First day on Caninsulin with vetpen- concerned about dose?

[Dentone]

Hi all! My cat has just had his first dose of Caninsulin and I'm concerned about the amount prescribed based on some comments I've seen elsewhere.
He's 5.6kg, big frame moggy, he's 8 and neutered. Prescribed 2.5 units of Caninsulin.
His Fructosamine was 695 umol a week ago, and his glucose was 22.7 mmol.
I am not able to measure his blood at home as was not supplied a meter by my vet so am trying to find one online but am unsure which is the most reliable.

I managed the first dose fine, there was a tiny drop on the end of the needle left over, and he had two portions of low carb chicken in jelly. That was 7.30pm, he's been sleepy since about 9pm, but not unresponsive and not floppy. If I poke him he wakes up (sorry cat!) I've given him a tiny bit of low carb tuna food as another comment else where said he vets dose was very high and I should give him a little to eat after 4/6 hours. Feeling worried and a bit confused....

 

[FrostD]

That is a rather high dose, yes. Makes me uncomfortable. I would just try to get him to eat whatever higher carb stuff he'll eat, even if that means dry food. 4/6 hours is the lowest point, so you want him to eat before that to head off low numbers.

What's current diet? Any history of ketones or DKA?

No meter is more reliable than another really, not even the pet meters; they are all allowed 15-20% variance. My advice is to just pick whichever is cheapest to buy and has cheapest strips - I use the WalMart ReliOn ones.

You'll also want to grab some urine ketone strips (human ones like Ketostix) and test daily if you can. You'll want to grab a variety of food with varying carb % - but I'll expand on that more a bit later once I have answers to the questions above

 

[Chris and Checkers]

Hi and welcome.

I don't have any experience with Vetsulin so I can't help you with that. There are some members here that can so I am sure they will be by to help.

I can tell you that most of us here use human glucose meters that you can pick up at any pharmacy, you can get one at Walmart and the strips at a really reasonable price. However, vets prefer a pet meter because they can be calibrated to cats but they and their strils are expensive and only available online, such as the Alphatrak.

Here is a link to advice on hometesting, it has lots of great info and videos. Hometesting is the best way to keep our kitties safe on insulin and hel
https://www.felinediabetes.com/FDMB/threads/hometesting-links-and-tips.287/

Also if you are worried about the current dose of insulin, here are some signs to look for.

https://www.felinediabetes.com/FDMB/threads/how-to-treat-hypos-they-can-kill-print-this-out.15887/

 

[Diane Tyler's Mom GA]

Always aim for the sweet spot warm the ears up first, you can put rice in a sock and put it in the microwave, test it on the inside of your wrist to be sure it's not to hot, like you would test a babies bottle. You can fill a pill bottle with warm water and roll it on the ears also.Just keep rubbing the ears with your fingers to warm them up

6. As the ears get used to bleeding and grow more capilares, it gets easier to get the amount of blood you need on the first try. If he won’t stand still, you can get the blood onto a clean finger nail and test from there.
When you do get some blood you can try milking the ear.
Get you finger and gently push up toward the blood , more will appear
You will put the cotton round behind his ear in case you poke your finger, after you are done testing you will fold the cotton round over his ear to stop the bleeding , press gently for about 20 seconds until it stops
Get 26 or 28 gauge lancets
A lot of us use the lancets to test freehand
I find it better to see where I'm aiming

Here is a video one of our members did
VIDEO: How to test your cat's blood sugar

 

[Diane Tyler's Mom GA]

Here is a link helping us to help you link. If you noticed, our members have some basic information about their cat's in their signature. This helps us to not pester you by asking the same questions (your cat's name, insulin type, date of diagnosis, etc.) repeatedly. We also have a link to our spreadsheet in our signature. We are very numbers driven. The spreadsheet is a record of your cat's progress. By linking it in your signature, we can follow along and provide feedback should you need the help.

With caninsulin you want to test, feed him then wait 30 minutes to shoot
Withhold food 2 hours prior to testing his AMPS ( AM test)
and at PMPS (PM test)
You can feed him multiple times a day during both 12 hour cycles

 

[Christie & Maverick]

The starting dose MOST DEFINITELY IS too high. Depending on what you are feeding (exclusively canned vs. dry food) the most we would suggest as a starting dose is 1u.

So, my suggestion as first / immediate course of action: reduce the dose, either to 1u if kitty is being fed dry, or 0.5u if kitty has been eating a low carb canned food diet.

Second, get a human meter, as suggested above, and test your cat's blood glucose levels, to be sure that it is safe to give insulin, and also to ensure that BG levels don't drop to unsafe levels.

Third, read the link here on Introduction to Caninsulin to familiarize yourself with the basics of this insulin.

Fourth, perhaps consider asking your vet about either Prozinc or one of the longer acting insulins like Lantus or Levemir. The American Animal Hospital Association guidelines no longer recommend Vetsulin for cats.

https://www.aaha.org/globalassets/02-guidelines/diabetes/diabetes-guidelines_final.pdf

 

[Dentone]

Hi guys, thanks for the replies. I'll try and do the spreadsheet when I'm home from work tonight. I'm in the UK. I was offered Prozinc but I elected for Caninsulin because of the pen and the shifts I work mean I'm going to have to fly home on an evening shift on a coffee break, inject and feed him at the same time and go back to work to meet the 12 hour window. The pen seemed easier for prep time. I don't know if I've done the right thing now.

he's only been diagnosed 2 weeks ago. Had two shots of insulin, one last night and one this morning. I called the vets at lunch time as I was concerned the dose was high but she assures me it's not?! She said if he was sluggish skip tonight's dose and start again tomorrow am and make sure he has food available.

he's been on low-ish carb wet for for about three weeks. I'll attach a photo of his latest blood test.

he was sluggish last night but easily worken and was fine after his jab today walking around and went outside down awhile. I was just worried as everyone's said my dose is so high but the vets saying it's not?!

Edit: can't upload a photo off my phone.
His Fructosamine was 695 umol
Glucose 22.7mmol
This was with no insulin, before he started treatment and having symptoms for a month but in wet low ish carb food for two weeks.

he's peeing and drinking back to normal now and his ravenous appetite has calmed down. I'm just worried about his dose?!

 

[Dentone]

Ps I've ordered an Alphatrak. I'm waiting for delivery.

 

[FrostD]

The problem is cats react very differently to Vetsulin - my cat was largely fine on it, though at the time I didn't exactly have the test data to say that for sure. But by and large, the majority of cats react very harshly to it - massive drops in BG, usually by 4 hrs after giving a shot. I will drop some links to spreadsheets here in a minute - but take a look at my 2020 tab, up until October when I switched.

I was shooting 2.5U blindly for about a month, I'm not really sure how he didn't die to be honest. Probably the dry food I was feeding.

Even the Vetsulin insert says starting dose is 1-2U per cat per dose, and to hospitalize them for the first day to make sure it isnt dangerous. Here, we say 0.5U if low carb to be absolutely safe.

I had asked about ketones because that would have made me think a little harder on dropping the dose so much, but I agree with Christie, the safest thing to do is drop to 0.5U until you can test

 

[FrostD]

Kloeys spreadsheet - you can see the vet kept her in office the first day to do a curve, and found dose was too high so they had to reduce

Ares spreadsheet - you can see how hard and fast Vetsulin was dropping him, 300+ points. And the too high of a dose, then it would fizzle out (no duration). So she ended up switching to Lantus.

I'd have to dig to find others, but there's nothing much more recent - you'll notice the Vetsulin forum is pretty dead, simply because vets aren't prescribing it anymore (no long recommended for cats as mentioned before) and/or people are switching to ProZinc

It's worth giving it a try, some cats do fine. We just like to see data to give recommendations. Fructosamine just tells you the average of blood sugar in the past 2 weeks, it does not predict how they will respond to any given insulin or what dose is needed.