Hi Beth et al,
Just checking in quickly. Good to see Elmo back in safe numbers.
Hopefully he won't jump up too high for the PMPS.
I'd like to share a little of my experience with Caninsulin/Vetsulin here.
When Saoirse started getting low nadirs on this insulin when it came to dosing I put most weight on the NADIR BG and not the preshot BG. At that stage a small dose might produce a relatively moderate drop from a mid-range preshot BG level but it could potentially produce a very big drop down to similar low numbers from a high preshot BG. Here's an example from Saoirse's data:
20.07.14 - Dose 0.5IU Caninsulin. PMPS: 265 / +3 139 (nadir) - Difference between preshot and nadir: 136 points.
21.07.14 - Dose 0.5IU Caninsulin. AMPS: 407 / +3 155 (nadir) - Difference between preshot and nadir: 252 points.
Saoirse's feeding was very well regimented and her activity levels were pretty constant at the time so it is reasonable to deduce that the insulin was the main factor responsible for the drops observed. On the second cycle above the same dose lowered her BG by c. 120 points more than it had the previous cycle.
Looking at Elmo's data he has been uncomfortably low for a Vetsulin cat on the 0.5IU BID dose many times in recent days. (If it were my cat and I were using Vetsulin I would not like to see it going into double digits at nadir as measured on an Alphatrak; it's safer to have a decent buffer in case numbers take an unexpected dip, e.g the pancreas decides to sputter and produce a little more insulin of its own.) Today's numbers were dangerously low and it took a fair bit of intervention to get Elmo back into safe numbers again. Also I note that Elmo seems to metabolise the Vetsulin quickly; his data shows that the Vetsulin's work is well on the way by +2, and his insulin needs seem to be reducing.
I would give serious consideration to reducing the dose for safety reasons; today's reading of 41 (Alphatrak) was dangerously low so the 0.5IU dose is too high. Even if numbers drift up a little bit on the reduced dose I'd still be inclined to
stick to the lower dose (for reasons given above). Also for safety, I suggest you get a +2 or +3 before bed test
every evening to see where the cycle's heading overnight so that you'll know whether or not to monitor Elmo more closely for that cycle.
Mogs
.
It didn't help being a complete FD numpty at the time. I'm just so glad I was home testing (and to this day I'm still cheesed off at the vet who refused to give me any help with it).
) .......
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