?Dose Advice Needed, New to Vetsulin

His 6-hour was 662. He did eat in between the 3 and 6 hr check. The vet office said I should only feed him at shot time with nothing in between. He has always been a grazer. Not sure if he can learn to eat as much as he needs twice a day.
 
That is common advice but you will find that 99% of us feed our cats several times a day. There is no reason to withhold food midday or during the night. The main thing is to be sure that Riley eats a decent amount before each shot and that food is not given in the 2 hours leading up to the pre-shot tests. Diabetics are not able to metabolize their food efficiently so they are often always hungry., Giving them snacks through the day helps them feel more satisfied and less frantic for food at shot times and it's easier on their pancreas which we are trying to heal by treating with insulin.
 
Thanks so much for that. I would never be able to explain to him that he has to eat as much as possible right now because he isn't getting fed for 12 hours. And he has kidney issues. Looking at Tanya's website the other day and I believe it mentioned being careful if trying to switch your cat to low phosphorus food - you don't ever want to starve them in order to force them to eat what you want.

His BG is 680. Cannot see how Vetsulin is any better. And I don't think he's feeling that great. His BG has been pretty high for a while.
 
Vetsulin sometimes causes kitties to feel poorly because of the dramatic ups and downs it causes in BG. If you are noticing Riley more lethargic and subdued than when on Lantus, you might want to reconsider going back to Lantus. A lot of cats start out on Vetsulin and some do very well but I've also seen a fair number end up switching to Lantus just because it is gentler and doesn't generally make kitty feel so out of kilter.
It may be that he needs a higher dose of the Vetsulin but because of the quick drops, it also causes more bouncing which again can make kitty feel poorly.
You may want to revisit the choice of insulin with your vet. I'm not sure how quickly the dose was increased while Riley was on Lantus but it's possible you went right past the right dose by making dose increase too large at one time, and that unfortunately can look the same as too little insulin. Insulin is not medicine like aspirin....it's a hormone and therefore doubling the dose isn't usually then answer to high BG numbers.
 
His BG 3 hrs post was 580. 6 hrs was 522. His amps was 727. I gave him 3 units (U-100) of Basaglar and he is now at 410. I'm not going to keep working with the Vetsulin. It may work fine after putting some time into it, and if he was younger and didn't have kidney issues, we would.

Now I wish I knew where to go with dosage on the Basaglar. Hold him at 3 units for 3 days and see where his numbers are I'm thinking.
 
Sorry I've been out all day and am just seeing your post now.
While Vetsulin does work for some cats, it is very unusual to see folks switch from Lantus to Vetsulin and as you witnessed the action of the two insulins is very different although I think some of that seriously low BG at 2u of Vetsulin was likely influenced by the Lantus depot. I think switching to Basaglar which is generic Lantus, it a good idea. Given the dose of Lantus Riley was on previously 3u seems to be a logical place to start dose wise. It may be that Riley does need a higher or lower dose but a slow methodical approach to dosing in 0.25u increments will keep you from jumping over a good dose for Riley.
Perhaps when you get back home, you can review the SLGS and TR approaches to using Basaglar and decide which method would be most appropriate for you and Riley.
The other thing I would encourage you to do is to test Riley for ketones when his BG numbers are so high. Ketostix are readily available in the pharmacy and
some folks can just hold the strip in a stream of urine while others can catch a sample in a ladle place under kitty's butt in the LB. If Riley is shy about his bathroom visits, then crumpling up plastic wrap and placing it in the litter box where he normally likes to pee, can catch a few drops of urine to test. It only takes a few drops.
 
Thanks again for the info. Much appreciated. I want to let you know how much I appreciate all the advice and support you've given me. Riley appreciates it too - he gets nervous when I'm freaking out. Thank you again for being with me through this. Of course the work of getting him on the right path isn't finished. Hopefully someone from the Basaglar group can help.

I do have some test strips that are combo ketone-glucose for urine. They are past expiration date but the strip did pick up the sugar in his urine - no ketones. I'll get some new ones to be sure.

How can I save a copy of our correspondence? You gave me some good links and great general advice that I'd like to keep.
 
You are very welcome. :DGlad to hear you tested and found no ketones. :)
The thread will stay here so you could just bookmark it for future reference in your browser, you could print it out or save it in your browser as an "htm" file that I believe you could still open offline.
How is Riley doing?
 
Riley is very, very tired. He only pestered me once last night to eat. This morning at the country place with no internet but plenty of birds, he was sitting in his favorite chair in front of the window he uses to watch birds at the feeder. Only he wasn't watching because he was sleeping and that's strange. On the way back to the city he didn't complain once. He usually gets tired of the drive fifteen minutes before we arrive. When we got here, he went back to sleep and didn't ask for any food (which he usually does). He seems weaker when he walks. He can still jump up on chairs and beds, etc. But when he walks he kind of zigzags. And I do believe he lost some weight. He has lost quite a bit of weight since being diagnosed, but if there was any left to lose, he just did.
 
I'd try to get as much food into Riley as you can and you may need to be a little more aggressive about the insulin in the days to come. Sounds like Riley could be developing some diabetic neuropathy which will cause some weakness in the hind quarters but sometimes in the front too. The best treatment for that is to get his BG down to better numbers. Many folks also give Zobaline which can be ordered online as a supplement to help with the neuropathy. Definitely keep checking for ketones and any lack of appetite is a concern. It's important for Riley to get at least his normal amount of food everyday but if you can get extra into him, it will help. Diabetics cannot efficiently use the food they consume so feeding them more until they are regulated is often needed to keep them from losing more weight and to keep their energy up and ward off ketones.
When you can, get the spreadsheet updated so we can see what Riley is up on the Basaglar. :)
 
I shouldn't have given him the Friskies after his injection yesterday evening, but he loves it, and he wasn't eating much yesterday. He ate a 5.5 ounce can overnight. Even though it does not appear to be a high carb food on Dr. Pierson's chart, it has in the past increased his BG levels. So just when it looked like there was some consistency at the 3U dose of the glargine, we are back up again. And now that he got a can of Friskies out of me, he is going to hold out until I give in again. I used to cook chicken for him and he LOVED it. And now he won't touch. When he was in remission he ate nothing but Tiki brand canned flavors that have zero carbs. And now he won't touch.
 
He may have dropped a bit lower last night and be bouncing a bit. Try to get a test before bed every night so you get some idea of what he does at night. Otherwise you're only getting half the picture and our kitties often go lower overnight for whatever reason.
Some cats are more carb sensitive than others and some react to certain ingredients so perhaps a different flavour in the Friskies would suit his tastes but also keep the carbs/his reaction under control.
Right now, if the Friskies is what he likes and will eat, I'd let him have it to ensure he is getting the calories he needs. Insulin dose can be adjusted accordingly but eating is not optional. :)
 
We need that test during the night, I know. Since his evening injection is about one hour before bedtime it doesn't provide enough info doing another test an hour later. If I'm going to get any good info from a test after evening shot, I set the alarm clock for 4, 5 or 6 hours post. I took last night off but shouldn't have. The alternative would be to change injection times
 
Finding a schedule that accommodates all CG needs as well as kitty's can be challenging. If you can grab a +4 to +6 during the night as much as possible that works just fine. I agree a +1 usually doesn't tell you much. Some folks drink extra water before bed so they HAVE to get up while some others set an alarm. I had the luxury of moving shot times periodically to accommodate social engagements etc. but when one is working, it's a lot tougher to figure out. :)
 
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