New Member - Insulin Question

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Jessica W

Jessica W

Member Since 2020
Hi! My cat, Kitty, is 13 years old and has been on & off insulin for the past 3 years. He has been in remission twice but has come out of it due to surgeries. He had emergency surgery for bladder stones, surgery to get his eye removed due to cancer and got his top two canines removed at the same time, & mostly recently he had to get half of his left ear removed due to a cancerous tumor. He is currently on 2 units once a day of vetsulin per my vet. I just started attempting to home test on Sunday 9/20/20. Sunday his glucose was 124 so I gave no insulin. Monday 9/21 his glucose was 126 so I gave no insulin. Yesterday 9/22 I couldn't get enough blood for a reading so I didn't give insulin just in case. Tonight 9/23 his glucose registered at 153. So my question is, do I give him insulin tonight or not? & if so, how much should I give because I do know that 2 units would be too much. Thanks!
 
Trying to plant some mums before dark so I'll be brief until I can come back in for a proper comment - no insulin if BG is below 200 please!

Could you give us more info on his past two "remissions" ... How did you decide to stop giving insulin? What insulin was he previously on? How long since he was last on insulin? Thanks!
 
Panic said:
Trying to plant some mums before dark so I'll be brief until I can come back in for a proper comment - no insulin if BG is below 200 please!

Could you give us more info on his past two "remissions" ... How did you decide to stop giving insulin? What insulin was he previously on? How long since he was last on insulin? Thanks!
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I thought I had read that about no insulin under 200 but I wanted to be sure! He has been on vetsulin the whole time he's been diabetic. His last shot was on Saturday 9/19 the day before I started home testing. In the past I stopped giving insulin after taking him back & forth to the vet numerous time over the course of a few weeks and his numbers stayed low so they got me to stop the insulin. Went back after stopping to get checked numerous times and his numbers stayed regulated. Didn't start back up until I got his glucose checked after his surgeries.
 
Jessica W said:
I thought I had read that about no insulin under 200 but I wanted to be sure! He has been on vetsulin the whole time he's been diabetic. His last shot was on Saturday 9/19 the day before I started home testing. In the past I stopped giving insulin after taking him back & forth to the vet numerous time over the course of a few weeks and his numbers stayed low so they got me to stop the insulin. Went back after stopping to get checked numerous times and his numbers stayed regulated. Didn't start back up until I got his glucose checked after his surgeries.
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You are awesome!

Okay, and what food is he on? What was the reason behind his diagnosis? Any history of ketones/DKA? It's harder the second time to get a cat in remission ... much less a third time. Not impossible, but Kitty's numbers look good. How did they determine he was out of remission the other times, was it just a BG test at the clinic or a fructosamine test? Surgeries, illnesses, stress ... they all raise BG. Trying to figure out if he was ever in remission ... or diabetic ... or both haha!

Vetsulin isn't my favorite insulin to use but it seems to be what he needs right now so we'll roll with it. No insulin below 200. I'd say if he is over 200 maybe stick with 0.25 - 0.5u for now, with close monitoring. Could you do me a favor and test him a few hours after he eats dinner? I want to see if his BG goes down on its own, that would mean his pancreas is doing its job.

Some notes about Vetsulin ... some people are already aware of them, others have never been told by their vets, so just covering my bases.

  • No insulin under 200
  • Test, feed, wait 20-30 minutes, then shoot. Food must be ON BOARD already with Vetsulin.
  • Feed small, frequent meals in the beginning of the cycle. Vetsulin hits hard and fast, usually 1-3 hours after injection and then peters out between 3-7 hours. Feed at +1 (meaning 1 hour after injection) every time.
  • Reduce by 0.25u if he drops below 90 - don't let him go much lower than that on Vetsulin!
 
As of right now he is on science diet urinary cat food. He gets dry food for breakfast and half a can of food at dinner time. I do want to switch him to low carb food like I see everyone talk about but I wanted to start home testing him first before I did that in case his BG dropped significantly from it.

His initial diagnosis if I'm remembering correctly was after he had emergency surgery to break up urinary crystals in his bladder.I took him to the vet because I noticed him drinking a lot more water than normal and peeing more than normal.

I have no idea about the ketones/DKA since that is something I just learned about joining the Feline Diabetes facebook group so if he has been checked for that I don't remember them telling me.

The other times he went into "remission" we figured it out after a series of BG tests at the vet and I took him back less and less often the longer his numbers looked good.

He ate dinner around 6:00 (Almost 3 hours ago, I'm not sure what time zone you're in) so I can attempt to test him in just a few minutes and see if I can get enough blood for a reading. It's only my 5th day testing so I'm still a little hesitant with it and it doesn't help that I don't have the ability to switch ears.

& thank you for the vetsulin info, I never asked but my vet also never mentioned the idea of home testing so I'm glad now to be apart of this group and start trying to control this on my own. We've been through so much with his health that I would hate myself if I was the reason something bad happened to him!
 
Okay good you're aware of that. Honestly if you can cold-turkey switch him without giving insulin, since you're already skipping a lot ... that might be all he needs! We recommend testing + switching gradually if kitty is already on insulin but you're skipping a lot. I think I'd go ahead and switch quickly while you can, it gets complicated when insulin is being given.

You would know if he had DKA ... it's normally a $2000 ER visit. :p

You are doing great so far! It might be late for you to get a +6 tonight, so maybe try one tomorrow if no insulin. Which ... I think I would hold off on insulin and switch his food really quick. Food can lower BG by up to 100 points so he might not even need insulin after that, we'll have to see!

I would like to see you get a Hypo Kit ... and to check for ketones while he's off insulin, need to keep him safe!

Hypo Kit Toolbox
Karo Syrup - $3
Ketone Test Strips (Ketostix) - $6
A few cans of Fancy Feast Gravy Lovers Marinated Morsels/Sliced in Gravy/Grilled in Gravy varieties - $0.60 each (these are your medium-carb cans)
A few cans of Fancy Feast Gravy Lovers/Medleys Tuscany/Medleys Gravy in Sauce varieties - $0.60 each (these are your high-carb cans)

Medium Carb is 11-15%
High Carb is 16%+

You can also search through the catinfo chart while you're at the store to check which cans available are the ones you need. They don't HAVE to be Fancy Feast but they're fairly easy to find.

Do you need low-carb food suggestions?
 
Okay, great! I'll go to the store tomorrow as soon as I get off work and get some of the can food you suggested. Thankfully he's never been a finicky eater and will eat whatever you give him so he shouldn't mind the switch at all. I'll go ahead and try to find/order the ketone strips as well. What exactly do you mean by +6? Haven't quite familiarized myself with all the terms yet but I'm trying!
 
Ahh sorry!

+1 is 1 hour after insulin
+2 is 2 hours after insulin
etc

It goes +1 through +11, and then it's AM/PM pre-shot (or AMPS / PMPS)
12 hours is one cycle
2 cycles in 24 hours

So on your spreadsheet, did you get those tests in 11 hours after giving insulin, or right at insulin time (even though you skipped)?
If you are skipping, please put either 0 or skip in the Unit section (U) on your spreadsheet. That way we know you didn't give anything. :)
 
Okay so I just got home and tested Kitty before giving him his dinner. His BG registered at a 204 so would that mean a little bit of insulin or no? I did go by the store and get him different canned food but I guess I misread and got him the medium carb cans like you were suggesting for the hypo kit instead of the low carb. :( The kind I got has 14 grams of carbs so still better I guess than his normal high carb food he eats. I'll just have to go to the store tomorrow and get some low carb kind. Haha.
 
I would hang on since you're doing a diet switch. So you have some medium carb cans on hand but no low carb? I'd give him the medium without insulin and snag the low carb when you can.
 
Okay, sounds good. I just wanted to be sure! And yes, I have the medium carb cans that I bought today. I'm going to grab some low carb cans tomorrow. Thanks so much for your help! He normally gets dry food for breakfast too so I'll go ahead and switch him to the medium carb can in the morning which I'm sure will be better than the dry food.
 
Yep! Did you get ketostix by chance? Want to keep an eye on those for now. I think with all the pancreatic activity he's showing anyway it wouldn't have been a good idea to shoot - that might have been too much
 
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