His preshot yesterday was better. What is confusing you specifically?
Just not sure how to read if there is any progress with him. He is so visibly unwell when his numbers are high, ie today, just really don't want to miss a beat if there is a way I can help him. I have got the testing and logging down, and I have got his food fixed up, but am completely unsure what to look for in numbers. Thanks! I think he is eating ok, but when his numbers are high its hard to get him to eat anything unfortunately
Ok I will do the PM cycle tonight. I figured it may be some bouncing going on, I had let him graze during the day, he generally will wake up to have food 1.5 hours after his shot, so potentially it is just hitting him too hard despite this. Is lantus longer acting? It is hard watching him in those few hours where it spikes back up, he spends the whole time drinking and is very lethargic. Not sure what to think about the black number this morning either :/ I would guess his numbers have been in the 400's and 500's since around april, which is when I first took him in several times and they blamed his spine (subsequently xray showed perfect spine), I am wondering if this is maybe making him more likely to have the glucose dumps you described? In two more days I am meant to give the vet all my data so they can readdress his dose, I am anticipating them raising it unfortunately. Thank you!
Very good to know, Bron. Will keep this little nugget of info filed away for future reference. Always learning here!
Absolutely, we never stop learning.Very good to know, Bron. Will keep this little nugget of info filed away for future reference. Always learning here!
Mogs
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I would raise the dose to 2.5 and see how he is over the next few days.
Thanks Janet, I think I'm going to do that, he just got his highest number yet and was drinking for what seemed like 15 minutes straight, really concerned :/
I'm going to talk to the vet tomorrow and show all of his numbers and request a longer acting insulin. Waiting the half hour after eating to give the dose, and feeding an hour after too trying to avoid a bounce. Today he ate well through the day, less than 4 carbs and raw, and through the roof again now
poor thingThank you for this detailed response. I asked the vet why the choice was caninsulin and I was told "cats usually respond best but we can change if it isn't suiting him". Given his numbers now, I'm thinking should I be upping the insulin in the mean time, he's so unhappy when it goes back up. I'm going to push for a longer acting insulin regardless, and I test him frequently so I don't believe there is any reason not to switch because I'll know if he is getting too low. That curve would be bearable if his numbers weren't in the 500s maybe..Hi Natasha,
Here's a graph showing an 'ideal' response of a cat to Caninsulin:
As you can see from the red curve, it is typical for the blood glucose lowering effect of this insulin to have pretty much petered out by +8 hours after the dose was administered. In essence, for 6 out of every 12 hours the cat's blood glucose sits around about the current preshot range (i.e. insulin is providing no BG lowering benefit). From the available data for Meowmeows it is starting to look as though his response may be quite typical for this insulin.
Even with gradual dose adjustments to bring a kitty into a better range, Caninsulin cats will still typically have this bucket-shaped curve, and although the nadir might get into a good range the likelihood is that the preshots will still be significantly higher. Further attempts to increase the Caninsulin dose tend to result in the nadir getting pushed into dangerous territory but without bringing the PS BGs into a desirable range.
As Bron suggests above, it is very much worth considering a switch to an insulin with a gentler mode of action and greater duration of effect (e.g. Lantus/Basaglar, Prozinc).
Mogs
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Sounds good.I'm going to talk to the vet tomorrow and show all of his numbers and request a longer acting insulin. Waiting the half hour after eating to give the dose, and feeding an hour after too trying to avoid a bounce. Today he ate well through the day, less than 4 carbs and raw, and through the roof again now
What kind of meter are you using? Would you mind adding it to the spreadsheet? There's no point to him doing the curve. Obviously the clinical signs are still not good if he's still drinking excessively and the numbers are still high. Esp if you are using a human meter.... The numbers he would get would be even higher. I disagree and think anytime the cat is spreading a majority of the time in 350+ ranges the potential for developing ketones and organ damage (long term) increases.
Agree strongly.
this is what I'm thinking. I'm worried about disagreeing with the vet and having resistance to what I'm asking for, because I do actually like my current vet, and he is quite old and very experienced (instantly knew what was wrong with MM where other vets failed to identify on 4 occasions). I think what I'll do is book him in for a curve for a month from now, and send my vet the spreadsheet to advise in the meantime, then just cancel the at vets curve. He did say to me that we can switch insulins in future if MM doesn't adjust, so I'm wondering if the vet is just thinking it's too early to say caninsulin is ineffective? (it's only been a week). If it doesn't start to balance out soon I'll ask for the switch. I wouldn't mind the cansulin curve if the numbers were more reasonable and I could effectively offset the bounces, but if it continues like this then definitely not. Thank you for your advice, I need to more confidently pursue what's in my cats best interests for quality of life
They actually sent me the wrong meter, so I'm using a human meter called "caresens dual". I agree there is little point doing a curve, I suspect maybe the vet meant we'll wait until Thursday to do a curve (a week since starting) where my cat was booked in, but he might be fine with me doing it myself I'm going to call them shortly. and I agree wholeheartedly, I'm seeing a daily increase of hind leg weakness, his coat deteriorating, and excessive thirst, he isn't in good shape at all, and at minimum a lot of stress on his organs and like you say potential for ketones and permanent damage
Thanks mogs. Exactly, I need to speak to my vet again to go over this, in retrospect maybe he meant he doesn't feel he is in exact immediate danger, and just wants to give it a week before adjusting the dose /switching insulin? I definitely won't leave it more than another few days without pressing the vet to make a call on dose at minimum. The hind leg weakness really concerns me. and I think neuropathy is definitely is a factor for him. Last tested at the vet he had high levels of glucose in the urine, just seems cruel to leave him surfing these kinds of numbers
Thanks mogs. Exactly, I need to speak to my vet again to go over this, in retrospect maybe he meant he doesn't feel he is in exact immediate danger, and just wants to give it a week before adjusting the dose /switching insulin? I definitely won't leave it more than another few days without pressing the vet to make a call on dose at minimum. The hind leg weakness really concerns me. and I think neuropathy is definitely is a factor for him. Last tested at the vet he had high levels of glucose in the urine, just seems cruel to leave him surfing these kinds of numbers
