Denise's answers from above post:
1. Feeding Friskies Paté.
2. Jagger was previously treated with Vetsulin prior to achieving remission.
3. Denise is using a Relion glucometer.
4. Vet has performed blood panel (things seemed normal). Didn’t Check his teeth.
Might be worth getting vet to check teeth and gums; it's a really common cause of kitties falling out of remission. UTIs are another common offender. If Jagger has any history of pancreatitis it might be advisable to ask the vet to run a Spec fPL test to check for any pancreatic inflammation (the test isn't normally included on a standard blood panel).
Denise asked:
Can constipation make their numbers go up. Not sure if he is cuz I have two other cats.
Yes, it can - though I don't know whether it would drive BG as high as the 500s you saw at Dx (although that test might have also been influenced by travel/vet stress). Lots of helpful info on feline gut health here:
felineconstipation.org
What sort of duration did Jagger get on Vetsulin first time around? Looking at today's curve data, the dose seems to be wearing off around the +8 mark.
Overall today's curve is quite smooth for a cat on Vetsulin and Jagger has spent some time under the renal threshold. (There are some members here who would be quite chuffed to see a Vetsulin curve like that!

) If you are considering adjusting the dose, I'd suggest doing so in very small increments (e.g. 0.25IU Vetsulin). Because of the way that Vetsulin can really drop BG from preshot BG to nadir, for safety it's wise not to target too low a nadir BG. Jagger's already dipping into the low 100s after only 10 days of treatment. If it were my kitty getting those numbers I'd be very cautious about tweaking the dose, especially as there's a question mark over whether constipation might be raising Jagger's numbers. Assuming for a minute that constipation is a contributing factor then Jagger's numbers might improve significantly and quickly once the constipation is resolved and the dose might need to be adjusted downwards. (Other members may have different suggestions.)
We use a really useful spreadsheet tool for tracking kitties' response to their insulin. If you could get one going it would help members here to offer more helpful suggestions. Here are links to tell you how:
FDMB spreadsheet instructions
Understanding the spreadsheet grid
(If' you'd like help with set-up, just holler.)
The spreadsheet provides a really helpful visual representation of a kitty's response to insulin treatment and it's very helpful as a guide to improving regulation and making dosing decisions.
You may find that by holding the current dose Jagger may start to trend down as the Vetsulin allows the pancreas to get some rest. Also, if you can identify any other issue(s) that bumped him out of remission then treating the underlying problem could lead to a big improvement in Jagger's BG levels.
Mogs
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