Hometesting number is 506!

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Susan and Timmy

Susan and Timmy

Member Since 2017
I am not sure where to post this. We had a problem with Timmy's numbers going lower than expected last night. I was guided through with the help of the wonderful folks here.

This morning he is a 506! I did not give him his injection last night so it was expected to be high.

He ate his wet food just now.

***How much insulin to give him. Vet had him on Vetsulin 4 units, which I am learning was really high. I am thinking 2 units and monitor him closely. Is that what you all would do?
 
Sorry that no one got back to you right away. That is a really high dose of vetsulin. I have learned on here that it is better to give a lower dose following a low drop if BG is high when next shot is due.
I had that experience with smoky a few times and always gave him a lower dose the next time around. He may be in a bounce so I would give him two units if it were my cat. Plus, vetsulin hits fast and hard. Smoky would drop by 200 or more in 4 hours after his shot. I would definitely monitor him today if you can.
 
Hi--

Not a Vetsulin expert so I can't give a recommendation here, but I'm tagging @Squalliesmom, and @Mum of two felines because they were able to help on last night's thread. @Critter Mom has also used Vetsulin in the past and may be able to offer some advice.

You definitely do want to get that number down. Just to confirm: you are able to monitor closely today?

For anyone jumping in, here's the history from the last thread:

Monday amps: 407
"throughout the day" (not sure of times): 259, 224, 198
Monday pmps: 401
Tuesday amps: 378
[no midday tests?]
Tuesday pmps: 194 no shot
Wednesday amps 506

Timmy is currently transitioning from an all-dry diet to a mix of dry and low-carb wet.

Edit for additional history from last thread: diagnosed 3 weeks ago, initial dose 2U bid, increased to 3U and 4U following weekly curves.
 
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One more thing, how long has he been on the vetsulin? Smoky was taking it for two and a half months and did very poorly on it. Every cat is different though and he may do well on the vetsulin.
 
Adding: I'm sorry no one got back to you earlier. If you have already done the shot (of whatever dose you were comfortable with), my advice is to now try to get some good data to try to help figure out how Timmy is responding to the insulin by monitoring throughout the day. As @Lisa and Smoky said, Vetsulin tends to hit fast, so if you could get a test in an hour or two hours after the shot, that would be great. If you then post that number here, I'm sure people will be able to jump in and give some guidance for the rest of the day with respect to further testing and feeding-- many more people on the boards are comfortable giving that kind of advice than are comfortable giving specific dosing advice, so I'm sure you'll get more prompt feedback.

We also have a particular spreadsheet that most of us use and put into our signature at the bottom of posts. It's a great way for not only you to keep track of Timmy's numbers, but also to get the quickest help because people can quickly scan the spreadsheet and get the whole history. Instructions are in this post in the Tech Support section: http://www.felinediabetes.com/FDMB/threads/fdmb-spreadsheet-instructions.130337/

shout out for help if you have any problems with it, and let us know how you and Timmy are doing today!
 
Thank you for responding. I gave him 2 units of Vetsulin at 10:00. Normally he gets insulin at 9 a.m. and 9 p.m. He has been on Vetsulin since December 14, 2016. I will test him now and post. I am home today with him. Very scared for him and the hypo. I made the decision this Sunday to test. Thank goodness I did. I am not good at it yet, but he is tolerant of it, and me trying to help him.

Be back after I test him.
 
@S. Russman, @Nan & Amber - Just saw the tag. Sorry I couldn't reply earlier (not online). I'm really not feeling well at all so may be very hit 'n' miss for the time being.

@S. Russman - As Nan has already recommended above, if you can get a spreadsheet going for Timmy it will help you to better understand his response to his insulin and also help members here to offer better suggestions to you. If you have the BG numbers for the vet curves it would be great if you could include those numbers as well as the BG tests you've done at home; the more info the better.

Here's another link to help you with the spreadsheet:

Understanding the spreadsheet grid

Also, because Timmy's not yet regulated it's an advisable precaution to test regularly for urine ketones. Here are some helpful stickies:

Are you testing kitty for ketones?

Tips for catching and testing urine samples

You should be able to pick up the urine test strips at a pharmacy or at Walmart (e.g. Keto-diastix, Relion ketone test strips).


Mogs
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S. Russman said:
I will test him now and post. I am home today with him.
Click to expand...
If you could manage it while you're home today, doing a test every 2 hours up to and including next preshot test (more if Timmy runs lower - post for help) would give you a home curve so that you can see how low the 2IU dose will take Timmy today and also give you an idea of how long the dose lasts.


Mogs
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Can you do the next test in 1 hour (i.e. +3.5 hours after dose was given). Timmy has dropped a fair bit since the AM preshot test (AMPS) and he may have an early nadir. (He's still in very safe numbers at the moment! :) )

Also can you please tell us which meter you're using to measure BG.


Mogs
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I watched Smoky closely as his nadir usually happened by five hours after his shot. It was important with vetsulin to monitor the first 7 hours in particular with Smoky. Timmie may go down more as its still early in the cycle. The 297 is still a safe number yet, you are doing a great job testing him and it will keep him safe.
 
Sorry I'm not more helpful today but I have my own little crisis going on (Squallie's BG is at 46 just 3 hours into the cycle, ughh) but you are in good hands with Critter Mom, Lisa and Smoky, and Nan and Amber!

Timmy looks a lot like my Squallie! :)
 
SITREP:

Diet Transition in progress: Day 3 | Foods: 3/4 cup Glycobalance dry + c. 4 oz wet food per day.

AMPS: 508 | Fed: ??? | Dose: 2.0IU Vetsulin (Local Time: 10:00) | Meter: Relion Prime

AM+2.50 - 298

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He ate wet food right after morning test 3.5 hours ago.
He snacked on dry food about 2.0 hours ago.

Lisa and Smokey, thank you for the words of encouragement.
Squalliesmom, sorry you're having a rough day with your baby.
 
Holding steady, I see. You're doing a great job with the testing. :)

To get some idea of how long this dose will keep Timmy down in this lower range and also when the dose starts to wear off I suggest testing at the following times (all relative to time dose was given):

+4.5 hours
+6.0 hours
+8.0 hours
+10.0 hours

NB:

For PMPS this evening, because you gave insulin an hour late at 10:00am local time I recommend that you don't give insulin any earlier than 9:30PM local time. Also be sure to wait about 20-30 minutes after feeding the preshot meal before giving Vetsulin. (FDMB User Guide)


EDITED TO ADD:

Be sure to post for input on dosing after the PMPS BG test and giving Timmy his PMPS feed. (I'm in the UK so several hours ahead of you but other US members should be around to help. :) )

Also be sure to get a 'before bed' test after the evening dose; I'd suggest +2 to see if numbers are dropping quickly again and, if yes, test again at +3 to check the drop is levelled out. If numbers go lower than you expected be sure to post for help from other members if you're worried about anything.


Mogs
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SITREP:

Diet Transition in progress: Day 3 | Foods: 3/4 cup Glycobalance dry + c. 4 oz wet food per day (Sheba perfect portions beef pate/no gravy)

AMPS: 508 | Fed: ??? | Dose: 2.0IU Vetsulin (Local Time: 10:00) | Meter: Relion Prime

AM+1.50 - **** | Snacked on dry food.
AM+2.50 - 298
AM+3.50 - 292

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Okay. Getting ready for the 4.5 hour testing and then will test the rest of the day according to the schedule. I will keep posting the numbers as I go. Just because I am worried and apprehensive. Having you all on the other end of my computer is such a blessing!
 
I can fully relate. :bighug:

The vet treating Saoirse when she was first diagnosed was positively hostile toward home testing of any sort - even of urine testing for ketones!! :banghead: I ended up having to dose Saoirse 'blind' for the first number of weeks of her treatment and I was absolutely petrified; she became very, very lethargic on Caninsulin and I had no way of telling whether or not she might be having a hypo. We moved to our current practice shortly after that and they are supportive of home testing. The relief of being able to confirm Saoirse was safe was immeasurable.

I was extremely grateful to the members here who helped us when Saoirse went unexpectedly low: I was so scared. It made such a difference not being alone with everything.


Mogs
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So his number at 4.5 hours was 277, down 15 points. He is getting testy with the ear pricks, but it has to be done.

My vet, while not hostile, did not seem too keen on the idea of home testing. I have been blind dosing since December 14th and feeling very uneasy about it. Thank goodness I got the courage to start testing on Sunday. The need to keep and know he is safe, and that I am doing everything I can for him in this situation is almost primal.

Knowing that I am not alone is such a relief.
 
S. Russman said:
Thank you for responding. I gave him 2 units of Vetsulin at 10:00. Normally he gets insulin at 9 a.m. and 9 p.m. He has been on Vetsulin since December 14, 2016. I will test him now and post. I am home today with him. Very scared for him and the hypo. I made the decision this Sunday to test. Thank goodness I did. I am not good at it yet, but he is tolerant of it, and me trying to help him.

Be back after I test him.
Click to expand...
I think 2 is good.
 
SITREP:

Diet Transition in progress: Day 3 | Foods: 3/4 cup Glycobalance dry + c. 4 oz wet food per day (Sheba perfect portions beef pate/no gravy)

AMPS: 508 | Fed: ??? | Dose: 2.0IU Vetsulin (Local Time: 10:00) | Meter: Relion Prime

AM+1.50 - **** | Snacked on dry food.
AM+2.50 - 298
AM+3.50 - 292
AM+4.50 - 277

.
 
Hi again!

Sorry for ducking out abruptly, I'm at work today so could only check in in spurts. Things are looking good, though! I'm happy to see that the initial drop has slowed, it's so helpful to see what his pattern is throughout the day.

On the ear pricks: yummy treats (or whatever he likes-- brushing, cuddles, play session with a fave toy) immediately afterwards do wonders for decreasing testiness. If the ear seems to be getting sore, make sure you are putting a little neosporin (gel, not cream) on afterwards (just dab a bit on and wipe off the excess after a bit). You guys are doing awesome for the first few days of testing, it will just keep getting easier from here!
 
Ran out quickly to get more testing strips. At +6.75 hours (4:45 my time) tested and it jumped to 404!

That's over 100 points! Did the Vetsulin just stop working?

I'm in Florida. I know it gets a bad rap, but we really are nice people down here. :)
 
S. Russman said:
Ran out quickly to get more testing strips. At +6.75 hours (4:45 my time) tested and it jumped to 404!

That's over 100 points! Did the Vetsulin just stop working?

I'm in Florida. I know it gets a bad rap, but we really are nice people down here. :)
Click to expand...

Others are more knowledgable than I about Vetsulin, but from what I know, the flipside to it dropping numbers very quickly in the beginning is that it can have a pretty short duration. It has two components to it, a structure which can partially counteract that, i.e. you get one component that is fast-acting and poops out fast, and another that is supposed to carry through in the later part of the cycle. It's still early days to figure out how those components are going to work in Timmy, though.

When you were out, did you get ketone testing sticks too? Have you managed to get a test in?

I've known many lovely people from Florida-- and the rest of us are very envious of your weather, especially this time of year!
 
S. Russman said:
Ran out quickly to get more testing strips. At +6.75 hours (4:45 my time) tested and it jumped to 404!

That's over 100 points! Did the Vetsulin just stop working?
Click to expand...

With a lot of cats (though not all) Vetsulin tends to run out of steam about 2/3 of the way through the cycle. Because Timmy's BG dropped fairly steeply in the early part of the cycle it may have caused his system to react to raise BG levels as a consequence (bouncing) and that may sometimes cause numbers to rise earlier after nadir. If it is a bounce it will clear as Timmy's system settles down again. Another thing which might be affecting the latest test is the dry food Timmy has been snacking on. With only a little data available at the moment all we can do is speculate but as you start filling in a spreadsheet for Timmy it will help you to better identify how different things affect his blood glucose levels.


Mogs
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SITREP:

Diet Transition in progress: Day 3 | Foods: 3/4 cup Glycobalance dry + c. 4 oz wet food per day (Sheba perfect portions beef pate/no gravy)

AMPS: 508 | Fed: ??? | Dose: 2.0IU Vetsulin (Local Time: 10:00) | Meter: Relion Prime

AM+1.50 - **** | Snacked on dry food.
AM+2.50 - 298
AM+3.50 - 292
AM+4.50 - 277
AM+6.75 - 404

.
 
S. Russman said:
Ran out quickly to get more testing strips. At +6.75 hours (4:45 my time) tested and it jumped to 404!

That's over 100 points! Did the Vetsulin just stop working?

I'm in Florida. I know it gets a bad rap, but we really are nice people down here. :)
Click to expand...
The vetsulin didn't stop working, that happened with smoky too. The dose never lasted him 12 hours, maybe 8 or 9 hours at the most. Timmie has only been on it for a short time now. It takes smoky about 4 to 6 weeks for good results to show up.
Give it a little more time to work .:bighug:
 
Example of typical Vetsulin curve:


latest


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How slow do I need to go to switch him to the wet food? I give him the wet food 3 times a day, but I leave out the dry just in case. How do I go about changing this?

The curve is starting to make some sense now. From the graph it looks like that spike was to be expected.

If the last test was 404, I am worried about the next blood test being off the charts.
 
It may just hang around the current level, Susan.

Re the food change, it's best to do it gradually and also at a time when you can monitor BG closely like you've been doing today because you may have to adjust the dose downwards quite quickly in tandem with the change in carb load. The BG testing you're doing now will help guide you through the transition. There's good information about this at catinfo.org. Here's a link:

http://catinfo.org/?link=felinediabetes


Mogs
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