New member, DOSING help?

TL;DR: We've been checking Purrscilla's levels for almost a week (more consistently for about 1.5 days), and they seem low. One unit of Vetsulin has sent her into hypo states, twice in a row. Now I'm not sure how much to give (or not give) her. Please help, if the limited data we have is enough. Thank you!

A little backstory...

Purrscilla (10 years old) was diagnosed with pancreatitis in April/May '21. She was put on steroids, pain meds, and Royal Canin's Gastrointestinal formula (mostly dry with a little wet). She's been a kibble addict her whole life, so adding the wet food was a struggle!

In Aug. '21, her pancreatitis was finally healed, but she was diagnosed with IBD. She was kept on the same meds and prescribed Purina's Hypoallergenic food (back to dry).

In Sept. '21, we went for a check-up on the IBD, and the vet ran a glucose spot test based on numbers from her previous labs. She was over 500; she's diabetic! He instantly had us start on 2 units of Vetsulin every 12 hours (and strongly encouraged Lantus) and Purina's Diabetic food (slowly transitioning from less dry to more wet). I shared my concern about putting her on this food with IBD. He said I could transition her off of the prescription food if I found something that was at least 40% protein. We didn't get much other info beyond the possibility of remission with Lantus.

So I did my own research into FD, and I switched her slowly over to FreshPet food fully (no more kibble! Yay!). Then I started adding Tiki Cat to the FreshPet as I learned more about the appropriate cat diet and the 7-10% max carbs rule. I decided to hold off my search for Lantus in hopes that we could get Purrscilla into remission with her food change. I wasn't aware of the need to home-test or change her insulin dosage based on her glucose readings.

Two weeks after the diagnosis appointment, we went for another check-up. and her glucose was at 88, which our vet seemed to be concerned about being too low. He had us decrease to 1.5 units of Vetsulin every 12 hours. We got to decrease her steroids by a little bit too!

Two days later, I found this site, learned about home-testing, and got our own supplies. Fast forward a week of testing only before giving insulin and not knowing what the numbers mean and being totally overwhelmed.

Two nights ago, I had a gut feeling to check her glucose before bed (it was at 69 before dinner, so we only gave her 1 unit of insulin). She was at 43 (3 hours after her shot)! YIKES! I followed some of the hypo protocols here and got her to 77 by midnight.

I called the vet in the morning and asked what her numbers should be. He said 120-250 on my human monitor and to check the numbers hourly if she ever reached the 80s. She had already been at 44 that morning (+3 AMPS of 1 unit), and we were doing hypo protocols again.

I joined the FB group last night to try to get some answers about her numbers. Now I'm here and have an updated spreadsheet. The colored legend for the glucose numbers has already made a huge improvement on my anxiety; thank you!

Please help me figure out what dose she should be getting now that 1 unit has sent her to hypos twice. Thank you in advance!

 

Hi and welcome Jessica and Purrcilla.
Well done setting up your signature and spreadsheet and hometesting! Lucky Purrcilla!

Just checking that now you have her on a low carb wet diet completely? And the meter you are using is a human meter?…..I have not heard of that meter.
If your meter is a human meter, normal numbers for a cat are 50-120. Anything under 50 and you need to be giving some high carb food and/or honey to bring up the BG over 50.
Do you have a hypo kit set up? If not I would get that set up today
HERE is a link to the hypo kit and how to treat. Print it off and put on your fridge for easy access.

I am not a vetsulin user so I will tag @JanetNJ for advice on the dose.
If she does not get back to you by the next dose, I would give 0.5 (1/2) unit….providing the BGis high enough to shoot. And get a test at +1 and +2 and +3 to see how she is going with the dose.
Are you feeding the main meal 30 minutes before the dose is given?
Also are you giving a snack at +2 and +4 each cycle?
Bron

 

Have you seen the beginners guide to vetsulin HERE

 

@JanetNJ

 

You were right to skip. Anything over 150 and you can test i might do 0.5 units... And even with that, be sure you will be around to test. 1+ units is too much with these low preshots

 

Thanks for all the feedback!

I will add pancreatitis to my signature when I can get back to a desktop.

Our monitor is for humans.

I have read the Vetsulin beginner's guide. It's been really helpful! I just wanted to be sure I'm doing the right stuff for my babe.

Purrscilla is currently on all-wet food. Half of it is FreshPet, which is medium-carb, and the other half is Tiki Cat, which is very low carb. (We'll be slowly taking her off FreshPet tomorrow; her new food came in today.)

I've only been feeding her twice a day, except for the hypo events, which I gave her FreshPet (and honey) during.

I was not waiting 30 minutes after meals to dose - just learned about that today as I was combing forums. Changing this as we speak!

I am setting up my hypo kit as we speak also. There wasn't much high-carb canned food at my store, surprisingly enough (supply problems, I'd guess). I got a food with gravy but the carbs are still only at 10%.

I think that covers all the questions so far.

 

Welcome to FDMB.

By our methods, Purcilla was started on a large dose of Vetsulin. It is a harsh, fast acting insulin that can cause numbers to drop quickly. The American Animal Hospital Assn no longer recommends Vetsulin for the treatment of feline diabetes given that it has a short duration. In other words, it poops out by about 8 - 10 hours after an injection resulting in swings in blood glucose (BG) numbers. On the other hand, Lantus is one of the insulins that is recommended. It is gentler and has a much longer duration.

If you can't find higher carb food, a drop or two (or three) of honey or corn syrup (e.g., Karo) will effectively raise BG numbers.

 

Jessica, I would start giving her a couple of snacks in the first half of each cycle as well as the main meal. As vetsulin hits hard it is good to have some snacks aboard as well.

 

@Sienne and Gabby (GA) With her numbers currently so low without insulin, I wonder if I should pursue Lantus. Thoughts?

Of course, if her numbers start to rise again, it'll be a different story.

 

With Vetsulin, typically the numbers will drop and then spring back up. Purcilla may be an exception. I would continue to get spot checks to see if she's maintaining these numbers. They are looking good but right on the edge between normal and a little high. (Normal range with a human meter is 50 - 120.)