Looking for spreadsheet insight

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plumsteal

plumsteal

Member Since 2022
After semi-lurking for a month+ and sponging up all the incredible information on this forum, I've finally created Meeko's spreadsheet. It really does help reveal patterns, doesn't it? I'm wondering what more knowledgeable folks might be able to glean from his numbers.

Here are some of my thoughts/questions:
  • He's been in the 300s on 1u, 2u, 3u, and 3.5u. I wish I'd gotten some mid-cycle numbers on 1u and 2u...imagine if his numbers trend the same on all those doses. How could that be possible?
  • Switching to low carb wet food made no real impact on his BG numbers. Why would that be? Are there cats here who eat HC and LC? Meeko definitely loved his gravy Fancy Feast and it feels a bit like I took that away from him for no reason.
  • I've been all over the place with his dosing. I eventually decided to stick with my vet's recommended dose and to stop "experimenting" based on the all the things I was reading and learning :bookworm: (and based on my nerves and impatience :facepalm:).
  • He's been bouncing for about a week. Is 4u of Vetsulin too high for him or is Vetsulin just too harsh? He finally had a good day today on 3.5u.
He's got a vet appointment day after tomorrow for full bloodwork and I've already sent an email asking if he can be switched to a different insulin. But now I'm thinking it's not the harsh nature of Vetsulin that is the problem but the high dose. Should I try sticking with Vetsulin @ 3.5u for a bit longer? I was going to ask the vet for Lantus.

Thanks in advance! :bighug:
 
plumsteal said:
After semi-lurking for a month+ and sponging up all the incredible information on this forum, I've finally created Meeko's spreadsheet. It really does help reveal patterns, doesn't it? I'm wondering what more knowledgeable folks might be able to glean from his numbers.

Here are some of my thoughts/questions:
  • He's been in the 300s on 1u, 2u, 3u, and 3.5u. I wish I'd gotten some mid-cycle numbers on 1u and 2u...imagine if his numbers trend the same on all those doses. How could that be possible?
  • Switching to low carb wet food made no real impact on his BG numbers. Why would that be? Are there cats here who eat HC and LC? Meeko definitely loved his gravy Fancy Feast and it feels a bit like I took that away from him for no reason.
  • I've been all over the place with his dosing. I eventually decided to stick with my vet's recommended dose and to stop "experimenting" based on the all the things I was reading and learning :bookworm: (and based on my nerves and impatience :facepalm:).
  • He's been bouncing for about a week. Is 4u of Vetsulin too high for him or is Vetsulin just too harsh? He finally had a good day today on 3.5u.
He's got a vet appointment day after tomorrow for full bloodwork and I've already sent an email asking if he can be switched to a different insulin. But now I'm thinking it's not the harsh nature of Vetsulin that is the problem but the high dose. Should I try sticking with Vetsulin @ 3.5u for a bit longer? I was going to ask the vet for Lantus.

Thanks in advance! :bighug:
Click to expand...
@Suzanne & Darcy :cat:
 
Hi and welcome to the forum.
Definitely stay with the low carb food. Feeding high carb food is like giving a child with Diabetes cakes and desserts all the time.
Great you are home testing and have a spreadsheet set up …and the signature…fabulous!

Vetsulin is not a good insulin for cats. It’s a dog insulin and it does not last the full 12 hours of the cycles.
So if you are not testing during the cycles, you will most likely see just high numbers, which is exactly what has been happening with Meeko.
On the cycles where you have got some tests in during the cycle see can see that he is dropping lower but then going back up again when the insulin wears off.
He is also most likely bouncing from the lower numbers he is getting because his body now thinks that the higher numbers are the normal numbers. I would not increase the dose without getting mid cycle tests in to see how low the dose is taking Meeko.

Here is information about bouncing from the Basics on the Lantus page
  • Bouncing - Bouncing is simply a natural reaction to what the cat's system perceives as a BG value that is "too low". "Too low" is relative. If a cat is used to BGs in the 200's, 300's, or higher for a long time, then even a BG that drops to 150 can trigger a "bounce". Bouncing can also be triggered if the blood glucose drops too low and/or too fast.The pancreas, then the liver, release glucogon, glycogen and counter-regulatory hormones. The end result is a dumping of "sugar" into the bloodstream to save the cat from going hypoglycemic from a perceived low. The action is often referred to as "liver panic" or "panicky liver". *Usually*, a bounce will clear kitty's system within 3 days (6 cycles).
You need to be getting at least one test in during every cycle so you can see how low the insulin is taking Meeko.

If I were you I would ask to be swapped to Lantus insulin. It is one of the insulins recommended by the American Animal Hospital Association (Vetsulin is not).
Lantus is a longer lasting more gentle insulin and is great for cats. We have a lot of cats here on Lantus.
I don’t think you have been all over the place with the dosing really. You have swapped around a bit but mainly just gone up slowly.
The thing is, if you are not testing during the cycles and seeing how low the dose is taking Meeko, you are only seeing the high pre shots and thinking you have to keep increasing. I would not stay any longer with Vetsulin.
If you are testing before all the shots and again during the cycles and following one of our dosing methods for Lantus …there is no guesswork at all. The BG numbers will tell you what you have to do. And we can help you until you are more confident.

We have lots of caregivers who arrive here with the same concerns as you do. Once they get onto a good insulin for cats and follow one of the dosing methods, things greatly improve.
When you do the swap to Lantus, post here about the dose.
You don’t go back to 1 unit as some vets suggest. We take into consideration what the cat has been getting when they are swapping to a new insulin.
Please let us know how you get on at the vet.
keep asking lots of questions. We are here to help
Bron
 
If you do switch to lantus you can get the genetic it's a lot less cheaper then the lantus, many members use the generic
just call around and see who might have the generic
Here is some info
Check this out also
https://www.goodrx.com/insulin-glargine?dosage=five-3ml-prefilled-pens-of-100-units-ml&form=carton&label_override=insulin glargine&quantity=1
The 5 pens will last about a year, we use the pens just like a vial, you would just insert the syringe it the gray rubber stopper on the pen and draw out your insulin
Its generic lantus

And U-100 syringes with half unit markings
Just ask we can tell you where to get them



Or this one also

I see some members will call CVS, Rite Aid, Costco, Walgreen's, to get the price for 5 pens
Posted by another member
One members posted this
. I paid $175 for a box of 5 pens at Walmart pharmacy, but GoodRX coupon says you can get it for around $90 if you have a Rite Aid pharmacy near you.
 
I agree with Bron, Vetstulin does not seem to be doing the trick, looking at the trend in your spreadsheet from a thousand-foot-view it seems like it is going in the wrong direction, from pinks to reds to blacks. Usually, as insulin therapy progresses towards regulation we see the opposite. I am a huge fan of Lantus/glargine insulin because it worked wonders on my boy and he is now in diabetic remission! Along with the Tight Regulation dosing method.

Miracles do happen.
 
Thank you all for your advice and help!

The good news is that Meeko won't be on Vetsulin anymore! The slightly less good news is that his vet wants to go back to ProZinc first and then try Lantus in 2-3 weeks if he's still largely in the red or having significant symptoms. Since Meeko was heading in the right direction on ProZinc, I'm willing to try this approach. Anything to get off Vetsulin.

The vet also mentioned that he wants to look into that new pill, Bexacat, but I'm guessing that Meeko has been on insulin too long to give that pill a try.

Unfortunately, he's also been having trouble with constipation and he was quite backed up this morning, so he's still at the vet waiting for an enema. :(
 
plumsteal said:
Thank you all for your advice and help!

The good news is that Meeko won't be on Vetsulin anymore! The slightly less good news is that his vet wants to go back to ProZinc first and then try Lantus in 2-3 weeks if he's still largely in the red or having significant symptoms. Since Meeko was heading in the right direction on ProZinc, I'm willing to try this approach. Anything to get off Vetsulin.

The vet also mentioned that he wants to look into that new pill, Bexacat, but I'm guessing that Meeko has been on insulin too long to give that pill a try.

Unfortunately, he's also been having trouble with constipation and he was quite backed up this morning, so he's still at the vet waiting for an enema. :(
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I can’t see the point of trying ProZinc for just three weeks!….that’s crazy. If ProZinc didn’t work before , why try it again! And I hope the ProZinc works well
But I can see you want to get off Vetsulin.
I don’t know much about Bexacat ( I will find out more) but I would caution you about using anything except insulin for a diabetic cat. There have been oral medications around that are supposed to treat FD but all they have done is stress the pancreas even more.
 
He sees 80-300 mg/dl as the ideal range for controlled diabetes in cats and since Meeko was approaching that on ProZinc just before the Vetsulin hampered all progress, he wants to see if we can get all the way there by returning to ProZinc.

I was given Vetsulin back in December when I was close to finishing the bottle of ProZinc I had. I didn’t want to run out over the holidays so I made sure to go ahead of time. I was charged for ProZinc but the techs handed me Vetsulin and when I asked why it was different, they said, “They’re both insulin.” I got the feeling today that this was a mistake on their part and the doctor had never intended for Meeko to switch insulins.
 
plumsteal said:
He sees 80-300 mg/dl as the ideal range for controlled diabetes in cats and since Meeko was approaching that on ProZinc just before the Vetsulin hampered all progress, he wants to see if we can get all the way there by returning to ProZinc.

I was given Vetsulin back in December when I was close to finishing the bottle of ProZinc I had. I didn’t want to run out over the holidays so I made sure to go ahead of time. I was charged for ProZinc but the techs handed me Vetsulin and when I asked why it was different, they said, “They’re both insulin.” I got the feeling today that this was a mistake on their part and the doctor had never intended for Meeko to switch insulins.
Click to expand...
Absolutely that was a big mistake on their part….saying they are both insulins shows how little they know about FD…it’s scary.


plumsteal said:
He sees 80-300 mg/dl as the ideal range for controlled diabetes in cats and since Meeko was approaching that on ProZinc just before the Vetsulin hampered all progress, he wants to see if we can get all the way there by returning to ProZinc.
Click to expand...
It depends what you are aiming for. There are a few different regulations …regulated, well regulated and tightly regulated. And then if you are lucky enough there is remission. But first you have to be regulated.

WHAT IS REGULATION
 
I am not surprised that to the vet, 80-300 is a good range. It seems like a lot of vets we hear about on the FDMB are only looking to get cats into slightly lower numbers and then call that success.

But it is not exactly ideal. The renal threshold is roughly around 250, meaning ketones can develop, kidney damage can occur and other issues if kitty spends too much time above 250.
 
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@Hendrick Cuddleclaw - I'm not sure I would agree with you about what vets look for. It truly depends on the vet and that vet's experience with feline diabetes.

If your vet is serious about Bexacat, please go slowly. It has only been FDA approved since December. There is a list of contraindications for prescribing including the cat having already been using insulin. This is a link to the FDA report.
 
Sienne and Gabby (GA) said:
@Hendrick Cuddleclaw - I'm not sure I would agree with you about what vets look for. It truly depends on the vet and that vet's experience with feline diabetes.
Click to expand...

you're right, I should have phrased it differently. Something like, "I've seen that same story time and time again on the FDMB, where someone's vet is really only looking to get the cat into slightly lower numbers and then considers that success"

which is what I really meant.
 
Meeko seems to be doing much better on ProZinc. His AMPS numbers are mysteriously all over the place, but he's steady on the PMPS. I'm going to hold 3.5 for a few more days to see if the AMPS numbers stabilize in the pink, get some more AM/PM mid-cycle values over the weekend, and then probably increase by 0.25u. I think his nadir is currently around 140-150 on 3.5u.

But his bloodwork came back today and while his diabetic numbers are "okay" (I need to go into the clinic to get a proper look at the numbers from the doctor to understand what "okay" means), his kidney numbers are high. He had been teetering near the edge for a while so I'm not too surprised, but I was hoping we'd be able to stave things off for a while longer.

Luckily (depending on how you look at it), I have two other CKD seniors, so I'm familiar with CKD treatments. Poor little guy, though. I was hoping his golden years (he's 17) would be a little more peaceful!
 
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