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I AM SO FRUSTRATED! What am I doing wrong? I can't get the BG in control. I feed 1 3 oz can of FF Classic in the morning around 6:00 am and she gets another 3 oz can around 4:00. I always give her her insulin around 20 to 30 minutes after she eats. It was just increased to 1.25 units. I am testing three times a day. I know for many of you that is not enough but it won't change the scores I am getting no matter how many times I test. Please, give me your opinions! Is this just the "bouncing" from a newly, diagnosed cat on insulin. I need help! PLEASE don't send me any more "links". I have read so many that are helpful. I just need your honest opinions. Is this normal? Is this not normal? Is it the food I am feeding her? Is her insulin dosage too low? I just want your opinions and I will take them to my Vet. Thank you. I might add one other thing that has been a mystery with my Susie from the day I brought her home from the shelter. Her urination has never been normal until the diabetes set in. She would just drip. Nothing like a normal cat. Very little urine. The vet was so concerned in the beginning that he thought it was a blockage and saw something on the ultrasound. He did surgery but it was not stones. He thought it was scare tissue from a previous surgery but we had no medical history on her. This was back in April 2019. She was fine until around the end of November 2020 when she started urinating a lot and drinking a lot of water. I knew something was not right so I took her in. That is when I got her blood test indicating she had diabetes - and other questionable test results. She has always been a happy kitty. Never shows any signs of discomfort. She is my total mystery but I want to help her with this diabetes.
 
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According to AAHA: "Note: When selecting products, veterinarians have a choice among those formulated for humans and those developed and approved by veterinary use. Manufacturers of veterinary-specific products spend resources to have their products reviewed and approved by the FDA for canine or feline use. These products are specifically designed and formulated for dogs and cats and have benefits for their use; they are not human generic products. AAHA suggests that veterinary professionals make every effort to use veterinary FDA-approved products and base their inventory-purchasing decisions on what product is most beneficial to the patient". I don't think that Lantus or Levemir were developed and approved for veterinary use - were they? Maybe this is why my Vet has prescribed the Vetsulin. Marge, what kind of food did you/do you feed Gracie to get her BG under control? How much? How often? Thank you.
I believe you are looking at an old rendition of the information from AAHA. Here is more recent info (click on the blue bold print). We’ve been using Lantus and Levemir here in this forum since 1996. We actually have a protocol for Lantus and Levemir that was printed in the Journal of Feline Medical Surgery and updated in a subsequent veterinary journal. I don’t mean to disparage your vet but any vet who knows even a little about feline diabetes typically prescribes Lantus or ProZinc, although ProZinc is not as good as it’s predecessor, PZI. I actually do not personally know any vet that prescribes Vetsulin other than the occasional one I see here (although it’s more common in the UK). It is difficult to get the BG under control with Vetsulin and it requires monitoring day and evening cycles.

Marge, what kind of food did you/do you feed Gracie to get her BG under control? How much? How often? Thank you.
Sadly, my baby girl passed five years ago. Initially, I fed her different Wellness canned varieties ranging from 3-10% calories from carbs and a 13% canned food to control lower numbers. Then I switched to ZiwiPeak canned food and, the last few months, I also did a homecooked balanced diet. How much you feed depends on Susie’s caloric needs. That varies by cat and takes some investigation. If Susie’s weight has been stable, you can calculate how many calories you’ve been feeding her to keep her weight stable and you will want to continue with that as much as possible. If she has lost or gained weight, I’d weigh her (it’s easy to get a pet scale), feed her a tiny bit more or less, depending on whether she needs to gain or lose weight, for a week and then weigh her again. You do this until her weight is stable where you want it but if you are decreasing her food, you want to be sure you do not decrease by more than 1% a week. Do it slowly.

As to when to feed, that depends on the cat and the insulin. Vetsulin onsets quickly and so you must have food on board before you even give her the shot. You then want to feed her at probably +1 and +2. This information will give you more detailed answers on feeding a cat who’s on Vetsulin.

I do not want to come off as being critical in any way, but please restore her SS to the full version. We need to see the entire SS. There is a reason why. If you need more room for remarks, please let me know and I’ll fix it for you. It is absolutely imperative that you test her at night. You don’t have to test her all night or as much as you do in the a.m. but cats frequently go low at night and by shooting and not testing, with the way Vetsulin works, you are really, really risking her having a symptomatic hypoglycemic episode and Vetsulin is not as forgiving as Lantus. It’s a much harsher insulin.

I AM SO FRUSTRATED! What am I doing wrong? I can't get the BG in control. I feed 1 3 oz can of FF Classic in the morning around 6:00 am and she gets another 3 oz can around 4:00. I always give her her insulin around 20 to 30 minutes after she eats. It was just increased to 1.25 units. I am testing three times a day. I know for many of you that is not enough but it won't change the scores I am getting no matter how many times I test. Please, give me your opinions! Is this just the "bouncing" from a newly, diagnosed cat on insulin. I need help! PLEASE don't send me any more "links". I have read so many that are helpful. I just need your honest opinions. Is this normal? Is this not normal? Is it the food I am feeding her? Is her insulin dosage too low? I just want your opinions and I will take them to my Vet. Thank you. I might add one other thing that has been a mystery with my Susie from the day I brought her home from the shelter. Her urination has never been normal until the diabetes set in. She would just drip. Nothing like a normal cat. Very little urine. The vet was so concerned in the beginning that he thought it was a blockage and saw something on the ultrasound. He did surgery but it was not stones. He thought it was scare tissue from a previous surgery but we had no medical history on her. This was back in April 2019. She was fine until around the end of November 2020 when she started urinating a lot and drinking a lot of water. I knew something was not right so I took her in. That is when I got her blood test indicating she had diabetes - and other questionable test results. She has always been a happy kitty. Never shows any signs of discomfort. She is my total mystery but I want to help her with this diabetes.
Ok--you asked so I will tell you.
The first thing you are doing wrong is not testing before every single shot. I cannot tell you how many times I’ve had to help members who have woken up to an AMPS of 30 or even lower. Thankfully, they tested before they shot because if they hadn’t, and they’d given insulin, their cat would have likely died from hypoglycemia. You must test before every single shot if you want to keep her safe.

The second thing you are doing wrong is not testing at night. If we can’t see what her BG is, we can’t offer you much help and neither can your vet. If she is going low at night, she could be bouncing high in the morning but you’ll never get that under control if you don’t test at night. Again, you don’t have to test all night but you need to see where her BG is headed and feed accordingly.

The third thing is not feeding her often enough. Without some carbs to work with the insulin, the BG drops fast. When it drops fast, it rises fast. I don’t know what the %calories from carbs are in the FF Classics you are feeding but alot of members use them here. It is incorrect that “it won’t change the scores...no matter how many times I test”. The BG drops and you have to feed to be sure it doesn’t drop too low because if it does, she’s going to bounce back high. When cats clear bounces, the BG drops fast and low, again. It’s a constant cycle. The more data you have, the more you understand her cycles (onset, nadir, duration) and that’s important for getting her BG under control.

I know you’ve been given alot of material but that’s what FD is constantly about....reading, learning. I still do it or else I wouldn’t be able to offer solid advice here. We are all constantly reading. If you have a few minutes to look around this site, you will see an amazing amount of information especially in the Feline Health Index and FAQs section. Many of us have worked hard to provide that information to help members with their diabetic cats.

What she is doing is totally normal. You have to remember that insulin is a hormone, not a medication. Thus, it doesn’t react as a medication. Hormones affect our bodies in different ways at different times. The best way to approach FD is to take a deep breath and understand that it is a marathon and not a sprint. It takes time and patience and data while remembering that your kitty is your beloved kitty and not just her BG. Sometimes we do get a little too data focused. ;)

Anytime her BG is higher, she will urinate more. I don’t know why she had issues urinating before and only your vet can help you with that. But anytime the BG goes up and sugar spills into the urine, drinking and peeing will increase.

Quite honestly, Susie’s BG doesn’t look that bad. I can show you hundreds of SSs at the same time of being diabetic as Susie and they look so much worse. So pat yourself on the back for the testing that you have been doing. And note that anytime Susie is really hungry.... her BG is likely low although not always so you can’t you that solely as a means for knowing when to test.
 
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Or a really safe treat

Have you tried the freeze dried treats like PureBites? They come in a wide variety of protein sources and are totally fine for diabetic cats. Orijen Wild Boar treats are also low carb and seem to be a favorite with cats that don't like the texture of the PureBites type treat.

Just look at ingredients....if the only ingredient is a protein source, it's a fine treat.
 
I believe you are looking at an old rendition of the information from AAHA. Here is more recent info (click on the blue bold print). We’ve been using Lantus and Levemir here in this forum since 1996. We actually have a protocol for Lantus and Levemir that was printed in the Journal of Feline Medical Surgery and updated in a subsequent veterinary journal. I don’t mean to disparage your vet but any vet who knows even a little about feline diabetes typically prescribes Lantus or ProZinc, although ProZinc is not as good as it’s predecessor, PZI. I actually do not personally know any vet that prescribes Vetsulin other than the occasional one I see here (although it’s more common in the UK). It is difficult to get the BG under control with Vetsulin and it requires monitoring day and evening cycles.


Sadly, my baby girl passed five years ago. Initially, I fed her different Wellness canned varieties ranging from 3-10% calories from carbs and a 13% canned food to control lower numbers. Then I switched to ZiwiPeak canned food and, the last few months, I also did a homecooked balanced diet. How much you feed depends on Susie’s caloric needs. That varies by cat and takes some investigation. If Susie’s weight has been stable, you can calculate how many calories you’ve been feeding her to keep her weight stable and you will want to continue with that as much as possible. If she has lost or gained weight, I’d weigh her (it’s easy to get a pet scale), feed her a tiny bit more or less, depending on whether she needs to gain or lose weight, for a week and then weigh her again. You do this until her weight is stable where you want it but if you are decreasing her food, you want to be sure you do not decrease by more than 1% a week. Do it slowly.

As to when to feed, that depends on the cat and the insulin. Vetsulin onsets quickly and so you must have food on board before you even give her the shot. You then want to feed her at probably +1 and +2. This information will give you more detailed answers on feeding a cat who’s on Vetsulin.

I do not want to come off as being critical in any way, but please restore her SS to the full version. We need to see the entire SS. There is a reason why. If you need more room for remarks, please let me know and I’ll fix it for you. It is absolutely imperative that you test her at night. You don’t have to test her all night or as much as you do in the a.m. but cats frequently go low at night and by shooting and not testing, with the way Vetsulin works, you are really, really risking her having a symptomatic hypoglycemic episode and Vetsulin is not as forgiving as Lantus. It’s a much harsher insulin.


Ok--you asked so I will tell you.
The first thing you are doing wrong is not testing before every single shot. I cannot tell you how many times I’ve had to help members who have woken up to an AMPS of 30 or even lower. Thankfully, they tested before they shot because if they hadn’t, and they’d given insulin, their cat would have likely died from hypoglycemia. You must test before every single shot if you want to keep her safe.

The second thing you are doing wrong is not testing at night. If we can’t see what her BG is, we can’t offer you much help and neither can your vet. If she is going low at night, she could be bouncing high in the morning but you’ll never get that under control if you don’t test at night. Again, you don’t have to test all night but you need to see where her BG is headed and feed accordingly.

The third thing is not feeding her often enough. Without some carbs to work with the insulin, the BG drops fast. When it drops fast, it rises fast. I don’t know what the %calories from carbs are in the FF Classics you are feeding but alot of members use them here. It is incorrect that “it won’t change the scores...no matter how many times I test”. The BG drops and you have to feed to be sure it doesn’t drop too low because if it does, she’s going to bounce back high. When cats clear bounces, the BG drops fast and low, again. It’s a constant cycle. The more data you have, the more you understand her cycles (onset, nadir, duration) and that’s important for getting her BG under control.

I know you’ve been given alot of material but that’s what FD is constantly about....reading, learning. I still do it or else I wouldn’t be able to offer solid advice here. We are all constantly reading. If you have a few minutes to look around this site, you will see an amazing amount of information especially in the Feline Health Index and FAQs section. Many of us have worked hard to provide that information to help members with their diabetic cats.

What she is doing is totally normal. You have to remember that insulin is a hormone, not a medication. Thus, it doesn’t react as a medication. Hormones affect our bodies in different ways at different times. The best way to approach FD is to take a deep breath and understand that it is a marathon and not a sprint. It takes time and patience and data while remembering that your kitty is your beloved kitty and not just her BG. Sometimes we do get a little too data focused. ;)

Anytime her BG is higher, she will urinate more. I don’t know why she had issues urinating before and only your vet can help you with that. But anytime the BG goes up and sugar spills into the urine, drinking and peeing will increase.

Quite honestly, Susie’s BG doesn’t look that bad. I can show you hundreds of SSs at the same time of being diabetic as Susie and they look so much worse. So pat yourself on the back for the testing that you have been doing. And note that anytime Susie is really hungry.... her BG is likely low although not always so you can’t you that solely as a means for knowing when to test.
 
Okay, Marje. Can you help me restore my spreadsheet? I just took a reading about 2 hours after her nighttime shot and it was 196 but I can't figure out how to restore my spreadsheet to the normal format? Showing the nighttime BG levels which I will rarely check but might want to follow the recommendations to do so. Thanks.
 
Have you tried the freeze dried treats like PureBites? They come in a wide variety of protein sources and are totally fine for diabetic cats. Orijen Wild Boar treats are also low carb and seem to be a favorite with cats that don't like the texture of the PureBites type treat.

Just look at ingredients....if the only ingredient is a protein source, it's a fine treat.
Thank you, Chris. Yes I did try the PureBites and she doesn't like them. I will look into the Origen Wild Boar treats. By the way, your kitty is very pretty. Love the black and whites, the blacks and the whites.
 
Have you tried the freeze dried treats like PureBites? They come in a wide variety of protein sources and are totally fine for diabetic cats. Orijen Wild Boar treats are also low carb and seem to be a favorite with cats that don't like the texture of the PureBites type treat.

Just look at ingredients....if the only ingredient is a protein source, it's a fine treat.
 
One other thing on your SS where you write in for example

on 1-6-21 day cycle you put 3-1/2 hours. You should put 161 @+3.5 which means
3-1/2 hours
Also for the rest of the ones you did that way

EXAMPLE
161 @+3.25. Means 3 hours and 15 minutes
161 @+3.5. Means 3 hours and 30 minutes
161 @+3.75. Means 3 hours and 45 minutes

You can take a look at my SS
@Summer and Susie
 
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Okay, Marje. Can you help me restore my spreadsheet? I just took a reading about 2 hours after her nighttime shot and it was 196 but I can't figure out how to restore my spreadsheet to the normal format? Showing the nighttime BG levels which I will rarely check but might want to follow the recommendations to do so. Thanks.
I can. I’ll send you a private message because you have to allow me editing rights.
 
I sleep at night. Don't you all?
What time do you test in the AM and PM
Yes we do sleep at night, but sometimes if our cats drop to very low numbers we have to feed them and test again until we get them back to safe numbers

When you test her BG at night you should get another test @+1 ( 1 hour later after shooting)
If it's much lower than her PMPS you would need to feed a small meal to bring it
up. It will all depend on what that +1 reading is.
You will never get her BG under control without some tests at night

Correction made about when to check BG after giving Vetsulin. I originally said +2
which is incorrect, it should be @+1
Thanks to Marje that she caught that
 
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What time do you test in the AM and PM
Yes we do sleep at night, but sometimes if our cats drop to very low numbers we have to feed them and test again until we get them back to safe numbers

When you test her BG at night you can get another test @+2. ( 2 hours later)
If it's much lower than her PMPS you would need to feed a small meal to bring it
up. It will all depend on what that +2 reading is.
You will never get her BG under control without some tests at night
Remember this is Vetsulin. It works differently than Lantus. Onset is usually by +1.
 
I sleep at night. Don't you all?
Not if there's a risk the cat may go too low.

In terms of night time testing, the general idea is to get your PMPS and then a 'before bed' test a few hours after the dose was administered. A test at PM+2 typically gives you an idea of how far and fast the drop is going thus far, and again typically by PM+3 you'll have a fair idea of how low the dose is going to take the cat (although it might be +4 or +5 when it hits nadir). Tests at these times will help you better gauge:

* whether your cat will be safe for the rest of the cycle while you are asleep.

* whether numbers look like they might go too low (in which case one stays up, monitors BG and steers the cat's BG levels with food until numbers rise up to a safe level and stay up without need for further feeding).

The night time mid-cycle numbers will also help you to better interpret the readings you get the following day (e.g. a fast drop early in the PM cycle may lead to higher, bounce-influenced BG levels in subsequent cycles. Being able to differentiate high numbers due to insufficient insulin versus high numbers due to bouncing will help you to make better, safer decisions for Susie's insulin dosing.


Mogs
.
 
Not if there's a risk the cat may go too low.

In terms of night time testing, the general idea is to get your PMPS and then a 'before bed' test a few hours after the dose was administered. A test at PM+2 typically gives you an idea of how far and fast the drop is going thus far, and again typically by PM+3 you'll have a fair idea of how low the dose is going to take the cat (although it might be +4 or +5 when it hits nadir). Tests at these times will help you better gauge:

* whether your cat will be safe for the rest of the cycle while you are asleep.

* whether numbers look like they might go too low (in which case one stays up, monitors BG and steers the cat's BG levels with food until numbers rise up to a safe level and stay up without need for further feeding).

The night time mid-cycle numbers will also help you to better interpret the readings you get the following day (e.g. a fast drop early in the PM cycle may lead to higher, bounce-influenced BG levels in subsequent cycles. Being able to differentiate high numbers due to insufficient insulin versus high numbers due to bouncing will help you to make better, safer decisions for Susie's insulin dosing.


Mogs
.
Again, we need to remember this is not Lantus. Vetsulin can often onset very quickly by +1. Using the +2 to predict the drop with Vetsulin is not the best idea as it might be a little late.. Yes, obviously, if the BG is headed down by +2, it might likely continue but at a different rate than the drop from PMPS or +1.
 
Again, we need to remember this is not Lantus. Vetsulin can often onset very quickly by +1.

Using the +2 to predict the drop with Vetsulin is not the best idea as it might be a little late..
I know full well it's not Lantus being discussed here, Marje, and I know from direct experience that it is possible to start observing a lowering effect from around the +1 mark in cats being treated with Vetsulin/Caninsulin. (Saoirse was a fast metaboliser of both Caninsulin and Lantus and usually had early onset with both.)

I didn't say anywhere in my previous post that the rate/magnitude of drop observed in a +2 reading was a predictor of the rate/magnitude of any subsequent drop in BG during the cycle. (Indeed, I went on to say that one would get a better idea of where the nadir for the cycle might land by testing at +3, and that the nadir might occur later in the cycle.) If you inferred that meaning from my post then I did not communicate effectively.

I was endeavouring in my post to give a general, broad-brush idea of the value of tests in the early part of the PM cycle and, with a couple of general examples, to convey that such tests can give a caregiver information with which to gauge whether it's OK to go to sleep or whether their cat may need additional monitoring for safety, and that they can also be an aid to interpreting significance of numbers in subsequent cycles. It appears that I have failed in this objective.


Mogs
.
 
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I know full well it's not Lantus being discussed here, Marje, and I know from direct experience that it is possible to start observing a lowering effect from around the +1 mark in cats being treated with Vetsulin/Caninsulin. (Saoirse was a fast metaboliser of both Caninsulin and Lantus and usually had early onset with both.)

I didn't say anywhere in my previous post that the rate/magnitude of drop observed in a +2 reading was a predictor of the rate/magnitude of any subsequent drop in BG during the cycle. (Indeed, I went on to say that one would get a better idea of where the nadir for the cycle might land by testing at +3, and that the nadir might occur later in the cycle.) If you inferred that meaning from my post then I did not communicate effectively.

I was endeavouring in my post to give a general, broad-brush idea of the value of tests in the early part of the PM cycle and, with a couple of general examples, to convey that such tests can give a caregiver information with which to gauge whether it's OK to go to sleep or whether their cat may need additional monitoring for safety, and that they can also be an aid to interpreting significance of numbers in subsequent cycles. It appears that I have failed in this objective.


Mogs
.
Easy, Mogs. Thank you for recognizing that however it sounded to me, knowing about the insulins, it would be less clear to Summer.

You did say this:

A test at PM+2 typically gives you an idea of how far and fast the drop is going thus far
 
Have you tried the freeze dried treats like PureBites? They come in a wide variety of protein sources and are totally fine for diabetic cats. Orijen Wild Boar treats are also low carb and seem to be a favorite with cats that don't like the texture of the PureBites type treat.

Just look at ingredients....if the only ingredient is a protein source, it's a fine treat.
Chris, I did try the PureBites and she did not like them. Thanks for the suggestion though.
 
What time do you test in the AM and PM
Yes we do sleep at night, but sometimes if our cats drop to very low numbers we have to feed them and test again until we get them back to safe numbers

When you test her BG at night you should get another test @+1 ( 1 hour later after shooting)
If it's much lower than her PMPS you would need to feed a small meal to bring it
up. It will all depend on what that +1 reading is.
You will never get her BG under control without some tests at night

Correction made about when to check BG after giving Vetsulin. I originally said +2
which I as incorrect, it should be @+1
Thanks to Marje that she caught that
Okay, so you are saying I should test her BG at one hour after her nighttime shot? I can do that. I'm afraid you will be disappointed in me for one thing. I get up very early and usually feed Susie her breakfast around 6:00 am. By 3:00 pm she is very, very hungry so I will test around 3:30 and give her her last shot of the day around 4:00. I know that is really early for her nighttime shot but she needs to eat by 4:00. She was used to being fed at 3:00pm but I backed that up. I am not spreading the shots out by 12 hours except after her night shot and before her morning shot and then it is more like 14 hours between shots. By the way, I usually try to test 2 to 3 hours after her morning shot and at least two more times during the day about three hours apart.
 
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Not if there's a risk the cat may go too low.

In terms of night time testing, the general idea is to get your PMPS and then a 'before bed' test a few hours after the dose was administered. A test at PM+2 typically gives you an idea of how far and fast the drop is going thus far, and again typically by PM+3 you'll have a fair idea of how low the dose is going to take the cat (although it might be +4 or +5 when it hits nadir). Tests at these times will help you better gauge:

* whether your cat will be safe for the rest of the cycle while you are asleep.

* whether numbers look like they might go too low (in which case one stays up, monitors BG and steers the cat's BG levels with food until numbers rise up to a safe level and stay up without need for further feeding).

The night time mid-cycle numbers will also help you to better interpret the readings you get the following day (e.g. a fast drop early in the PM cycle may lead to higher, bounce-influenced BG levels in subsequent cycles. Being able to differentiate high numbers due to insufficient insulin versus high numbers due to bouncing will help you to make better, safer decisions for Susie's insulin dosing.


Mogs
.
Sounds almost not worth trying to get the numbers low because then you have to worry about them dropping too low. Frankly, I would be happy if I could keep her numbers around 150 as the normal range for glucose, according to my blood test information, is 64 to 170.
 
I'm sorry about your kitty, Marje. I love the tribute to her at the end of her SS.
Thank you so much, Summer. :bighug:

Okay, so you are saying I should test her BG at one hour after her nighttime shot? I can do that. I'm afraid you will be disappointed in me for one thing. I get up very early and usually feed Susie her breakfast around 6:00 am. By 3:00 pm she is very, very hungry so I will test around 3:30 and give her her last shot of the day around 4:00. I know that is really early for her nighttime shot but she needs to eat by 4:00. She was used to being fed at 3:00pm but I backed that up. I am not spreading the shots out by 12 hours except after her night shot and before her morning shot and then it is more like 14 hours between shots. By the way, I usually try to test 2 to 3 hours after her morning shot and at least two more times during the day about three hours apart.
That’s not how the insulins work. Yes, Vetsulin is a shorter-acting insulin and, if you were more experienced, you could shoot the rises but for now, you should stick to sticking every 12 hours. If you feed her more throughout the cycle, as I suggested, then she won’t be so hungry at 4. Also, if you feed her too early late in the cycle, you are shortening whatever duration she will get from the insulin.

Sounds almost not worth trying to get the numbers low because then you have to worry about them dropping too low. Frankly, I would be happy if I could keep her numbers around 150 as the normal range for glucose, according to my blood test information, is 64 to 170.
If you don’t get the kitty into normal numbers, the pancreas doesn’t heal. The manufacturers of the AT have not set what is “normal” for cats. Many vets will quote specific numbers based on the actual lab analysis but not the AT. Also, the renal threshold (the BG at which the kidneys spill sugar into the urine) varies by cat. We have had some members here who have monitored that and found their cats spilled glucose in the upper 100s. Our mantra here is “Every Cat is Different” (ECID) and so you want to be sure you are getting them into BGs below 100 to ensure the pancreas is healing. Otherwise, there is no chance for remission. Have you thought about switching to a human meter? All of our methods of regulation are based on human meter numbers. You will find the AT strips get quite expensive and human meters are very reliable and much less expensive. There are some which only require the same amount of blood as the AT.

Okay, ladies, when should I test after the PM shot. +1 or +2? And should the same theory apply with the AM shot. Should I test at +1 or +2 with the Vetsulin?
IMHO, I would start with +1 for a few cycles until you can see when she onsets. If, at +1, she is consistently showing a food spike, you can then try doing the first post-shot test at +2. I see you did not get an AMPS today. Again....please....I know you love your kitty. Do not skip these vital preshot tests.
 
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Thank you so much, Summer. :bighug:


That’s not how the insulins work. Yes, Vetsulin is a shorter-acting insulin and, if you were more experienced, you could shoot the rises but for now, you should stick to sticking every 12 hours. If you feed her more throughout the cycle, as I suggested, then she won’t be so hungry at 4. Also, if you feed her too early late in the cycle, you are shortening whatever duration she will get from the insulin.


If you don’t get the kitty into normal numbers, the pancreas doesn’t heal. The manufacturers of the AT have not set what is “normal” for cats. Many vets will quote specific numbers based on the actual lab analysis but not the AT. Also, the renal threshold (the BG at which the kidneys spill sugar into the urine) varies by cat. We have had some members here who have monitored that and found their cats spilled glucose in the upper 100s. Our mantra here is “Every Cat is Different” (ECID) and so you want to be sure you are getting them into BGs below 100 to ensure the pancreas is healing. Otherwise, there is no chance for remission. Have you thought about switching to a human meter? All of our methods of regulation are based on human meter numbers. You will find the AT strips get quite expensive and human meters are very reliable and much less expensive. There are some which only require the same amount of blood as the AT.


IMHO, I would start with +1 for a few cycles until you can see when she onsets. If, at +1, she is consistently showing a food spike, you can then try doing the first post-shot test at +2. I see you did not get an AMPS today. Again....please....I know you love your kitty. Do not skip these vital preshot tests.

This statement confuses me "If you feed her more throughout the cycle, as I suggested, then she won’t be so hungry at 4. Also, if you feed her too early late in the cycle, you are shortening whatever duration she will get from the insulin". So, I should give her a little food around noon so she can last later getting her dinner (around 6:00)? When is too early in the cycle? Shouldn't it be noted that she ate during the middle of the day? In the notes? I need specific instructions on what time and how much to give her during the cycle.

I bought a ReliOn meter, strips and lancets before my Vet told me to buy the AlphaTrak 2. I use the AlphaTrak because that is what he told me to buy and use and I just ordered more strips and lancets. If I use the ReliOn there will be no "setting" for cats (or dogs). Does that matter? I cannot afford to buy yet a third testing system. At least not now.

Okay, I'll test, feed and shoot around 6:00 - 6:30 am. I'll then test one hour after the shot. I'll try to get at least two more test in before her PMPS reading around 6:00, then her dinner, then the shot and one hour later I will test again.

Marje, I don't know if I am going to be able to get her into remission. I'm worried about the numbers being too low and me worrying about her and having to test all night. I need my sleep at night and what is being requested is a lot. What do people do that have to work all day and need their sleep at night? How do they possibly manage all that you are asking? Can't cats live reasonably well with numbers in the low to mid 100's, testing during the day and the shots? I know you want to see her in remission and I appreciate all that you are advising but staying up all night - testing and worrying - is asking a lot of anyone. I get up around 5:30 in the morning and I am in bed at 6:30 pm.

Thank you for fixing my spreadsheet
 
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This statement confuses me "If you feed her more throughout the cycle, as I suggested, then she won’t be so hungry at 4. Also, if you feed her too early late in the cycle, you are shortening whatever duration she will get from the insulin". So, I should give her a little food around noon so she can last later getting her dinner (around 6:00)? When is too early in the cycle? Shouldn't it be noted that she ate during the middle of the day? In the notes? I need specific instructions on what time and how much to give her during the cycle.
I’m sorry....it was too early for me to be posting without :coffee::p I’ve corrected my sentence with a strikeout. What I meant to say is that feeding later in the cycle, after nadir, can slow down the duration of the insulin and, in some cases, stop it cold.

If you look back in post #102 above, I discuss how you to determine how much to feed and also linked information with regard to Vetsulin and feeding schedules so please take the time to read that.

I always kept a record in a separate column on Gracie’s SS (linked in my signature) on how much food I fed, the % calories from carbs, and the time (in hours from shot). It’s helpful for you and the people that help you.

If I use the ReliOn there will be no "setting" for cats (or dogs). Does that matter? I cannot afford to buy yet a third testing system. At least not now.
The ReliOn is perfect and what many members use. I also had a ReliOn I used but that model is no longer made. It doesn’t need a setting for pets. It’s a human meter. Again, the dosing methods we have here for all the primary insulins used inc Vetsulin/Caninsulin, Humulin/Novolin, PZ, Lantus, Levemir, etc were all developed using human meters so we know what numbers on those meters are safe. If/when you start using it all the time (and we suggest you pick a meter and stick with it), I can change the formatting on Susie’s SS with the ranges for human meters that we use.

Okay, I'll test, feed and shoot around 6:00 - 6:30 am. I'll then test one hour after the shot. I'll try to get at least two more test in before her PMPS reading around 6:00, then her dinner, then the shot and one hour later I will test again.
Remember that with Vetsulin, you need to feed at least 30 mins before shooting. I’m assuming that’s what you mean...you will test and feed at 6 and then shoot 30 mins after she eats.


Marje, I don't know if I am going to be able to get her into remission. I'm worried about the numbers being too low and me worrying about her and having to test all night. I need my sleep at night and what is being requested is a lot. What do people do that have to work all day and need their sleep at night? How do they possibly manage all that you are asking? Can't cats live reasonably well with numbers in the low to mid 100's, testing during the day and the shots? I know you want to see her in remission and I appreciate all that you are advising but staying up all night - testing and worrying - is asking a lot of anyone. I get up around 5:30 in the morning and I am in bed at 6:30 pm.
The first goal is getting well regulated. I did mention remission but that was only to let you know if that was your goal, she was going to have to be in BGs below 100 most of the time. But, first...regulation.

How do we do it? We just do....we sleep/test. If you look at Gracie’s SS, you’ll see we tested a lot at night but had to because Gracie liked to drop. I worked all but the last four months of her life and my husband worked the entire time. Were we exhausted....yes and I’m no spring chicken...I’m older than you are. We figured out how to feed her so that, most of the time when she was running in normal numbers at night, we could sleep a couple hours at a time.

But that was certainly not every night so when her BG was higher at night...we slept. If the BG is not headed down towards the mid-blue range, you can often feed a medium carb snack and sleep or leave some in an auto feeder. Most of us use auto feeders as much as possible and, believe me, most cats that are good eaters quickly learn when they come on and wait for them to open.

Everyone is afraid of normal numbers. When we were new, we both said we would never shoot below 150 and it was only a few weeks before we were shooting BGs below 100 with the help of members here. We gradually teach how to shoot lower and lower but with Vetsulin, you would not shoot as low as we do with the long-lasting depot insulins (Lantus/Levemir). Typically with Vetsulin, you wouldn’t shoot below 90 but we have ways to coach you to shoot as the BG rises above it. Also, the 90s are a good goal for nadirs with Vetsulin whereas with some of the other long-lasting insulins, we are looking at 60s-80s as good nadirs. As we teach you to shoot lower and lower gradually, any member that advises you to shoot below 200 and then later 150 will also stay with you until the BG has flattened out, helping you learn which foods to feed. It’s a promise we make here.

You can see why it becomes difficult for vets to really help with insulin. When I asked my vet why so many other vets think it’s ok for cats to be in the range of 200-300, she said it’s because they can’t spend the time on a daily basis helping with a diabetic cat. They actually have very little free time to do it and that’s why sites like ours are so important. There’s usually always someone around to help 24/7 as we have members like Mogs, @Gill & George, @Bandit's Mom, @Bron and Sheba (GA), to name a few, who live in the UK, Spain, India, and Australia, respectively, to help while the rest of us in the US are sleeping.

You’re welcome on the SS...just PM me anytime you need assistance with it.
 
I’m sorry....it was too early for me to be posting without :coffee::p I’ve corrected my sentence with a strikeout. What I meant to say is that feeding later in the cycle, after nadir, can slow down the duration of the insulin and, in some cases, stop it cold.

If you look back in post #102 above, I discuss how you to determine how much to feed and also linked information with regard to Vetsulin and feeding schedules so please take the time to read that.

I always kept a record in a separate column on Gracie’s SS (linked in my signature) on how much food I fed, the % calories from carbs, and the time (in hours from shot). It’s helpful for you and the people that help you.


The ReliOn is perfect and what many members use. I also had a ReliOn I used but that model is no longer made. It doesn’t need a setting for pets. It’s a human meter. Again, the dosing methods we have here for all the primary insulins used inc Vetsulin/Caninsulin, Humulin/Novolin, PZ, Lantus, Levemir, etc were all developed using human meters so we know what numbers on those meters are safe. If/when you start using it all the time (and we suggest you pick a meter and stick with it), I can change the formatting on Susie’s SS with the ranges for human meters that we use.


Remember that with Vetsulin, you need to feed at least 30 mins before shooting. I’m assuming that’s what you mean...you will test and feed at 6 and then shoot 30 mins after she eats.



The first goal is getting well regulated. I did mention remission but that was only to let you know if that was your goal, she was going to have to be in BGs below 100 most of the time. But, first...regulation.

How do we do it? We just do....we sleep/test. If you look at Gracie’s SS, you’ll see we tested a lot at night but had to because Gracie liked to drop. I worked all but the last four months of her life and my husband worked the entire time. Were we exhausted....yes and I’m no spring chicken...I’m older than you are. We figured out how to feed her so that, most of the time when she was running in normal numbers at night, we could sleep a couple hours at a time.

But that was certainly not every night so when her BG was higher at night...we slept. If the BG is not headed down towards the mid-blue range, you can often feed a medium carb snack and sleep or leave some in an auto feeder. Most of us use auto feeders as much as possible and, believe me, most cats that are good eaters quickly learn when they come on and wait for them to open.

Everyone is afraid of normal numbers. When we were new, we both said we would never shoot below 150 and it was only a few weeks before we were shooting BGs below 100 with the help of members here. We gradually teach how to shoot lower and lower but with Vetsulin, you would not shoot as low as we do with the long-lasting depot insulins (Lantus/Levemir). Typically with Vetsulin, you wouldn’t shoot below 90 but we have ways to coach you to shoot as the BG rises above it. Also, the 90s are a good goal for nadirs with Vetsulin whereas with some of the other long-lasting insulins, we are looking at 60s-80s as good nadirs. As we teach you to shoot lower and lower gradually, any member that advises you to shoot below 200 and then later 150 will also stay with you until the BG has flattened out, helping you learn which foods to feed. It’s a promise we make here.

You can see why it becomes difficult for vets to really help with insulin. When I asked my vet why so many other vets think it’s ok for cats to be in the range of 200-300, she said it’s because they can’t spend the time on a daily basis helping with a diabetic cat. They actually have very little free time to do it and that’s why sites like ours are so important. There’s usually always someone around to help 24/7 as we have members like Mogs, @Gill & George, @Bandit's Mom, @Bron and Sheba (GA), to name a few, who live in the UK, Spain, India, and Australia, respectively, to help while the rest of us in the US are sleeping.

You’re welcome on the SS...just PM me anytime you need assistance with it.

This does not appear to be the case with Susie:
  • There are particular considerations when using faster-acting insulins such as Caninsulin (Vetsulin) especially for newcomers or for those with little or no BG test data about how their cat responds. This is because Caninsulin/Vetsulin can sometimes drop the BG fast in the first few hours of the cycle.
Seems her early numbers, after her first shot of the day, are always the highest.

This is why I am so confused. After her first shot of the morning she gets huge numbers!
 
This does not appear to be the case with Susie:
  • There are particular considerations when using faster-acting insulins such as Caninsulin (Vetsulin) especially for newcomers or for those with little or no BG test data about how their cat responds. This is because Caninsulin/Vetsulin can sometimes drop the BG fast in the first few hours of the cycle.
Seems her early numbers, after her first shot of the day, are always the highest.

This is why I am so confused. After her first shot of the morning she gets huge numbers!

Thanks, Marje. I am doing my "curve" today. You can see my numbers tomorrow when I finish the testing (for tonight) which I expect to do at about 5:45 pm tonight when I do the +1 BG test after her pm shot. I don't think I will be doing any BG testing after this one. I like to sleep. Please look at my curve today (1/11) and tell me what you think. I am thinking an increase to 1.5 units might help but the last time I attempted this Susie stopped eating. Looking forward to your advice and not additional links. I will give Susie some food around noon to tie her over until around 5:00 to feed her dinnertime meal. As you said, the Vetsulin does not last 12 hours so I don't think I should try to give it at 12 hour intervals during the day. She will suffer at night though.
 
This does not appear to be the case with Susie:
  • There are particular considerations when using faster-acting insulins such as Caninsulin (Vetsulin) especially for newcomers or for those with little or no BG test data about how their cat responds. This is because Caninsulin/Vetsulin can sometimes drop the BG fast in the first few hours of the cycle.
Seems her early numbers, after her first shot of the day, are always the highest.

This is why I am so confused. After her first shot of the morning she gets huge numbers!
It’s because she’s going lower at night and bouncing back up. Also, without preshots and at least a before bed test, it’s difficult to know 100%. But...great job getting the +#2 last night! You can see she was already in blue numbers and likely went lower....perhaps by a lot.
 
Thanks, Marje. I am doing my "curve" today. You can see my numbers tomorrow when I finish the testing (for tonight) which I expect to do at about 5:45 pm tonight when I do the +1 BG test after her pm shot. I don't think I will be doing any BG testing after this one. I like to sleep. Please look at my curve today (1/11) and tell me what you think. I am thinking an increase to 1.5 units might help but the last time I attempted this Susie stopped eating. Looking forward to your advice and not additional links. I will give Susie some food around noon to tie her over until around 5:00 to feed her dinnertime meal. As you said, the Vetsulin does not last 12 hours so I don't think I should try to give it at 12 hour intervals during the day. She will suffer at night though.
A basic principle here is that we don’t increase the dose if you don’t know how low it’s taking her. Also, with the method we use for dosing Vetsulin, with the nadirs she is getting, we would not raise the dose for another week.

I didn’t say Susie was not getting duration. I said feeding after nadir can shorten duration. If she is headed for a 12-hour duration and you shoot early, you could be fighting really low numbers.

I don’t agree with the approach you are taking based on my experience but you hold the syringe. All of us are willing to help but we can only do so much.
 
A basic principle here is that we don’t increase the dose if you don’t know how low it’s taking her. Also, with the method we use for dosing Vetsulin, with the nadirs she is getting, we would not raise the dose for another week.

I didn’t say Susie was not getting duration. I said feeding after nadir can shorten duration. If she is headed for a 12-hour duration and you shoot early, you could be fighting really low numbers.

I don’t agree with the approach you are taking based on my experience but you hold the syringe. All of us are willing to help but we can only do so much.
So help me understand why, one hour after her nighttime shot, she scored 426. What the hell is going on? It does not seem like the insulin is helping her at all. I am totally lost here.
 
So help me understand why, one hour after her nighttime shot, she scored 426. What the hell is going on? It does not seem like the insulin is helping her at all. I am totally lost here.
She’s bouncing. If you had the preshots, you would likely see they were high. When the BG drops down lower than the pancreas and liver are used to, they secrete counterregulatory hormones that dump sugar into the blood. The BG goes up and sometimes a lot. Then the bounce clears, the hormones clear out, the BG drops. It’s a cycle.

However, I see nowhere on her SS that she went up to 426 at night because I only see one test at night on her SS and that’s the +2 from last night....and it’s blue.
 
... It does not seem like the insulin is helping her at all. ...

First of all, well done on today's curve! It was only a few weeks ago you were in the depths of despair about testing. You've clearly got the process down now.

If you look at today's numbers, 393 to 180 to 166 to 209 to 318, you can clearly see that the insulin is working. It's having a progressively stronger effect for several hours, and then it starts wearing off.

Look at your numbers for January 6. AMPS was 369, after which you fed her and gave her insulin. Three and 1/2 hours later she was at 161 (down 200 points), and 2 hours after that she was at 92!

Tonight's +1 of 426 was after you'd fed her and given her insulin, right? So the +1 was no doubt raised by the food but the insulin may not have started to work yet. (See today's readings and the 1/6 readings showing that the numbers really started to drop at +3 and +4.)

It would be really interesting to see what Susie's +2 and +3 would be. And that's what all the testing is about -- to see how Susie's body reacts to the insulin. I don't think anyone's suggesting that you have to do this level of testing every day, forever and ever, amen, but in these early days it's important to learn how Susie responds so you can predict what might happen down the road (like if she got a lower than usual reading one day -- you'd be able to say "yes, I know that the insulin is at its strongest in Susie at +__ , so that's when I need to keep an especially close eye on her in order to keep her safe).

Enid
 
Marge, I fed Susie shortly after she had the 426 score. She was really hungry. About 1 1/2 hours later her BG was down to 110. I will never understand this but this was my "curve" of the week and I will send it to my Vet. I'm not going to put my cat through this many test again, during the day, at least for a few days. I will try to get an AMPS tomorrow morning before all the chaos in my home with my dogs.
 
She’s bouncing. If you had the preshots, you would likely see they were high. When the BG drops down lower than the pancreas and liver are used to, they secrete counterregulatory hormones that dump sugar into the blood. The BG goes up and sometimes a lot. Then the bounce clears, the hormones clear out, the BG drops. It’s a cycle.

However, I see nowhere on her SS that she went up to 426 at night because I only see one test at night on her SS and that’s the +2 from last night....and it’s blue.
I have the 426 on SS for tonight. Please look again.
 
Susie

It looks like you are not recording the data correctly on the SS. If 318 was taken at +10 but you fed and shot 30 mins later, it needs to be recorded in the PMPS column as “318 @ +10” so we know you shot early. Otherwise, it looks like you didn’t test before your shot. Thanks!
 
I have the 426 on SS for tonight. Please look again.
Thank you. It wasn’t there before I mentioned it. I appreciate you entering it.


Marge, I fed Susie shortly after she had the 426 score. She was really hungry. About 1 1/2 hours later her BG was down to 110. I will never understand this but this was my "curve" of the week and I will send it to my Vet. I'm not going to put my cat through this many test again, during the day, at least for a few days. I will try to get an AMPS tomorrow morning before all the chaos in my home with my dogs.
This is what I mean by diving into lower numbers. I’m glad you retested later to be sure she is safe. So this piece of data gives you a clue to when she onsets....+2 and how far she can drop.
 
Marge, I fed Susie shortly after she had the 426 score. She was really hungry. About 1 1/2 hours later her BG was down to 110. I will never understand this but this was my "curve" of the week and I will send it to my Vet. I'm not going to put my cat through this many test again, during the day, at least for a few days. I will try to get an AMPS tomorrow morning before all the chaos in my home with my dogs.
I just got 104 tonight at 8:15 pm. This is where I get worried. When it drops dramatically. Can I go to sleep
First of all, well done on today's curve! It was only a few weeks ago you were in the depths of despair about testing. You've clearly got the process down now.

If you look at today's numbers, 393 to 180 to 166 to 209 to 318, you can clearly see that the insulin is working. It's having a progressively stronger effect for several hours, and then it starts wearing off.

Look at your numbers for January 6. AMPS was 369, after which you fed her and gave her insulin. Three and 1/2 hours later she was at 161 (down 200 points), and 2 hours after that she was at 92!

Tonight's +1 of 426 was after you'd fed her and given her insulin, right? So the +1 was no doubt raised by the food but the insulin may not have started to work yet. (See today's readings and the 1/6 readings showing that the numbers really started to drop at +3 and +4.)

It would be really interesting to see what Susie's +2 and +3 would be. And that's what all the testing is about -- to see how Susie's body reacts to the insulin. I don't think anyone's suggesting that you have to do this level of testing every day, forever and ever, amen, but in these early days it's important to learn how Susie responds so you can predict what might happen down the road (like if she got a lower than usual reading one day -- you'd be able to say "yes, I know that the insulin is at its strongest in Susie at +__ , so that's when I need to keep an especially close eye on her in order to keep her safe).

Enid

Thank you, Enid. I am so much more comfortable with the testing now but I have to give credit to Susie. She has learned to accept it. I couldn't do it without the vaseline and I also bought something that has really helped me. It is a headlamp that I wear around my forhead so I have light directed to where I need to see her ears. My eyes are not very good and I always struggled with seeing if there was blood. Now, my headlamp shines down on her ears so I can really see if there is enough blood for the test. I am never up this late at night (8:30) but I did my last test of the night on her about 20 minutes ago. Her BG was down to 110. This is when I will start to worry. That the BG will continue to go down and I won't be awake to see if there is an emergency. I don't know how to deal with this but I do know that I need to sleep at night. I'm up at 5:30 and like to be in bed (on a normal night) at 6:30. Tonight was the exception. I wanted the curb. Anyway, thank you for your support. I really never thought I would ever become comfortable with the testing but I am now and I think Susie is doing so much better, too.
 
So help me understand why, one hour after her nighttime shot, she scored 426. What the hell is going on? It does not seem like the insulin is helping her at all. I am totally lost here.

Hi Summer,

I go through the same thing with my cat, Sergei, all the time and I know how frustrating it can be. We start the cycle somewhere up in the mid-500s, he gets insulin, then we drop for a while. If we are lucky, once or twice a week we hit the blues; most of the time we visit the yellows for a few hours and then it's a quick journey through the reds and then back up into the black stratosphere. For a while we were in the "healing greens," and then the nail biting greens, but those were the good old days, and they did not last long. But since I know they are possible on that dose of Caninsulin (Vetsulin), I could not adjust our dose up. At some point, symptoms of hyperglycaemia returned so it became clear we had reached an impasse with Caninsulin. Our routine is 100% fixed other than activity, so you'd think the numbers would be similar from day to day, right? Wrong. Welcome to feline diabetes.

Blood glucose level is just one piece of the puzzle. Last week, after months of frustration with very unsatisfying numbers, we finally got Sergei in to see an internal medicine specialist who specialises in endocrinology and very specifically feline diabetes. Importantly, the specialist stressed not letting our preoccupation with getting the perfect BG numbers obscure our view of Sergei's overall condition. He asked us to look at a video on Youtube about the RVC Clinical Score and to track important indicators like how much the cat is drinking and peeing, how hungry he is, what his attitude and activity is like, and what his weight is doing. These are really important things and can tell a story that the blood glucose numbers are not telling. We learned at some point that our meter reads pretty high in higher numbers compared to other meters. For example, our vet's meter gives us much happier numbers. If I had one of those we'd spend a lot more time in blues. The specialist said the same thing and told us that the numbers tend to vary between meters, cycles, and days. I think they call the last inter-day variability. I don't really think about Sergei's numbers in terms of bouncing. The correlation between lows and highs with Sergei is unproven. What I do know is that when my cat's insulin wears off he just has high glucose numbers and as I understand it, that is diabetes.

Good luck to you and Susie.


Cheers,

Scott

 
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Hi Summer,

I go through the same thing with my cat, Sergei, all the time and I know how frustrating it can be. We start the cycle somewhere up in the mid-500s, he gets insulin, then we drop for a while. If we are lucky, once or twice a week we hit the blues; most of the time we visit the yellows for a few hours and then it's a quick journey through the reds and then back up into the black stratosphere. For a while we were in the "healing greens," and then the nail biting greens, but those were the good old days, and they did not last long. But since I know they are possible on that dose of Caninsulin (Vetsulin), I could not adjust our dose up. At some point, symptoms of hyperglycaemia returned so it became clear we had reached an impasse with Caninsulin. Our routine is 100% fixed other than activity, so you'd think the numbers would be similar from day to day, right? Wrong. Welcome to feline diabetes.

Blood glucose level is just one piece of the puzzle. Last week, after months of frustration with very unsatisfying numbers, we finally got Sergei in to see an internal medicine specialist who specialises in endocrinology and very specifically feline diabetes. Importantly, the specialist stressed not letting our preoccupation with getting the perfect BG numbers obscure our view of Sergei's overall condition. He asked us to look at a video on Youtube about the RVC Clinical Score and to track important indicators like how much the cat is drinking and peeing, how hungry he is, what his attitude and activity is like, and what his weight is doing. These are really important things and can tell a story that the blood glucose numbers are not telling. We learned at some point that our meter reads pretty high in higher numbers compared to other meters. For example, our vet's meter gives us much happier numbers. If I had one of those we'd spend a lot more time in blues. The specialist said the same thing and told us that the numbers tend to vary between meters, cycles, and days. I think they call the last inter-day variability. I don't really think about Sergei's numbers in terms of bouncing. The correlation between lows and highs with Sergei is unproven. What I do know is that when my cat's insulin wears off he just has high glucose numbers and as I understand it, that is diabetes.

Good luck to you and Susie.


Cheers,

Scott

I don’t really agree with all that’s said here but I would like to ask you if you are giving advice of any kind....even supportive.....we’d like to have you post your cat’s spreadsheet in your signature block. It’s helpful to other members. Thank you!
 
I don’t really agree with all that’s said here but I would like to ask you if you are giving advice of any kind....even supportive.....we’d like to have you post your cat’s spreadsheet in your signature block. It’s helpful to other members. Thank you!

Hi. I'm not sure which part of my post describing my personal experience was controversial. Is posting a spreadsheet a condition for sharing one's experience and offering a little moral support? I don't believe I gave any advice in my post. I merely reported my experience, acknowledged the frustration of what I saw as a similar experience, and reported the existence of a scale that some leading academic researchers in feline diabetes often use to evaluate a patient. The RVC's Feline Diabetes Remission Clinic at University of London has done a lot of good for diabetic cats. I've seen it quoted many times here. And I don't believe I was presenting their meaning out of context. I did not advise Summer not to test her cat and I did not really offer her any advice. I was trying to let her know she was not alone.
 
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Hi Summer,

I go through the same thing with my cat, Sergei, all the time and I know how frustrating it can be. We start the cycle somewhere up in the mid-500s, he gets insulin, then we drop for a while. If we are lucky, once or twice a week we hit the blues; most of the time we visit the yellows for a few hours and then it's a quick journey through the reds and then back up into the black stratosphere. For a while we were in the "healing greens," and then the nail biting greens, but those were the good old days, and they did not last long. But since I know they are possible on that dose of Caninsulin (Vetsulin), I could not adjust our dose up. At some point, symptoms of hyperglycaemia returned so it became clear we had reached an impasse with Caninsulin. Our routine is 100% fixed other than activity, so you'd think the numbers would be similar from day to day, right? Wrong. Welcome to feline diabetes.

Blood glucose level is just one piece of the puzzle. Last week, after months of frustration with very unsatisfying numbers, we finally got Sergei in to see an internal medicine specialist who specialises in endocrinology and very specifically feline diabetes. Importantly, the specialist stressed not letting our preoccupation with getting the perfect BG numbers obscure our view of Sergei's overall condition. He asked us to look at a video on Youtube about the RVC Clinical Score and to track important indicators like how much the cat is drinking and peeing, how hungry he is, what his attitude and activity is like, and what his weight is doing. These are really important things and can tell a story that the blood glucose numbers are not telling. We learned at some point that our meter reads pretty high in higher numbers compared to other meters. For example, our vet's meter gives us much happier numbers. If I had one of those we'd spend a lot more time in blues. The specialist said the same thing and told us that the numbers tend to vary between meters, cycles, and days. I think they call the last inter-day variability. I don't really think about Sergei's numbers in terms of bouncing. The correlation between lows and highs with Sergei is unproven. What I do know is that when my cat's insulin wears off he just has high glucose numbers and as I understand it, that is diabetes.

Good luck to you and Susie.


Cheers,

Scott

Thank you so much, Scott. Yes, this is all very frustrating. A good video and looking at the four clinical areas is very important. Susie seems to be a 0 with her urine/water, a 3 with her appetite, I don't know about her weight (need a scale) and her activity level varies. When she is really hungry she is more active. What insulin and meter do you use? I have been told I should switch to Lantus and the ReliOn meter. I want to wait until I need insulin again and then hopefully my Vet will approve the change. I am currently using the AlphaTrac 2 which is also not recommended on this site. Too bad I just ordered more supplies for it. I wish I could afford a specialist Vet. I don't even know if we have one. I appreciate all the information. It helps me to realize that I am not alone in this very challenging disease.
 
Hi. I'm not sure which part of my post describing my personal experience was controversial. Is posting a spreadsheet a condition for sharing one's experience and offering a little moral support? I don't believe I gave any advice in my post. I merely reported my experience, acknowledged the frustration of what I saw as a similar experience, and reported the existence of a scale that some leading academic researchers in feline diabetes often use to evaluate a patient. The RVC's Feline Diabetes Remission Clinic at University of London has done a lot of good for diabetic cats. I've seen it quoted many times here. And I don't believe I was presenting their meaning out of context. I did not advise Summer not to test her cat and I did not really offer her any advice. I was trying to let her know she was not alone.
You are correct and I apologize. You didn’t give advice. But, I didn’t actually say you did; I said “...if you are giving advice...even supportive.” The statement I disagree with is that you said the correlation between Sergei’s highs and lows is unknown but I am certain we could address that here. However, without a SS, we can’t and so what happens is it leaves Summer likely wondering if the same thing is going on with Susie....unknown correlation between highs and lows and it isn’t. When you see those kinds of patterns, it’s either bouncing or loss of duration.

You aren’t required to post a SS but we strongly urge you to do so. It’s helpful for everyone when you are trying to get a point across about your cat. SSs are learning experiences for everyone but especially new members. Summer would benefit from seeing Sergei’s SS so she could understand that everyone faces the same issues when starting out with FD. I can’t remember the last time I saw a SS that I thought was “different” or unique or something was going on that we couldn’t figure out.

You are also correct that the RVC Feline Diabetes Remission Clinic is well respected. I wish we had a parallel clinic in the US. And I very much appreciate you offering support to Summer.
 
hi Summer,
I was just like you with the testing. Haven't needed to do it for a while but with the rice sock, I would hold it against the underside of Angel's ear whilst gently massaging the top of his ear until it was nice and warm, and always give him treats afterwards. Freeze dried treats are low carb. I'm wondering why your vet has put Susie on Vetinsulin as that is more formulated towards dogs. To be honest Angel was heading for remission when he was on it, but did better on Prozinc. I use Alpatrak meter but with freestyle lite strips which are basically the same product. x
 
Thank you so much, Scott. Yes, this is all very frustrating. A good video and looking at the four clinical areas is very important. Susie seems to be a 0 with her urine/water, a 3 with her appetite, I don't know about her weight (need a scale) and her activity level varies. When she is really hungry she is more active. What insulin and meter do you use? I have been told I should switch to Lantus and the ReliOn meter. I want to wait until I need insulin again and then hopefully my Vet will approve the change. I am currently using the AlphaTrac 2 which is also not recommended on this site. Too bad I just ordered more supplies for it. I wish I could afford a specialist Vet. I don't even know if we have one. I appreciate all the information. It helps me to realize that I am not alone in this very challenging disease.
Hi Summer, I’m glad that you got some value from the video. I shared it because, as you said, not everyone has access to a specialist, and I am happy to share what I can of that experience with others so that they can maybe consider clinical approaches to the disease. I thought the video might be a helpful complement to other information you’ve received, especially after I read that your vet kept telling you to test less. My vet said the same thing to me! The video, in my opinion, contains a clue about what’s going on there. I think a lot of vets are trained to listen for certain details from their patients like, “my cat is asking me for water from the faucet ten times a day” or “I just hauled a huge bag full of litter clumps from the box; this is not right” or “my cat has lost 1 kilo this month and he eats like a horse but acts like he’s starving.” If instead they hear “my cat’s blood glucose level was 350 at +4, something must be wrong!” they may not be hearing what we really mean to say, which is, “My cat is ill, and I am worried about it.” That’s precisely what happened between me and my vet. I kept sending her glucose readings that were high and she kept saying test less. I thought she would intuit from the BG numbers that Sergei was not feeling well. She didn’t. And he kept getting sicker. Perhaps the RVC score was developed to help clients learn how to get their vets to hear them: talk about thirst and urine quantity and attitude.

You asked what insulin we are using. We started with Caninsulin (Vetsulin). They started Serg at a dose of 2.5U, which turned out to be the max he could safely take. Our lowest test came back around 60 (3.3), so we knew Caninsulin could get him down to greens. And it even seemed to have good duration. Our first curve was surprisingly lovely. He went to 108 (6) at +7. The problem was that for whatever reason, shortly thereafter the insulin just stopped having good effect and symptoms came back. We speculated about failures within the VetPen itself, failure of the particular vials of insulin, failures of administration. Everything got looked at. Specialist just noted variability and duration as possible problems. He switched us to ProZinc and said if that is not optimal then we can go to Lantus. As for our meter, we use Contour. We are in Europe, so the brands may be different than where you are. Our vet uses FreeStyle Lite and as I mentioned, there is some divergence between the two meters. Above 180 the divergence is pretty significant. Alphatrack 2 is supposed to be the meter calibrated for cats, right? To me that seems like a pretty reasonable benefit. I’ve heard the strips are more expensive, but I would be glad sometimes not to worry about how far off I am from cat calibration. You’ll get a lot of advice from people here. And they genuinely mean well. But it can be overwhelming to feel like everything you are doing is wrong. I’ve had to let that go a bit and just give myself space to do things my own way.

For the record, I’m not opposed to letting others see my data, so if you want to have a look, I’d be glad to make it available to you. My partner has asked me not to post it here publicly and since I don’t really accept dosing advice from anyone other than my vet, its value here is pretty limited. I keep my discussions here to things like helpful extra tools, moral support, and cat snack chat. It can feel like a lonely, overwhelming disease sometimes. It’s good to find a place where others understand what you are going through.
 
You are correct and I apologize. You didn’t give advice. But, I didn’t actually say you did; I said “...if you are giving advice...even supportive.” The statement I disagree with is that you said the correlation between Sergei’s highs and lows is unknown but I am certain we could address that here. However, without a SS, we can’t and so what happens is it leaves Summer likely wondering if the same thing is going on with Susie....unknown correlation between highs and lows and it isn’t. When you see those kinds of patterns, it’s either bouncing or loss of duration.

You aren’t required to post a SS but we strongly urge you to do so. It’s helpful for everyone when you are trying to get a point across about your cat. SSs are learning experiences for everyone but especially new members. Summer would benefit from seeing Sergei’s SS so she could understand that everyone faces the same issues when starting out with FD. I can’t remember the last time I saw a SS that I thought was “different” or unique or something was going on that we couldn’t figure out.

You are also correct that the RVC Feline Diabetes Remission Clinic is well respected. I wish we had a parallel clinic in the US. And I very much appreciate you offering support to Summer.
Hi, thanks for the clarification. I appreciate the distinction you noted in the use of "if" and completely agree with you. As for the question about correlation between lows and highs I would point out that the word I used was "unproven" not "unknown". I chose that word very deliberately because I'm personally not convinced, and some literature supports my skepticism. Correlation and causation are tricky. Somogyi is still referred to in some literature as a theory. I'm not definitively saying it's not real, I'm just saying that in my cat it is not proven.

With all due respect and many apologies, I'm not ready to repost my SS here yet. My partner has asked me not to do so, which is reasonable, given Sergei's current situation. Numbers lead to advice and advice makes it very easy to second guess my vets instructions and to get off plan. Eventually I may be happy to do so again.
 
Hi, thanks for the clarification. I appreciate the distinction you noted in the use of "if" and completely agree with you. As for the question about correlation between lows and highs I would point out that the word I used was "unproven" not "unknown". I chose that word very deliberately because I'm personally not convinced, and some literature supports my skepticism. Correlation and causation are tricky. Somogyi is still referred to in some literature as a theory. I'm not definitively saying it's not real, I'm just saying that in my cat it is not proven.

With all due respect and many apologies, I'm not ready to repost my SS here yet. My partner has asked me not to do so, which is reasonable, given Sergei's current situation. Numbers lead to advice and advice makes it very easy to second guess my vets instructions and to get off plan. Eventually I may be happy to do so again.
Thank you.

If you have any chance to look around this site, you’ll see that we do not support the existence of Somogyi in cats. One of our most experienced members and a moderator, Sienne, has access to a university medical library and is in the medical field herself. She has done extensive research on this subject. Roomp and Rand have also dismissed the existence of Somogyi in cats. It hasn’t actually been proven to occur in humans but the difference between Somogyi, in its theory, and bouncing is that Somogyi results from a chronic overdose.
 
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hi Summer,
I was just like you with the testing. Haven't needed to do it for a while but with the rice sock, I would hold it against the underside of Angel's ear whilst gently massaging the top of his ear until it was nice and warm, and always give him treats afterwards. Freeze dried treats are low carb. I'm wondering why your vet has put Susie on Vetinsulin as that is more formulated towards dogs. To be honest Angel was heading for remission when he was on it, but did better on Prozinc. I use Alpatrak meter but with freestyle lite strips which are basically the same product. x
Thank you, Cassandra. I tried the sock with rice but just felt I didn't need it. I'm doing so much better with the testing now and so is my Susie. I still hate poking her ears though. I spoke to my vet earlier today about getting Susie off the Vetsulin and on Lantus. He is definetly open to doing that but we are going to wait just a little while. I'm trying to get her dinner and pm shot out to the 12-hour requirement to see if it makes a difference in the morning BG tests. He agrees that Vetsulin might not be the best for controlling her diabetes but says Lantus is very expensive. We will see what happens with her numbers in the next week and make the change if we don't see any improvement. Susie is "on and off" with the freeze dried treats. Most of the time she doesn't like them - unless she is really hungry. I have purchased the PureBites. Do you have another suggestion? I'm glad you haven't had to test in a while. Does that mean that Angel is in remission? That would be wonderful. Thank you for your support. This diabetes thing is so confusing. I hope I have some time to get it right.
 
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