new member 3/20 on vetsulin - need help

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AMPS is 179 and no insulin was given overnight. He ate about 85% of PM meal and then 3AM snack overnight.

Do I keep holding insulin? Or stalling and re-check?
 
AM shot held as I'm still not certain about shooting at <200. PMPS is 188. He ate about 80% of his food today. Not sure whether to continue holding insulin or give .5 or 1U. Any dosing advice is appreciated.
 
I am not a vetsulin user but I would not keep withholding the insulin.
If he is eating I would at least give 0.5 units or 0.75 units if you can monitor the cycle and feed him during the cycle.
 
Also it is my understanding that if you drop 90 on vetsulin you reduce the dose immediately by 0.25 units. He dropped under 90 on 4 occasions in the last 5 days so you should have reduced the dose to 1 unit.
 
Thanks so much for the reply. I didn't make any adjustments based off the PM checks from 3/31 since I had not been previously checking him throughout the night (that's my mistake.) In hindsight, the 84 on 4/1 - I definitely should have dropped his dose. I posted for advice but I think I was too nervous to make adjustments on my own. And then yesterday he got lower and wasn't acting like himself and wasn't really interested in eating. So then I was nervous to give him a shot if he wasn't going to eat like he normally would. This is such a learning curve. Hopefully I haven't messed up too bad so far :(

Plan to continue .5U and monitor.
 
Hi Krista, Tuko is a handsome boy!
No you haven’t messed up. It is a learning curve..
I would get a+1 and a +2 because you have shot a lower number than you normally do. This will be good data and if he does drop lower early in the cycle you won’t get a nasty surprise when you test later in the cycle.
If you find him dropping lower early on, you can give him a snack of ordinary low carb food to slow him down. Always post if you are unsure and change the subject line to alert us you need help
 
Thanks so much!
I have changed the subject line when I was stalling to indicate stalling several times and then changed it back once I held the dose. I think it has just happened when nobody was available. I've tried not to stall over 1-1.5hrs to try to keep a schedule (although my schedule is far from perfect). Is that correct for stalling? I just hate the point where you have stalled and have to make a decision and move on - and you hope you choose the right thing!
 
ittybitty said:
Thanks so much!
I have changed the subject line when I was stalling to indicate stalling several times and then changed it back once I held the dose. I think it has just happened when nobody was available. I've tried not to stall over 1-1.5hrs to try to keep a schedule (although my schedule is far from perfect). Is that correct for stalling? I just hate the point where you have stalled and have to make a decision and move on - and you hope you choose the right thing!
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I would not stall for more than 2x20 mins as it throws the schedule out too much. Do you work from home and how flexible can you be?
When are your shot times? (In relation to the time now?)
We might be able to find someone who is online at that time to keep an eye out for you.
 
I work 12hr shifts but am currently out on medical leave with mono and have been for weeks. I have been trying to shoot around 9:30 AM/PM (2 hrs prior to now) but could adjust that as needed. I will have to adjust back to 6AM/8PM once I am working but couldn't make myself get up at 6AM while I've been so sick.

Also at some point I may need SS help. I'm not sure if I have entered all the stalling information correct. Specifically, when I held a dose - do I continue on as if 9:30 was my shot time (even though I didn't give it). If I checked it at 11:30, I would still chart that under +2?
 
I am going to ask @Bandit's Mom to have a look at your SS. She is a whizz with fixing them.
She may also be around when you shoot your PM dose so you could tag her or me for the pm dose help if needed. We have just changed times with daylight savings two days ago so I’m a bit at sea with times at the moment.
For the morning dose you might be able to tag Christie and maverick or tiffmaxee. To tag you just put a @ in front of the name ...like this @Bron and Sheba (GA) and a box will come up and it will give you a choice of who you tag. Just click on the name you want.
 
Thanks!

Just shot PM dose an hour ago and did the .5U. JanetNJ had been advising me but I know it's impossible for one person to be available at all times. I'm still learning everyone and who uses vetsulin. My AM dose would be 10 hrs from now approximately. Is there a number that's an absolute no shoot? Or if he stays >150 pre shot - continue with the .5U?
 
@Bandit's Mom

@JanetNJ

@Bron and Sheba (GA)

@Christie & Maverick

@tiffmaxee

If anyone is available for dosing help I would appreciate it. I followed @Bron and Sheba (GA) advice last night and gave .5U. Tuko did drop down to 89 but it came up on it's own with his scheduled feedings and he ate all of overnight meals. This morning AMPS is 161 @ +10.75. I'm not sure if the 89 earned him the reduction and I should give .25U. I've also never shot this low. Times are a little off since I stalled last night and was trying to allow stall time this AM if needed. Thanks is advance!!
 
ittybitty said:
I'm not sure if the 89 earned him the reduction and I should give .25U. I've also never shot this low. Times are a little off since I stalled last night and was trying to allow stall time this AM if needed. Thanks is advance!!
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I'm not familiar with Vetsulin, but a quick glance at this sticky, says you reduce by 0.25U if the BG falls below 90.
https://www.felinediabetes.com/FDMB/threads/beginners-guide-to-caninsulin-vetsulin.231587/

Have you fed? the 161 is at +10.75? So more than an hour to AMPS? Let's see where he is at AMPS.

Can you monitor if you shoot?
 
This is his "normal" shoot time.. because I stalled for an hour last night it has made his normal only be +10.75 this morning. I'm trying to learn the ropes of stalling and getting back on track, too.
Yes, can monitor.
No, have not fed yet.
 
Thanks so much!
Stalling hasn't seemed to work well with him and I would rather go ahead and get him eating while he is wanting his AM meal. He's finicky about meals lately when I keep stalling. And I would like to keep him on his schedule, if feasible.

@Bandit's Mom - also, @Bron and Sheba (GA) mentioned that you were great with spreadsheets. If you have time would you look at my stalling and see if it seems right on the spreadsheet. Also - when I held insulin but continued to check glucoses... does that get charted the same. Example - his normal shot time is 9:30 but I held the dose but then checked him at 11:30 - I would chart that under +2 even though he didn't get a shot?
 
ittybitty said:
Stalling hasn't seemed to work well with him and I would rather go ahead and get him eating while he is wanting his AM meal. He's finicky about meals lately when I keep stalling. And I would like to keep him on his schedule, if feasible.
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Go ahead and shoot :-)

ittybitty said:
If you have time would you look at my stalling and see if it seems right on the spreadsheet
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All the +12 and above when stalling will go into the PS (AMPS or PMPS) cell.

ittybitty said:
Example - his normal shot time is 9:30 but I held the dose but then checked him at 11:30 - I would chart that under +2 even though he didn't get a shot?
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Yes, that's correct!
 
I like the 0.5 dose, but if you can't test or wanna play it safe 0.25 is fine. Why did you reduce after last night? Numbers in the high greens are good.

Edited to say I see it was because of the 89. I always assumed for numbers in the 80's, but if it makes you nervous then maybe do just below 0.5.
 
I'm fine with 0.5 and he was super happy/playful/alert last night. And yes reduced because of the 89, mainly because I didn't want to not follow the rules again. I had several times previously I should have reduced that I didn't realize that I should have. We were doing so good and then he has thrown me for a curveball the last few days. I don't understand what happened.

How long do I hold my dose? And I would reduce for lows below 90? And post for help if he starts running high again?
 
ittybitty said:
I'm fine with 0.5 and he was super happy/playful/alert last night. And yes reduced because of the 89, mainly because I didn't want to not follow the rules again. I had several times previously I should have reduced that I didn't realize that I should have. We were doing so good and then he has thrown me for a curveball the last few days. I don't understand what happened.

How long do I hold my dose? And I would reduce for lows below 90? And post for help if he starts running high again?
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Hold it unless it goes too low. If it starts going much lower or you find you need to steer it often, I would reduce. For now maybe do a "skinny" 5... just under the line.
 
Thanks @JanetNJ I think I will have to go with a skinny .5. I did .5U this AM since .25 didn't do much yesterday and we are already down to 84 at +3. How do I chart the skinny .5u?

Also, what should my no shoot number be? I know this AM he was 153. Or I should just reduce to .25 and not skip a shot?
 
@JanetNJ @Bron and Sheba (GA)

Dosing advice please. I gave .5 as JanetNJ suggested on 4/5 PM and it looked like 86 was the lowest he went. I held that .5 yesterday AM since the .25 had not helped the day before. Yesterday 84 was my lowest so last night I gave a skinny .5 but he dropped to 78 last night. @JanetNJ I'm not sure if I should be reducing by .25 due to these lows <90 of if it is okay to see some 80-90s or if I need to adjust to a fat .25. Does anyone ever give a different dose for AM/PM? I'm trying to get all the data I can because when I go back to work I will not be able to test anywhere near as frequent. It seems like .25 doesn't help during the day but .5 maybe too much for the night OR .5 is okay if 70s-90s is okay (I know we want green numbers, just not sure how low).

Thanks so much!!
 
I am not vetsulin user so we will see what Janet says. If she doesn’t come on before your next shot, I would reduce the dose to 0.25 units, because of the 82/78.
He is looking good!
 
@Bron and Sheba (GA) thanks for the reply!! I will shoot .25 this AM and see what @JanetNJ recommends for dosing. His AMPS is now 147 (numbers just keep getting better). This forum has been invaluable - just to know there's somebody else out there and I'm not alone in this. :) Thanks again.
 
I'm using syringes that have 1/2 unit markings but that's as detailed as it gets. I'm assuming there aren't any more detailed syringes, right? I feel like .25 is such a tiny amount (and hard to see) , but I agree I'm loving the blues too!!

@JanetNJ thanks for looking at his numbers!!
I didn't get an email notification about your post so I gave a regular .25 this AM, will make it a little fuller next time.
 
ittybitty said:
I'm using syringes that have 1/2 unit markings but that's as detailed as it gets. I'm assuming there aren't any more detailed syringes, right? I feel like .25 is such a tiny amount (and hard to see) , but I agree I'm loving the blues too!!

@JanetNJ thanks for looking at his numbers!!
I didn't get an email notification about your post so I gave a regular .25 this AM, will make it a little fuller next time.
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Unfortunately no they don’t Come in 1/4 markings. Are the ones you are using.33cc or 0.5cc?
 
New problem tonight -
He has literally refused to eat the friskies pate. I've tried multiple flavors that he has previously eaten with no problem. He is following me around the house, meowing like he wants to eat and when I put food down he smells it and walks away. I did give him a little under .25 U tonight because he has never skipped a meal. We are at 82 @ +2.5. I went ahead and gave a 3oz can of FF chicken (I think medium carb) and he is eating it. I'm not sure how much of it he will eat. Any ideas why he would suddenly refuse his normal food?? I haven't changed anything about the way I fed him tonight and he ate almost all of his AM meal and +5 small meal like normal.

Update: he ate a little over half of the can.
 
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If he sniffs it and walks away, that sounds like nausea.
You did the right thing to try the medium carb if he refuses all else and you have given insulin.
I would keep testing in case he drops lower this cycle and offer him whatever he will eat.
If he still seems nauseated in the morning I would either give him some cerenia if you have any, or speak to the vet about getting some to have on hand, or taking him to the vet to see why he is nauseated.

With all the cans you have opened, I would transfer them into plastic containers or bags, mark them and freeze them for later.
 
It's just so odd because I've never seen him do this. He would eat his freeze dried treats with no problem and beg for them, but not the friskies. When I put that medium carb out he went straight to eating it like he was starving even though I've been offering food for several hours but he ate half and then tried to cover the rest up. I just rechecked and he is up to 120 but fiesty and swatted at me after ear prick (only his second time to do that). I don't have any meds for nausea but will definitely call the vet if this continues.

I mixed water in with them so they will probably just be garbage.

I guess in the future if he doesn't start eating it would have been better to just skip the dose of insulin?

I did get him a catnip banana that he has played with a few times since yesterday - do you think any correlation?
 
I would test until nadir.
I am not a vetsulin user so I’ll ask @Deb & Wink about skipping doses with vetsulin when they don’t eat.... vetsulin hits hard and fast and I know you need food aboard.
Has he ever had ketones?
I have no idea about the catnip banana.....
If he’s swatting at you it sounds as if he is not feeling 100%.
 
Ketones were negative at vet office with diagnosis. On 4/5 I did ketone strip in wet litter puddle (not sure if 100% accurate) and it was negative.
He is acting completely fine otherwise, almost like he just doesn't want to be bothered by me.
 
He is 109 @ +11.5. Not sure what to do about insulin this morning. He ate all of the medium carb that I gave him last night (3oz) and a little of the friskies that I left out. I'm leaning towards skipping his shot completely this AM but I don't want to mess up.
 
@JanetNJ @Deb & Wink

Looking for vetsulin dosing help. I held this AM dose because I wasn't sure he would eat after he initially refused food last night. I gave him 3/4 can of friskies this AM and he has eaten almost all of it (in small meals throughout the day). We are at +7 right now. I don't want to make a mistake by holding insulin but I don't want to cause a hypo either. It seems like everytime I think I have him figured out he throws me another curveball.
 
I would have recommended that you skip the insulin this morning also. I see by looking at your SS that you did skip the dose. Good judgement call on your part.

You will not "mess up" if you skip the dose when he's that low.

That BG of 109 is too low to dose your kitty Tuko. You need more test data to know how your cat will react to getting a dose when the BG is that low.
We usually recommend STALLING without food, retesting and seeing if the BG is rising. It needs to rise more than meter variance (20% or more) before you would want to give a dose.

What has changed in the last 6 days? Since 4/4/21? Something has dramatically changed.

The next lower dose that you could give is 0.1U. So the syringe plunger is barely above the very first line on the syringe barrel, what we think of as the zero (0) line.
 
@Deb & Wink

Nothing has really changed that I can think of. I switched to the friskies (from high carb dry) in the beginning of this and that's the only food he has had until last night when I used FF medium carb. I've kept the same routine with feedings (3/4 can for AM and PM meals and 1/4 can around +5). I've used freeze dried treats. He was getting some "lean treats" in the beginning but that was only a few a day with testing until the freeze dried came in. Catnip banana was new starting on 4/7.
4/2 PM was where I started questing my doses because we were starting to be <200 for pre shot and seem to keep dropping from there. 4/3 he didn't eat much and then last night he refused friskies. I tried to keep up in the notes on how much he has eaten. He has slept alot today but me and him were awake all night last night so I partially feel like our sleep schedule is just off. I don't know what to do with this kitty. o_O
 
ittybitty said:
I don't know what to do with this kitty.
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Well, what I think you do is keep doing what you are doing. Because so far, what you are doing is fantastic!

It's possible that the switch to lower carb wet food has made a dramatic difference for Tuko. Sometimes, a change in diet with a short course of insulin is all a cat needs to turn the situation around. Keeping paws crossed here that you are headed for diet controlled remission.

p.s. Would you please start a new post, and link this old one in at the top, for some history. This thread is getting very, very long and we like to keep threads to 50 replies or less. Thanks.
 
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