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Beachlover

Member Since 2022
So my 10 year old feline fella was drinking triple from usual, and walking funny. To the vet we go. Blood tests only showed diabetes. So 2 units of regular insulin two times a day after eating (7am,7pm) canned cat food. Dry food is out. Drinking and walking back to normal

So here's all the current glucose dates and numbers:

Mar 25 11am 180 mg/dL (vet visit)
Apr 4 2pm 83 (vet visit)
Apr 12 2pm 80
Apr 20 2pm 76

So can anyone suggest a testing plan of action going forward? Such as when there are signs the insulin dose should be lowered? And/or testing days/times to better understand if he has gone into remission where insulin isn't needed anymore, just monitoring. It isn't easy to do this testing, so I'd really rather not be doing it multiple times a day.
 
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Welcome
We need some information about your kitty in order to answer some of your questions
Here is a link helping us to help you link. If you noticed, our members have some basic information about their cat's in their signature. This helps us to not pester you by asking the same questions (your cat's name, insulin type, date of diagnosis, etc.) repeatedly. We also have a link to our spreadsheet in our signature. We are very numbers driven. The spreadsheet is a record of your cat's progress. By linking it in your signature, we can follow along and provide feedback should you need the help.
  • Add info we need to help you:
    • Caregiver & kitty's name
    • DX: Date
    • Name of Insulin (do not include dose or frequency)
    • Name of your meter
    • Diet: "LC wet" or "dry food" or "combo"
    • Dosing: TR or SLGS or Custom (if applicable)
    • DKA or other recent health issue (if applicable)
    • Acro, IAA, or Cushings (if applicable)
    • Spreadsheet link. Please put the signature link on the bottom line of your signature information, on its own, so it is easy to find.
    • Please do not put any information about your location in the signature for security reasons. If you wish to add your country location, please add it to your profile.
Be sure to click the 'Save Changes' button at the bottom. If you need help urgently it is important we know these things at a glance. We don’t want to waste valuable time finding out information.


Here is a link on how to create our spreadsheet and how it works
https://felinediabetes.com/FDMB/threads/how-to-create-a-spreadsheet.241706/
 
Hi and welcome to the forum.
We will need more information about your kitty before we can help you.
What insulin are you using?
Are you still using 2 units of this insulin?
What type of meter are you using? Human or pet meter?
Are you feeding during the cycles?
Do you have a hypo kit set up? This is very important that you do.
It would help a lot if you could set up the spreadsheet that Diane mentioned above. We need to see a lot more number than just the ones you have posted. If you need help setting it up let us know and someone will help you.
However, the numbers you have posted do indicate that the insulin is working. But without knowing the type of insulin you are using we can’t know when to reduce the dose ….we need to see more blood glucose numbers, not just 4 random numbers taken over a month.

I would recommend you test before every dose is given to make sure it is safe to give the dose. And then test again about 5 to 7 hours later to see how low the dose is taking him. Depending on what type of insulin you are using, the times of that might change.

We can certainly help you with your kitty moving forward and look forward to doing so.
 
Bron and Sheba (GA) said:
Hi and welcome to the forum.
We will need more information about your kitty before we can help you.
What insulin are you using?
Are you still using 2 units of this insulin?
What type of meter are you using? Human or pet meter?
Are you feeding during the cycles?
Do you have a hypo kit set up? This is very important that you do.
It would help a lot if you could set up the spreadsheet that Diane mentioned above. We need to see a lot more number than just the ones you have posted. If you need help setting it up let us know and someone will help you.
However, the numbers you have posted do indicate that the insulin is working. But without knowing the type of insulin you are using we can’t know when to reduce the dose ….we need to see more blood glucose numbers, not just 4 random numbers taken over a month.

I would recommend you test before every dose is given to make sure it is safe to give the dose. And then test again about 5 to 7 hours later to see how low the dose is taking him. Depending on what type of insulin you are using, the times of that might change.

We can certainly help you with your kitty moving forward and look forward to doing so.
Click to expand...

Thank you. The spreadsheet might be tricky since I use a cell phone, not a computer or laptop. But I will try.

Anyways:

What insulin are you using? Porcine Insulin Zinc

Are you still using 2 units of this insulin? Yes, 2 units two times a day

What type of meter are you using? Human or pet meter?
Alpha Trak 2 pet
Btw, as we are in Canada it gives reading as mmol/L I thought I was being helpful by converting to mg/dL. Which is easier for the members here?


Are you feeding during the cycles? Not sure I understand the question, but if you mean giving food other than the 12 hour apart meals, just a spoon of wet food for a 1pm snack, unless testing the glucose.

Do you have a hypo kit set up? We do not, but will.

I do understand to test more, but that's why I was first asking opinions on a "testing plan of action". Such as the best times, maybe anticipating whether the dosage should be investigated to become lower, higher, or stopped. Because it's not only difficult, but we don't have unlimited test strips. If we test as you have advised, we'd be out of test strips two weeks ago. And they ain't cheap in Canada, see upload. Scratch that, it isn't allowing me to upload a screenshot. But it's $97 plus shipping plus 13% tax for 50 test strips from amazon.ca
 
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Diane Tyler's Mom said:
Welcome
We need some information about your kitty in order to answer some of your questions
Here is a link helping us to help you link. If you noticed, our members have some basic information about their cat's in their signature. This helps us to not pester you by asking the same questions (your cat's name, insulin type, date of diagnosis, etc.) repeatedly. We also have a link to our spreadsheet in our signature. We are very numbers driven. The spreadsheet is a record of your cat's progress. By linking it in your signature, we can follow along and provide feedback should you need the help.
  • Add info we need to help you:
    • Caregiver & kitty's name
    • DX: Date
    • Name of Insulin (do not include dose or frequency)
    • Name of your meter
    • Diet: "LC wet" or "dry food" or "combo"
    • Dosing: TR or SLGS or Custom (if applicable)
    • DKA or other recent health issue (if applicable)
    • Acro, IAA, or Cushings (if applicable)
    • Spreadsheet link. Please put the signature link on the bottom line of your signature information, on its own, so it is easy to find.
    • Please do not put any information about your location in the signature for security reasons. If you wish to add your country location, please add it to your profile.
Be sure to click the 'Save Changes' button at the bottom. If you need help urgently it is important we know these things at a glance. We don’t want to waste valuable time finding out information.


Here is a link on how to create our spreadsheet and how it works
https://felinediabetes.com/FDMB/threads/how-to-create-a-spreadsheet.241706/
Click to expand...
I know you know what all these abbreviations and terms mean, but being a newbie, I certainly don't.

"
  • Dosing: TR or SLGS or Custom (if applicable)
  • DKA or other recent health issue (if applicable)
  • Acro, IAA, or Cushings (if applicable)"
You don't need to answer, I will lookup, but just wanted you to know.
 
2U is a little high for ProZinc so I'm a little concerned by that - especially with the numbers you posted. We normally start at 0.5U if on a low carb wet diet, 1U if there's higher carb food in there. I would reduce to 1.5U - we never want them below 68 on a pet meter, and that's with the more aggressive dosing method. The other method we don't want them below 90.

Most of us use human meters exactly for that reason - cost. A lot of us just use WalMart's ReliOn brand, they work just fine. Human meters tend to read lower than pet meters, but we account for that when figuring out dosing.

The mg/dL is the standard here, the spreadsheet has an automatic conversion as well. It's not a big deal if you put it in mmol/L, just easier for us at a quick glance to have it mg/dL.

Diabetics do better with multiple smaller meals as it's easier on the pancreas; it also allows you to control the BG curve a bit better. I would not change your feeding schedule just yet, once spreadsheet is up well take a look (I also use my phone, just use the Sheets app).

As for test times - before each shot at minimum. That tells you if it's safe to shoot (we say it's safe to shoot if above 200 BUT I suspect your cat is a bit overdosed, so need to be a little cautious). Then ideally close to nadir, which on ProZinc is usually +4 to +6 (4 to 6 hours after a shot)? Dose is determined by how low it takes a cat, so that is why nadir is important.

As for the DKA, acro, IAA, Cushing's - those are all things you'd know if your cat was already diagnosed with it. Sometimes a diabetes diagnosis eventually uncovers one of the others (or causes DKA).

Don't worry about dosing method just yet - for now if you ever get a number below 90, reduce your dose by 0.25U (and keep it reduced).

I will drop some links later, just wanted to pop in to get you some quick answers.
 
FrostD said:
2U is a little high for ProZinc so I'm a little concerned by that - especially with the numbers you posted. We normally start at 0.5U if on a low carb wet diet, 1U if there's higher carb food in there. I would reduce to 1.5U - we never want them below 68 on a pet meter, and that's with the more aggressive dosing method. The other method we don't want them below 90.

Most of us use human meters exactly for that reason - cost. A lot of us just use WalMart's ReliOn brand, they work just fine. Human meters tend to read lower than pet meters, but we account for that when figuring out dosing.

The mg/dL is the standard here, the spreadsheet has an automatic conversion as well. It's not a big deal if you put it in mmol/L, just easier for us at a quick glance to have it mg/dL.

Diabetics do better with multiple smaller meals as it's easier on the pancreas; it also allows you to control the BG curve a bit better. I would not change your feeding schedule just yet, once spreadsheet is up well take a look (I also use my phone, just use the Sheets app).

As for test times - before each shot at minimum. That tells you if it's safe to shoot (we say it's safe to shoot if above 200 BUT I suspect your cat is a bit overdosed, so need to be a little cautious). Then ideally close to nadir, which on ProZinc is usually +4 to +6 (4 to 6 hours after a shot)? Dose is determined by how low it takes a cat, so that is why nadir is important.

As for the DKA, acro, IAA, Cushing's - those are all things you'd know if your cat was already diagnosed with it. Sometimes a diabetes diagnosis eventually uncovers one of the others (or causes DKA).

Don't worry about dosing method just yet - for now if you ever get a number below 90, reduce your dose by 0.25U (and keep it reduced).

I will drop some links later, just wanted to pop in to get you some quick answers.
Click to expand...
Thank you, very useful insight. Can I also have clarification that Caninsulin Porcine Insulin Zinc is Prozinc for short.
 
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Beachlover said:
And they ain't cheap in Canada
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Welcome. Waving from Ontario.
Yes, strips are more expensive in Canada. A number of Canucks use the FreeStyle Lite. It needs the smallest drop of blood. Last time I checked it was roughly $80/100. You can use any PC Optimum points you have lying around.

There is an even cheaper meter but it has a few downsides.
1. It needs a much larger drop of blood.
2. You can only get strips online which means you have to have a minimum of 300 strips on hand (+ 100 in your hypo kit) at any given time because Canada Post is not all that fast these days.
https://diabetesexpress.ca/products/bravo-meter

There is also a strip subscription service that a few people have used.
https://onedrop.today/en-ca/collections/bundle-3
 
Red & Rover (GA) said:
Welcome. Waving from Ontario.
Yes, strips are more expensive in Canada. A number of Canucks use the FreeStyle Lite. It needs the smallest drop of blood. Last time I checked it was roughly $80/100. You can use any PC Optimum points you have lying around.

There is an even cheaper meter but it has a few downsides.
1. It needs a much larger drop of blood.
2. You can only get strips online which means you have to have a minimum of 300 strips on hand (+ 100 in your hypo kit) at any given time because Canada Post is not all that fast these days.
https://diabetesexpress.ca/products/bravo-meter

There is also a strip subscription service that a few people have used.
https://onedrop.today/en-ca/collections/bundle-3
Click to expand...

Yes, Ontario also. It's unfortunate that all the information I found prior to coming here insisted that one had to get a pet specific meter. This site seems to be ok with human meters as long as you make allowances. Well, that's what I'm good at.

I have PC Optimum points. And love the program. Can you elaborate more on why you mentioned that?
 
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Beachlover said:
Thank you, very useful insight. Can I also have clarification that Caninsulin Porcine Insulin Zinc is Prozinc for short.
Click to expand...
Oh Caninsulin, no they are different.

In that case definitely reduce to 1.5U...id actually consider 1.25U. We never want them below 90 on Caninsulin (you'll also see it called Vetsulin here, that's how it's labeled in the US). It tends to be very harsh and unpredictable in most cats, it's actually no longer recommended for cats here in the US. We can see how he does on it, but many cars often need a different insulin. Unfortunately, it is double important to get the tests in with Caninsulin, it is by far the most risky of the insulins.

You will see mention of changing to a low carb diet - do not do that yet. Need more data. Chances are you'll see a good improvement from it, but it is a very delicate balance while cha going diet and trying not to overdose insulin
 
Again, FrostD thank you.

And anyone else reading this, is welcome to agree or disagree. I'm a firm believer in getting 10 opinions, let them fall where they may.
 
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Now some links:

Ketones and DKA - you can use human urine ketone strips, I'd recommend twice a week until I get a better look at his numbers. If you think getting a urine sample will be difficult, they make blood ketone meters but those are a bit pricey.

Food chart - ideally you eventually want him on 4-7% carbs. Again, do not do this yet, it will be dangerous with his current numbers. For your hypo kit you will want some from 10-15% (medium carb, MC), some in the 16-20% (high carb, HC) and realistically his current kibble probably counts as very high carb and good if you're in an absolute pinch.
 
FrostD said:
Now some links:

Ketones and DKA - you can use human urine ketone strips, I'd recommend twice a week until I get a better look at his numbers. If you think getting a urine sample will be difficult, they make blood ketone meters but those are a bit pricey.

Food chart - ideally you eventually want him on 4-7% carbs. Again, do not do this yet, it will be dangerous with his current numbers. For your hypo kit you will want some from 10-15% (medium carb, MC), some in the 16-20% (high carb, HC) and realistically his current kibble probably counts as very high carb and good if you're in an absolute pinch.
Click to expand...
Thanking you again, for such a wealth of info.

Here's the thing, the vet had us stop giving the high carb kibble on day one (March 25th). It's heartbreaking because our boy begs for food ever since. We do give him three pea sized pieces to get his cooperation for the insulin shot.

The link that I would like to find is where Vetsulin is no longer recommended for cats.
 
FrostD said:
Oh I misunderstood the "dry food is out", I thought you meant free-fed, out for him to eat during the day. Ok. What brand and flavor of food is he eating?

https://www.aaha.org/aaha-guidelines/diabetes-management/diabetes-management-home/

There is a link to the PDF on that page above ^. They recommend ProZinc, Lantus, or Levemir. Again, it's an American organization so I'm not sure if there's a Canadian equivalent.
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Ha ha, yes, I see how that can be taken two ways. And completely different!!!

He's just being fed Friskies canned pates. However, you still seem to be advising to not be going low carb, yet. But as he already has, I'm concerned our vet is behind the times. I'm already investigating switching vets.
 
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Beachlover said:
I have PC Optimum points. And love the program. Can you elaborate more on why you mentioned that?
Click to expand...
You can use your points to buy FreeStyle Lite strips at Shoppers or any President's Choice grocery that has a pharmacy. If you are a senior or have one handy, you can also take advantage of Shopper's Seniors Day for a further discount.
 
Beachlover said:
Ha ha, yes, I see how that can be taken two ways.

He's just being fed Friskies canned pates. However, you still seem to be advising to not be going low carb, yet. But as he already has, I'm concerned our vet is behind the times. I'm already investigating switching vets.
Click to expand...
No if he's already low carb that's fine. I was just concerned he was still high carb, at 2 units, seeing the numbers you posted. A switch would be ill advised, but now you're here, you're here ha the Friskies pates are perfect.

I am still concerned his dose is too high, even the 1.5U I recommended may be too high but the tests around nadir are what I'd need to see. Nadir on Caninsulin is usually on the earlier side - +2 to +4, but can be later in some cats.

Yes, to put it bluntly, your vet is behind the times. But honestly, we see that from probably 90% of the newly diagnosed cats/caregivers here. I wouldn't ditch the vet just yet - the important thing is if they're willing to educate themselves and work with you. My vet has never used Levemir (the most recent insulin I've used, but I started on Vetsulin), he's never treated an acromegaly/IAA cat before, but he's been willing to read up on things and work with me. That's the important thing. I can't expect him to be an expert on every disease possible in every small animal....and from what we've heard they get maybe a day's worth of education on diabetes in general.

Some cats do well on Caninsulin, mine was one of them until his underlying conditions took over. Given the numbers you've listed your cat may be one as well - the ones that tend to do ok on it often have lower numbers to start with.

We have a subforum for Caninsulin, you may want to peruse some of the stickies: https://www.felinediabetes.com/FDMB/forums/caninsulin-vetsulin-and-n-nph.19/
 
FrostD said:
No if he's already low carb that's fine. I was just concerned he was still high carb, at 2 units, seeing the numbers you posted. A switch would be ill advised, but now you're here, you're here ha the Friskies pates are perfect.

I am still concerned his dose is too high, even the 1.5U I recommended may be too high but the tests around nadir are what I'd need to see. Nadir on Caninsulin is usually on the earlier side - +2 to +4, but can be later in some cats.

Yes, to put it bluntly, your vet is behind the times. But honestly, we see that from probably 90% of the newly diagnosed cats/caregivers here. I wouldn't ditch the vet just yet - the important thing is if they're willing to educate themselves and work with you. My vet has never used Levemir (the most recent insulin I've used, but I started on Vetsulin), he's never treated an acromegaly/IAA cat before, but he's been willing to read up on things and work with me. That's the important thing. I can't expect him to be an expert on every disease possible in every small animal....and from what we've heard they get maybe a day's worth of education on diabetes in general.

Some cats do well on Caninsulin, mine was one of them until his underlying conditions took over. Given the numbers you've listed your cat may be one as well - the ones that tend to do ok on it often have lower numbers to start with.

We have a subforum for Caninsulin, you may want to peruse some of the stickies: https://www.felinediabetes.com/FDMB/forums/caninsulin-vetsulin-and-n-nph.19/
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I did that. I'm trying to reconcile the lower dosage idea with the sticky starting dose statement "The manufacturer recommends a starting dose of 0.25u to 0.5u per kg body weight". So I should mention he weighs in at 23lbs (10.4kg).
 
That is too high in my opinion based on the numbers you've listed. We do not want nadir below 90, and you saw that several times.

Take a look at my spreadsheet from the beginning of 2020. My vet put him on 2.5U (actually wanted me to do 3U) and said "change diet if you want". No mention of the danger. Thank goodness I found this site and starting testing right before I switched - you can see he came down to 0.1-0.5U immediately.

If you have some time, peruse some of the other spreadsheets on the Vetsulin forum. You'll see overdosing is a very common theme.

It's been awhile since I've read the Caninsulin I sent, I'll try to tonight. But remember it is intended for use in dogs, and actually I think once a day in dogs because their metabolism is different. Most manufacturers also do not seem to factor diet into the equation.

I'll get you links to several example spreadsheets/threads as soon as I get a chance tonight
 
FrostD said:
That is too high in my opinion based on the numbers you've listed. We do not want nadir below 90, and you saw that several times.

Take a look at my spreadsheet from the beginning of 2020. My vet put him on 2.5U (actually wanted me to do 3U) and said "change diet if you want". No mention of the danger. Thank goodness I found this site and starting testing right before I switched - you can see he came down to 0.1-0.5U immediately.

If you have some time, peruse some of the other spreadsheets on the Vetsulin forum. You'll see overdosing is a very common theme.

It's been awhile since I've read the Caninsulin I sent, I'll try to tonight. But remember it is intended for use in dogs, and actually I think once a day in dogs because their metabolism is different. Most manufacturers also do not seem to factor diet into the equation.

I'll get you links to several example spreadsheets/threads as soon as I get a chance tonight
Click to expand...
But 3 of the 4 weren't nadir numbers, as they were 7 hours after eating and insulin. And the first one might technically be a nadir number, but insulin wasn't ever given. I will try for a nadir number tomorrow.
 
Beachlover said:
But 3 of the 4 weren't nadir numbers, as they were 7 hours after eating and insulin. And the first one might technically be a nadir number, but insulin wasn't ever given. I will try for a nadir number tomorrow.
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Exactly why I'm concerned. It means he was much lower before those numbers.

....please don't tell me he was diagnosed just off that 180....

Did they do a fructosamine? What were his symptoms at diagnosis if any?

I understand it's an odd position to be in. Your vet, who you look to as the expert on things for your pet's health, tells you one thing. Then manufacturer maybe says something slightly different. And professional organizations say something else. And then these random people on the internet chime in with more stuff. It's quite a bit to wrap your head around
 
Overdosed cats:
Manu - this was just last week she came here. Vet upped it to 3U, she happened to do a home curve and just barely avoid a serious hypo event. Right now she's at about 1.5U. But the big swings in his curve and rainbow of colors mean Vetsulin likely isn't going to be a good insulin for him.

Ares - came here at 4U and she was just starting to test. Same story, lucked out and caught some very low numbers, had her reduce to 3U. The big swings indicative that it likely wouldnt be a good insulin, so she went ahead and switched to Lantus (glargine). You can see big difference after she did.

Kloey - started at 3U, same story. She got a 90, 11 hours after the shot so we had her proactively reduce to 2U. As more testing was done more lows were caught and she "settled" between 1-1.75U. Now she was a post-DKA cat, and not enough insulin is a day for in DKA. Because the swings were big with her, she was switched to Lantus as well. Night and day difference for her as well.

Cats that did well (based on the few numbers you tossed out I suspect this may be the case for your cat...if he's even diabetic):
My cat (again, 2020 spreadsheet...in July he developed some underlying conditions that changed everything)

Shadow - full disclosure, there are several missed reductions in this spreadsheet, there was coaching happening along the way. Any time there is a number under 90, it's a 0.25U reduction for safety.

Tessa - note she started pretty low to begin with (200s) and had fairly gentle curves. She didn't quite get the duration from it, but is currently trying an OTJ trial (off the juice, 2 weeks without insulin to see if they hold normal numbers...if so, then we declare remission)

Sergio - I hesitate to put this one here because it's not that he did well on Vetsulin, but moreso the difference the diet change made. Currently in remission

I hope having some examples helps, though it may also have the opposite effect of overwhelming. It just sounds like you're trying to gather as much information as you can and make educated decisions, which is great.
 
FrostD said:
....please don't tell me he was diagnosed just off that 180....

Did they do a fructosamine? What were his symptoms at diagnosis if any?
Click to expand...
The symptoms were mentioned in the first sentence. High thirst, and walking funny.

Yes, the diagnosis was off that first reading and a general exam. But supposedly verified via blood testing work (phone call later). Which also confirmed no other issues. Never informed as to what blood tests were being done. As you said, I just trusted the vets procedures.

Btw, I'm going to test today, just before feeding (update 7.2 mmol/dL = 130 mg/dL) . Then 3 hours later (nadir?) (Update two strips burned, both error codes) then 6 hours later. (update +6 is 3.1 mmol/dL=56 mg/dL)
 
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Beachlover said:
tw, I'm going to test today, just before feeding (update 7.2 mmol/dL = 130 mg/dL) . Then 3 hours later (nadir?) then 6 hours later. Am I understanding things correctly?
Click to expand...
That's a good plan.
I'm going to ask @Bandit's Mom to help you with the spreadsheet and signature as you only have a cell phone. She will contact you.
It will help us so much more if you have the SS and signature set up as we need basic information to help you
 
Bron and Sheba (GA) said:
That's a good plan.
I'm going to ask @Bandit's Mom to help you with the spreadsheet and signature as you only have a cell phone. She will contact you.
It will help us so much more if you have the SS and signature set up as we need basic information to help you
Click to expand...
Thank you for chiming in. It is appreciated, as I want any and all advice/opinions. I'm pretty sure all the information, that I know of, has been offered, other than putting readings in the spreadsheet. As I don't have many, but also don't want to burn up all the test strips unnecessarily.
 
Beachlover said:
Thanks. I'm pretty sure all the information, that I know of, has been offered, other than putting readings in the spreadsheet. As I don't want to burn up all the test strips unnecessarily.
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Yes, I'm sure you have told us everything....... its just much easier for us if the essential things such as date of diagnosis, type of meter, type of insulin, what food is being fed, any other illnesses or medications are in the signature at the bottom of all your posts for us to see. You can see mine in small type under my posts.
When we have a lot of people to help it is much easier and quicker to look at the signature than to keep looking back through long threads for information.:)
 
Beachlover said:
The symptoms were mentioned in the first sentence. High thirst, and walking funny.

Yes, the diagnosis was off that first reading and a general exam. But supposedly verified via blood testing work (phone call later). Which also confirmed no other issues. Never informed as to what blood tests were being done. As you said, I just trusted the vets procedures.

Btw, I'm going to test today, just before feeding (update 7.2 mmol/dL = 130 mg/dL) . Then 3 hours later (nadir?) then 6 hours later. Am I understanding things correctly?
Click to expand...
Had he recently been on steroids, or had an infection?

130 is a low preshot, we actually recommend not shooting if below 200 until you get more data. What dose did you give last night, and what did you give this morning? Assuming you shot please do keep a very close eye. I would actually start with a +2.

What foods do you have on hand, and had you gotten a chance to check their carb %?
 
Beachlover said:
I'm concerned about that too. Can all of you see my birthday in my profile? That's a piece of information used for identity theft, and shouldn't just be out there.
Click to expand...
I can, but there are privacy settings. If you click in your username in the top banner, there is a drop down, and a link for privacy settings.

You only need to share what youre comfortable with, the same things that apply to general online safety. Most people here like to know first name, but I didn't share that for a long time
 
information you put in your signature is not sensitive or at risk at all btw. Only logged in users can see it, and you can put just information about your cat. I don't see that you have shared your sugar cat's name, if you believe that should be private that's fine too.

The ask regarding the signature is just basic info so that experts offering advice here don't have to bug you by asking the same questions again and again.
 
Hendrick Cuddleclaw said:
information you put in your signature is not sensitive or at risk at all btw. Only logged in users can see it, and you can put just information about your cat. I don't see that you have shared your sugar cat's name, if you believe that should be private that's fine too.

The ask regarding the signature is just basic info so that experts offering advice here don't have to bug you by asking the same questions again and again.
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My point was mostly that in this day and age I hope everyone can understand why someone might be cautious about just automatically putting all this info out there. Especially because see how I would have already been compromised. That is except for the fact that I purposely use a fictitious birthdate just for this reason.

I was however successful putting some info in the signature that should be helpful.
 
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FrostD said:
Had he recently been on steroids, or had an infection?

130 is a low preshot, we actually recommend not shooting if below 200 until you get more data. What dose did you give last night, and what did you give this morning? Assuming you shot please do keep a very close eye. I would actually start with a +2.

What foods do you have on hand, and had you gotten a chance to check their carb %?
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No steroids or infection.

At this point we are still following vets instructions of 2 units. I would tell everyone if anything was changed.

Whenever someone says +2 are you meaning 2 hours after eating? Or the insulin shot? Or something else?

As per recommendation Friskies Grilled chicken with gravy, and favourite kibble, and honey is at the ready.

What's confusing to me right now, is if we didn't shoot below 200, he would have never been given any insulin because none of the readings were higher than 180. I know we don't have many readings, but the vet didn't even tell us we could get our own meter. He only did the first two readings, and was only going to do a third one today at 2pm.
 
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Beachlover said:
My point was mostly that in this day and age I hope everyone can understand why someone might be cautious about just automatically putting all this info out there. Especially because see how I would have already been compromised. That is except for the fact that I purposely use a fictitious birthdate just for this reason.
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I work in technology and I agree 1000% you can NOT be too careful these days. I completely respect your caution, more people should follow your example.
 
T
Beachlover said:
No steroids or infection.

At this point we are still following vets instructions of 2 units. I would tell everyone if anything was changed.

Whenever someone says +2 are you meaning 2 hours after eating? Or the insulin shot? Or something else?

As per recommendation Friskies Grilled chicken with gravy, and favourite kibble, and honey is at the ready.

What's confusing to me right now, is if we didn't shoot below 200, he would have never been given any insulin because none of the readings were higher than 180. I know we don't have many readings, but the vet didn't even tell us we could get our own meter. He only did the first two readings, and was only going to do a third one today at 2pm.
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The 200 cutoff is only until you gather enough data to know what dose is safe in higher numbers, then once you know it's a pretty good dose you slowly start to lower that threshold and shoot lower numbers. Other options are to shoot reduced/token doses at lower numbers.

Yes, 2 hours after the shot.

Just to be straightforward - yesterday I recommended a reduced dose. I understand your hesitation to follow internet advice that contradicts the vet. If you choose to keep the vets dosing, you will want to add "Dosing per vet" to your signature. We won't be able to help with dosing, but can still assist with any other general health and diabetes-related questions.

Shooting 2U at these numbers in my opinion is very dangerous. There is a slim chance he'll be ok and this dose is ok, but experience tells me you're flirting with trouble. Please keep a close eye on him, any number under 68 needs high carb food (16% or higher) and ideally testing and feeding every half hour til you're sure he's coming up on his own. Under 60 ish you will want to add honey/karo to boost him out of those numbers. If he becomes symptomatic hypo or you cannot get numbers up, follow directions in the hypo doc linked the other day . You can also flag a post as 911 for emergency help.
 
FrostD said:
I understand your hesitation to follow internet advice that contradicts the vet. If you choose to keep the vets dosing, you will want to add "Dosing per vet" to your signature.
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You gotta also understand I'm not the only one making decisions on this. And I don't want to scare anyone from advising on dosing. If a few other members here had echoed your advice, maybe I could convince my family. And precisely why I have a call out to another vet, etc. And more bad news, tried for the +3 reading. Error codes, two test strips burned for nothing. Gonna have to find a 1,000 strips value pack if this trend continues. That the meter purchase only included 25 strips and 30 lancets is almost ridiculous.
 
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Beachlover said:
You gotta also understand I'm not the only one making decisions on this. And I don't want to scare anyone from advising on dosing. If a few other members here had echoed your advice, maybe I could convince the group. And why I have a call out to another vet, etc. And more bad news, tried for the +3 reading. Error codes, two test strips burned for nothing. Gonna have to find a 1,000 strips value pack if this trend continues.
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FrostD's advice is sound and I wholeheartedly agree with it. She helped me with Hendrick and without her help he might have died or had a really bad hypoglycemic episode.

@tiffmaxee @Bron and Sheba (GA) (Bron probably asleep, but it is a Friday night...)

@Wendy&Neko

@Bandit's Mom

@Suzanne & Darcy
 
I totally get it. Whether it is just a single spouse or a family group, I can only imagine the responses one might get "you're going to listen to random strangers on the INTERNET??"

And trust them OVER your vet's advice to boot.

It is a lot to swallow for most but it is true the vast majority of vets receive very little education on feline diabetes and most have more experience with diabetic dogs, if anything. Almost everything two different vets told me was severely outdated. I was following that advice and it almost killed Hendrick, if not for this group well I....*grabs tissue* -- I can't even speak of it.

As far as dosing advice goes, this place is gold. The dosing methods, SLGS or Tight Regulation, were carefully developed and honed to perfection. They have been proven to drive high remission rates and accepted in scientific publications. I can personally vouch for TR, following that method my boy is like new again. Oh shoot, need another tissue!

-Kyle
 
Beachlover said:
Thank you. Not saying it isn't, but convincing a family to deviate from the vets advice requires more consensus.
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That's why I said I understand, but I also want to make sure you understand the risks associated with various choices. Unfortunately you will find I am the most regularly-online adviser for Caninsulin because it isn't widely used (or used for very long in many cats), but the few people Kyle tagged will hopefully chime in at some point today.

@Elizabeth and Bertie is sometimes able to pop in as well
 
FrostD said:
That's why I said I understand, but I also want to make sure you understand the risks associated with various choices. Unfortunately you will find I am the most regularly-online adviser for Caninsulin because it isn't widely used (or used for very long in many cats), but the few people Kyle tagged will hopefully chime in at some point today.

@Elizabeth and Bertie is sometimes able to pop in as well
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I do understand, and am trying to get up to speed. It's your advice that even makes me realise how my vet is indeed behind on this. Almost seems more interested in us continually coming in for testing. Of course, he has rent, overhead, and employees to pay. Whereas there isn't any financial motive for you, so I do trust your advice. But even then, there has also been misunderstandings, so everything is being taken slowly. If you hadn't posted everything you've posted, I shudder to think where we might be weeks from now.

I don't know if this is a crazy idea or not. But until I talk to the new vet, or convince the family to lower the dosage, might giving some kibble carbs with his meals help "offset" the extra insulin that he may be receiving?
 
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Re the misunderstanding on insulin - I understand, but it does not change how we dose in the beginning (reductions under 90, no shoot below 200 til there's more data). The only difference is I tend to recommend more cautious reductions in probable overdosed cats when they are on Caninsulin

So the extra carb food is like shooting yourself in the foot a bit but yes, that would keep him safer. If you cannot get a test in soon, leave kibble out please.

Now the flipside to giving high carb food until you can make a decision either way is if it raises his numbers too much, he is then technically not getting enough insulin which is a factor in DKA
 
If you get a chance to ask the vet, I'd like to know what labs he had done.

A diagnosis based on a single value of 180 isn't exactly wise, they are often elevated at the vet from stress (or infections, etc which is why I asked), and 180 isn't too far out of range. The fructosamine is the better initial diagnostic because its indicative of average BG over the last 2 weeks-ish (but also isn't super reliable if the cat had some other cause of inflated BG like infection).

I know you read the stickies but there's two things I'd like to highlight, because I know there's a lot to retain:
With caninsulin we recommend testing, then feeding, and shooting 30 minutes later. That lets the carbs get on board before the insulin kicks in so it hopefully slows down the insulin action

We do have the cats fast 2 hours before the preshot test, this is simply to get a consistent data point to base shoot/no shoot/temporary reduced doses/etc on
 
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Beachlover said:
Thank you. Not saying it isn't, but convincing a family to deviate from the vets advice requires more consensus.
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Welcome!
Just from observation - when someone with the knowledge and experience of @FrostD posts good advice, many others scan or read and learn, and don't often join in.

When you mentioned giving kibble to help your cat not go low, well that's not a bad idea. However imo it would be much better to lower the insulin dose as previously advised. Folks around her are so hands on with their help. Most vets are nowhere near as knowledgeable as people here on FD.

One more thought - I would not trust a vet treating feline diabetes who recommended Caninsulin for my cat.
 
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Tina Marie (GA) and Jan said:
When you mentioned giving kibble to help your cat not go low, well that's not a bad idea. However imo it would be much better to lower the insulin dose as previously advised. Folks around her are so hands on with their help. Most vets are nowhere near as knowledgeable as people here on FD.
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See, even a newbie has helped others, as no one else mentioned this plan B idea, to help the conversation along. Especially as plan A is still being vetted. And as I keep saying, I want to, and am switching vets towards that end. And if that's true about most vets, then their system needs to change. At the very least you'd think vets would come across this site and participate, and learn.

Look, now I was sidetracked and I forgot why I came here. Oh yeah. Trouble: the +6 reading is 3.1 mmol/dL=56 mg/dL
 
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FrostD said:
If you get a chance to ask the vet, I'd like to know what labs he had done.

A diagnosis based on a single value of 180 isn't exactly wise, they are often elevated at the vet from stress (or infections, etc which is why I asked), and 180 isn't too far out of range. The fructosamine is the better initial diagnostic because its indicative of average BG over the last 2 weeks-ish (but also isn't super reliable if the cat had some other cause of inflated BG like infection).
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I'm constantly agreeing with you ( dose too high, not being told options, immediate ending of carbs, diagnosis from one test, etc.) But as I'm switching vets because of these facts coming to light, I can hardly have this type of conversation with him. For all I know he tossed the blood in the garbage and told me everythings fine keeping the $250 charged for testing.
 
Beachlover said:
See, even a newbie has helped others, as no one else mentioned this plan B idea, to help the conversation along. Especially as plan A is still being vetted. And as I keep saying, I want to, and am switching vets towards that end. And if that's true about most vets, then their system needs to change. At the very least you'd think vets would come across this site and participate, and learn.

Look, now I was sidetracked and I forgot why I came here. Oh yeah. Trouble: the +6 reading is 3.1 mmol/dL=56 mg/dL
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Can you feed your sweetie some higher carb food? If you don't have any, at least let him eat . . .I don't know if at +6 he might keep going down? @FrostD
oh, you can feed kibble to raise BG . . . it won't work too quickly, but should keep him from going lower.
I don't have any experience with your insulin!
 
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