Dosage advice - Vetsulin lasting past 12 hours?

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RedCedar

RedCedar

Member Since 2023
Hello everyone,

My kitty has been on Vetsulin for about 6 months now. We went back and forth about switching him to Glargine with his vet a few months ago, but then paused that effort because we've been dealing with a number of health issues for multiple pets and humans in the household and it's been very hectic, not a good time to switch insulin and tweak dosages. I completely understand that Glargine is better and it is top of mind for me, we just have too much going on right now.

(Note the #s below are with a pet meter)
After several months of pre-shot numbers in the 300s, he has started having PMPS numbers below 200. What seems to be happening is that at +11.5 when we test him, his BG is still lowered by his AM shot and eventually goes back up within a few hours if we skip the dose, to end at his usual low 300s AMPS value.

We tried tweaking his dose a bit and went down from 2 to 1.5 for both shots. Surprisingly his AM cycle seems almost unchanged with 1.5U, but 1.5 is still too much for his PM cycle (the one time we tried giving 1.5 with a 199 PMPS he went down to 87 within 3 hours, although we managed to get it back up with a bit of high carb food).

At this point my initial thought was to try with keeping his 1.5U dose for the AM cycle and lower (perhaps 1U?) for the PM cycle. But, does it make any sense or are there any downsides with doing two different dosages for AM and PM?
I know our spreadsheet has a lot of gaps, but we both work full time and we test when we can. :( My husband handles most of the shots and pre-shot checks, but he doesn't use the spreadsheet so the data is spotty around that too.

I'm also really confused as to why this is happening to start with. It seems he's handling the Vetsulin better and better, we went from nadir within 4 hours to nadir around 6 hours and now he is coming back up from the nadir really slowly. We were at the end of an insulin bottle last week and I even wondered if anything was weird with what was left in the bottle, but switching to the new one hasn't really changed anything.

Thank you in advance for any advice!
 
Thank you so much! I have read through the sticky notes and didn't see anything that covers this specific scenario. Usually the issue with Vetsulin is harshness/short duration, which we have also had in the past... So this seems quite different from usual.
 
You're very welcome! I know some cats do experience a late nadir like at +11 from what I've heard here. I believe the advice is to try to feed a bit of food at around +9, but let's see what the others think since I'm not sure it applies to Vetsulin.
 
As Ale suggested, it may be a matter of late nadir. The scenario I like better is that maybe Bart's pancreas is on the mend. You've gone from seeing a fairly colorful spreadsheet to one that's largely blue. You're still not seeing consistent duration which could be due to Vetsulin or that Bart's pancreas is sputtering.
 
Thank you both!!
I am timidly hoping that Bart's pancreas might be trying, because the numbers are quite stable during the day with not much variation... it seems too stable for Vetsulin!?
With that said, @Sienne and Gabby (GA), do you think that continuing with a lower dosage for the PM for now is a good path? When it's under 200 it seems just too risky for his full dose of Vetsulin, and I've tried stalling multiple times but his BG seems just fairly flat around that time of the day. For example, two days ago we had 169 at normal PMPS time and 171 30 minutes later without feeding... basically the same number taking into account test variance.

Thank you again!
 
If you could set up a spreadsheet and add the BG data for us to see, we can give you dosing advice.
Here is the link for the SS HELP US HELP YOU
I will tag @Bandit's Mom to help with the SS in case you need help.
Once we can see the data on the SS we can help you with the dosing and hopefully get your sweet kitty into remission.
It is really important that a kitty gets a strong remission and we can help you do that be reducing the dose down gradually (as the Bgs dictate) to minute amounts.
For now you need to find a dose that you can shoot both cycles and not have to skip doses.
 
Bron and Sheba (GA) said:
If you could set up a spreadsheet and add the BG data for us to see, we can give you dosing advice.
Here is the link for the SS HELP US HELP YOU
I will tag @Bandit's Mom to help with the SS in case you need help.
Once we can see the data on the SS we can help you with the dosing and hopefully get your sweet kitty into remission.
It is really important that a kitty gets a strong remission and we can help you do that be reducing the dose down gradually (as the Bgs dictate) to minute amounts.
For now you need to find a dose that you can shoot both cycles and not have to skip doses.
Click to expand...
Hello and thank you for the help! I have the spreadsheet in my signature, not sure if it might not be showing up? Let me add the link here directly too: Bart's spreadsheet - Google Sheets

The challenge is that he gets blues on his current AM does and am worried about going back to yellows if I reduce that further?
 
I can see your SS thank you!
If you add the 2 doses you give each day together it adds up to 2.25 U.
If you divide that by 2 you get 1.125U.
That is a bit hard to draw up so I think I would try 1 unit for both cycles and see if that works better.
I will tag @Suzanne & Darcy as she has used vetsulin to see what she thinks. She might suggest 1.25 U.
Lets see what she says.
 
Thank you! To be honest I think we could have been OK with 1U or possibly even 1.25 for his PM cycles and we were just being excessively conservative with the dosage because we were a bit scared (especially with this being the overnight dose). So perhaps 1.25 for both could be a good middle ground?
 
Hi Angela I just had to tell you what a gorgeous kitty Bart is , I hope you can find a dose that will work for both cycles :cat:
Can you please add Vetsulin to your signature also just so members know, that's the first thing members will look at :cat:
@RedCedar
 
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I liked Bron's suggestion but I would have leaned toward a dose of 1.25u twice a day.

By any chance, do you have a timed feeder? I'm wondering if you gave Bart a snack at around +8 in the PM cycle if his AMPS would be lower. Food can stimulate the pancreas to produce insulin and it may drop the AMPS numbers.
 
You've gotten some great advice. Bart is doing really well. It would be good if, once in a while you could get up and snag a +10 (or a +8, 9, whatever) test so we could see how that p.m. cycle is going and give us some clues as to how long it's lasting in the p.m. cycle? No pressure, just if you can make it work. Doesn't have to be every night. It does look a bit like his pancreas may be trying to help out, doesn't it :-) Nice!
 
Diane Tyler's Mom said:
Hi Angela I just had to tell you what a gorgeous kitty Bart is , I hope you can find a dose that will work for both cycles :cat:
Can you please add Vetsulin to your signature also just so members know, that's the first thing members will look at :cat:
@RedCedar
Click to expand...
Thank you so much! He is a handsome boy and also very sweet, everyone loves him at the vet's office :) I will add Vetsulin to my signature, thank you for the suggestion!

Sienne and Gabby (GA) said:
I liked Bron's suggestion but I would have leaned toward a dose of 1.25u twice a day.

By any chance, do you have a timed feeder? I'm wondering if you gave Bart a snack at around +8 in the PM cycle if his AMPS would be lower. Food can stimulate the pancreas to produce insulin and it may drop the AMPS numbers.
Click to expand...

Thank you for the recommendation! We do have a timed feeder. Bart is a weird kitty and not very good at getting up to eat on his own (usually he needs some nudging to come eat...) but it is definitely worth trying anyway.

Suzanne & Darcy said:
You've gotten some great advice. Bart is doing really well. It would be good if, once in a while you could get up and snag a +10 (or a +8, 9, whatever) test so we could see how that p.m. cycle is going and give us some clues as to how long it's lasting in the p.m. cycle? No pressure, just if you can make it work. Doesn't have to be every night. It does look a bit like his pancreas may be trying to help out, doesn't it :) Nice!
Click to expand...

Thank you! We have done 1.25 for a few cycles now and that brings his PS values in the low 200s for both AM and PM. I assume it is better than being above 300 in the AM, so we will continue with this for a bit and do a full curve a week in. I was away for work the last couple of days and my husband didn't do much mid cycle tests, but the AMPS and PMPS have been really consistent.
That would be a really impressive 0.75 drop, go Bart! :)
 
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