Need help, not sure how much to give

[Lisa and Smoky]

I just tested smoky about 20 minutes ago and his BG went from 173 to 237. Not sure what dose to give him. He was 173 at +7 and up to 237 at +11 which is his PMPS number. Any suggestions? I just posted a spreadsheet for smoky in my signature if that helps.

 

[MrWorfMen's Mom]

Hi Lisa, If I were you I'd probably stick with 0.5u tonight for a couple of reasons. First our kitties often have a habit of going lower in the night cycle than they do during the day. Secondly, you don't have any readings during the night cycle to see what she is actually doing. And as a side note, with those new to this dance, with little data, we generally suggest no shot if the pre shot reading is 200 or less and Smoky is not that much above.

The 0.5u today took Smokey's BG down but not excessively, so even though the pre shot reading was higher this morning, you still had some wiggle room. It would be very helpful if you could get a test 2 or 3 hours after the PM shot. This will give you an idea if Smokey does run lower at night and if she is dropping faster than expected, you can slow her down with some food. If you are not comfortable with this or can't test again before bedtime, then it's OK to skip the shot and start again tomorrow.

You're best bet for assistance is to post in Health. There are not a lot of Vetsulin users on the board although the numbers have increased a bit of late, so the Vetsulin forum doesn't tend to get much traffic. I saw your message in Health and came to have a look.

 

[Lisa and Smoky]

Hi Lisa, If I were you I'd probably stick with 0.5u tonight for a couple of reasons. First our kitties often have a habit of going lower in the night cycle than they do during the day. Secondly, you don't have any readings during the night cycle to see what she is actually doing. And as a side note, with those new to this dance, with little data, we generally suggest no shot if the pre shot reading is 200 or less and Smoky is not that much above.

The 0.5u today took Smokey's BG down but not excessively, so even though the pre shot reading was higher this morning, you still had some wiggle room. It would be very helpful if you could get a test 2 or 3 hours after the PM shot. This will give you an idea if Smokey does run lower at night and if she is dropping faster than expected, you can slow her down with some food. If you are not comfortable with this or can't test again before bedtime, then it's OK to skip the shot and start again tomorrow.

You're best bet for assistance is to post in Health. There are not a lot of Vetsulin users on the board although the numbers have increased a bit of late, so the Vetsulin forum doesn't tend to get much traffic. I saw your message in Health and came to have a look.

Did u get a chance to look at smokys SS in my signature? Thank you for the advice, could really use it. Smoky is going for his follow up visit to vet tomorrow. I can compare my relion meter to theirs

 

[MrWorfMen's Mom]

Yes I did. Great job BTW! I based my suggestion on what I saw there. I think the 1.5u may have been too high causing that 322 midcycle reading yesterday. You gave 1u last night but we don't know what that did mid cycle which is why I suggested 0.5u. I tend to be conservative especially when there is little data on how kitty is reacting and I have one of those kitties who often throws me her lowest numbers at night. Getting those +2 or +3 tests in during the night cycle can be very valuable in determining dose.

 

[Lisa and Smoky]

Yes I did. Great job BTW! I based my suggestion on what I saw there. I think the 1.5u may have been too high causing that 322 midcycle reading yesterday. You gave 1u last night but we don't know what that did mid cycle which is why I suggested 0.5u. I tend to be conservative especially when there is little data on how kitty is reacting and I have one of those kitties who often throws me her lowest numbers at night. Getting those +2 or +3 tests in during the night cycle can be very valuable in determining dose.

I am working on updating his numbers from today yet. AMPS, BG was 288, BG @ 173 +7, bg 237 at +11 and also 237 at PMPS if that helps. I'm new to all this, smoky has only been on vetsulin since Sept 6 and was at boarding at animal hospital from Sept 12-16 while I was on vacation. So only had about 9 days into routine so far.

 

[MrWorfMen's Mom]

You're doing great Lisa! The home testing alone is worth it's weight in gold. Smoky is in good hands and lucky to have you for his bean (human)!

 

[Elizabeth and Bertie]

Hi Lisa @Lisa and Smoky ,

Another reason to be cautious with the dose at this point is that sometimes the insulin needs of newly diagnosed cats can reduce quite quickly in a short space of time.
Once a cat starts on insulin the body can begin to get stronger, and it can begin to heal from the damage caused by high blood glucose. When the damaged cells begin to heal they can become more receptive to the insulin, and this may mean that the insulin requirements reduce as a result.

Have you only recently changed to low carb wet food? (What was Smoky eating before?)
And I see that he is allergic to chicken. That must be very difficult for you. So many cat foods contain chicken....

Eliz

 

[Elizabeth and Bertie]

You're best bet for assistance is to post in Health. There are not a lot of Vetsulin users on the board although the numbers have increased a bit of late, so the Vetsulin forum doesn't tend to get much traffic. I saw your message in Health and came to have a look.

As Linda says, the general advice at the moment is that Vetsulin/Caninsulin users post on the main health forum for advice, as this Caninsulin/Vetsulin forum doesn't get a whole lot of traffic. (This is particularly important if there is an urgent question).

Personally though, I would like to see more posts here. There are quite a few kitties on Vetsulin/Caninsulin right now, and it would good for their caregivers to be able to share experiences - or just chat - in the same way that users of other insulins currently can/do on FDMB. I think Vetsulin/Caninsulin users miss out on this opportunity to have their own support community, and this can sometimes lead to feelings of isolation.
.

 

[Lisa and Smoky]

Hi Lisa @Lisa and Smoky ,

Another reason to be cautious with the dose at this point is that sometimes the insulin needs of newly diagnosed cats can reduce quite quickly in a short space of time.
Once a cat starts on insulin the body can begin to get stronger, and it can begin to heal from the damage caused by high blood glucose. When the damaged cells begin to heal they can become more receptive to the insulin, and this may mean that the insulin requirements reduce as a result.

Have you only recently changed to low carb wet food? (What was Smoky eating before?)
And I see that he is allergic to chicken. That must be very difficult for you. So many cat foods contain chicken....

Eliz

Hi Eliz,
Smoky was switched to low carb wet food about 6 months before his dx due to urinary issues. He had a blockage and had to have PU surgery in April of 2014. He was already neutered but then they took most of the rest. Poor guy! He was on a prescription food, Royal Canin SO which only made him gain weight.
He became allergic to chicken which is the main ingredient. I put him on canned food after that.

In April of this year had to take him to a specialist, he was scratching and half his hair came out. He had to take allergy drops once a day under his tongue. Smoky grew most of his hair back. He got off of those and was dx with diabetes a month later. He really has had it rough the last two years.

 

[MrWorfMen's Mom]

He had to take allergy drops once a day under his tongue.

Were those drops by any chance a steroid? Steroids are known to induce diabetes and if Smoky's diabetes was steroid induced but is no longer getting steroids, there is a good chance that he will revert and no longer need insulin. As Eliz said, his insulin needs could change rather quickly so home testing is going to be key to keeping Smoky safe.

 

[Lisa and Smoky]

Were those drops by any chance a steroid? Steroids are known to induce diabetes and if Smoky's diabetes was steroid induced but is no longer getting steroids, there is a good chance that he will revert and no longer need insulin. As Eliz said, his insulin needs could change rather quickly so home testing is going to be key to keeping Smoky safe.

I'm not really sure about the drops but it would be a good thing to ask the specialist though. I didn't want to give him allergy shots so opted for the drops. I had no idea steroids could do that, he was on and off those a few times for urinary and bladder infections while eating the dry prescription food .
He has not had any crystals in his urine since I stopped giving him dry food a year ago. The prescription food really packed on the pounds, he was 17 lbs and dropped down to 12 after he stopped eating it. I have to wonder if a combo of that food, steroids, antibiotics, and the extra weight contributed to his dx of diabetes.

 

[MrWorfMen's Mom]

It would be a good idea to check with the specialist about the drops so you know if that could be a contributing factor in Smoky's diabetes. Can't think of what else it would be for allergies unless it was an antihistamine. The combo of excess weight and steroids could definitely set off the diabetes. While I totally agree that dry food is not ideal cats, I don't think that is a major contributor to diabetes although I suppose that might depend on the quality of the dry food and other factors like weight feeding into the situation. I know there will be those that disagree with me on that point but I personally think the dry food is more of a potential hazard for the kidneys than the pancreas.

 

[Lisa and Smoky]

It would be a good idea to check with the specialist about the drops so you know if that could be a contributing factor in Smoky's diabetes. Can't think of what else it would be for allergies unless it was an antihistamine. The combo of excess weight and steroids could definitely set off the diabetes. While I totally agree that dry food is not ideal cats, I don't think that is a major contributor to diabetes although I suppose that might depend on the quality of the dry food and other factors like weight feeding into the situation. I know there will be those that disagree with me on that point but I personally think the dry food is more of a potential hazard for the kidneys than the pancreas.

OK the allergy drops were antihistamine, he had watery eyes and runny nose and was sneezing, along with the scratching at his head and neck all the time. Glad he is done with that now, the treatment for that was quite pricey, around $1000. The dermatologist asked me did I want another 6 month supply and I said nope, still have the second bottle but he didn't need it. Geez!

 

[MrWorfMen's Mom]

Knowing steroids were not a cause in Smoky's case is good to know because those kitties can decide to go off insulin on a dime! Not that others can't/don't do likewise but generally those who go OTJ without steroids in the picture tend to be somewhat less dramatic about it and make a smoother transition to OTJ. As for cause, most of don't know for sure what caused it. Unfortunately some of it may just be genetics over which we have no control. The wonderful thing is that our kitties can and do go into remission so fingers crossed Smoky will one day soon be added to the long list of success stories here.