New - Help dosing/testing

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jvtech

jvtech

Member Since 2016
My cat Sage was diagnosed about 1 month ago. I brought her in after she stopped eating, then the test results came back(low 200s I believe) and we hospitalized her for three days for fluid therapy and to stabilize her glucose.

My vet sent me home with a bottle of Vetsulin with instructions to give 1 unit 2x a day. The first week she wouldn't really eat too much, so I fed her a lot of treats just so she would have some energy (Temptations). At the end of the week we tested again and it was still high (285 I think). So we doubled to 2 units 2x a day. Now she is eating well again, about 4oz of Blue Buffalo Wilderness wet food and about 1/2cup of the equivalent dry food. I am concerned that the second reading was skewed due to the poor quality treats that I had to feed her to get her to eat. I had started moving over to all wet food until I read up on it and the danger of hypoglycemia.

Anyway, I am going to pick up a Relion Prime meter as suggested in other posts and start doing in-home monitoring (vet made it seem like it wasn't that important). So my question is a) Is Vetsulin good? b) How do I know how much to give based on the meter reading (Which is meant for human glucose testing?).

Sorry for the long read. Thank you.
 
I will tell you that vetsulin was made for dogs and they metabolize things differently than cats-

We increase in increments of .25 as you are looking for the right dose and might miss it with such a large increase and cause big bounces -- a full unit dose is HUGE especially with vetsulin. Home testing is VERY important, we can help you with that-
Let me try to get some of our expert eyes on this for you....
BUMP
 
me again--
if you change your thread title it will generate more of the experienced people to help you
on the top right it says thread tools-
drop down and click the ?
on subject something like "new help dosing / testing":cat::cat:
 
Welcome to the board...you'll find so much good info here. Our sugarcat, Joshi, is also on Vetsulin (since the beginning of December). So far, Joshi has done okay on it (she may need some dose adjustment as her BG numbers are are starting to come in lower). Here's a link to the Vetsulin guide on the board you can read: Vetsulin/Caninsulin User Guide. Since I'm still a relative newbie, I don't have the expertise to tell you whether Vetsulin is "good" or "bad" insulin as it is the only insulin we've used with Joshi so far. You'll hear both negative and positive - some cats don't seem do to well with it; however, its formulation apparently changed a few years ago - some have said that it works better than it used to. So...no definitive answer there.

As far as amount of insulin to give based on reading...I'll definitely let others speak to that as I'm learning, too. Probably the best advice I've gotten is if your newly diagnosed cat tests at 200 or below preshot, it's safest not to give insulin. Vetsulin does drop the BG reading steeply in it's first couple of hours - best not to risk a hypo episode. On the subject of hypoglycemia...you'll want to learn what to do if Sage's BG drops too low. Here's a link to the post on how to treat a hypoglycemic cat: How to Treat Hypos... With home testing, you can catch these episodes much sooner than without.

Most of all...relax, take a deep breath. :) There is a lot to learn and you could easily overwhelm yourself learning it all in one day. Learn the basics first - the finer points will come as you learn more. Others will chime in on those things that you absolutely learn first thing.
 
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I did read something earlier today (and of course I've now closed the internet tab it was on) that said that Vetsulin does now work better for cats than it used to because it was reformulated somehow. Unfortunately, I read so much information some days, that I don't remember how recently the reformulation happened. While I have a preference for Lantus because it worked well for Rosa, the best insulin is the one that works for your cat. If, once you're home-testing successfully, and after you're able to switch to an all-wet food diet safely, you find that Sage's numbers are good on Vetsulin then stick with it. If you find you're not getting enough duration from it, that would be the time to think about switching to a longer-acting insulin.

The meter readings you'll be looking for as normal range are, thankfully, the same for cats as for humans on a human meter (50-120). That said, with Vetsulin, you probably want to be cautious about the lower end of the normal range simply because Vetsulin can drop a cat's numbers a long way very quickly.

I would suggest the first thing to change is to go ahead and get that meter so you can start home-testing. Once you're able to do that and you can see the sort of numbers Sage is getting, then you can start changing diets and thinking about dose adjustments. I do think that increasing by a whole unit with any insulin is too much of an increase at once, especially based on a reading at the vet where numbers can run up to 100 points higher due to stress. I would definitely not take the dry food out of Sage's diet until you are able to monitor her at home to make sure that the reduction in carbs isn't dropping her too low especially with the recent dose increase.

Unfortunately, I don't know how to adjust dosage with Vetsulin on a sliding scale based on pre-shot numbers - that isn't something I've ever had to do. However, I know there are more people here recently who are using Vetsulin than there were when I first joined so hopefully someone will be able to give you some help with that.
 
laur_danny_famoussweetspot.jpg
 
Thanks for all of the quick replies. My vet did mention that if home testing is done it needs to be a pet meter because the level of glucose in a cat's plasma vs inside the cells is different than the ratio in humans. Is this difference negligible and thus it doesn't really matter if its a animal/human tester?
 
jvtech said:
Thanks for all of the quick replies. My vet did mention that if home testing is done it needs to be a pet meter because the level of glucose in a cat's plasma vs inside the cells is different than the ratio in humans. Is this difference negligible and thus it doesn't really matter if its a animal/human tester?
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Most people here use human meters --there is a variance in all meters but alpha track is pretty close to what the vets numbers will be. I use AT and I like it a lot but the strips are very expensive. Relion is a popular human meter in the forum it is from walmart and the strips are reasonable--
I test often so we go thru lots of strips.... if we end up as long term diabetics (hoping for remission) we will probably switch.
With human meters below 50 is a dangerous/possible hypo number
on alpha track 68 is the "no fly" zone..... break out the high carb food time.
If you decide to use AT they have a starter kit on amazon-but after that each strip is about 1$ (a little more:eek:)
 
A human meter will read lower than a pet-specific meter. However, as long as you know the low, normal and too-high ranges for the meter you are using, any of them are accurate enough for home testing. And even within the same brand, meters do vary. The ReliOn Confirm I have reliably reads within 5 points of lab value - yes, I was lucky with my meter, but I don't think I could get more accurate than that even with a pet-specific meter.
 
I use both. One thing to understand is high is high and low is low regardless of what meter you use. My AT is spot on with outside labs an within 10 points of the vet who uses AT. The strips are expensive and you have to make sure you never run out.

I don't get into the differences or variables, it would make me crazy. I go by the color range usually, unless we get low readings then the number comes into play.

Sorry I can't get into this right now as I'm dealing with Smokey.
 
Regarding whether Vetsulin is a good insulin--unfortunately, it is not one of the recommended insulins for cats (see under Insulin Therapy in the Cat, where it states "This panel does not recommend the veterinary-approved porcine zinc (lente) insulin suspension [i.e. Vetsulin] as the initial treatment for the cat, because its duration of action is short and control of clinical signs is poor"). Cats' metabolisms are twice as fast as people's or dogs', so Vetsulin only lasts about 6-8 hours in a cat. To get good control over blood glucose levels (which is how you get cats well regulated, and eventually into remission), you need an insulin that will last closer to 12 hours in a cat.

If you aren't seeing good results with the Vetsulin within 4-6 weeks, I would strongly recommend switching insulins. There is a window with remission, and the sooner you start a cat on one of the recommended insulins, the better their chances for remission.

Lantus, Levemir, and Prozinc are the recommended insulins for cats because they last long enough to allow for good control of blood glucose levels. Lantus and Levemir offer the best control, but Prozinc can also offer good control for some cats. Very few cats have good long term control with Vetsulin.

Because Lantus and Levemir are pricy in the US, many of us order our insulin from an online Canadian pharmacy, where it is much more affordable. I know some vets will start with Vetsulin to avoid sticker shock with the other insulins for their newly diagnosed patients, but there are ways to get insulin that both works well and is affordable. All you need to order insulin from Canada is the script from your vet.
 
Just came back from the vet and levels were 585. Vet upped Vetsulin to 3 units 2x day. They also gave me a loaner pet glucose tester and I bought a Relion. Now I feel comfortable switching to 100% wet food. I'm curious to see how close the meters are.
 
I feed Sage Blue Buffalo Wilderness, which I don't see anywhere on the lists of wet foods and their nutrition values. Its grain-free and supposed to mimic a raw diet, so I have to assume its good for diabetic cats. Anyone else use that for their kitty?
 
From Dr Lisa Pierson's catinfo.org website concerning Blue Buffalo foods:-

A customer service representative provided carbohydrate values over the phone. Note that, despite being “grain free”, all of the canned foods are high in carbohydrates, including the ‘Wilderness Wild Delights’. The only diets that appear to be low in carbohydrates are the ‘Wilderness’ pate varieties - Kitten, Chicken, Turkey, Salmon, and Duck. However, I will not use or recommend products from any company that refuses to provide ‘typical nutrient analysis’ data for their diets.

ETA: I just looked at Blue Buffalo's website. In comparison to most of the manufacturers' sites, there is minimal information available even for GA values - just protein, fat, fiber and water content. There isn't even a calorie count provided which makes it impossible to accurately calculate the carbs.
 
With the new dose in the equation you'll need to let that settle before reducing the food carbohydrate load. Trying to do the two at once might lead to unexpected drops in blood glucose levels.


Mogs
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jvtech said:
I feed Sage Blue Buffalo Wilderness, which I don't see anywhere on the lists of wet foods and their nutrition values. Its grain-free and supposed to mimic a raw diet, so I have to assume its good for diabetic cats. Anyone else use that for their kitty?
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Was she on 2 units 2x a day ?
Did the vet increase a full unit at once ?
 
Yes, she was on 2. He said since it is Vetsulin he isn't too concerned about Insulin OD. And I use the Wilderness pate so it sounds like they are low carb and should be acceptable. She was already about 50% wet food, so I won't do it all at once. I was gonna gradually decrease it.
 
jvtech said:
And I use the Wilderness pate so it sounds like they are low carb and should be acceptable.
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All I can say is "probably". All the Wilderness pates do contain potatoes as about the 4th ingredient on the list which would put me off feeding them. And the info on the catinfo.org site hasn't been updated all that recently and definitely won't have been updated for foods that the manufacturer wouldn't provide values for.
 
jvtech said:
Yes, she was on 2. He said since it is Vetsulin he isn't too concerned about Insulin OD. And I use the Wilderness pate so it sounds like they are low carb and should be acceptable. She was already about 50% wet food, so I won't do it all at once. I was gonna gradually decrease it.
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I do not know enough about vetsulin
Bump
 
Well, she also likes Wellness, so maybe I will switch her to that. I see that on the list around 4-5 carb
 
Wellness is good - I use a couple of their lower phosphorus flavors for our cats here. It was one of the very few foods that was an instant hit with all of them. :)
 
jvtech said:
He said since it is Vetsulin he isn't too concerned about Insulin OD.
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I'd like to know what evidence base he has for this statement. My cat had her only symptomatic hypo on Caninsulin (same thing as Vetsulin) and @Squalliesmom, Lucy, also had a job fighting off hypos in the early days of Squallie's treatment when her previous vet had him on too high a dose.

Vets should be very concerned about insulin OD, full stop.



Mogs
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I believe he said it isn't absorbed the same/isn't as potent as the other more expensive types they prescribe. Also her levels being almost 600 the last 2x I was in there might have been a factor I would assume.
 
Critter Mom said:
I'd like to know what evidence base he has for this statement. My cat had a symptomatic hypo on Caninsulin (same thing as Vetsulin) and @Squalliesmom Lucy also had a job fighting off hypos in the early days of Squallie's treatment.

Vets should be very concerned about insulin OD, full stop.
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That concerns me too. I know over the last year I've stayed with a few people late at night whose cats were in hypo numbers from one of the short-acting insulins. I don't think the length of the insulin action really matters - too much is too much and hypo is hypo. @Mum of two felines - any comments you'd like to add about short acting insulins and overdose as I know you've dealt with this recently for your boys.
 
Critter Mom said:
I'd like to know what evidence base he has for this statement. My cat had a symptomatic hypo on Caninsulin (same thing as Vetsulin) and @Squalliesmom, Lucy, also had a job fighting off hypos in the early days of Squallie's treatment when her previous vet had him on too high a dose.

Vets should be very concerned about insulin OD, full stop.



Mogs
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manxcat419 said:
That concerns me too. I know over the last year I've stayed with a few people late at night whose cats were in hypo numbers from one of the short-acting insulins. I don't think the length of the insulin action really matters - too much is too much and hypo is hypo. @Mum of two felines - any comments you'd like to add about short acting insulins and overdose as I know you've dealt with this recently for your boys.
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@jvtech I cannot even begin to comprehend what your vet is talking about. My cat has had several hypos on Vetsulin, the most recent just two days ago! I was very lucky that I caught it early and prevented his BG from dropping any lower.

The length of action of the insulin doesn't matter, hypos can happen with ANY insulin!!!
 
jvtech said:
I feed Sage Blue Buffalo Wilderness, which I don't see anywhere on the lists of wet foods and their nutrition values. Its grain-free and supposed to mimic a raw diet, so I have to assume its good for diabetic cats. Anyone else use that for their kitty?
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I have used it before
 
manxcat419 said:
That concerns me too. I know over the last year I've stayed with a few people late at night whose cats were in hypo numbers from one of the short-acting insulins. I don't think the length of the insulin action really matters - too much is too much and hypo is hypo. @Mum of two felines - any comments you'd like to add about short acting insulins and overdose as I know you've dealt with this recently for your boys.
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Well both my cats hypoed regularly on Novolin. Buzz (the second spreadsheet) hypoed many times before I found this board. So glad I did. The vet started him on 2u then raised him to 3. Talk about freaking out when his eyes started jerking sideways and then his head started jerking. We went through 2 tubes of NutraCal in 2 months! When my other kitty was diagnosed he was getting 13u of Novolin. Even after explaining to my vet how much they were using the NutraCal, they still didn't take it serious. The first day I took the BG with the alphatrax Woody was registering low! That means he was under 20! Thankfully the people on this board knew what to do and helped me reduce his dose over 3 days. Eventually I reduced his dose to nothing and I am waiting to see if Woody follows his half brother into remission.

Cats DO go into hypo and it's very scary. But you are home testing which will at least give you information on what this insulin is doing. But, just know and be prepared, that your cat can hypo anytime on insulin.
 
jvtech said:
I believe he said it isn't absorbed the same/isn't as potent as the other more expensive types they prescribe.
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Vetsulin can drop BG like a rock in a very short space of time (even on a miniscule dose if the cat's pancreas has some function). It is one of the harsher insulins used to treat cats. It doesn't have the duration of effect that some of the gentler insulins like Lantus and Levemir possess.

Incidentally, we can point members in the direction of more reasonably-priced Lantus than is typically available in the US.

Also her levels being almost 600 the last 2x I was in there might have been a factor I would assume.
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That is high but there is also the possibility that the 600 value may be influenced by vet/travel stress; it is possible that Sage may run a bit lower at home where she feels safe and relaxed. That's why home test data tends to provide a sounder footing upon which to base dose adjustments.

As Lucy says above, Sage is absolutely adorable. Such beautiful and unusual markings! :cat:


Mogs
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Hi @jvtech , welcome to the best place you never wanted to be :bighug:
Bit late to the party here, glad you bumped your thread up.


I'm not sure your vet understands the insulin at all. Vetsulin is one of the faster acting, harsher insulins and the more expensive Lantus and Levemir are gentler and less likely to cause hypos. All insulins carry a risk of hypo.

The higher (5-600) readings could be bounces from low numbers.

edit to add: have you started home testing yet?
 
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