? Management of a cat nearing a remission but not quite yet

[Oliver the Roman]

I would like an advice on how to manage my cat, who has been on caninsulin since last October.
Since January, his numbers started to constantly decline. I have been reducing the dose, and by the end of February, it was clear that even 0.5ui x 2 daily was excessive.
I stopped injection when the reading was 92 after 11.5 hours.
He was mostly stable for 2 and a half weeks, albeit an occasional jump to mid 200s but then coming down by himself.
But the number started to slowly climb back last week, I had to restart the therapy when the he gave me 340 5 days ago. (0.5ui x2 a day)
His numbers immediately went back to normal, around 80 after 4hrs, 130-150 after 11.5hrs.
Yesterday, after 3 days his numbers were 55 after 4hrs, 99 after 11hrs, so I withheld the injection.
This morning he was right back to 299 so I gave him another 0.5
---------------------------------------------------
My veterinarian insists that I have to maintain the same dose (including 0) for at least for 3 weeks to stabilize his condition, but with the way he is reacting, that seems impossible
If anyone ever experienced such episode with your cat, what would be the best course of action?
Would it be possible to give him, like 1 shots a day, or 1 day on - 1 day off??? Or shoot as needed?
It looks pretty much like even 0.5ui x 2 is a little too much for him, but not quite enough to be totally independent.
Any advice would be appreciated!

 

[Sienne and Gabby (GA)]

Is there a reason you haven't tried a dose of 0.25u?

Caninsulin doesn't have great duration to begin with. Once a day dosing will leave your kitty without insulin for over 12 hours versus providing support throughout the cycle so hopefully, your kitty's pancreas will continue to repair itself. Generally, when a cat is nearing remission, we encourage a gradual reduction of insulin with macrodosing (i.e., 0.25 to 0.1 to a drop).

 

[Oliver the Roman]

I have asked my veterinarian about that, but according to her 0.5 is the minimum dose possible. I could try but I am not sure if I am capable of measuring such a minuscule dose correctly. With the siringe I use (40ui), 0.5 is the smallest mark, I have to just guess-work for a dose in between ticks. Do specific siringes for smaller dose exist???

 

[Elizabeth and Bertie]

but according to her 0.5 is the minimum dose possible.

Hi, it is possible, with just a wee bit of practice, to measure doses much smaller than 0.5 of a unit. For example, 0.25 is fairly easy as it is mid way between the first two lines on the syringe barrel, the 'zero' line and the 0.5 line. But it's also possible to measure even smaller doses, for example, 0.1 of a unit... (I use a magnifying glass...).

Or... It is possible to use Caninsulin with different syringes using a conversion chart. This can make measuring small doses much easier...
Quick explanation... Caninsulin is a U40 insulin, that means it has 40 units of insulin per ml. But human insulins are usually U100 and have 100 units of insulin per ml. So, the U100 insulin is 2.5 times as 'strong' (for want of a better word) than the U40. That means, for example, that one unit of U40 Caninsulin would measure to the 2.5 unit mark on a U100 syringe. And if you wanted to give 0.2 of a unit of Caninsulin that would measure to the 0.5 mark on a U100 syringe.
U100 syringes are pretty widely available because they're made for human use. It is important to get the ones with half unit markings.

If you want to try the conversion chart the link is here:
http://www.felinediabetes.com/insulin-conversions.htm

What are you feeding your kitty at the moment? Just wondering if there's a chance of reducing the carb content of the diet...?

 

[Oliver the Roman]

Hi, it is possible, with just a wee bit of practice, to measure doses much smaller than 0.5 of a unit. For example, 0.25 is fairly easy as it is mid way between the first two lines on the syringe barrel, the 'zero' line and the 0.5 line. But it's also possible to measure even smaller doses, for example, 0.1 of a unit... (I use a magnifying glass...).

Or... It is possible to use Caninsulin with different syringes using a conversion chart. This can make measuring small doses much easier...
Quick explanation... Caninsulin is a U40 insulin, that means it has 40 units of insulin per ml. But human insulins are usually U100 and have 100 units of insulin per ml. So, the U100 insulin is 2.5 times as 'strong' (for want of a better word) than the U40. That means, for example, that one unit of U40 Caninsulin would measure to the 2.5 unit mark on a U100 syringe. And if you wanted to give 0.2 of a unit of Caninsulin that would measure to the 0.5 mark on a U100 syringe.
U100 syringes are pretty widely available because they're made for human use. It is important to get the ones with half unit markings.

If you want to try the conversion chart the link is here:
http://www.felinediabetes.com/insulin-conversions.htm

What are you feeding your kitty at the moment? Just wondering if there's a chance of reducing the carb content of the diet...?

Thank you so much for some helpful suggestions. using U100 syringe for humans may be the best idea at this point, never thought of that. It's already stressful measuring exactly 0.5ui, with such a small dose, making it just above, below or right in the middle of the line seems like a significant difference so to measure 0.25 probably I will need to use a magnifying glass like you do! What's with the current situation (I live in Rome, Italy so go figure!!!) I am not sure when I can get my hands on the U100 syringes so I will need to practice on that skill in the meantime!

I do pay attention to select low carbohydrate food for Oliver, he hasn't been given any biscuits for nearly 2 years. Some brands may not be well known outside Italy but he eats Stuzzy monoprotein, Nutro Wild Frontier, Prolife Adult Salmon & Rise or Diabetic, and for treat Schesir Tuna or Salmon in spring water, or steamed chicken which I prepare. All of them contain no more than 2% of rise (wild frontier 2% tapioca starch, Stuzzy monoprotein and Prolife diabetic don't list anything starchy). The veterinarian suggests he needs to eat exactly the same thing every time, but the boy tends to get fed up quickly with monotony, so I must rotate between several different variations!