New member - information overload...

[EmilyB]

Hi all! I just recently found out my 12 year old cat, Drew, is diabetic. It has been a very scary few weeks and I am beyond stressed. We had a hypoglycemic scare last week, something I never want to experience again in my life. But it's something that has made me kind of terrified of insulin.

The vet prescribed us Vetsulin at 3 units, twice a day. I was doing this blindly at first - no meter - because I truly did not know about any of this and my vet didn't provide much info. As we went about the first week, I slowly got supplies. Researched the best food to give, ordered it, attempted to take the dry kibble that has always been free-fed away, ordered a meter, etc. I sat and learned how to use the meter the night before the hypoclycemic episode. But hadn't used it yet.

I was able to get him to the vet within 15 minutes when I saw him having his episode. I thought he was having a stroke - that's how little I knew about all of this at that time. :-( He stayed at the vet the whole day and they gave him dextrose throughout the day to keep his BG up. Finally the insulin wore off and he slowly got better. The vet said to stop the insulin for 2 days and then to start back up at 1.5 unit twice a day. They gave us a LibreLink unit which has been extremely helpful, but I've also read that they are not always super accurate.

Anyways, we started the insulin back up but started very low because we were scared of that happening again.

That's all a little back story of what has been going on while we are rushing to learn everything. We are now up to 1.5 units twice a day. But by hour 6 after the shot, his BG is already getting into the 200's. And by the 12 hour mark, his levels are reading "hi" on the LibreLink. Are we giving him too low of a dose of insulin? Was the vet right telling us to give him 3 units to start? Is it normal for his levels to be so low that one morning that the 3 units put him into hypoglycemia? It's all just so confusing to me. I don't want him to suffer but I am so scared of doing something wrong. But also, feel like what we're doing now is wrong. We do have the support of the vet and he is scheduled for a curve this Thursday. But I've learned more online (specifically this website) than from the vet.

I apologize for not having the spreadsheet completed. I plan on working on that tomorrow. I just feel alone in all of this and wanted to post something to maybe get some guidance or reassurance or even someone saying we're doing it all wrong...just something. It's hard to take in all of this information when your baby's health is on the line. Because everything feels literally like a life or death decision and I had a taste of that last week when I was just simply doing what the vet told me to do. Ugh...just feeling very defeated.

I appreciate all of the work that has gone into this website. What an amazing resource for all of us going through this with our kitties.

-Emily

 

[Snickers and Chrissy]

Hello and welcome. I'm not one of the members qualified to give dosing advice. I just wanted to let you know that you're in the right place.

I'm pretty sure that when the experienced members start chiming in they will tell you that Vetsulin is not the preferred insulin for cats. It's no longer recommended by the American Animal Hospital Association because it was created for dogs and doesn't work as well in cats.

A lot of times Vetsulin causes a fast (as in too fast/too low) drop, and then wears off quicker than other insulins. The better insulins are Lantus, it's generic glargine, and Prozinc. It's possible I'm missing something there, but if I am someone will fill it in. Also, if you decrease dry food or carb-rich foods too quickly while on Vetsulin it can result in a steeper drop or hypo event. So maybe don't change their food any further until you hear from one of the experts on this forum.

I seriously doubt anyone will tell you to increase the Vetsulin, especially after the hypo you had. Three units is way too much of a starting dose. They'll probably tell you to decrease and see if you can switch to Lantus or it's generic. I'll stop there though and let the other members take over. Just stay calm for now. It will get better.

 

[Snickers and Chrissy]

Oh! I forgot to ask if you know to wait 30 minutes after feeding to administer the Vetsulin? Because of the steep and quick drop Vetsulin creates, you need to feed, wait, and then shoot. Here, I copied and pasted this from the Vetsulin forum for you.

(1)test , (2) feed (3) wait 20 – 30 minutes (4) shoot

Hope this helps.

I think @Suzanne & Darcy is one of the members who knows a lot about Vetsulin. I'm tagging them for you.

 

[Wendy&Neko]

If 3 units of Vetsulin caused a hypo, it is too high a dose to give. I'm glad you were there to observe and get your kitty to the vet quickly!

My vet started me on Caninsulin (what Vetsulin is called in the rest of the world), but started at 1 unit then worked our way up. It's much easier to start with a lower dose and work your way up. I did eventually manage to get switched to Lantus, which is what I asked my vet for from the beginning. But that's another story. Caninsulin/Vetsulin does not last the full 12 hours in most cats, so you'll end up with very high numbers at the end of the cycle. My girl was howling for food the last couple hours before the next shot, cause her numbers were so high. Lantus was much easier on her. And me.

We will be able to help you more with dosing once we've seen some of the blood sugar data in your spreadsheet, so thanks for working on that.

How is the progress going on the dry to wet food switch? That can also make a huge difference in blood sugar numbers.

 

[EmilyB]

Hello and welcome. I'm not one of the members qualified to give dosing advice. I just wanted to let you know that you're in the right place.

I'm pretty sure that when the experienced members start chiming in they will tell you that Vetsulin is not the preferred insulin for cats. It's no longer recommended by the American Animal Hospital Association because it was created for dogs and doesn't work as well in cats.

A lot of times Vetsulin causes a fast (as in too fast/too low) drop, and then wears off quicker than other insulins. The better insulins are Lantus, it's generic glargine, and Prozinc. It's possible I'm missing something there, but if I am someone will fill it in. Also, if you decrease dry food or carb-rich foods too quickly while on Vetsulin it can result in a steeper drop or hypo event. So maybe don't change their food any further until you hear from one of the experts on this forum.

I seriously doubt anyone will tell you to increase the Vetsulin, especially after the hypo you had. Three units is way too much of a starting dose. They'll probably tell you to decrease and see if you can switch to Lantus or it's generic. I'll stop there though and let the other members take over. Just stay calm for now. It will get better.

Thank you so much for your response!! I did not know that about Vetsulin. One of the things I hadn’t really looked into because I assumed it was good. But as soon as I started googling I saw some info that matched what you said. I think I’ll check with the vet to see if I can switch.

 

[EmilyB]

Oh! I forgot to ask if you know to wait 30 minutes after feeding to administer the Vetsulin? Because of the steep and quick drop Vetsulin creates, you need to feed, wait, and then shoot. Here, I copied and pasted this from the Vetsulin forum for you.


(1)test , (2) feed (3) wait 20 – 30 minutes (4) shoot

Hope this helps.

I think @Suzanne & Darcy is one of the members who knows a lot about Vetsulin. I'm tagging them for you.

I have been doing it maybe 10 minutes after eating. Just because of everything I’ve read. Some things say wait 30 some say do it while they’re eating. I will start to wait the 30 min. Thank you so much for this info!!

 

[EmilyB]

If 3 units of Vetsulin caused a hypo, it is too high a dose to give. I'm glad you were there to observe and get your kitty to the vet quickly!

My vet started me on Caninsulin (what Vetsulin is called in the rest of the world), but started at 1 unit then worked our way up. It's much easier to start with a lower dose and work your way up. I did eventually manage to get switched to Lantus, which is what I asked my vet for from the beginning. But that's another story. Caninsulin/Vetsulin does not last the full 12 hours in most cats, so you'll end up with very high numbers at the end of the cycle. My girl was howling for food the last couple hours before the next shot, cause her numbers were so high. Lantus was much easier on her. And me.

We will be able to help you more with dosing once we've seen some of the blood sugar data in your spreadsheet, so thanks for working on that.

How is the progress going on the dry to wet food switch? That can also make a huge difference in blood sugar numbers.

Ok, good to know!! I have racked my brain thinking why did that cause a hypo when he had been fine for the first 5 days on 3 units twice a day. I think the vet seriously thought I double dosed but I am so neurotic about all of this, there is just absolutely no way I did.

It also made me wonder WHY they started us at 3 units. Why not do what you said and start low and increase if need to. If I would have known at the time what a hypo event was like I would have 100% asked them that or said no, we’re going to start lower than that.

And yes, Drew is also just begging for food starting at like 1.5 hours before feeding time. I feel so awful because here he has lived 12 years being able to eat whenever he wants and now he can’t. Poor guy. But I also realize it’s necessary.

That’s another thing I’ve seen conflicting info on. If he is acting super hungry before, is it really bad to feed him a little bit in between feedings? I feel like I know the answer to that. But it’s hard to get the look of hunger from the guy like he’s been doing & not being able to give him what he wants. But I know it’s for the greater good too. Ugh, it’s all so much change SO fast.

 

[Snickers and Chrissy]

That’s another thing I’ve seen conflicting info on. If he is acting super hungry before, is it really bad to feed him a little bit in between feedings?

Are you feeding just twice a day? Many vets recommend that but it's actually old school thinking. Most everyone on this forum feeds more often than that. We generally give the two largest meals at shot time and then smaller meals throughout the day. This is easier on the pancreas than eating two huge meals, and it also keeps blood sugar more stable (it helps prevent hypos).

The only thing is that we make sure not to feed within two hours of shot time so that the blood sugar is not influenced by the food when we check it. Does that make sense?

So for example I give Snickers her breakfast, then give her a snack at +6, another at +9, and then her dinner at +12. I also use an automatic feeder to give her snacks at night while I'm sleeping, otherwise she would go crazy, haha.

 

[Snickers and Chrissy]

I have been doing it maybe 10 minutes after eating. Just because of everything I’ve read. Some things say wait 30 some say do it while they’re eating. I will start to wait the 30 min. Thank you so much for this info!!

Part of the reason you might be finding conflicting info is because Vetsulin is treated differently than other insulins like Lantus. With Lantus, the blood sugar does not drop so quickly and the numbers tend to be flatter. So you can absolutely shoot while feeding. My Snickers is on Lantus and I give her her shot while she's eating and she doesn't even notice.

So with Lantus, you can test BG (blood glucose), feed, and shoot all in like five minutes. But if you do that with Vetsulin it can cause problems. Not everyone is aware of this, unfortunately. But now you know, so that's a good start! I would definitely ask your vet about switching to Lantus. The generic is fine, and it's less expensive.

I know there's tons that I'm forgetting to mention, so I think I'll tag a couple more people for you. @Sienne and Gabby (GA) @Ale & Bobo & Minnie (GA)

 

[Snickers and Chrissy]

Also, just wanted to mention that while not all cats achieve remission, they have a much better chance of it on Lantus or Prozinc. Not so much on Vetsulin. Lots of people on this forum have achieved remission, so it is a real possibility. Snickers was in remission for 3.5 years and only recently fell out. Just something else to consider, and another reason to switch.

 

[Ale & Bobo & Minnie (GA)]

Chrissy has already given you a lot of great and accurate info.

unregulated cats are hungry all the time because they can’t process the nutrients in food well. It’s best to feed the 2 main meals at shot times and then 3-4 additional smaller meals or snacks throughout the day. It’s easier on their pancreas and it helps avoid big sugar spikes.

Are you giving 1 unit now? If you can setup a spreadsheet, we’re able to help your with dosing. You may also want to consider switching him to a better insulin. You may want to read and share with your vet the guidelines from the American Animal Hospital Assn for the treatment of diabetes in both dogs and cats. the AAHA no longer recommends Caninsulin/Vetsulin for treating feline diabetes.

With a diabetic cat you need:

• A low carb wet diet that is 10% carbs or under. Most of us use around 4-7% carbs
• A suitable insulin such as Lantus or Prozinc which are long acting, more gentle insulins than the old insulins.
• We recommend hometesting the blood glucose with a human meter…it is not necessary to use a pet meter which is expensive to run and is no better. It will keep your kitty safe and you will know how the dose is working for your kitty. Only testing every so often will not tell you what is happening in between those times and an awful lot can happen in even a day.
• HELP US HELP YOU has information about the spreadsheet, signature and hypo box which you will need to be able to look after your beloved kitty properly

We are happy to help you with setting up the spreadsheet, sorting out what food to buy, how to transition safely to a low carb diet, how to learn to home test and much more.

This is an excellent site for diabetic cats…it has been around for more than 25 years and has very experienced people to help you.

Keep asking lots of questions!

 

[Sienne and Gabby (GA)]

Welcome to FDMB!

If it's not already obvious, you are no longer alone in the process of managing Drew's diabetes. There is a community of people here who are generous with their knowledge and support.

@Ale & Bobo & Minnie (GA) said:

unregulated cats are hungry all the time because they can’t process the nutrients in food well.

. That's not entirely accurate. A diabetic is processing food just fine. Whatever your cat eats is metabolized into glucose. It's what happens from that point on that's more the issue. Insulin is a hormone that helps glucose move from the bloodstream into the cells. When you are testing your cat, you're testing the blood glucose level. In other words, you're testing to see how much glucose is floating around in the blood. You don't want to have very much glucose in the bloodstream because that's what tells you your cat is diabetic. If the glucose is in the blood and not in the cells, the end product of food being metabolized (i.e., glucose) isn't "feeding" the cells and as a result, your cat is starving all the time.

It's also just fine to feed Drew multiple small meals throughout the day.

Please let us know if you have questions. We're here to help.