? Feeling discouraged after having good numbers, spreadsheet review

[TankNRK]

We were doing wonderful for awhile with great numbers, now Lando's been climbing again higher and higher and can't get him below 200 anymore.
Still waiting for my vet to get back with me about switching to Glargine, was planning to call her tomorrow to touch base on it as it's been a couple weeks since I last heard from her (we had a big ice storm so I didn't want to bother her)

I think I'll try to hold the 1u dose for possibly 2 weeks Incase there's some bouncing going on, but I'm feeling discouraged. I got new strips and was even wondering if my meter was broken. Sometimes I test him back to back because I've gotten readings with 100 point differences right after each other, so I test on myself to make sure it's reading accurately... Fancy feast pate is still the main food. Chicken pieces now and again as snacks. He eats a can of food and 10 minutes later he screams and screams until he gets more. He's peeing more, no keytones. Not getting into contraband.
I'm just struggling emotionally with it, worried it's me doing something wrong, feeling bad he was doing so well and now shooting to the moon. Still new at this so hoping for some experienced insight again that I'm still doing it right and I just have to prepare for the marathon.

 

[jayla-n-Drevon]

@tiffmaxee @Bron and Sheba (GA)

 

[Bron and Sheba (GA)]

Hi Tank, you are not doing anything wrong.

@tiffmaxee @Bron and Sheba (GA)

I think there are a couple of things….vetsulin is not a good insulin for cats. It is harsh and it does not have a long enough duration for cats. This means that by the time the 12 hours of the cycle have come about the insulin has stopped working a few hours before the end of the cycle, and the BG is up high again.
And you probably haven’t reached the best dose yet.
Switching to glaring is an excellent idea. Glargine is a longer acting more gentle insulin and is recommended for cats….unlike vetsulin which is not.
The reason he is so hungry all the time is because ie is not regulated and unregulated cats can’t absorb. All the nutrients in the food so they are always hungry. This will improve once the BG numbers are in more normal range. In the meantime if he is not overweight…let him eat if he is hungry. Are you feeding him snacks during the cycles a well as the pre shot meals?

Dont be discouraged. You are doing a good job and I think once you swap to glargine, things will be much better

edit….can you remove the GA please as that indicates that the kitty is no longer with us.

 

[TankNRK]

Hi Tank, you are not doing anything wrong.


I think there are a couple of things….vetsulin is not a good insulin for cats. It is harsh and it does not have a long enough duration for cats. This means that by the time the 12 hours of the cycle have come about the insulin has stopped working a few hours before the end of the cycle, and the BG is up high again.
And you probably haven’t reached the best dose yet.
Switching to glaring is an excellent idea. Glargine is a longer acting more gentle insulin and is recommended for cats….unlike vetsulin which is not.
The reason he is so hungry all the time is because ie is not regulated and unregulated cats can’t absorb. All the nutrients in the food so they are always hungry. This will improve once the BG numbers are in more normal range. In the meantime if he is not overweight…let him eat if he is hungry. Are you feeding him snacks during the cycles a well as the pre shot meals?

Dont be discouraged. You are doing a good job and I think once you swap to glargine, things will be much better

edit….can you remove the GA please as that indicates that the kitty is no longer with us.

Sure thing! Sorry lemme figure out how to do that edit... Thought it stood for "general advice" so my bad lol.

Yes sent the text to my vet couple weeks ago which she read about switching over and she's ready it just haven't gotten to touch base with her yet (she's always been on board for the change just need to get the ball rolling on it) we had good numbers for awhile and knew it wouldn't get any better on Vetsulin but I was surprised we just started climbing again for seemingly no reason at all, as we've done .25u back and forth from 1.5u now, so it's frustrating to see the dosage have to go up and down so much and I was concerned I may have missed something.

The vet said he could use to lose a tad bit of weight, but when he was diagnosed he was very boney, he's put on a bit since starting insulin which I feel is muscle as he's started filling out in the shoulders, hips, and spine again. I'd say he's at a good weight currently, but he's prone to becoming overweight easily due to being an amputee so his weight has to be carefully monitored.

We do feed small snacks between meals usually anywhere from 3-5hrs after dosing and teeter off after 6 because the Vetsulin starts wearing off, and we fast the 2 hours before dosing unless he's really screaming and begging for food (he'll go nonstop) and if that's the case I give him a teeny bit of shredded chicken mixed with warm water up to an hour before insulin time.

 

[TankNRK]

Sure thing! Sorry lemme figure out how to do that edit... Thought it stood for "general advice" so my bad lol.

Yes sent the text to my vet couple weeks ago which she read about switching over and she's ready it just haven't gotten to touch base with her yet (she's always been on board for the change just need to get the ball rolling on it) we had good numbers for awhile and knew it wouldn't get any better on Vetsulin but I was surprised we just started climbing again for seemingly no reason at all, as we've done .25u back and forth from 1.5u now, so it's frustrating to see the dosage have to go up and down so much and I was concerned I may have missed something.

The vet said he could use to lose a tad bit of weight, but when he was diagnosed he was very boney, he's put on a bit since starting insulin which I feel is muscle as he's started filling out in the shoulders, hips, and spine again. I'd say he's at a good weight currently, but he's prone to becoming overweight easily due to being an amputee so his weight has to be carefully monitored.

We do feed small snacks between meals usually anywhere from 3-5hrs after dosing and teeter off after 6 because the Vetsulin starts wearing off, and we fast the 2 hours before dosing unless he's really screaming and begging for food (he'll go nonstop) and if that's the case I give him a teeny bit of shredded chicken mixed with warm water up to an hour before insulin time.

I've also tried to give a couple days of not testing to often because I've been doing it OFTEN lately and wanted to give his paws a little break where I could. We have lots of trouble testing on the ears so it works best for us. I'm planning to do extra tests tomorrow and next Tuesday at 1 week of the new dosage.

 

[Bron and Sheba (GA)]

I would give three small snacks between +2 and +7 ( hopefully the +7 will stop him asking for food until Thor next preshot.) and add some warm water to the food so it fills him up.
Another thing you could do is cook some chicken broth and give him that after +7 to help with his hunger.
To cook the broth you can use chicken legs and plain water…nothing else. Cook slowly and after a couple of hours remove most of the chicken flesh and keep cooking the bones for a few more hours. When cooked remove the bones ( throw away) and cool the liquid. When cool put into either ice cube trays or small plastic containers and freeze..get out as needed. I used these for Sheba. They not only kept her hydrated but also filled her up. And you can use the chicken from the legs as treats or snacks.

 

[TankNRK]

I would give three small snacks between +2 and +7 ( hopefully the +7 will stop him asking for food until Thor next preshot.) and add some warm water to the food so it fills him up.
Another thing you could do is cook some chicken broth and give him that after +7 to help with his hunger.
To cook the broth you can use chicken legs and plain water…nothing else. Cook slowly and after a couple of hours remove most of the chicken flesh and keep cooking the bones for a few more hours. When cooked remove the bones ( throw away) and cool the liquid. When cool put into either ice cube trays or small plastic containers and freeze..get out as needed. I used these for Sheba. They not only kept her hydrated but also filled her up. And you can use the chicken from the legs as treats or snacks.

Good idea I will do that! I have a timed feeder for when I'm at work that's at +3 and +5 and I usually get home at about +8 1/2 and give him 1/4-1/2 a FF can with warm water to help hold him over for dinner. He's always been very good motivated and it's at +10 to +11 where he just goes ballistic screaming and screaming for food x.x I gave him an extra bit of food for dinner tonight.... Just hit nadir at 232. Should I consider a dose increase at the 7 day mark do you think, or hold out maybe 10 days before increasing? It just feels crazy that a couple weeks ago we had him doing well at .25u-.50u

Thank you for the tip for the broth, Lando will love that and since I work in a meat market I can make that happen for him easily!

 

[TankNRK]

Figured out how to edit the GA tag, hurrah!

 

[Bron and Sheba (GA)]

Should I consider a dose increase at the 7 day mark do you think, or hold out maybe 10 days before increasing? It just feels crazy that a couple weeks ago we had him doing well at .25u-.50u

I would follow the SLGS and do a curve and increase after 7 days. If he needs an increase and you leave it longer, you risk glucose toxicity. And that means you may need to give more insulin to get where he needs to be.
Also insulin needs change. What worked 2 or 3 weeks ago may not work now.
He is still a very newly diagnosed diabetic. We say here that FD is a marathon not a sprint. And the fact you were not started on a good insulin has not helped. Once you swap to glargine I’m sure his numbers will improve.

 

[TankNRK]

I would follow the SLGS and do a curve and increase after 7 days. If he needs an increase and you leave it longer, you risk glucose toxicity. And that means you may need to give more insulin to get where he needs to be.
Also insulin needs change. What worked 2 or 3 weeks ago may not work now.
He is still a very newly diagnosed diabetic. We say here that FD is a marathon not a sprint. And the fact you were not started on a good insulin has not helped. Once you swap to glargine I’m sure his numbers will improve.

Thank you so much for taking the time today to look at this with me and keep me encouraged!
I'll do just that and call our vet tomorrow to get with her on the swap. I'm glad to know I'm still doing everything alright. I'll keep at it, Lando says thank you!!

 

[Bron and Sheba (GA)]

I’m very happy to help anytime. Just ask.
Please let us know how you get on with the vet and the swap to glargine.

 

[Sienne and Gabby (GA)]

I agree with everything that Bron posted.

I tend to think that most of us, especially early in the process of managing our cat's diabetes, expect the same dose of insulin to work the same way every time. It may help to think a bit differently about how insulin works. First, it's not like an antibiotic. It's a hormone. Other hormones that we/our cats produce have an effect on our blood glucose (BG) levels. For example, if your cat gets frightened or is stressed by something in the environment or by illness, stress hormones are released. They cause a rise in BG levels. Exercise can lower BG. Obviously, food has an effect -- especially high carb food. Some of those effects are temporary. Longer terms effects may be that your cat's system gets used to the insulin you're injecting and adjusts. As a result, you may need to give a higher dose.

 

[TankNRK]

I agree with everything that Bron posted.

I tend to think that most of us, especially early in the process of managing our cat's diabetes, expect the same dose of insulin to work the same way every time. It may help to think a bit differently about how insulin works. First, it's not like an antibiotic. It's a hormone. Other hormones that we/our cats produce have an effect on our blood glucose (BG) levels. For example, if your cat gets frightened or is stressed by something in the environment or by illness, stress hormones are released. They cause a rise in BG levels. Exercise can lower BG. Obviously, food has an effect -- especially high carb food. Some of those effects are temporary. Longer terms effects may be that your cat's system gets used to the insulin you're injecting and adjusts. As a result, you may need to give a higher dose.

Thank you for that! I'm glad I can pop in occasionally and get reassurance that my spreadsheet is still looking good and I'm doing things right.

I noticed as I've been moving to increases, it seems the first day we get numbers in the range we need and then POOF he goes up and we aren't in a good range anymore. I assumed at first it was a bounce but it never clears by the 7 day mark. Can you give me any insight into the phenomenon? I was worried it was cause I was doing something wrong.

 

[TankNRK]

I’m very happy to help anytime. Just ask.
Please let us know how you get on with the vet and the swap to glargine.

I just touched base with her, she's gonna write the script Tuesday when she's back in town to start Lantus! We're going to try to get the $35 manufacturer coupon to work first (Lantus) then if we struggle too much we're going to try the coupons with semglee and GoodRX then outsource to Canada if need be. I'm so excited to switch!!!

 

[Sienne and Gabby (GA)]

There may be a few other considerations. The way you've adjusted doses may have had an effect on what you're seeing. For example, reducing the dose from 0.75 to 0.25u was likely too big of a reduction. With Vetsulin, I don't know if changing the dose from 0.25 to 0.35 was a good idea or not. It's such a harsh insulin I would likely have been tentative with increases. The other factor is how long you hold the dose. This is true for any insulin in that you don't want to hold a dose more than a week if you're not seeing good numbers. Holding a dose that's not doing what you want it to do can result in glucose toxicity (i.e., your cat's body treats higher numbers like a new "normal"). It makes it harder to get the numbers back down to where you want them.

 

[TankNRK]

There may be a few other considerations. The way you've adjusted doses may have had an effect on what you're seeing. For example, reducing the dose from 0.75 to 0.25u was likely too big of a reduction. With Vetsulin, I don't know if changing the dose from 0.25 to 0.35 was a good idea or not. It's such a harsh insulin I would likely have been tentative with increases. The other factor is how long you hold the dose. This is true for any insulin in that you don't want to hold a dose more than a week if you're not seeing good numbers. Holding a dose that's not doing what you want it to do can result in glucose toxicity (i.e., your cat's body treats higher numbers like a new "normal"). It makes it harder to get the numbers back down to where you want them.

Thanks for that insight! I realized that awhile back about going from .75 to .25, someone had recommended I give it a shot since we'd started getting such low numbers and I see now that wasn't really something I should have done and instead should have gone to .50.
I'd never heard of glucose toxicity until today so I will read up more on that! Glad to know that it's good to keep searching for the right dose in small increments, as I'd started to wonder if I should hold a dose longer then a week and if he needed time to settle, but it seems like with how often I test 5-7 days is the right amount of time to decide and have accurate results for a curve. Thank you!
Looking forward to starting Glargine <3

 

[Paula and Sammy(GA)]

We were doing wonderful for awhile with great numbers, now Lando's been climbing again higher and higher and can't get him below 200 anymore.
Still waiting for my vet to get back with me about switching to Glargine, was planning to call her tomorrow to touch base on it as it's been a couple weeks since I last heard from her (we had a big ice storm so I didn't want to bother her)

I think I'll try to hold the 1u dose for possibly 2 weeks Incase there's some bouncing going on, but I'm feeling discouraged. I got new strips and was even wondering if my meter was broken. Sometimes I test him back to back because I've gotten readings with 100 point differences right after each other, so I test on myself to make sure it's reading accurately... Fancy feast pate is still the main food. Chicken pieces now and again as snacks. He eats a can of food and 10 minutes later he screams and screams until he gets more. He's peeing more, no keytones. Not getting into contraband.
I'm just struggling emotionally with it, worried it's me doing something wrong, feeling bad he was doing so well and now shooting to the moon. Still new at this so hoping for some experienced insight again that I'm still doing it right and I just have to prepare for the marathon.

Hi Tank! I'm going through a similar situation with my 3 legged cat who also has asthma. He seems to be peeing more but his numbers, while weird, are in the blue range. Sam's dose is so low I am wondering if it is correctly helping him. He's been off of steroids for a few months, and I'm hoping this is his change. More to your point, I know we must stick with the monitor we have (I've got the Walgreems True Metrix). Keep the lowest carb food. Have faith in yourself. I am in your shoes. I know EXACTLY what you are feeling.

 

[Bron and Sheba (GA)]

@Paula and Sammy i don’t want to hijack TankNRK’s thread so it would be great if you could start a thread for yourself as I would like to make some comments about your SS

 

[TankNRK]

Hi Tank! I'm going through a similar situation with my 3 legged cat who also has asthma. He seems to be peeing more but his numbers, while weird, are in the blue range. Sam's dose is so low I am wondering if it is correctly helping him. He's been off of steroids for a few months, and I'm hoping this is his change. More to your point, I know we must stick with the monitor we have (I've got the Walgreems True Metrix). Keep the lowest carb food. Have faith in yourself. I am in your shoes. I know EXACTLY what you are feeling.

Give your 3 leggie baby a big hug from Lando and I! Best tripod friends forever!
I am hoping for the best for y'all, keep on keeping on you two, Sammy's gotta get in the groove! <3