Getting there slowly - I think, second home curve today

[Alexi]

So 2 1/2 weeks in I am beginning to feel things are starting to get under control. After a curve at the vets where she went on hunger strike and was running over 30 for much of the day I did a home curve last week where she dropped quickly and bounced. Today's I think is more like what a caninsulin curve should look like.

Earlier this week she was running high, then I found out after I had asked someone to pop in on her in the middle of the day to check in on her she had been given a bowl of cat biscuits 'because she seemed hungry', which probably pushed her numbers up. Yesterday I was going to do a curve but she helpfully walked away mid shot so she didn't get her full shot, her behaviour yesterday was more normal than I have seen for weeks. She is still slightly underweight and dropped 0.1kg this week.

Of note: no ketones, overnight vomits have stopped. I have changed to give insulin 30 mins after she starts eating and split her food to give a snack in the evening and ensure she has access to some food whilst I am out at work. Today her lowest point was 7.1 and she was looking a bit stunned but not wobbly so I decided to just observe her and her numbers have come up again. By PMPS she was bouncing around eager for food!

My vet is investigating ProZinc as an alternative for her as my biggest fear is she goes hypo when I am not there.

My interpretation is that with the right feeding regime (which we seem to have now) she is getting better control but the caninsulin is pushing her numbers right down mid cycle and she may do better by changing insulins to one which is a bit gentler. I did post in the ProZinc forum earlier this week and the consensus was it would be a good choice given my hectic lifestyle.

Any comments on today's curve?

 

[Tuxedo Mom]

Today's curve is a perfect example of why home testing is so important...the AMPS and PMPS are both higher but look at the mid cycle. The testing tells the whole story. The Caninsulin obviously works for your kitty but it is a faster acting, harsher insulin and really requires being able to monitor especially in the earlier part of the cycle. A longer acting insulin like Prozinc, Levemir or Lantus might help to smooth out the numbers better. If you have a hectic lifestyle Prozinc might be the best choice, since it allows a little more flexibility with shot time.

The first(and only) curve my Tuxie had done at the vet was just like yours. He was SO SO stressed, wouldn't eat and just cowered in the litter box all day at the vets. They stopped the curve at the 6 hour point since it was not working. Doing curves and regular testing at home is so much less stressful (and cheaper) for both the petparent and the furkid. Congratulations on taking the initiative of home testing!!

 

[Alexi]

My vet curve was after feeding and shot but I had to collect her to get her to eat at home, and then get her back as soon as she had her shot so they could test, it was a slightly hectic morning as this was all within the space of an hour. They agreed home testing and curves might be the way to go after that! I have e mailed them the link to the spreadsheet today and given them view permissions as she has no further vet visits planned for now.

 

[Tuxedo Mom]

My vet curve was after feeding and shot but I had to collect her to get her to eat at home, and then get her back as soon as she had her shot so they could test, it was a slightly hectic morning as this was all within the space of an hour. They agreed home testing and curves might be the way to go after that! I have e mailed them the link to the spreadsheet today and given them view permissions as she has no further vet visits planned for now.

That is WONDERFUL that your vet is advising home testing!!! There are far too many vets that tell people not to home test. The first 2 weeks when I started I was just doing what the (old no longer my vet) vet told me and shooting blind. I cringe when I look back at those days!

When my second kitty was diagnosed with FD my new vet said maybe I could hold off on testing....I said "NO WAY" and she never pushed the point after that. I will never do without home testing.

 

[Sarah Smith]

We're also on the vetsulin (caninsulin) and its reassuring to see from your spreadsheet that the bouncing is common with this insulin. I was freaking out a bit earlier with the difference in Cooters readings between +5 and +7, but see your girl is having the same thing (Her 4/16 reading was very close to what we had today). Is that the day she got the extra food by playing the hungry cat with your visitor?

 

[Critter Mom]

Hi Alexi,

Those blues in today's cycle are at the top end of the feline normoglycaemic range. Given that Cappuccino is getting nadirs in that range I strongly recommend that, for safety, you get +2 - or, better, +3 - tests every night for the next few nights to determine whether Cappuccino runs lower at night; many, many cats do. If she does have that natural tendency then she may get even lower nadirs at night than what you saw in today's curve.

The curve itself is very typical of the action profile of Caninsulin. Drop like a rock then poop out way before the next dose is due.


Mogs
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[Alexi]

We're also on the vetsulin (caninsulin) and its reassuring to see from your spreadsheet that the bouncing is common with this insulin. I was freaking out a bit earlier with the difference in Cooters readings between +5 and +7, but see your girl is having the same thing (Her 4/16 reading was very close to what we had today). Is that the day she got the extra food by playing the hungry cat with your visitor?

4/16 was the first attempt at testing, 4/18 was the 'cat biscuit incident' then I didn't test for a few days because I ran low on strips and after a bit of to and fro with delivery attempts I finally got a new pack and resumed testing. I didn't want to run out completely in case of an emergency.

 

[Critter Mom]

I didn't want to run out completely in case of an emergency.

Smart move!

I bought an Accu-Chek Aviva as a backup meter for just such a circumstance. The strips are fairly easy to get hold of at short notice. (Morrisons carry them.)


Mogs
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[Sarah Smith]

Any thoughts to the decrease on Cappucino's numbers on 4/16 between +7 and +9? We just had the same exact thing..... Still trying to figure out exactly how this insulin works, i have read the info about it in the vetsulin forum section, but am still a little sketchy.

 

[Critter Mom]

Still trying to figure out exactly how this insulin works

Caninsulin/Vetsulin is made up of both amorphous and crystalline insulins.

The amorphous fraction kicks in early in the cycle and, when at an effective dose, produces a significant drop in BG levels typically by about +3 and then holds them down for a few hours before starting to wear off. The crystalline fraction kicks in later - about +7 - and it works to try to keep levels down up until about +10, sometimes producing a slight dip in BG levels before +10. The crystalline fraction does not have as powerful a BG-lowering effect as the amorphous fraction.

Thereafter the dose typically poops out and BG levels start heading north again. If the drop in the early part of the cycle has been particularly precipitous then the climb to the next preshot level may also be influenced by an element of bouncing.


Mogs
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[Alexi]

Any thoughts to the decrease on Cappucino's numbers on 4/16 between +7 and +9? We just had the same exact thing..... Still trying to figure out exactly how this insulin works, i have read the info about it in the vetsulin forum section, but am still a little sketchy.

She had already been on insulin for 10 days before I started home testing and had started out on 2 iu bid, with an increase to 2.5 iu bid after the first week, when I was feeding her more food than now as she had lost 1/4 of her body weight at diagnosis, she soon regained and I asked the vet to set a target weight.

I am still figuring it out as well. It has a similar profile to an insulin we don't use much in people any more which is a mix of short and long acting insulins. As far as I can see what should happen is a drop mid cycle with a slow rise back to fasting levels. The drop is pretty fast though and what had happened last week I think is that her body detected a number which was too low for her to cope with and there was a release of stored glucose from the liver to compensate which overshot her on her numbers.

What I would advise is to take things slowly and experiment with the feeding regime and not be tempted to change doses too quickly, my vet did suggest putting her dose up again this week but I wasn't happy to do that as she didn't seem to cope well with being fed just twice a day and I wanted to see if I could manage her a bit better myself. If you can do a first full curve with hourly testing like my first one it will give you a better idea of what is going on. This time the vet suggested 2 hourly testing but to switch to hourly once the numbers started to drop to check how low she got.

Hi Alexi,

Those blues in today's cycle are at the top end of the feline normoglycaemic range. Given that Cappuccino is getting nadirs in that range I strongly recommend that, for safety, you get +2 - or, better, +3 - tests every night for the next few nights to determine whether Cappuccino runs lower at night; many, many cats do. If she does have that natural tendency then she may get even lower nadirs at night than what you saw in today's curve.

I am planning a +2 or +3 this week at night-time and a pre-bed snack which does seem to be helping slow the drop.