Help with dosing Caninsulin

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kimouette

kimouette

Member Since 2012
Hi everyone,

I am helping a woman named Sylvie with her diabetic kitty (12 year old male). He was diagnosed with diabetes almost 2 months ago.
It is VERY DIFFICULT to bring his BG levels down to something acceptable.
We've been increasing the dosage at every cycle for 3 days now and the nadirs are still pretty high, with extremely high preshots.
The current situation is temporary cuz Sylvie should receive her low carb food anytime between tomorrow and Friday, but I just cant let the poor kitty with these terrible BG levels for couple of days.
She tests him everyday for ketones and it's negative.

Do you guys agree that should keep on increasing the dosage like we are doing right now (0.5U at every cycle)? Do you guys have any idea what could be blocking the action of the insulin? I know that the food is the first thing to look at, but she told me that he wasnt very hungry this morning and left half of his normal breakfast... and yet he still had this pretty ugly nadir, so this time the food is not to blame!

Here's his spreadsheet:
https://docs.google.com/spreadsheet/ccc ... sp=sharing

Oh and by the way, we are thinking of switching to Lantus, but not before she receives her new food.
 
Yes, I would continue with the increases; those high nadirs can contribute other damage in the body besides DKA. Keep monitoring mid-cycle, though. The nadir for Caninsulin may be closer to +4 to +5 as it is a mixture of 2 different duration insulins. In fact, in dogs, they sometimes see 2 distinct nadirs.

You've got a few data points showing the Caninsulin is starting to wear off at +8. I would consider going to TID (every 8 hours) if possible. Take the total daily dose and divide by 3 to get each dose amount.

Up to 20-25% of the diet can be plain meat or poultry per Dr Pierson of Cat Info, so that is something you could start adding in now, even before getting the ordered food.
 
You've got a few data points showing the Caninsulin is starting to wear off at +8. I would consider going to TID (every 8 hours) if possible. Take the total daily dose and divide by 3 to get each dose amount.
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How does it work with nadirs if we give 3 shots a day? I mean is the girl ever supposed sleep? Or is it risky if she doesnt test all 3 nadirs? She loves her cat, I'm almost sure she'll do it if I ask her to, but she is not gonna sleep a lot :(

Up to 20-25% of the diet can be plain meat or poultry per Dr Pierson of Cat Info, so that is something you could start adding in now, even before getting the ordered food.
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Why didn't I think of it!!! Thanks BJM that's right. So simple and it will atleast give us an idea if carbs are too high in his current food! But I'm thinking of suggesting 50/50% chicken breast/Almo .. Like I said this is temporary so I am not affraid of a lack of vitamin. The most important thing right now it his BG levels!!
 
It is much more intense to give insulin TID, but maybe because it's for a short time, it's be doable. I think she could test around +4-6. You want to make sure the number is rising before the next shot. So if the kitty reaches the low point around +5 or so, and clearly starts up, shooting at +8 when he is clearly higher should be safe. But yes, a midcycle number is imperative every cycle so she can be sure the number is rising.

For some reference, check out Lucian's spreadsheet on the PZI forum. He is a very unusual cat and alternates between 8/10/12 hour cycles. She tests alot and catches him rising and then shoots before he goes too high. She is using PZI but it is working a little like the shorter duration insulin for some cycles. His mom Deb doesn't get much sleep. The hope is that he continues to stretch his cycles.

https://docs.google.com/spreadsheet/lv?key=0AjhvMJzoVTQ3dGNiNmxrWVhLMF91cGtZWFZyRi14N2c&usp=sharing
 
Because Caninsulin is not a depot insulin, she can stretch the overnight block of time a bit as that is when cats are most likely to go low.
So maybe 2 periods of 7.5 hours during the day and the ovenight could be 9 hours.

Check Dr Pierson's formula for raw food to see the supplements she adds in. You may be able to find them locally.
 
Because Caninsulin is not a depot insulin, she can stretch the overnight block of time a bit as that is when cats are most likely to go low.
So maybe 2 periods of 7.5 hours during the day and the ovenight could be 9 hours.

Check Dr Pierson's formula for raw food to see the supplements she adds in. You may be able to find them locally.
 
Check Dr Pierson's formula for raw food to see the supplements she adds in. You may be able to find them locally.
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I know her recipe. Dr. Lisa Pierson's website is my bible! I always refer the people I help to her website.. Always!
But instead of telling Sylvie she should start with a recipe, I simply asked her to mix his regular food with cooked (but almost raw) chicken or turkey. She started yesterday with 1/4 of his food replaced by meat, and today half of his food. The meat is mixed with his regular food so the carb intake should be steady.
We finally managed to reach a yellow value!Woohoo! But that cat's metabolism would definitely require 3 or even 4 injections of Caninsulin, or even better, Lantus. She will not be able to manage all the tests required by so many injections, so we decided to be a little moe patient.
She has a diabetic friend who will give her 2 pens of Lantus this afternoon (and she already bought the U-100 seyringes with the half unit marked). She is currently learning how to handle that insulin and reading the protocol with Lantus that I have translated for her. But since she should receive her super low carb food order before Thursday, we will simply wait for the food and start Lantus at the same time. So no TID for Kabaret. We hope the food arrives today or tomorrow! But in the meantime, he is already eating a healthier food in terms or carbs and we will adjust the dosage as needed.

https://docs.google.com/spreadsheet/ccc ... _web#gid=0
See ya guys in the Lantus group!
:)
 
Hi Kim,

There are 2 Lantus forums here. The larger forum is for those following the Tight Regulation protocol (TR). The smaller "Relaxed" Lantus forum is for those that aren't using that protocol (and for those wanting to follow the 'Start Low Go Slow' technique (SLGS)).

Bless you for helping this lady and her cat. You have a very kind heart. :smile:

Eliz
 
Can you guys look at Kabaret's spreadsheet and tell me what you would do?
the pm shot is supposed to be in an hour but his BG levels keep getting lower. I'm glad they do but I'm just not too sure about what to do. My feeling is that we should wait until his BG starts increasing and shoot at that moment, but then what dosage?
Today is a weird day cuz he has been introduced to very low carb food for the first time in his life. He hates the 3 different brands Sylvie bought for him!! He did eat a little bit this morning cuz she motivated him with little pieces of chicken, but since this morning he didn't touch his 3 plates.
That could explain his BG results being the lowest he's been for a while!!

If you guys could confirm that my "plan" for tonight makes sens, and what dosage you guys would give... It would be very appreciated!!!

By the way he is still under Caninsulin, we were hoping to switch tomorrow to Lantus but with this appetite problem we might have to wait before switching.. And with a little miracle we even might not need to change anything but the dosage (giving less and less until a remission.. Yes that is utopist I know!)
 
Yes, it's probably that he hasn't eaten that is causing the lower levels. Has she tried the usual ideas: parmesan cheese on top, warm water to make a gravy, tuna juice, even crushed up pieces of the dry food he likes on top.

If he is rising and 200+ maybe 1.5 units. It may not be enough, but better too high than too low, if he continues not eating.
 
I have never seen this!
Kabaret was 171 at + 11
He ate about 60g of low carb food
At PMPS he suddenly was 519!
I asked Sylvie to do another test cuz it made no sense... She did another test 5 minutes later and he was 568
She gave him 1.5U cuz I don't think he's going to eat much for the rest of the night and evening... Just in case...
But how is that even possible, between +11 and +12 with a low carb food? The same food he ate this morning and made him go lower and lower the whole day...
Could it be the contour breeze 2 not working properly?
 
If he wasn't eating, and then finally ate, then yes, even low carb can have that kind of spike from food.

If he has frequent issues with eating, you may find you'll need an advanced protocol with a lower level of the depot insulin plus as needed short acting insulin. Its tough doing that because you'd need to test more to know how the short acting insulin worked in him, as well as the testing for the depot insulin. It can be done, though, with caution.
 
If he wasn't eating, and then finally ate, then yes, even low carb can have that kind of spike from food.
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That is sort of reassuring. With such an elevation I was also about to doubt the manufacturer's nutrtional analysis!
To avoid that, Sylvie will try to give him 5 small meals throughout the day instead of leaving the food on the floor for a while.
The good news is that he kind of likes one of the 3 brands now.. That cat is changing his mind every single day! A very complicated little patient!
If he has frequent issues with eating, you may find you'll need an advanced protocol with a lower level of the depot insulin plus as needed short acting insulin. Its tough doing that because you'd need to test more to know how the short acting insulin worked in him, as well as the testing for the depot insulin. It can be done, though, with caution.
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Let's hope he doesnt change his mind about the Feringa food he now enjoys a little, so we can stabilize his apetite in the first place (if he does change his mind, we'll try every single tip from Lisa Pierson's document : http://catinfo.org/docs/TipsForTransitioning1-14-11.pdf
Once that is achieved, we are ready to start him on Lantus. We will try Lantus alone before considering mixing different types of insulin. But I'll keep this suggestion in mind if his levels cant be stabilized any other way.

Thanks BJM! I'm amazed how you always have a solution or suggestion even for very specific problems!

:)
 
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