Lou Lou First curve, thoughts please

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darren

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Did BG test on Lou today, She's on Caninsulin, 4u morning, 3u evening, done in uk, not sure of american translation so apologies for you guys getting your calculators out.

AMPS 21.1, +2 15.7, +4 12.7, +6 15.6, +8 16.8, +10 18.1, +12 pmps 20.1
 
We use the same numbers in Sweden and that is good numbers, Darren,m for you first curve! Congrats and welcome to the cat diabetes world!
 
That's a nice curve for showing why we don't recommend caninsulin. Very fast drop and no duration.
Board must be slow tonight as I see Ann bumped it after an hour with no response. I'm not sure what your plans are for an insulin change, but she would probably do better on even the UK version of PZI.
 
Hi Darren, can we go back to basics on this situation so we all have the up to date info on this new thread?

I was late coming to it last week when I was poorly but have now read the first thread more thoroughly and am a bit confused. Maybe I have missed something. How long has Lou lou been on doses of 4u and 3u? Most vets would start much lower than that, so I am presuming that she was started lower and the dose has been increased? You say that blood tests showed that her insulin doses were ok - where did that come from? Did the vet do a fructosamine test (which is a single blood test that is sent to the lab for analysis, resulting in a number that is average for a cat's BGs over a period of time)? If so that might have been the basis for changing an earlier dose.

The thing is, from the numbers you got for yesterday's curve, it looks as if an increase is needed. BUT if Lou lou has been having high doses without knowing her BG numbers, it's possible that she has been over-dosed, which can cause a rebound effect and higher BGs.

It's interesting that you told me yesterday that Lou lou had been drinking much less since you'd been feeding her low-carb Butchers. It may be down to diet change but that much of a difference would normally be if she had gone from all-dry to all-wet food, and she was on Whiskas Supermeat anyway wasn't she? (Both foods are about the same in carbs I think so no need to stop the Whiskas if she likes it).

As I explained to you last night, the curve you got yesterday was very typical of Caninsulin - you need a gentler insulin which acts in a different way, giving a more gradual drop and is longer-lasting. So we do know now that Lou lou does respond to insulin - she just needs another type. Tell your vet these results. Meanwhile, a bit more history would help here. It may be that the vet has prescribed too high a dose and confused the issue, in which case it might be best to go back to basics and start over at 1u BID.

American (and other) members, chip in please!

Diana
 
Hi Diana,

She was started on 1u twice a day, which was increased over time from blood test results, getting to the point we're at now (4u and 3u). This has been her dose now for about 6weeks maybe more. her insulin doses were ok according to the vet.

Her diet up until saturday was fish (cod), whiskers supermeat and dry food, the dry food i found was very high in carbs, but she hardly touched it (overnight having a handful or so). I took the dry food away sunday morning before test, and changed wet food to Butchers classic has the carb content seemed like a straight swap for the whiskers. The difference yesterday was significant because of one of these changes, and the usual bowl and a half of water went down to a couple of sips here and there, no lying over the bowl all day long as usual. Added to this, she was bright and alert, watching everything that was going on at home, and not looking on the verge of sleep, no head flopping and she actually went outside and lay on the grass for a while, another thing she hasnt done in ages

So either the small amount of dry food was throwing her off or there's something in the whiskers that doesnt agree. One thing i'm pretty certain of, the readings would have been a lot higher without one of these changes, the vets blood test analysis last week showed 25% increase from the test before.

I've already emailed results to the vets, along with lou's food intake between testing and she's offered to prescribe a new insulin once she's had a look and worked out the dosage needed, low would be something i'd want then keep the testing going.

I'm new to all this Diana so if there's any info you need to help matters, just ask me and i'll answer the best i can. By the way, amps yesterday were 21.1, today down to 18.6
 
Sounds like the food swap has made at least some change Darren so that's good news! Try to avoid feeding any dry at all if you can- it is just tooooooooo high in carbs and yes, may be what has made the difference in Lou lou's numbers and behaviour.

So you started at 1u and worked your way up, that seems ok, but from these numbers Lou lou is not regulated yet, whatever the vet says. We are needing to see numbers in single digits, not in the late teens or 20s. It's great that the vet is going to prescribe a new insulin - any of the others available should work better than Caninsulin. Hopefully from what I wrote to you yesterday and what others have already said, you can see that!

Yes - keep testing, before every shot as a minimum. There may be times when Lou lou will throw you a curve ball in the form of an unusually low number and you definitely wouldn't want to be shooting that dosage of insulin at anything below 10.0.

Let us know how you get on.

Diana
 
Hi Diana,

If i ever get a 10 or lower, what should i do, leave injection altogether? or lower dose? I think i may have that info on previous thread but i'll check. Think someone posted a BG to unit run down.

Also, if the food change is making a difference, will the amps/BG's continue to drop for a few days or is it usually an instant levelling off?
 
If you get a 10.0 or lower the ideal thing is to wait an hour and see what the trend is - if it's the same or lower, don't shoot - if it's rising you have to make a judgement about it. If it's only slightly higher you may want to hang off and test again in another hour, and keep doing this until the BG rises or give a smaller dose (maybe half) than usual. The risk in that instance is that the BGs may suddenly go high again, probably after food, but it's better to err on the side of safety. We don't want you to have to face a hypo situation.

I would think that the food change would make a fairly instant difference but yes, BGs might drop a bit further as Lou's body gets used to having less carbs in it... but this is one of those situations where testing is so vital. Every cat is different and may have a different response.

Diana
 
The word 'minefield' just popped into my head.

I'll keep you posted on how things are going and what happens with the vet once she gets in touch. And in the meantime i'll keep amps testing lou lou.

Darren
 
Yes it is a minefield Darren but remember, we have all been through it and it does get easier, it really does, you just need to stay alert. Maybe to help it all sink in you could print off your other thread and the various links, and read and re-read it until it all falls into place.

I'm off to work now and won't be back till late afternoon but others will be around if you need any other thoughts. If you're ever seriously stuck, start a new thread with the word URGENT in it.

Diana
 
Unfortunately I don't have any advice for you, but I just had to chime in and say that I am so glad that Lou Lou is doing better on the new food, and that you were able to get all those tests for the curve! You are doing a fantastic job with her, so keep up the great work!
 
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