Caninsulin question

[Sue484]

One of my other cats, Romulus, is also diabetic. He is well regulated on Caninsulin (therefore no spreadsheet) and is on 3 units twice a day, and a wet only low carb diet. However, some days, he throws me a curve ball by having a pre shot of say 10 (180) instead of around the 16 (288) numbers. I know that Caninsulin is not a depot insulin , so really it shouldn't matter too much if I am an hour late with his shots to see if he rises without food? If I am going to work though, I don't have time to hang around after pre shot time so should I just shoot a reduced dose for a lower than usual pre shot and go back to normal when he is back in the 288 range? Would that throw his fructosamine results out the window as they would give the vet the results as if he was always on 3 units every shot rather than a sliding scale.

 

[manxcat419]

I think if you're not going to work when it happens, waiting to see if he's rising and then giving a shot once you're sure that he's on his way up and over 200 should be fine as there's no depot action from Caninsulin. On the days where you have to leave for work, do you have a chance to get a second test, even if it's just 30 minutes later to make sure he's definitely rising? I'm in no way knowledgeable about Caninsulin as I've never used it, but from what I've read shooting a falling number under 200 (11.1) with one of the faster-onset insulins might not be a safe thing to do. I think as you're home-testing BG already, I'd be more concerned with the safety aspect than I would with the effect on a fructosamine test result. Hopefully others who have used Caninsulin can help further with this and maybe help you work out what would be a safe dose to give on those days.

 

[Elizabeth and Bertie]

I think as you're home-testing BG already, I'd be more concerned with the safety aspect than I would with the effect on a fructosamine test result.

Absolutely seconding what April said.
Safety is paramount; and, IMHO, would seem to trump the importance or otherwise of fructosamine results (you are hometesting, and that info is likely to be way more valuable than the fructosamine test.)

I have used Caninsulin. And because I know it can drop the blood glucose fast I would be reluctant to give 3 units at a preshot of 10. (And is this an Alphatrak 10?)
Caninsulin is quite adaptable to a sliding scale (since it has no depot). So, it is relatively easy to change the dose according to the preshot and the expected drop from any given dose (based on hometesting data).
Sue, do you know how low Romulus drops on his usual dose of 3 units? (Have you given 3 units at a preshot of 10? And if so, what happened?)

Eliz

 

[Sue484]

I was just giving 10 as an example. The lowest I have shot the full 3 units is 14.2 (on Alphatrak) and he dropped to 5.4 which is roughly his usual nadir. I would never do anything to harm my boys. The question was more to do with the sliding scale and whether that would affect the fructosamine results. Is there a dosing protocol for Caninsulin?

 

[Elizabeth and Bertie]

Is there a dosing protocol for Caninsulin?

There isn't an established dosing protocol for Caninsulin (in the way that there is for Lantus).
Edited to add: However there is a flow chart produced by the manufacturer that is supposed to be a guide for vets when calculating dose adjustments (see post below this one).

Most people here use the 'start low go slow' approach. And there is a Vetsulin/Caninsulin 'user guide' on FDMB. Much of it is useful, though some of it seems possibly a tad out of date now:
Vetsulin/Caninsulin user guide
Sliding scales are always worked out according to the individual cat and his/her response to insulin.

Regarding your question about how a sliding scale might affect the fructosamine result, that's not really possible to predict, and it would depend on how effective the sliding scale dosage was: If it works well then the numbers might be improved...
.

 

[Elizabeth and Bertie]

Sue, FYI, the manufacturers of Caninsulin have a flow chart which they propose using for dose adjustments. The link is here:
http://www.caninsulin.com/dose-adjustment-cats.asp

The suggested dose adjustments are in increments/reductions of .5 or 1 unit. From what we have seen here it is sometimes necessary to make much smaller adjustments.

Hoping this helps.

Eliz

 

[Sue484]

Thanks Eliz. I have never seen that before. I was thinking more of a sliding scale dosing chart, for example, below 8 do not shoot, between 8-10 half unit, 10-12 1 unit something like that. Rom is pretty much consistently 15-16 pre shot, so I was just wondering what to do on the days where he goes lower than normal. Does something like that exist?

 

[BJM]

A sliding scale is usually customized to the specific cat. You look at the most recent week or so of data, sort into pre-shot groups by roughly 50 mg/dL or 2.7 mmol/L increments and examine how much drop you got with the particular insulin dose. The dose:drop isn't linear, so you have to use some judgement in deciding how much to give at a particular pre-shot level and then observe how well it worked by testing around the nadir.

 

[Sue484]

That makes sense. Thanks @BJM