low numbers?

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MHHCoach

Member Since 2020
so the vet dx Tux on Saturday, after doing all of the glucose tests he was at 480/490.
(also was stressed and had a lose tooth that was extracted)

so i was told to give 2 units of vetsulin u40 2x a day.

he started acting so much better so fast i only did 1.5u at 6 am.

finally got a relion, and was only 120 and 125 earlier. 3 hours after eating still at 124, so i panicked and thought it's over 120 and the vet wanted 2u, and so I gave just under 1u.

it's night so naturally he is sleeping, he ate some food. but now I'm freaking out that i should have just waited due to a recommendation I did get. and I'm seriously worried he could go hypo but may not, and it's only been 1.5 hours since i have him the almost 1u.

should i get him to eat?
leave out hard food?
give honey?
don't stress?
should i check bg now or just wait until about 4 hours and 6 hours?
 
MHHCoach said:
so the vet dx Tux on Saturday, after doing all of the glucose tests he was at 480/490.
(also was stressed and had a lose tooth that was extracted)

so i was told to give 2 units of vetsulin u40 2x a day.

he started acting so much better so fast i only did 1.5u at 6 am.

finally got a relion, and was only 120 and 125 earlier. 3 hours after eating still at 124, so i panicked and thought it's over 120 and the vet wanted 2u, and so I gave just under 1u.

it's night so naturally he is sleeping, he ate some food. but now I'm freaking out that i should have just waited due to a recommendation I did get. and I'm seriously worried he could go hypo but may not, and it's only been 1.5 hours since i have him the almost 1u.

should i get him to eat?
leave out hard food?
give honey?
don't stress?

should i check bg now or just wait until about 4 hours and 6 hours?
Click to expand...

Yes you can get him to eat. Vetsulin is a harsh insulin and acts quickly. Feed him something now before you do anything else, then I would take his blood glucose again and see what it is. Post and tell us what it is. If it is under 50, give him a drop of honey then post the result..
 
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Well done starting to test the blood glucose levels. 2 units is too much to start with. 1 unit is the usual starting dose.

I would set up a spreadsheet and start posting here daily and we will teach you how to keep Tux safe. Here is the link to the SS
https://www.felinediabetes.com/FDMB/forums/spreadsheets-tech-support-testing-area.6/
If you have any trouble setting it up post and we will help you.

Hee is a link to vetsulin care. Please read carefully
https://www.felinediabetes.com/FDMB/threads/introduction-to-cannisulin-vetsulin-n-nph.231602/

You may have to test and monitor Tux’s blood glucose levels for several hours to ensure he doesn’t drop too low. We recommend not shooting if the BG is under 200 until you get more data.

Keep asking questions as we are happy to answer them
 
Bron and Sheba (GA) said:
Well done starting to test the blood glucose levels. 2 units is too much to start with. 1 unit is the usual starting dose.

I would set up a spreadsheet and start posting here daily and we will teach you how to keep Tux safe. Here is the link to the SS
https://www.felinediabetes.com/FDMB/forums/spreadsheets-tech-support-testing-area.6/
If you have any trouble setting it up post and we will help you.

Hee is a link to vetsulin care. Please read carefully
https://www.felinediabetes.com/FDMB/threads/introduction-to-cannisulin-vetsulin-n-nph.231602/

You may have to test and monitor Tux’s blood glucose levels for several hours to ensure he doesn’t drop too low. We recommend not shooting if the BG is under 200 until you get more data.

Keep asking questions as we are happy to answer them
Click to expand...
thank you a bunch. I am so thankful for FB groups and access to experienced people.

i feel like if i had done full 2u yesterday, this morning and evening i could have a real emergency already.
 
MHHCoach said:
1.5 hours, he ate a little wet food with a little milk at that timeand a few drops of honey about 30 minutes ago
Click to expand...
Ok. I would give him another small snack now, about a good teaspoon of normal food and test again 1 hour after the last test and post the result.
I would also try and set up the SS if you can (although Tux is the priority at the moment). If you have any trouble @Bandit's Mom is a whizz at setting them up quickly.
As long as there were no ketones mentioned at diagnosis, I would go back to 1 unit twice a day and test before EVERY shot to see it is safe to give the shot. Read the info on Vetsulin and don’t shoot if it’s under 200. If it is, stall, DONT FEED, and test again 20 minutes later to see if the number is going up. Also post and ask for help.
You will also need to test during the cycle to see how low the dose is taking Tux. I would test at +2 and +4 to start with. Test more often if the BG is dropping. If you are unsure post and ask for help. We are always happy to help.
I would also make sure you feed him 1/2 hour BEFORE you give the insulin. And again 1 hour after the dose and again at maybe +3 depending on the BG numbers.
 
Bron and Sheba (GA) said:
Yes you can get him to eat. Vetsulin is a harsh insulin and acts quickly. Feed him something now before you do anything else, then I would take his blood glucose again and see what it is. Post and tell us what it is. If it is under 50, give him a drop of honey then post the result..
Click to expand...


I think I got at least a chart to link if not I've attached what I have so far. it seems like tonight I may need to give him a low dose or in the morning I added all of his test results too.
 

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Hi Bron, the SS looks like our format but I'm not sure. It's saved on One Drive rather than Google Drive. This is what I can see.

upload_2020-12-25_16-2-25.png
 

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MHHCoach said:
@Bandit's Mom @Bron and Sheba (GA) I saved it to excel. I'm on my laptop updating to google sheets now
Click to expand...

Ok...I can see it, but it’s a bit unstable and it has a bright green background. @Bandit's Mom is probably not awake yet but when she comes online she may be able to tweak it for you.

I would stay with the 1 unit as long as the preshot is high enough and he is eating ok. . Remember to stall, dont feed and test again 20 minutes later to see if the BG is rising. Post and ask for help in the meantime while you are waiting.

Also try and get some tests in during the cycles...also during the pmcycle as cats often drop lower at night.
A +2 and a + 4 is a good idea if you can and test more often if Tux is dropping.
We suggest always getting a before bed test in every night and if the bedtime test is the same or lower than the preshot, set the alarm and test again later as it is most likely going to be an active cycle, meaning it will drop.

Also remember to always feed 1/2 hour before every shot so Tux has food aboard for when the insulin hits.

I see you have both a pet meter and a human meter. Which one are you entering into the spreadsheet?
It is important to just stick with one or the other on the SS as it is too confusing. I’d suggest the human meter.
And could you put in your signature the type of meter you are using and the type of insulin and date of diagnosis please as we always look at the signature and SS when advising, thanks.
 
  • when you get a chance ,It would be helpful if you can set up your signature so we don't have to ask you the same questions over again. Members will look at this first .
  • It appears after each post in gray, look at mine,



  • On the left, under Settings, Click on Signature. This is where you will put information that helps us give you feedback.
    • There is a limit of two lines which may include two links; you may separate pieces with commas, dashes, | etc. This is where you paste the link for your spreadsheet, once it is set up.
    • Add any other text, such as
    • Caregiver & kitty's name (optional)
    • DX: Date
    • Name of Insulin
    • Name of your meter
    • Diet: "LC wet" or "dry food" or "combo"
    • Dosing: TR or SLGS or Custom (if applicable)
    • DKA or other recent health issue (if applicable)
    • Acro, IAA, or Cushings (if applicable)
    • Spreadsheet link. Please put the signature link on the bottom line of your signature information, on its own, so it is easy to find.
    • Please do not put any information about your location in the signature for security reasons. If you wish to add your country location, please add it to your profile.
Be sure to click the 'Save Changes' button at the bottom. If you need help urgently it is important we know these things at a glance. We don’t want to waste valuable time finding out information.


tap on your avatar where it says your name ,then hit profile page ,tap on that ,then go up to the very top, upper right hand side and tap on your name ,it will bring down a drop box, tap on signature, the signature will be under settings, tap on the signature then and you can start to add what I posted above, make sure you hit save ,
Welcome to the best place you could ever be and an awesome group of people
You can also add where you live in your profile, not your signature
 
@Bron and Sheba (GA)
so I was trying to strike a Balance between the vet, 2nd opinion and this groups guidance for shoot no shoot.

vet 1- says 2u 2x a day
vet 2 - says 1u anytime it's over 100
group- over 200 when a rookie and most of the time
me- over 165 try 1u


this morning, it worked fine but i didn't do a +2.
this evening his leg cramped a little, so at +2.5 he is down from 172 to 87


I'm a little freaked out because i think on vetsulin u40, the lowest point of still to come
 
MHHCoach said:
@Bron and Sheba (GA)
so I was trying to strike a Balance between the vet, 2nd opinion and this groups guidance for shoot no shoot.

vet 1- says 2u 2x a day
vet 2 - says 1u anytime it's over 100
group- over 200 when a rookie and most of the time
me- over 165 try 1u


this morning, it worked fine but i didn't do a +2.
this evening his leg cramped a little, so at +2.5 he is down from 172 to 87


I'm a little freaked out because i think on vetsulin u40, the lowest point of still to come
Click to expand...

did a +3 and he went up 2 pts to 89, and is eating some fancy feast canned food
 
Well done catching the +2 87. Probably would be a good idea to get a + 1 each cycle until you can see when the onset of the insulin is. Then keep testing until he starts to rise after nadir (lowest Point). Did you feed at +2?

i would be guided by the experienced folk here about when to shoot, as they know a lot more about feline diabetes than most vets do. Just look at the two options your vets gave you.....quite a difference and early on in the FF journey and using vetsulin, neither of them is correct. I would keep testing tonight until he comes back up on his own without the influence of food. If unsure post and ask.

can you put in the preshot BG for this morning please as it is blank at the moment and looks as if you didn’t test. Thanks!
 
MHHCoach said:
ya i use the relion as the reported numbers, but I'm keeping track of the cat one for now because the vet refuses to acknowledge the relion.

ya I'll update the sig
Click to expand...
ok gotcha ya, thank you for setting up your signature :cat:
Just one more little thing can you put DX in front of 12-19-20 on your signature Thanks
 
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Diane Tyler's Mom said:
@Bandit's Mom

@Bron and Sheba (GA)

I was reading what Ashley wrote in #24 where she
wrote me- over 165 try 1 unit

I thought as a newbie it says

For those new to dealing with feline diabetes we recommend that you post and ask for help if the BG is below 200 mg/dL (11 mmol/L) on a human glucose meter.
Click to expand...


what I wrote was,
what the vet recommended,
what you guys recommend,
and me trying to strike a balance between the 2 trying to honor both opinions, but also being vulnerable in talking with Bron as I've learn to trust in @Bron and Sheba (GA) since she's been here for me since my first day getting support. that's why i sent that to her.

Yes your chart says For newbies your rule is under 200. I also had 2 vets tell me otherwise even with me giving push back because of the help I'm getting here.

I also know my cat would likely be dead by now if it wasn't for the help here.

So I'll get to reupdating my signature. I know it's important for you guys to be able to help quickly, but know that I'm a full time working Mom of 5, a teen, 2 preteens, 2 toddlers and making sure that my best friend Tux is cared for.. my priority was getting help, then getting set up thoroughly.
I also just got over covid, and memory isn't the best. on top of everything else in the last 5 days my 78 yr old grandfather has had a fever for the last 24 hours and it was Christmas. so a lot going on, tux is a priority.

so i don't want to seem like I'm being difficult, lazy, or anything like that. thank you for being supportive in this very difficult time.
 
MHHCoach said:
vet 1- says 2u 2x a day
vet 2 - says 1u anytime it's over 100
group- over 200 when a rookie and most of the time
me- over 165 try 1u
Click to expand...
MHHCoach said:
this evening his leg cramped a little, so at +2.5 he is down from 172 to 87
Click to expand...
After dropping below 90 last night, in line with recommendations in the FDMB Vetsulin guide the dose needs to be reduced by 0.25IU down to 0.75IU - regardless of how high the preshot BG may be!

That lower number may trigger a bounce into a higher range for a few cycles. Please do not try to use sliding scale dosing because Vetsulin can really yank down higher preshots and a cat can still end up in numbers that are a bit too low for comfort without any increase in the dose.

Re the lower numbers last night, for future reference if your kitty is that low at +2/+3 the Vetsulin is still working at its strongest and BG could drop even lower in the following hours so it is wise to keep testing till numbers are back into 3 figures and staying up without help from food. (If it's not possible to stay up testing then feed the cat - possibly some medium carb? - and leave food out it can graze on while you're asleep.) I note from the spreadsheet remarks that Tux was very hungry last night. If that was in the hours after the 87 reading his BG may have gone lower (potentially even too low).


Mogs
.
 
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Hi Ashley...what a busy mother you must be! I am glad you are recovering from COVID. And I hope your grandfather is ok.

Please listen to what @Critter Mom is telling you about using Vetsulin and when to reduce the dose and what to look out for.
I am not a vetsulin user (I used Lantus and levemir) so she is much more experienced with vetsulin than I am and I trust what she says..
What she is saying about reducing the dose at the next preshot, no matter what the preshot BG is......is correct.

I know it must be hard when you get conflicting advice from 2 vets and then us but experienced people here, who have used Vetsulin with their kitties, know a lot more about how it works and the pitfalls you need to look out for as they are looking after their kitties 24/7.
 
Critter Mom said:
After dropping below 90 last night, in line with recommendations in the FDMB Vetsulin guide the dose needs to be reduced by 0.25IU down to 0.75IU - regardless of how high the preshot BG may be!

That lower number may trigger a bounce into a higher range for a few cycles. Please do not try to use sliding scale dosing because Vetsulin can really yank down higher preshots and a cat can still end up in numbers that are a bit too low for comfort without any increase in the dose.

Re the lower numbers last night, for future reference if your kitty is that low at +2/+3 the Vetsulin is still working at its strongest and BG could still drop lower in the following hours so it is wise to keep testing till numbers are back into 3 figures and staying up without help from food. (If it's not possible to stay up testing then feed the cat - possibly some medium carb? - and leave food out it can graze on while you're asleep.) I note from the spreadsheet remarks that Tux was very hungry last night. If that was in the hours after the 87 reading his BG may have gone lower (potentially even too low).


Mogs
.
Click to expand...
oh wow thank you so much for making sense of the number movement. okay so if he is only at about 1u, you're right he bounced back up this AM to 198, so just a .75u

are u100 needles easier to use for the .75U measurement do you happen to know?

@Critter Mom @Bron and Sheba (GA)



on a side note, just breaking emotionally for a moment, this stuff is really tough emotionally, trying to do the right thing, get the right balance, and thank God for you ladies and this group. I really didn't know diabetes was such a tough thing in the beginning. I'm sure it'll get easier as I get used to figuring out how he reacts, but it feels like a lot even more so because this has taught me i have a big fear of needles and am having to just be strong so I can take care of Tux.
I'm really excited he started sleeping above my head again after not doing that for a few months.
I hope this gets a little easier. It does crush me to think that had I followed the first vets recommendation and gave him 2 units this whole time i could have lost him. the second opinion was almost unwilling because of the brotherhood of vets.
 
MHHCoach said:
are u100 needles easier to use for the .75U measurement do you happen to know?
Click to expand...
Not really for 0.75 units but very easy for 0.8 units. When using Vesulin with a human U100 syrine with half-unit markings each 1/2 unit marking on the U100 syringe equals 0.2 units of Vetsulin. Thus, with using Vetsulin in a U100 syringe one typically doses in 0.2 or eyeballs halfway in between for 0.1
 
Are you using the U-40 syringes with the half unit markings. It will make it a lot easier, you have to eye ball some of the different units still

With the half units marking syringes U-40 you would put the top of the
plunger between the 0.5 and 1 unit mark , like in the middle of them
Eyeball it as best as you can
You can get them at Walmart, I order mine from
ADW Diabetes for half unit markings
 
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Diane Tyler's Mom said:
Are you using the U-40 syringes with the half unit markings. It will make it a lot easier, you have to eye ball some of the different units still

With the half units marking syringes U-40 you would put the top of the
plunger between the 0.5 and 1 unit mark , like in the middle of them
Eyeball it as best as you can
You can get them at Walmart, I order mine from
ADW Diabetes for half unit markings
Click to expand...



okay ya I'll have to eye ball it mine until i run out which is okay for now it's easy to gauge halfway

thanks a bunch!
 
MHHCoach said:
are u100 needles easier to use for the .75U measurement do you happen to know?
Click to expand...
You can use U100 syringes to dose Vetsulin with a conversion chart. Here's a link to one:

www.felinediabetes.com/insulin-conversions.htm

In terms of better understanding how Vetsulin works, this diagram shows an example of an 'ideal' response for a feline diabetic:

eADcxbPJ2JnNh2lSNJND0_wT4yz4A3Y71CrTNoDJfbWfCTH5m_LSx8bIqc_8XsNxdIIVibS6Rm5BUf37WIe3XPJwQjh4EPhui-nFcwaX6hNFLSfU3NpFvo8wwzZNTc1CUPzdzC--



As you can see from the above, it typically produces bucket-shaped curves. Bounces can lead to even higher preshot numbers.


Mogs
.
 
MHHCoach said:
on a side note, just breaking emotionally for a moment, this stuff is really tough emotionally, trying to do the right thing, get the right balance,
Click to expand...
There can be many tearful and white knuckle moments on this journey.

MHHCoach said:
I'm really excited he started sleeping above my head again
Click to expand...
There is also much joy to be had. :cat:

When times are tricky, hang on tight to the good stuff! :)

:bighug:


Mogs
.
 
@Critter Mom so good call on the .75/.5. I've actually been doing .5 since that's a little easier to gauge since i don't have half markings. He seems to move 80-90 points on .5U but doesn't seem to go under 100

of course i'll check in about 3 hours, then PM. and tomorrow I'll do a different set of hours with .5U as long as he is high enough does that sound like a good plan of action? or should I try to get closer to .75U?
 
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