New Diagnosis - starting Caninsulin

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From the Beginner guide to caninsulin


Q. Is my cat’s BG high enough for insulin?
For those NEW to treating feline diabetes, and/or those who don’t have much data about how their cat responds to insulin, we generally recommend that a shot isn’t given if the pre-shot BG, is below 200 mg/dL [11 mmol/L] on a human meter.
If you use a pet meter, such as AlphaTrak2, you may want to raise the initial ‘no shoot’ threshold. This gives an added margin of safety when using a pet meter. (If in doubt seek advice from your vet.)


Q. It’s time for my cat’s shot, but the BG is a little too low. What now?
  • If your cat’s BG is a bit below 200 mg/dL [11 mmol/L] on a human meter, consider ‘stalling’.
  • Stalling is waiting - without feeding your cat - for 20+minutes, then retesting to see if the BG has risen to a suitable level.
  • If using a pet meter, such as Alphatrak2, you may want to raise number above 200 mg/dL. (If in doubt seek advice from your vet.)
  • You are looking for a number that is rising, not falling, and is high enough to give insulin.
  • Note: As you gain experience with home testing, and have gathered data to show how your cat responds to insulin, you might consider it safe to reduce the ‘no shoot’ threshold, and to give insulin at lower pre-shot numbers.
  • If you have time, you can repeat the stalling process to see if the cat’s BG reaches a number you can shoot. If in doubt, skip the shot. However if your cat has history of ketones or DKA, or other health issues, or you are concerned, DO post on the Main Health forum for further advice.
  • Ask for help on the forum before giving insulin if you are unsure, as you can never ‘un-shoot’ insulin.
 
OK the first shot was an hour before the shot, the second was 15 minutes after he ate 1/3 of his meal

He's not eaten the rest of his meal yet, as he's interested in looking at a new girl cat who has moved in next door.
However he will come back and finish it later on.

Not sure what to do

Does this mean if I shoot him with 1 unit, he will go to low and risk a hypoglacimic episode?
But what if I don't give him any tonight?
Then I test again before the 2nd shot in the morning?

I called my vet today and he said to give him 1 unit x 2 per day for the next 2 weeks, to see how his body responds and get his system used to it.
Then when I bring him in in 2 weeks, he will start the curve
He said 1 unit is a low dose
 
Please remember that’s what all vets say because they don’t test daily. To just leave the same dosage for 2 weeks disregarding your test results is not good advice. So, you shot him already I assume? Please take another reading at +2 to make sure he’s still going up. In the future, you need to test right before the shot. An hour before is no good because you don’t know what’s happening in that hour unless you test again right before the shot. Makes sense? I’m not an expert on your insulin, but with Lantus we have the option to give a token dose. I don’t see that in the guidelines above.

let’s see what others have to say!
 
Also know that most of us do the curves at home and send the results to the vet, not at the vet as cats are more stressed there and the numbers will be higher than normal.
 
he's also not finishing his food quickly, he only ate 1/4 ... I remember the vet said no food, no insulin and he has to eat at LEAST 1/2
Aleluia Grugru & Minnie said:
Also know that most of us do the curves at home and send the results to the vet, not at the vet as cats are more stressed there and the numbers will be higher than normal.
Click to expand...

this first meter reading was 1 hour before the shot.
The second one was also before the shot, but 15 minutes after eating only 1/4 of his food.
- I am giving the shot 20-30 minutes after food, as was suggested on this forum.

He's not eaten 'at least half' of the food that the vet advised and has now fallen asleep
The vet also said 'no food, no insulin'

- as his number was 7.3 and he didn't eat enough, shall leave him to sleep tonight with out insulin?
... then try to test him again in the morning before his shot, but after his breakfast ?
- I will aim to start plotting the curve tomorrow

I assume he will eat the rest of his food during the night ... but I will be asleep ...
would you recommend I take it away? since he has no insulin ?
 
Zephre said:
he's also not finishing his food quickly, he only ate 1/4 ... I remember the vet said no food, no insulin and he has to eat at LEAST 1/2


this first meter reading was 1 hour before the shot.
The second one was also before the shot, but 15 minutes after eating only 1/4 of his food.
- I am giving the shot 20-30 minutes after food, as was suggested on this forum.

He's not eaten 'at least half' of the food that the vet advised and has now fallen asleep
The vet also said 'no food, no insulin'

- as his number was 7.3 and he didn't eat enough, shall leave him to sleep tonight with out insulin?
... then try to test him again in the morning before his shot, but after his breakfast ?
- I will aim to start plotting the curve tomorrow

I assume he will eat the rest of his food during the night ... but I will be asleep ...
would you recommend I take it away? since he has no insulin ?
Click to expand...

i would say yes, but I’d like someone with more experience with your insulin to answer this @JanetNJ @Marje and Gracie @Sienne and Gabby (GA)

I see. In that case, what you want to do is test again before the feeding. So you tested an hour before the shot, then test again right before you feed, then feed then shoot. Testing an hour before is too long in advance and testing after you feed will give you a higher number
 
I wouldn’t take the food away because you want him to eat just know you may be getting a higher number in the am because of the skipped shot. But do make sure he doesn’t eat at least 2 hours before morning shot. Is that doable?
 
Is there a chart that you can recommend I read please? So I can know about the levels, I am a little scared to work against my vets advice and I don't have a clear plan.

So far I've just tested him for the first time and now I'm a bit lost with the result

sorry I need to do more reading I think
 
Zephre said:
he's also not finishing his food quickly, he only ate 1/4 ... I remember the vet said no food, no insulin and he has to eat at LEAST 1/2


this first meter reading was 1 hour before the shot.
The second one was also before the shot, but 15 minutes after eating only 1/4 of his food.
- I am giving the shot 20-30 minutes after food, as was suggested on this forum.

He's not eaten 'at least half' of the food that the vet advised and has now fallen asleep
The vet also said 'no food, no insulin'

- as his number was 7.3 and he didn't eat enough, shall leave him to sleep tonight with out insulin?
... then try to test him again in the morning before his shot, but after his breakfast ?
- I will aim to start plotting the curve tomorrow

I assume he will eat the rest of his food during the night ... but I will be asleep ...
would you recommend I take it away? since he has no insulin ?
Click to expand...
I would skip with it that low and without much data yet.
 
Zephre said:
Is there a chart that you can recommend I read please? So I can know about the levels, I am a little scared to work against my vets advice and I don't have a clear plan.

So far I've just tested him for the first time and now I'm a bit lost with the result

sorry I need to do more reading I think
Click to expand...
There's no chart... I can tell you that normal is about 68-150 on an alphatrak (3.8 -8.3 on your scale). Usually around shot time new diabetics are way above this, and we hope to get them into this range. Your cat was in this range at shot time which is why we said to hold off. We usually tell new folks not to shoot under about 11-13 because you don't have much data yet. I wonder if your cat is on his way to being diet controlled (Crossing fingers). You don't want your cat to go lower then the 3.8.... it can be dangerous which is why we say to have high carb food and honey on hand JUST in case.

There is not a chart that says if the level is this, give this. THat's because one cat might barely react at all to a certain dose, while another could have a steep drop. You have to get to know how YOUR cat reacts to it. The only way to know is by collecting data.
 
Zephre said:
Is there a chart that you can recommend I read please? So I can know about the levels, I am a little scared to work against my vets advice and I don't have a clear plan.

So far I've just tested him for the first time and now I'm a bit lost with the result

sorry I need to do more reading I think
Click to expand...
BTW the US uses a different scale. If you multiply your numbers by 18 you get the US scale. If you divide US numbers by 18 you get your numbers.
 
Sharon14 said:
:cool:
Click to expand...
I'm a bit confused 'to shoot or not to shoot'

I had this reading pre-shot this morning, then went on the advice of above and only gave him 0.75 U.
He ate his breakfast, now is sleeping

Will take a pre-shot test in 12 hours and check levels again

Then 'to shoot or not to shoot' ... that is the questions ... as last night I didn't shoot, due to a low reading and very little food intake
Thoughts?
 
Zephre said:
4 hours ago
Click to expand...
If you have a blue number for your preshot, I would hold off shooting until you have more data. You could not feed and stall for an hour and retest to see if the number comes up... otherwise just skip it until you have more data. Now since you already shot, just keep a close eye and feed her if she's dropping. I would give it a test right now since it's been 4 hours and she will probably be at her lowest in the next hour or two. I'm glad you lowered the dose a little.
 
JanetNJ said:
If you have a blue number for your preshot, I would hold off shooting until you have more data. You could not feed and stall for an hour and retest to see if the number comes up... otherwise just skip it until you have more data. Now since you already shot, just keep a close eye and feed her if she's dropping. I would give it a test right now since it's been 4 hours and she will probably be at her lowest in the next hour or two.
Click to expand...

So you suggest to test, if it's a low number, don't shoot.
Keep testing, if low don't shoot - but just note down in journal.

He is asleep now, he was quite lively before his shot, but then decided to sleep on his mat.
he looks relaxed.

A 2nd vet has told me to test pre-shot, shoot the insulin, then test again at 8 hours, to see how the body digests the insulin
But withhold further food until that test has been done, so to collect data on how he is processing insulin

I am working with 3 different options - so trying to sift through the advice and do the right thing .... :confused::confused::confused:
 
Zephre said:
So you suggest to test, if it's a low number, don't shoot.
Keep testing, if low don't shoot - but just note down in journal.

He is asleep now, he was quite lively before his shot, but then decided to sleep on his mat.
he looks relaxed.

A 2nd vet has told me to test pre-shot, shoot the insulin, then test again at 8 hours, to see how the body digests the insulin
But withhold further food until that test has been done, so to collect data on how he is processing insulin

I am working with 3 different options - so trying to sift through the advice and do the right thing .... :confused::confused::confused:
Click to expand...

Caninsulin typically reaches it's peek 4-6 hours after the shot... (some earlier, some later) Your vet may be more familiar with diabetic dogs who have a slower metabolism. By 8 hours your insulin is wearing off.

Here's what I'm saying.

  • ALWAYS GET A PRESHOT TEST. always. esp. since your cat does not have high numbers, you always want to make sure it's safe.
  • Don't feed for at least two hours before the preshot tests so that the number is not food influenced. It's ok to feed mid day, just pick it up at least two hours before shot time.
  • In the beginning, while you don't have much data, don't shoot blue preshot numbers. Once you know how your cat reacts you might EVENTUALLY give a small dose if in blue but over "normal".
  • If you get a blue preshot number, you can hold off on feeding for an extra hour and retest and assess if the number has gone up or not. If still blue, skip. If yellow, feed and shoot as normal.
  • Caninsulin reaches peek USUALLY in 4-6 hours... so get some tests in during that time if you can. This is how we know how your cat reacts to the insulin... and you want to make sure they aren't dropping too much (hypoglycemia).
If you haven't had a chance to look at the info on Caninsulin, read through the yellow notes at the top here. http://www.felinediabetes.com/FDMB/threads/beginners-guide-to-caninsulin-vetsulin.186099/
 
Zephre said:
What would this number at this point indicate pls?
That I should decrease the dosage ?
Click to expand...
well i think when at a similar preshot, yes, I would lower the dose (if you choose to shoot those high blue numbers). If the preshot was yellow .75 would probably be fine... but the preshot was low this morning. 3.8 is the very bottom of safe on an alphatrak (68 US Scale)... please feed your cat some medium carb food. I'd like to see that number just a LITTLE higher. since we don't know when your cat's nadair (lowest point) is yet, we need to assume he could drop a bit further. Feeding him will help even it out.
 
I'm getting a little bit stressed as my initial vet didn't say to adjust anything when I gave him his pre-shot number - he just said it 'looks good' but then keep injecting him 1 unit and come back in two weeks

a second vet has told me NOT to stop shooting him, just lower the dose - as his liver needs to heal

you guys say stop shooting him altogether

I'm really confused what to do
 
Zephre said:
I'm getting a little bit stressed as my initial vet didn't say to adjust anything when I gave him his pre-shot number - he just said it 'looks good' but then keep injecting him 1 unit and come back in two weeks

a second vet has told me NOT to stop shooting him, just lower the dose - as his liver needs to heal

you guys say stop shooting him altogether

I'm really confused what to do
Click to expand...
7.1 (with food influence) is too low to shoot. It's in the normal range. I think your vets aren't used to seeing cats go into remission. What was his number at diagnosis? Did they do a fructosamine test?
 
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