Dosing advice please >.< Shooting in the dark...

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KleineMue

Member Since 2014
*gnarl*hiss*throws tantrum*stamps feet*curses OH, the cat, the illness, the universe*despairs*laments the unfair nature of it all*swears profusely*

Rahhhhh! angry(2)_cat

So, we have practically no useful data since DAYS now, actually make that a week! Last Sunday the vet recommended to increase the dosage to 2.5 units and we didn't test his glucose levels for 48 hours after (IDIOTS!!!). And then we had a short night time curve which showed that fantastic nadir of 4.2 and because we felt smug we then only tested AMPS and PMPS for a few days which was all hunky-dory until we got the crazy low 5.8 PMPS on Friday which didn't raise alarm bells with me and I injected him with 2.5 units of Caninsulin anyway. Clever cat tried to steal Josie's nutella bread in desperation, doubtlessly to counteract the dangerously low blood sugars and miraculously survived the night and then Saturday morning as we realised what has happened we unlocked a whole new level of complexities around food and monitoring and gah!

And when I say 'we' it's actually 'me' because OH is seemingly terrified of poking the cat and it leaves both of them traumatised without any results. He also claims he can't feel when the needle goes in when he injects Pedro so really it's all down to me. He also hasn't really read that much about feline diabetes at all and he hasn't quite caught up with the much more complex playing field we are now moving on.

Which sadly didn't stop him feeding the cat Sunday evening before I could get a PMPS after a rather disrupted and odd 'curve' which ended in 22.3 before dinner!!! And then Monday morning because the cat wouldn't leave him alone.
And again this afternoon coming home early from work before me after two failed attempts to get BG data. *squinty eyes*tight lips*menacing growling*

So, where are we at? Decided to stay up and test Pedro throughout the night to get SOME kind of handle on his blood sugars again! Also using secondary observation as he is actually giving away a lot more than we think. Before I tested him at +2 he had big pupils, he was clearly hungry despite having gotten his 'prescribed' portion of diabetic cat food.

At +2 he was 12.6 and at +3 just now he was 6.9. He was desperately looking for some food so initially gave a teensy amount of extra diabetic cat food and when that clearly wasn't enough a tiny amount of carb rich dry food. (don't have a hypo 'kit' just yet, but have dry Hill's Science Plan left over which would fit the bill except for being dry, no?) He is now settling down to sleep.

Now, one of the things I had to get my head around is the relationship between food and insulin. You all actually wrote it on my original thread, the fact that I can feed a bit more as that's common and necessary as we learn to 'regulate' the diabetes. I didn't really 'get' it until this weekend and we still haven't really translated this into action in our new rhythm.

From hereon in it's
7.30am
AMPS
Food (2/3)
8am: Insulin (2 'fat' units) plus 1/3 food
when possible test +2 (10am), +4 (12pm), +6 (2pm). +8 (4pm) and +10 (6pm)
Up until +8 we can give a bit more food if needed to soften the 'crash' and 'bounce'
No extra food from 5pm

7.30pm
PMPS
Food (2/3)
8pm: Insulin (2 'fat' units) plus 1/3 food
when possible test +2 (10pm), +4 (12am), +6 (2am), +8 (4am) and +10 (6am)
Up until +8 we can give a bit more food if needed to soften the 'crash' and 'bounce'
No extra food from 5am

Does this look right?

In my smugness from a week ago I thought "Awesome, we got this! He will be regulated and sorted within the next 2 weeks and we can then move him onto the <8% carb calorie food!!" Instead I now think we will get this started a bit sooner and I will research what brand is readily available near us and then very very slowly start changing both cats over while we still have a small supply of the prescription foods. Do you think that's ok?

Oh, tested Enzo, our other cat. He was most upset that I poked him and put up much more of a fight than Pedro. His PMPS came back as 2.9. I should probably do a couple more to be sure but it looks like he doesn't have diabetes. Yay!!! He does however have unusually long claws in the moment and clearly lacks the inclination and/or opportunity to scratch them shorter. Maybe a nice new scratching post is in order for Christmas?

Love from the Wirral,
Mue x
 
Re: >.< Shooting in the dark...

KleineMue said:
*... Before I tested him at +2 he had big pupils, he was clearly hungry despite having gotten his 'prescribed' portion of diabetic cat food...

Yikes!!! Big Pupils can be a sign of hypoglycemia, as in, the glucose is way too low for the cat and that could kill him!

Have we given you the link for HYPOs and How to Handle Them?
 
Re: >.< Shooting in the dark...

BJM said:
Yikes!!! Big Pupils can be a sign of hypoglycemia, as in, the glucose is way too low for the cat and that could kill him!

Have we given you the link for HYPOs and How to Handle Them?

Seen the page and while his pupils appeared bigger his blood sugars all look alright so far. That said, I don't know where he started his evening without the PMPS, could have been a steep drop. :/ He is all settled and sleeping now. ^_^

x
 
Re: >.< Shooting in the dark...

Hi

These are still big drops from red right through to green and this must make Pedro feel pretty hungry. I hope others will comment on the dosage as I wonder if it might still be a little high. You don't want to risk pedro going hypo or dropping so dramatically but again I am not experienced in caninsulin and haven't been doing this very long myself. I see you are doing a fat 2 units. It might be worthwhile considering lowering the dose slightly so the drop isn't quite so hard and fast and then let the blood glucose settle somewhat.

I think you should edit the title of this thread (go back to the first post and press the edit title ) and change it to dosing advice requested.

I really also think you really should consider contacting the the trial I mentioned. They are having great success with lantus insulin And getting kitties in remission.
 
Re: >.< Shooting in the dark...

What you have to be really careful of is a low preshot and then giving the same dose as you have been doing and have him drop even lower.

Don't get too hung up feeding him more. If he wants it let him have the food at least until his insulin peaks.
 
Just to add one final thing- if you ever get worried about pedro and want quick advice that go to your first post and edit it again and click on the 911 icon.

If you want to highlight that you have a question then add the ? Mark icon, etc.

Finally if you haven't already done so then add the insulin you are using to your signature. You need to go to your control panel JD edit signature from there. Sorry I am off to bed now. Be safe pedro
 
And again this afternoon coming home early from work before me after two failed attempts to get BG data. *squinty eyes*tight lips*menacing growling*
As long as he is tight lipped his mouth is closed so he isn't biting, poke away :razz:

I think your new testing regimen looks like a good plan. There is obviously some swinging going on. You need to figure out what is going on in order to figure out how to react to it. The insulin you are on is a shorter acting insulin, it can bring a cat down fast and low, and then let them go up high at the end of the cycle when the insulin has quit working. Caninsulin/Vetsulin usually peeks 3-6 hours, wearing off 6-10 hours. You want to test enough to figure out if this is going on. Shooting this kind of insulin without knowing where he is at can be dangerous because of the way it can kick in so quickly.
 
Melanie and Smokey said:
And again this afternoon coming home early from work before me after two failed attempts to get BG data. *squinty eyes*tight lips*menacing growling*
As long as he is tight lipped his mouth is closed so he isn't biting, poke away :razz:

Oh, it's me doing the growling here through tight lips in face of OH's unwillingness and/or inability to get his head around how to do this (poke the cat, get blood, get glucose data, give insulin, etc.) and it all being left with me alongside everything else I am doing. :evil:

Mue x
 
E-mailed whom?

I must have missed something; I didn't understand that post.
 
BJM

it's the clinical trial in the UK where you go under the care of the royal vet college. :-D

That's great news. Even if you don't go on the trial they offer great advice and if you ask may phone your vet to discuss the benefits of lantus.
 
Ruth, the clinical trial manager of the RVC feline diabetic remission clinic, emailed me back and said that judging by the info I sent her (spreadsheet and intro I wrote on here) Pedro might be a suitable candidate and if I want to learn more about the trial to give her my number to arrange a call!! *squee*

Have a few questions for her though, ie the trial being randomised, randomised insulin, so could it be we end up with Caninsulin or will it be one of the longer acting insulins? Also have to work out when they need the cat as each visit is a 2 night overstay and we can't really do that during the week due to work commitments. Do they work at the weekend? Driving down to London and dropping him off and then picking him up again 2 days later would be quite a journey, although if done by train (is that allowed? Cat in carrier on train?) I could get a phenomenal amount of quality knitting time in!

Also worried about how to make a lengthy car/train journey would be for Pedro and how to make it more comfy for him.

Will hopefully talk to Ruth shortly! Exciting!
Mue x
 
KleineMue said:
..Have a few questions for her though, ie the trial being randomised, randomised insulin, so could it be we end up with Caninsulin or will it be one of the longer acting insulins?
As I understand it there are two insulins being trialled; Lantus and Prozinc. Lantus is already being prescribed by a number of vets in the UK. Prozinc is not yet 'on general release' in the UK, but those kitties who receive it during the trial can (or so I understand it) continue to be prescribed it after their year's trial is over.
Both of these are good insulins, so, no need to fret about which one you'd get, Mue.

I think the RVC remission clinic's Facebook page has details about exactly how much time the cat needs to spend at the clinic. If you want to talk to someone who's been on the trial then you could PM Cassandra (FDMB user name is 'Sweet Angel'). Her cat, Angel, was on Prozinc (I think!) and went into remission while on the trial...

Eliz
 
I think its a great opportunity for mue as long as you can make it work for you both. I couldn't get remi onto the trial because of his asthma but she still spoke to my vet about what they were doing up there and the success they were having.
 
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