kimouette said:
You have brought up a good point about caninsulin working quickly in the front half of the cycle.
While Caninsulin/Vetsulin may not be great to use as your basal insulin because it will not last the full 12hrs since cats have faster metabolism, it can be used as an alternative to Humulin R as a bolus to assist when you are having high numbers around ps times, or rather, in the same situations as when many in the US and Canada use R.
In the beginning, it's very hard to see such high numbers, and it's vital to test urine as often as possible for ketones, but with such constant high numbers as Rosy is getting, Caninsulin would not be sufficient, and could be dangerous with ketones in the picture here.
On Rosy's spreadsheet, there are 2 columns labeled U if you can put the dose for the shot given in those 2 columns as opposed to the far right Comments column, it will be most helpful to those who are reading the spreadsheet.
Now, it looks like you have only 3 days worth of test numbers recorded so far, and all the numbers are during the am cycles. Would it be possible to get some test numbers from the pm cycles? It's almost impossible to know what is going on with numbers from only half days... many cats go lower at night, so with no test numbers, Rosy could be going low in the pm cycles and then bouncing back up higher during the daytime. I don't think that's what is happening, but we don't know because there are no test numbers to prove that theory right or wrong.
You did get a 26.3 and a 16.1 around mid cycle on the 26th and 28th, so you are seeing some movement to lower numbers a bit, but Lantus does not like the dose being changed all the time.... you need to stick to the same dose, for am and pm shots, for at least 3 or 4 days in a row.
If you want to go with the 3units at am and pm, fine. When the shed/depot is settled, you will start to see better numbers, but you will not see improvement if you feed any dry food at all and keep changing the dose.
Here are some DOSING guidelines to help you along:
"General" Guidelines:
--- Hold the initial starting dose for 5 - 7 days (10 - 14 cycles) unless the numbers tell you otherwise. Kitties experiencing high flat curves or prone to ketones may want to increase the starting dose after 3 days (6 cycles).
--- Each subsequent dose is held for a minimum of 3 days (6 cycles) unless kitty earns a reduction (See: Reducing the dose...).
--- Adjustments to dose are based on nadirs with only some consideration given to preshot numbers.
Increasing the dose...
--- Hold the dose for 3 - 5 days (6 - 10 cycles) if nadirs are less than 200(11.1) before increasing the dose.
--- After 3 consecutive days (6 cycles)... if nadirs are greater than 200(11.1), but less than 300(16.7) increase the dose by 0.25 unit.
--- After 3 consecutive days (6 cycles)... if nadirs are greater than 300(16.7) increase the dose by 0.5 unit.
Reducing the dose...
--- If kitty drops below 40(2.2) (long term diabetic) or 50(2.8) (newly diagnosed diabetic) reduce the dose by 0.25 unit. If kitty has a history of not holding reductions well or if reductions are close together... sneak the dose down by shaving the dose rather than reducing by a full quarter unit. Alternatively, at each newly reduced dose... try to make sure kitty maintains numbers in the normal range for seven days before reducing the dose further.
In case you have not seen the info on the shed, here's the info:
Lantus & Levemir – Insulin Depot –AKA- Storage Shed
There's a storage shed/insulin depot under your cat's skin. It has first dibs on the insulin. Once it is filled, the insulin that you shoot doesn't have to go into the shed. It can be used. The shed HAS to be filled before the Lantus or Levemir gets to use the extra on cat's BGs. So by skipping shot, or waiting too long to shoot, or giving a fur shot... the cat starts dipping into it's shed and the next shot or shots have to partially go to refilling shed before they can work on BGs.
When you get impatient and overfill the storage shed by upping the dose too fast, you get into a situation where at first it looks like nothing is happening because the shed is still filling up. Then you reach the point where it is totally full and yet you are still giving a dose that's too high. Now suddenly none is going into shed, because that is full. It is all working on the cat... and the numbers drop out on you.
Worse case scenario is when you over fill the shed/insulin depot... get very low numbers... then empty out shed by dropping dose too much... or having to skip the shot. Then you'll see high numbers from the combo of the effects of rebound and an empty storage shed/insulin depot. Most react by bumping the dose back up which overfills the shed/depot again resulting in a roller coaster ride to nowhere. Not the way to work this insulin.
~ written by jojo and bunny(GA) and Y
INSULIN DEPOT
One's subcutaneous "spare tank" of insulin, which has yet to be used by the body.
Because no insulin injection is immediately 100% absorbed by the body, the yet to be used insulin stays under the skin, the system drawing on this "reserve" as needed. Any such insulin effects that last after the insulin's expected action is over are also known as carryover in some literature.
If you're using only intermediate-acting or long-acting insulin alone (without any short-acting insulin), about 24 hours worth of insulin requirements are in your depot.
The larger your insulin dose, the larger the insulin depot in your subcutaneous fat tissue. Having a large vs smaller insulin depot means the effect of the insulin can be less consistent--more chance of it varying from day to day. This same insulin depot is the reason why it can take anywhere from 2-5 days to see any effect of insulin dosage changes.
This handy "extra tank" is also there to give you a hand if you miss or are late with an injection.
On the other hand, when you do miss an injection, your "spare tank" is very low by next injection time, and so the next injection may have less effect than expected!
So there's you info to explain why changing dose back and forth or too often will create problems with Rosy's numbers.
Rosy got a nice 16.1 mid cycle on the 3units am dose; keep on the 3units dose for a couple more days and if Rosy seems to stay around the 11.1 to 16.6 range in mid cycle, you can increase her dose by .25units, to a new dose of 3.25 units.
There are some cats who take a bit longer for their numbers to settle after a dose change; my Oliver sometimes took 3 days / 6 shots before I could see how a dose was working and if I needed to make a change.
Rosy is getting there; that 16.1 is a terrific number.
Just keep testing for ketones whenever you can and hopefully, this dose will begin to settle as Rosy's body gets used to the lower numbers.
Let's hope that the whiskas canned food is good for her now that her illness has been fixed with meds.
