New member. Dosing advice doing a curve today

[StaceyA]

My cat Zach is 13 and diagnosed on 3/10. He was eating a Purina One dry food. He stayed for almost 48 hours there while they started him on insulin. They sent me home with Vetsulin @ 4u 2x a day. They did not mention testing. He weighed 19.5 at the vet.
I joined a few support groups and ended up getting a Relion meter and also took advantage of the free offer for the pet test meter. After a few days of advice from a FB support group I did not give the 4u as he is also on a pate diet at home. Their advice was to lower it I believe to 1u and than even .5 since he usually tests before in the mid 200s. I’m currently using the pet test until I run out of strips in a few days. I test AMPS and PMPS. I am not home to test during the day. I get home around 5 and his shot is usually 730 depending on his PS # and on how long it takes him to eat. I honestly don’t think I can afford to test more than 3 times a day everyday. I’m stretched too thin as it is with the rising cost of food and gas and Ive gone from being ok paycheck to paycheck with some money left to almost nothing left by my next check.
He can be picky with the wet food and I’m getting very worried this will not be affordable for me. I can’t afford to give him Fancy Feast everyday. He’ll eat the Friskies Turkey and Giblet but has frowned on the the other flavors I have been able to find so far. He’ll also eat the FF fish flavors. Sometimes he turns his nose up at the Turkey and Giblets so I’ll give him the FF fish and then go back to the Turkey & G the next day. I tried the Aldi pate and he won’t eat it.
Last Saturday I woke up and he threw up in the night. I thought maybe it was a new flavor I gave him. His appetite was poor Saturday morning. He threw up clear liquid mid day and later that night bloody liquid. I took him to the ER. He was diagnosed with severe pancreatitis and he stayed at his vet for the week. His appetite was poor even on the usual meds. The vet said don’t worry about the diabetic diet just give him what he’ll eat since that’s important for pancreatitis. He got home and was eating the pate fine. He’ll usually eat 1/2 -3/4 of the Friskies can and 3/4 of the FF. I have samples of the Epigen, Young Again and Dr Elseys both the Duck and Chicken. I was hoping to feed the Epigen to my other cat bust she doesn’t like it and neither does Zach. He’ll eat a few pieces here and there. I tried the Young again and he’ll eat it but it’s giving him loose and runny poop. I can try the Dr Elseys but was going to wait till his poop firmed up but I’m also concerned because you can’t find the chicken flavor. I know wet is best. My thought on giving some dry was that it’s something to give if he won’t eat the canned and he also hears my other getting dry and meows. I have my other cat on 1 can of Friskies wet but also still the Purina.
Zach went to the vet for a check from the Pancreatitis yesterday. I did not mention I was not giving him the 4u. They lowered their price for the curve and instead of 1,100 it was 660. I have not gotten the bill for his panc stay but the vet said he wouldn’t charge the hospital fee after day two. When I questioned him about the 4u even if he’s only in the mid 200s he said yes give it because they have his curve data. I don’t want to irritate the vet and have him charge me the full price of the visit by telling him I’m not giving the 4u. I did mention yesterday about doing a curve today. He said to send the numbers when done and they will run it through their system to see where he should be. However, if I’m not dosing him the 4u like they said they will think those curve numbers are based off giving him the 4u. I don’t know what to do. I feel completely overwhelmed. I was going to try the .5 dose and he got pancreatitis and was gone and now I feel like I’m starting all over. And of course his AMPS Number was 137 this morning. So now he doesn’t need the insulin ‍ . Do I still do the curve and see where he is without insulin? I have enough pet test strips for this curve but would have to switch to the Relion to do another curve with insulin. I was liking the pet test strips since it’s a smaller blood sample and I don’t always get blood with each poke. Thank you for reading all this so far! I didn’t intend it to be so long. Any advice is appreciated. I have a spreadsheet for the FB groups but don’t think it’s compatible if I post here. I’ll try to get that started.

 

[Sienne and Gabby (GA)]

A couple of thoughts and some background.

Vetsulin is not an insulin that is endorsed by the American Animal Hospital Association for the treatment of feline diabetes. It was developed for and is still used to treat dogs. (It's original name was Caninsulin -- like in canine.) Cat's have a faster metabolism than dogs and as a result, the Vetsulin hits hard and fast and can drop numbers dramatically. Further, it doesn't last 12 hours. The AAHA recommends either Prozinc or Lantus (glargine) for treating feline diabetes. Frankly, your vet should know this since the guidelines were published in 2018. Lantus (or the biosimilars) and Prozinc are widely used here. You can save money by purchasing Lantus from Canada -- it costs about $139 for a pack of 5 pens (about 15mL). Many people purchase Prozinc from Chewy's where it costs around $113 (for 10 mL).

The dose the vet suggested is crazy. Your instincts and the information you were given were completely on target. Since you're feeding Zach a low carb diet, you would want to start at 0.5u of Vetsulin as an initial dose. It's far better to start at a lower dose and gradually increase than to shoot a dose that's too high and have a hypoglycemic episode to deal with. This is a link to our beginner's guide for Caninsulin/Vetsulin. Unfortunately, the curve data from the vet's office is likely to be inaccurate. Most cats get stressed from both being at the vet and from the car ride to get there. Stress increases blood glucose levels. As a result, the numbers at the vet's office are falsely high -- it's called stress hyperglycemia. If you're seeing numbers in the 200s at home, they are more likely accurate.

BTW, you need to set the permissions on your spreadsheet so anyone with the link can open it. At the moment, there's an error message that access is denied.

The cost for the strips for a pet meter are horrible. They cost about $1/strip. It looks like you're planning on switching to a Relion meter. The cost for strips is $17.88 for 100 strips (18 cents/strip). The cost is why so many people here don't use a pet specific meter. It's not affordable and it's one of the biggest expenses in treating FD.

You're probably seeing some less than solid poop due to the Young Again. You need to transition very slowly as diarrhea is common until your cat's system gets used to the new food. A probiotic can help with the poop issue.

 

[StaceyA]

A couple of thoughts and some background.

Vetsulin is not an insulin that is endorsed by the American Animal Hospital Association for the treatment of feline diabetes. It was developed for and is still used to treat dogs. (It's original name was Caninsulin -- like in canine.) Cat's have a faster metabolism than dogs and as a result, the Vetsulin hits hard and fast and can drop numbers dramatically. Further, it doesn't last 12 hours. The AAHA recommends either Prozinc or Lantus (glargine) for treating feline diabetes. Frankly, your vet should know this since the guidelines were published in 2018. Lantus (or the biosimilars) and Prozinc are widely used here. You can save money by purchasing Lantus from Canada -- it costs about $139 for a pack of 5 pens (about 15mL). Many people purchase Prozinc from Chewy's where it costs around $113 (for 10 mL).

The dose the vet suggested is crazy. Your instincts and the information you were given were completely on target. Since you're feeding Zach a low carb diet, you would want to start at 0.5u of Vetsulin as an initial dose. It's far better to start at a lower dose and gradually increase than to shoot a dose that's too high and have a hypoglycemic episode to deal with. This is a link to our beginner's guide for Caninsulin/Vetsulin. Unfortunately, the curve data from the vet's office is likely to be inaccurate. Most cats get stressed from both being at the vet and from the car ride to get there. Stress increases blood glucose levels. As a result, the numbers at the vet's office are falsely high -- it's called stress hyperglycemia. If you're seeing numbers in the 200s at home, they are more likely accurate.

BTW, you need to set the permissions on your spreadsheet so anyone with the link can open it. At the moment, there's an error message that access is denied.

The cost for the strips for a pet meter are horrible. They cost about $1/strip. It looks like you're planning on switching to a Relion meter. The cost for strips is $17.88 for 100 strips (18 cents/strip). The cost is why so many people here don't use a pet specific meter. It's not affordable and it's one of the biggest expenses in treating FD.

You're probably seeing some less than solid poop due to the Young Again. You need to transition very slowly as diarrhea is common until your cat's system gets used to the new food. A probiotic can help with the poop issue.

My cat Zach is 13 and diagnosed on 3/10. He was eating a Purina One dry food. He stayed for almost 48 hours there while they started him on insulin. They sent me home with Vetsulin @ 4u 2x a day. They did not mention testing. He weighed 19.5 at the vet.
I joined a few support groups and ended up getting a Relion meter and also took advantage of the free offer for the pet test meter. After a few days of advice from a FB support group I did not give the 4u as he is also on a pate diet at home. Their advice was to lower it I believe to 1u and than even .5 since he usually tests before in the mid 200s. I’m currently using the pet test until I run out of strips in a few days. I test AMPS and PMPS. I am not home to test during the day. I get home around 5 and his shot is usually 730 depending on his PS # and on how long it takes him to eat. I honestly don’t think I can afford to test more than 3 times a day everyday. I’m stretched too thin as it is with the rising cost of food and gas and Ive gone from being ok paycheck to paycheck with some money left to almost nothing left by my next check.
He can be picky with the wet food and I’m getting very worried this will not be affordable for me. I can’t afford to give him Fancy Feast everyday. He’ll eat the Friskies Turkey and Giblet but has frowned on the the other flavors I have been able to find so far. He’ll also eat the FF fish flavors. Sometimes he turns his nose up at the Turkey and Giblets so I’ll give him the FF fish and then go back to the Turkey & G the next day. I tried the Aldi pate and he won’t eat it.
Last Saturday I woke up and he threw up in the night. I thought maybe it was a new flavor I gave him. His appetite was poor Saturday morning. He threw up clear liquid mid day and later that night bloody liquid. I took him to the ER. He was diagnosed with severe pancreatitis and he stayed at his vet for the week. His appetite was poor even on the usual meds. The vet said don’t worry about the diabetic diet just give him what he’ll eat since that’s important for pancreatitis. He got home and was eating the pate fine. He’ll usually eat 1/2 -3/4 of the Friskies can and 3/4 of the FF. I have samples of the Epigen, Young Again and Dr Elseys both the Duck and Chicken. I was hoping to feed the Epigen to my other cat bust she doesn’t like it and neither does Zach. He’ll eat a few pieces here and there. I tried the Young again and he’ll eat it but it’s giving him loose and runny poop. I can try the Dr Elseys but was going to wait till his poop firmed up but I’m also concerned because you can’t find the chicken flavor. I know wet is best. My thought on giving some dry was that it’s something to give if he won’t eat the canned and he also hears my other getting dry and meows. I have my other cat on 1 can of Friskies wet but also still the Purina.
Zach went to the vet for a check from the Pancreatitis yesterday. I did not mention I was not giving him the 4u. They lowered their price for the curve and instead of 1,100 it was 660. I have not gotten the bill for his panc stay but the vet said he wouldn’t charge the hospital fee after day two. When I questioned him about the 4u even if he’s only in the mid 200s he said yes give it because they have his curve data. I don’t want to irritate the vet and have him charge me the full price of the visit by telling him I’m not giving the 4u. I did mention yesterday about doing a curve today. He said to send the numbers when done and they will run it through their system to see where he should be. However, if I’m not dosing him the 4u like they said they will think those curve numbers are based off giving him the 4u. I don’t know what to do. I feel completely overwhelmed. I was going to try the .5 dose and he got pancreatitis and was gone and now I feel like I’m starting all over. And of course his AMPS Number was 137 this morning. So now he doesn’t need the insulin ‍ . Do I still do the curve and see where he is without insulin? I have enough pet test strips for this curve but would have to switch to the Relion to do another curve with insulin. I was liking the pet test strips since it’s a smaller blood sample and I don’t always get blood with each poke. Thank you for reading all this so far! I didn’t intend it to be so long. Any advice is appreciated. I have a spreadsheet for the FB groups but don’t think it’s compatible if I post here. I’ll try to get that started.

I think he started him on it because I mentioned money being a factor. When I asked about switching to a longer acting he said he didn’t want to switch at the moment because of the pancreatitis flare. He said switching it could cause another flare. I see them again in a month.
I have access to the SS to anyone with the link can view. I deleted the one that was there and tried it again. Maybe it will work. I’ll post in the FB group as well.
How would I transition him to the Young Again since he’s not currently eating dry? I was giving him maybe a teaspoon or two a day. Will the loose poop eventually become solid as he gets used to it? Also, how much of a BG spike is to much for food related BG spikes? So say I feed a food and test him within 30-45 minutes how much of an increase in BG is too much to say the food is not good for him.

 

[Sienne and Gabby (GA)]

You can certainly keep your cat on Vetsulin especially if cost is an issue. I just wanted you to be aware of the pros and cons. Obviously, we have members who use this insulin and we have a guide for its use.

Your spreadsheet is accessible. Thanks.

If your cat isn't eating dry, that's fine. His GI system should calm down as he gets used to what you're feeding. You can also use a probiotic like S. boulardii, Visbiome, or other members may have suggestions.

As long as you're feeding Zach low carb food, I wouldn't worry about it spiking his numbers. Right now, whatever you're doing is looking good. I would encourage you to read over the guide that I linked above. It will give you suggestions as to when to raise and lower Zach's dose.

 

[Chris & China (GA)]

Just FYI...the spreadsheet you're using is from a Facebook group that's not connected with this board and when they pirated our spreadsheet, they did something to it that causes it to crash on a lot of phones/tablets which is what a lot of people use.

The only group on Facebook that's associated with this board is the Feline Diabetes group (not the Feline Diabetes Support Group).

Since your spreadsheet doesn't have a lot of data yet, it might be a good idea to switch to our original one. Here are the instructions on getting the original spreadsheet.

This board has been around over 25 years (before Facebook was even an idea) so there's lots more experience here than in most of the groups on FB.