony

I agree that the current dose is not high enough. You were getting some nice runs of blue numbers before when you were at 1.0 unit. It would be good if you could hold the 1 unit dose for awhile. However if the midcycle numbers drop too low or if the preshot number is lower than you are comfortable with you can always post for help on the forum. Caninsulin is an "in and out" insulin so what you see is the effect of the dose you just gave. The longer acting insulins often have some "carry over" from one shot to the next.

It is not that changing the dose is messing with her pancreas, but if the numbers stay in the higher ranges it does not allow the pancreas to begin healing in the hopes that it can recover. The Caninsulin is working but the dose does need to be higher at this time. Since you don't have the spread sheet right up to date it is hard to comment on the last day or so, but the other days with the lower dosing aren't giving the best numbers.

For any days when you have a lower than usual preshot reading please ask for help. Starting a new thread (post) and using the "?" icon from the title drop down box will get more attention. Although shooting a sliding scale is a more advanced approach, it can certainly be done if the preshot numbers are lower than expected.

:bighug::bighug:
 
Hi Anthony
I agree that the dose needs to be higher to get Shelley down from the very high numbers... I think you know this too, but go into panic mode when you get an unexpectedly "low" number and reduce the dose at next shot time... I completely understand that and I'd be just the same, but it is something to try to overcome and, as Mary Ann says, get more tests and post here for help if you need it. I fully appreciate that this is easy for others to say and less easy for you to put into practice; you have my heartfelt understanding!
Maybe you could go with the 1u dose over the weekend and monitor then (ie do a few more tests than usual)? If after a couple of days you are seeing nicer numbers throughout the cycle and can (hopefully) see that Shelley is not going to hypo on that dose, you will be less wary after that. It is a concern that she has suddenly gone lower before, but if you get into a routine with testing at the critical times of the cycle you should start to feel more in control.
It is difficult, I know... treating FD is not a walk in the park but it is do-able!

Let us know what you plan to do and remember, as Mary Ann says, you can start a new thread any time you have a specific or urgent question. People do want to help.

Best of luck!
 
Anthony

I agree that the current dose is not high enough. You were getting some nice runs of blue numbers before when you were at 1.0 unit. It would be good if you could hold the 1 unit dose for awhile. However if the midcycle numbers drop too low or if the preshot number is lower than you are comfortable with you can always post for help on the forum. Caninsulin is an "in and out" insulin so what you see is the effect of the dose you just gave. The longer acting insulins often have some "carry over" from one shot to the next.

It is not that changing the dose is messing with her pancreas, but if the numbers stay in the higher ranges it does not allow the pancreas to begin healing in the hopes that it can recover. The Caninsulin is working but the dose does need to be higher at this time. Since you don't have the spread sheet right up to date it is hard to comment on the last day or so, but the other days with the lower dosing aren't giving the best numbers.

For any days when you have a lower than usual preshot reading please ask for help. Starting a new thread (post) and using the "?" icon from the title drop down box will get more attention. Although shooting a sliding scale is a more advanced approach, it can certainly be done if the preshot numbers are lower than expected.

:bighug::bighug:
Hello Mary Ann,
Thank you for replying so quickly.
I will try and stick with 1.0u. I will also ask for advice if unsure as you suggest.
My vets views don't always agree with those I see on the FDMB but hopefully considered together I will be able to improve Shelley's control.
Thanks again,
Anthony
 
Hi Anthony
I agree that the dose needs to be higher to get Shelley down from the very high numbers... I think you know this too, but go into panic mode when you get an unexpectedly "low" number and reduce the dose at next shot time... I completely understand that and I'd be just the same, but it is something to try to overcome and, as Mary Ann says, get more tests and post here for help if you need it. I fully appreciate that this is easy for others to say and less easy for you to put into practice; you have my heartfelt understanding!
Maybe you could go with the 1u dose over the weekend and monitor then (ie do a few more tests than usual)? If after a couple of days you are seeing nicer numbers throughout the cycle and can (hopefully) see that Shelley is not going to hypo on that dose, you will be less wary after that. It is a concern that she has suddenly gone lower before, but if you get into a routine with testing at the critical times of the cycle you should start to feel more in control.
It is difficult, I know... treating FD is not a walk in the park but it is do-able!

Let us know what you plan to do and remember, as Mary Ann says, you can start a new thread any time you have a specific or urgent question. People do want to help.

Best of luck!

Thank you Diana, that is very good of you. I am certainly going to try and stick at 1.0 u and monitor to see how it goes.
I appreciate the support!
 
Shelley had a high AMPS today of 25.3 and the 1.0u hasn't brought her numbers down as well as I had hoped.
A worrying development is that she is not walking so well today, she seems to have some hind leg weakness. She has a wobbly gait and after a few steps stops as if she is not sure how to go further. I am wondering if this may be neuropathy. I will have to see how things are tomorrow and speak to the vet again.
 
Sorry to hear she hasn't dropped as much as you'd hoped today, Anthony... hang in there and persevere with the 1u, things may stabilise after a few days. Remember too that different foods can cause higher than expected numbers... as can pain. It may well be that she has diabetic neuropathy - there are supplements that can help to address this, see what your vet says.
Try not to be disheartened - you're doing the right thing by trying the 1u dose so see how that pans out.
 
Sorry to hear she hasn't dropped as much as you'd hoped today, Anthony... hang in there and persevere with the 1u, things may stabilise after a few days. Remember too that different foods can cause higher than expected numbers... as can pain. It may well be that she has diabetic neuropathy - there are supplements that can help to address this, see what your vet says.
Try not to be disheartened - you're doing the right thing by trying the 1u dose so see how that pans out.

Thank you Diana, very good of you to reply so quickly. Yes, I certainly will continue with 1.0u. Shelley hasn't had that much strength in her back legs for a while but her walking has been the poorest I have seen it today. But perhaps not surprising when the diabetes has not been properly controlled for some weeks now. I will look into the supplements as well. Thanks again!
 
No worries, Anthony.
I think the supplement you'll be advised to try is called Cosequin (there may be others, similar) - should be readily available online and worth a try to make Shelley more comfortable.
 
Many kitties with uncontrolled glucose numbers will develop diabetic neuropathy. A good supplement for this is B12 Methylcobalamin format. In Canada and the US a lot of people use the Zobaline for cats formula, but I don't know if it is available in the UK.

40302.jpg



You would want the oral Methylcobalamin format not the Cyanocobalamin format as the latter is not absorbed as well as the Methylcobalamin. For myself I buy B12 Methylcobalamin from my local health food store, making sure it does NOT contain any xylitol (can be poisonous to kitties) I buy a brand in pill form that has no added ingredients or sweetners and crush it and add it to the wet food. There is no taste so the kitties are fine with that.


Cosequin is very useful for arthritis, but will not be as useful with diabetic neuropathy.
 
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Many kitties with uncontrolled glucose numbers will develop diabetic neuropathy. A good supplement for this is B12 Methylcobalamin format. In Canada and the US a lot of people use the Zobaline for cats formula, but I don't know if it is available in the UK.

40302.jpg



You would want the oral Methylcobalamin format not the Cyanocobalamin format as the latter is not absorbed as well as the Methylcobalamin. For myself I buy B12 Methylcobalamin from my local health food store, making sure it does NOT contain any xylitol (can be poisonous to kitties) I buy a brand in pill form that has no added ingredients or sweetners and crush it and at it to the wet food. There is no taste so the kitties are fine with that.


Cosequin is very useful for arthritis, but will not be as useful with diabetic neuropathy.

Thank you very much for that advice Mary Ann. I will make some enquiries, that is really helpful!
 
This video shows more advanced neuropathy. Walking on the hocks and rear leg weakness are usual signs:


There is a great video on this forum but I can't find it right now sorry.
 
If you let the video play all the way through a second video will start that shows how well a kitty responds to treatment with B12. Of course trying to keep the glucose numbers in good ranges is also part of the process to helping reverse diabetic neuropathy. Both my kitties had signs of this. My girlie kitty is in much better numbers and her hind leg weakness has improved to the point that she is as good as prediabetes. My other fellow is impossible to regulate because of other health conditions so his neuropathy is still evident, but is helped with the B12 supplements.
 
This video shows more advanced neuropathy. Walking on the hocks and rear leg weakness are usual signs:


There is a great video on this forum but I can't find it right now sorry.

Thank you, Shelley isn't down on her hocks as much as that but she has nowhere near as much mobility as that cat. She has only walked slowly for sometime but today doesn't seem to have as much strength in her hind legs as usual. I suppose it could be something else, I will just have to see how things go.
 
I just remembered a query here not long ago about Zobaline in the UK (it's not available here but there is a thread with some very helpful suggestions... if you do a search on this site for Zobaline by member Elizabeth & Bertie, back in January, that should shed some light...
 
There is always a chance that it could be part neuropathy and part arthritis. My fellow has both, so I use the B12 supplements and Fish oil as another supplement. Cosequin is very useful for arthritis. My Tuxie never got down to walking on his hocks like the kitty in the video, but did definitely have diabetic neuropathy and the B12 helped with that. With a kitty getting older arthritis can also come into effect, so using an anti=inflammatory like fish oil can be useful to try.
 
I just remembered a query here not long ago about Zobaline in the UK (it's not available here but there is a thread with some very helpful suggestions... if you do a search on this site for Zobaline by member Elizabeth & Bertie, back in January, that should shed some light...
Sorry... just read this again... has some useful info about how to get something similar to Zobaline in the UK and add folic acid to give the same effect... sorry I can't link that thread here but do try and find it!
 
I just remembered a query here not long ago about Zobaline in the UK (it's not available here but there is a thread with some very helpful suggestions... if you do a search on this site for Zobaline by member Elizabeth & Bertie, back in January, that should shed some light...
There is always a chance that it could be part neuropathy and part arthritis. My fellow has both, so I use the B12 supplements and Fish oil as another supplement. Cosequin is very useful for arthritis. My Tuxie never got down to walking on his hocks like the kitty in the video, but did definitely have diabetic neuropathy and the B12 helped with that. With a kitty getting older arthritis can also come into effect, so using an anti=inflammatory like fish oil can be useful to try.
There is always a chance that it could be part neuropathy and part arthritis. My fellow has both, so I use the B12 supplements and Fish oil as another supplement. Cosequin is very useful for arthritis. My Tuxie never got down to walking on his hocks like the kitty in the video, but did definitely have diabetic neuropathy and the B12 helped with that. With a kitty getting older arthritis can also come into effect, so using an anti=inflammatory like fish oil can be useful to try.

It is going to have to be looked into, see how she does by tomorrow. I was only at the vets on Thursday as well and Shelley was very stressed by the time we got home. I appreciate the help, if it is that I will certainty try those ideas. Thank you!
 
Sorry... just read this again... has some useful info about how to get something similar to Zobaline in the UK and add folic acid to give the same effect... sorry I can't link that thread here but do try and find it!

Thank you, I will have a look for it.
 
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