Beachlover
Member Since 2022
Absolutely can. Just waiting if thats everyone's advice.
Newbie looking forward to opinions
- Thread starter Beachlover
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FrostD
Member Since 2020
This is why I started with verifying the doses given, the food you had on hand, and starting with that first test. We don't want to reintroduce high carb food, especially kibble, if we don't have to. The effects can tend to hang around for days. When you said you couldn't get the test, it coincided with you also asking the question about kibble, that was my next step. If it was a big drop or you couldn't get it, kibble because that's safest. If it wasn't too bad, if have considered one of the other foods.
So again with that 56, that is hypo range on a pet meter. Just reiterating the current dose is too high, and you are right up against/in symptomatic (and very possibly fatal) hypo territory. Give him some karo please, start with a few drops and kibble as well if you're not already.
Do some googling and you will find a variety of desired ranges for diabetic cats - some will say never below 120, some will say never below 80 on pet meter. You will not find anything saying below 68, and that is with a very aggressive dosing method for depot insulins (Caninsulin is NOT a depot insulin, and the aggressive methods have much more strict guidelines, primarily around testing, to keep cats safe)
FrostD
Member Since 2020
I will refer you again to the hypo document as I can't stick around - this was written based on *human* meter, which tend to read lower (so the pet "equivalents" (there is no direct conversion/relation) of the numbers here are roughly 10-20 points higher) https://www.felinediabetes.com/FDMB/threads/how-to-treat-hypos-they-can-kill-print-this-out.15887/
FrostD
Member Since 2020
With Vetsulin/Caninsulin, a nadir after +6 is not out of the question, but would be unusual. But yes I would still intervene with high carbs and honey/karo because that is well below where we want them on an AlphaTrak (plus very little data and difficulty testing - not a criticism, just a statement, that's the case with nearly all newbies here). The "problem" is the nadir on Vetsulin is usually closer to +4, so he was likely lower earlier. Dangerously low.
Angela & Cleo
Member Since 2022
Hi I'm fairly new too ...only a couple of months in, and I too have a Vet, who I actually like and seems knowledgeable but didn't exactly give the best starting advice and I too have the issue of balancing family apprehension with this forum vs. Vet advice.
My personal journey started in January with strictly following Vets advice which was (1) feed only 2 times a day at shot time, (2) give 2 units, (3) feed prescription food only and (4) monitor her water consumption and urine output and I will see you in two weeks.
We ended up at the ER Clinic twice with super high sugars and a really LOW episode twice. It took these scary experiences to get my family to understand that I would rather follow the guidance of people who are doing THIS day in and day out almost all day long and altruistically than strictly adhering to the Vet.
I will further say that my Vet did (eventually) come around and "agreed" to smaller meals throughout the day, "agreed" that I should be home-testing BG levels and smaller increment dose changes (because its a Hormone with ever changing needs NOT an antibiotic). He initially said changes in whole units, not quarter increments as suggested here.
Now here we are...almost 4 months in...and I cannot and do not have the right words to express my gratitude to everyone here AND ESPECIALLY TO @FrostD . She has been INVALUABLE and I personally owe her a debt that I could not never repay in 9 lifetimes (hehe cat humor).
The Vet TOLD US what to do in less than 15 mins and went on to the next patient. On one occasion in the very beginning, I got a reading on a pet meter of 69 and immediately called the Vets office who told me (after keeping me on hold for 15 minutes) to reduce insulin to 1 unit and have a nice night. FYI - hypo episode and ER trip then she bounced, then glucose toxicity took hold (all terms you will soon become familiar should you decide to stick around). That is what it took (and several $$$$$ later) for my family to come around.
@FrostD has held my hand and is teaching me and guiding me and we are finally seeing some good numbers!! Great numbers compared to where we started if you ask me! I like to think that she gives me GUIDANCE by giving me the options she has ascertained by reviewing the data and her day-to-day experiences and leaves the actually decision to me.
This Message Board is more than just science and dosing and data, its taking all those things and factors in the feline and human elements. How much can your furbaby tolerate? How much can the FurMommy/FurDaddy tolerate? Stress levels, comfort of shooting, being "data" ready to do these things takes time and lots of experience. To be completely honest, I LIKE MY VET, but he doesn't have the day-to-day data nor the time in his day to help a "newbie like me" be "data" ready to help my Cleo. I wish you the best of luck and I hope to see you around the message boards.
My personal journey started in January with strictly following Vets advice which was (1) feed only 2 times a day at shot time, (2) give 2 units, (3) feed prescription food only and (4) monitor her water consumption and urine output and I will see you in two weeks.
We ended up at the ER Clinic twice with super high sugars and a really LOW episode twice. It took these scary experiences to get my family to understand that I would rather follow the guidance of people who are doing THIS day in and day out almost all day long and altruistically than strictly adhering to the Vet.
I will further say that my Vet did (eventually) come around and "agreed" to smaller meals throughout the day, "agreed" that I should be home-testing BG levels and smaller increment dose changes (because its a Hormone with ever changing needs NOT an antibiotic). He initially said changes in whole units, not quarter increments as suggested here.
Now here we are...almost 4 months in...and I cannot and do not have the right words to express my gratitude to everyone here AND ESPECIALLY TO @FrostD . She has been INVALUABLE and I personally owe her a debt that I could not never repay in 9 lifetimes (hehe cat humor).
The Vet TOLD US what to do in less than 15 mins and went on to the next patient. On one occasion in the very beginning, I got a reading on a pet meter of 69 and immediately called the Vets office who told me (after keeping me on hold for 15 minutes) to reduce insulin to 1 unit and have a nice night. FYI - hypo episode and ER trip then she bounced, then glucose toxicity took hold (all terms you will soon become familiar should you decide to stick around). That is what it took (and several $$$$$ later) for my family to come around.
@FrostD has held my hand and is teaching me and guiding me and we are finally seeing some good numbers!! Great numbers compared to where we started if you ask me! I like to think that she gives me GUIDANCE by giving me the options she has ascertained by reviewing the data and her day-to-day experiences and leaves the actually decision to me.
This Message Board is more than just science and dosing and data, its taking all those things and factors in the feline and human elements. How much can your furbaby tolerate? How much can the FurMommy/FurDaddy tolerate? Stress levels, comfort of shooting, being "data" ready to do these things takes time and lots of experience. To be completely honest, I LIKE MY VET, but he doesn't have the day-to-day data nor the time in his day to help a "newbie like me" be "data" ready to help my Cleo. I wish you the best of luck and I hope to see you around the message boards.
Beachlover
Member Since 2022
Ok. Giving a little kibble and karo.
Beachlover
Member Since 2022
Thank you, this posting helped a lot. Much better when someone can see both sides of the coin.Hi I'm fairly new too ...only a couple of months in, and I too have a Vet, who I actually like and seems knowledgeable but didn't exactly give the best starting advice and I too have the issue of balancing family apprehension with this forum vs. Vet advice.
My personal journey started in January with strictly following Vets advice which was (1) feed only 2 times a day at shot time, (2) give 2 units, (3) feed prescription food only and (4) monitor her water consumption and urine output and I will see you in two weeks.
We ended up at the ER Clinic twice with super high sugars and a really LOW episode twice. It took these scary experiences to get my family to understand that I would rather follow the guidance of people who are doing THIS day in and day out almost all day long and altruistically than strictly adhering to the Vet.
I will further say that my Vet did (eventually) come around and "agreed" to smaller meals throughout the day, "agreed" that I should be home-testing BG levels and smaller increment dose changes (because its a Hormone with ever changing needs NOT an antibiotic). He initially said changes in whole units, not quarter increments as suggested here.
Now here we are...almost 4 months in...and I cannot and do not have the right words to express my gratitude to everyone here AND ESPECIALLY TO @FrostD . She has been INVALUABLE and I personally owe her a debt that I could not never repay in 9 lifetimes (hehe cat humor).
The Vet TOLD US what to do in less than 15 mins and went on to the next patient. On one occasion in the very beginning, I got a reading on a pet meter of 69 and immediately called the Vets office who told me (after keeping me on hold for 15 minutes) to reduce insulin to 1 unit and have a nice night. FYI - hypo episode and ER trip then she bounced, then glucose toxicity took hold (all terms you will soon become familiar should you decide to stick around). That is what it took (and several $$$$$ later) for my family to come around.
@FrostD has held my hand and is teaching me and guiding me and we are finally seeing some good numbers!! Great numbers compared to where we started if you ask me! I like to think that she gives me GUIDANCE by giving me the options she has ascertained by reviewing the data and her day-to-day experiences and leaves the actually decision to me.
This Message Board is more than just science and dosing and data, its taking all those things and factors in the feline and human elements. How much can your furbaby tolerate? How much can the FurMommy/FurDaddy tolerate? Stress levels, comfort of shooting, being "data" ready to do these things takes time and lots of experience. To be completely honest, I LIKE MY VET, but he doesn't have the day-to-day data nor the time in his day to help a "newbie like me" be "data" ready to help my Cleo. I wish you the best of luck and I hope to see you around the message boards.
Tina Marie (GA) and Jan
Member Since 2019
Very glad you came on quickly Because when Pet Meter came to mind after I posted, I got quite worried about my lazy response and came back. Under 68 is always serious on the AT, whether near nadir or not. As an example, Tina, off insulin and doing well, ran right at 100 on the AT.
Thank you Melissa!
Angela & Cleo
Member Since 2022
I think I do understand your hesitation. I was lurking as a guest on this forum for quite some time before I finally joined and even after joining, it took me quite some more time to finally post and ask for advice and opinions. I can empathize. Its nerve wrecking. We got your back!
How's Piper? What's the latest BG number? The Spreadsheet is a wonderful tool! I highly recommend setting it up.
AmyL
Member Since 2021
These recommendations are for canines (CANinsulin). Dogs are dosed by weight, and only once per day, because their metabolisms are much slower than cats. FrostD is spot on with her advice here. She's one of our most knowledgeable members when it comes to Caninsulin/Vetsulin. Many vets could learn a thing or two from her.
Chris & China (GA)
Member Since 2013
If you would like a totally new opinion to add to the others for your family from somebody that's been here for many years, you NEED to reduce Piper's dose!
Dropping below 68 on a pet meter is getting into the hypoglycemic crisis territory. Some cats who are very sensitive to insulin have been known to go into seizures at numbers barely below the 68.
Even a cat that doesn't show outward signs of hypoglycemia can still be incurring brain damage due to the low glucose. The brain uses the most glucose of any organ in the body and needs about half of the glucose in the body to function properly. If the amount of total glucose in the body is too low, the cells in the brain can quickly die.
You can always go up in dose if a lower dose proves ineffective but it only takes 1 dose that's too high to possibly kill your cat (or require a panicked run to an ER vet with the outrageous bill that comes with it....and no guarantee there will be a good outcome).
Our number 1 rule here is to keep the cat safe which is why so many of us are begging you to reduce Piper's dose.
We only want the best for every single cat (and caretaker) that comes here. Our knowledge might not be from a vet college but we have the 24/7/365 real life experience that no vet will ever have.
Dropping below 68 on a pet meter is getting into the hypoglycemic crisis territory. Some cats who are very sensitive to insulin have been known to go into seizures at numbers barely below the 68.
Even a cat that doesn't show outward signs of hypoglycemia can still be incurring brain damage due to the low glucose. The brain uses the most glucose of any organ in the body and needs about half of the glucose in the body to function properly. If the amount of total glucose in the body is too low, the cells in the brain can quickly die.
You can always go up in dose if a lower dose proves ineffective but it only takes 1 dose that's too high to possibly kill your cat (or require a panicked run to an ER vet with the outrageous bill that comes with it....and no guarantee there will be a good outcome).
Our number 1 rule here is to keep the cat safe which is why so many of us are begging you to reduce Piper's dose.
We only want the best for every single cat (and caretaker) that comes here. Our knowledge might not be from a vet college but we have the 24/7/365 real life experience that no vet will ever have.
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Rebecca & Max (GA)
Member Since 2020
Hello, Beachlover! Just wanted to pop on and add in my support for what @FrostD has stated- All if it. I’m not an admin or moderator here, but I am proof of what happens when you follow the advice given here. I did not use Caninisulin, because my vet knew that Lantus was a better option. However, that’s about where his expertise stopped. My cat almost died from a hypo due to my vets bad dosing advice. Thank goodness I had just stumbled across Jojo’s Hypo Kit and had everything on hand.
I know this whole journey is overwhelming and confusing. It’s like you are in a dance competition but you don’t know the steps. If you go into the Caninisulin files and read up on the info posted there, you’ll see FrostD’s advice comes from there However, YOU also hold that syringe and can decide what to do. You do not need your vet’s approval, or even your families approval (unless you are all in it together). This group has been around since the 90’s. It’s not done fly by night diabetes group that has no leg to stand on. Much of what posted here has been vetted in real life. The Lantus protocols have even been published in a veterinary journal. So that says something about how serious these people are.
Testing is an absolute pain, BUT it’s your superpower. If your cat was a human child, you would not have been able to even give insulin without showing doctors you knew how to test (at least here in the US). Thus is one of the few feline health issues that you can know exactly what’s going on at home and with a simple blood test. The concern is that your cats diagnosis was flawed (IMO). You were not given enough info to begin with. The fact that your cat is below 200 WITHOUT insulin tells me that 2U is way too much. A simple change in diet may have been all your cat needed. I’m a moderator due the Facebook group and we have seen so many cats become diet controlled diabetics. Some never needed insulin- just a low carb diet. My fear is that is your cat, and the insulin is going to cause a very serious hypo very soon. 56 on the AlphaTrak is scary to me, so I’m glad to see you added carbs and Karo.
I know this whole journey is overwhelming and confusing. It’s like you are in a dance competition but you don’t know the steps. If you go into the Caninisulin files and read up on the info posted there, you’ll see FrostD’s advice comes from there However, YOU also hold that syringe and can decide what to do. You do not need your vet’s approval, or even your families approval (unless you are all in it together). This group has been around since the 90’s. It’s not done fly by night diabetes group that has no leg to stand on. Much of what posted here has been vetted in real life. The Lantus protocols have even been published in a veterinary journal. So that says something about how serious these people are.
Testing is an absolute pain, BUT it’s your superpower. If your cat was a human child, you would not have been able to even give insulin without showing doctors you knew how to test (at least here in the US). Thus is one of the few feline health issues that you can know exactly what’s going on at home and with a simple blood test. The concern is that your cats diagnosis was flawed (IMO). You were not given enough info to begin with. The fact that your cat is below 200 WITHOUT insulin tells me that 2U is way too much. A simple change in diet may have been all your cat needed. I’m a moderator due the Facebook group and we have seen so many cats become diet controlled diabetics. Some never needed insulin- just a low carb diet. My fear is that is your cat, and the insulin is going to cause a very serious hypo very soon. 56 on the AlphaTrak is scary to me, so I’m glad to see you added carbs and Karo.
FrostD
Member Since 2020
Ok so most importantly - try to get another test 20 mins after giving that kibble and karo. If you can't get one, let him free feed on kibble until +10 (and let him have one more round of karo/honey, just a few drops, whenever you do try to test around +6.5 ish). The karo/honey is a quick boost.out of low numbers, but it does not last. Need the kibble to kick in and jeep him up
One of the things we advise, because it is an open forum and anyone can post and give advice, is take a look at who is helping you. Take a look at their spreadsheets, their posting activity, etc. I believe that is in all the welcome stuff as well, and when you first sign up for the forum. Take a look at the posts I - or anyone giving advice - have made, you can find it in their profile. Take a look at who is tagging who for certain things (you will find I am tagged for ProZinc, Caninsulin/Vetsulin, Novolin, and usually stuff related to acro and high dose conditions). I am active across the main forum and all the insulin subgroups, with ProZinc and Main Forum being the more high traffic ones (I keep an eye on Caninsulin forum, but more often than not it's fairly dead).
I will never, and have never, given unsafe advice. In fact, I err much more on the side of caution. If there is a situation I'm not comfortable advising, I will say so. Any time I give advice, I list the various options as I see them, along with pros/cons/considerations. So, along those lines, here are your options as I see them:
Hold the 2U per vet advice. I really truly cannot stress enough how dangerous this is, I truly think you will find him in a very serious/possibly fatal hypo very soon, but I think I've conveyed that well enough by now. If you are going to go this route, put "dosing per vet" in your signature, and I would go back to kibble strictly for safety reasons. Test as often as you can. I would also call the vet and say hey I tested him 6 hours after his shot and he was 56 what are your thoughts ..I suspect their answer will tell you a lot (unless you've already told them off...). I don't think there is any "safe to shoot" numbers at this dose, the 200 does not apply to overdoses
Reduce. After today, realistically, I think you need to go down to 0.5-1U (I much prefer 0.5U just due to testing challenges), and only if above 200. If he just kind of floats lower and never hits 200 then we'd brainstorm. Now any time insulin is drastically reduced we do recommend staying on top of ketone testing as a precautionary measure. We can always go back up in dose quickly if the reduction is too low.
I really do have to log off, I'll be back around later this evening.
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Tina Marie (GA) and Jan
Member Since 2019
Please let everyone know that your cat is ok, and what his BG reading was 20 minutes after giving Karo and kibble.
Hope you don't feel bombarded with info. We just care deeply about diabetic kitties
Hope you don't feel bombarded with info. We just care deeply about diabetic kitties
Beachlover
Member Since 2022
Exactly, and I think you may have hit the nail on the head. I was going to say that to my vets credit, at least he gave insulin, although the diagnosis to get there may have been flawed, because the symptoms cleared up quickly. But now that you mention the low carb diet happened at the same time. So maybe that was indeed the "cure" rather than it being the insulin.
Cat is doing fine. But again, can't keep doing BG four/five times a day.
Beachlover
Member Since 2022
Again, all appreciated. And may be so. But you keep taking offense, as if this is all something that I, who doesn't know you, should know. Have you not seen the show Catfish? There are many people on the internet who aren't genuine, even creating multiple personas, including ones to back them up. I have read many glowing reviews on certain websites that if you read them closely can determine they are actually shills.
FrostD
Member Since 2020
I've not taken any offense, it would take much more than simply discussing FD to do that!
It is clear you are skeptical, and as we've said, we understand that - but at the same time, I am not sure what more we can do to help you figure out what direction to take. So we are just trying to arm you with the tools to keep your cat safe while you work your way through everything. I previously linked the AAHA guidelines, have a read through that website and their flowcharts.
Here is a paper from ISFM as well: https://www.google.com/url?sa=t&sou...MQFnoECAYQAQ&usg=AOvVaw3A5zQWS3hKfB7YtC1RKJyr (sorry for the ugly Google link)
There are also a number of scholarly papers and resources linked here as well: https://www.felinediabetes.com/FDMB/forums/health-links-faqs-about-feline-diabetes.14/
You will see that they both define hypoglycemia as being under 80 mg/dL, and also both recommend reducing the dose (AAHA says 10-50% and do a BG curve within 24 hours, ISFM says reduce by 50%...some other stipulations in there if you read through them). We don't follow all of their guidelines exactly, the main differences being we increase and reduce by 0.25U increments + we target a normal BG range as much as possible (so roughly 90-150 for Caninsulin using a pet meter) + we use slightly different reduction points depending on insulin type and meter.
Rebecca & Max (GA)
Member Since 2020
Well, on the flip side, if you aren’t giving insulin because your cat may be diet controlled then there is no need for 4-5 tests per day. Good luck! I hope you’ll have a diet controlled kitty very soon- if you don’t already.
Suzanne & Darcy
Member Since 2020
I was just going to say.... isn't anybody going to point out how many hours that vets receive in vet school on diabetic animals... mostly dogs. And here Kyle did just that. They receive next to no training in diabetic cats.
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Suzanne & Darcy
Member Since 2020
All the more reason to lower the dose drastically and/or to discontinue insulin altogether and test to see where he is on only a low-carb diet.
Diane Tyler's Mom GA
Member Since 2018
One more thing to add to your signature, that you are using the Alpha Trak Meter
Just wanted to put a couple posts side by side. Your kitty got well below 68 on that pet meter. That is a very dangerous level that tells us 2.0 units is too much insulin. Please take FrostD's suggestion of lowering the dose to 1.5 units tonight. Cats are unique creatures. Well, in many ways, but specifically for us that their pancreas can heal and start producing more insulin on it's own. When that happens, you'll see lower numbers that are your clue the dose needs to be lowered. If things go well, kitty can even go into remission.
I hope you tested your cat's blood sugar again. We want to make sure he's now above 68 and in safe numbers range again. Yet another plug for using cheaper human meters - it allows you to test more often, especially when blood sugar is low.
My story, from Canada as well. My girl was started on Caninsulin, vet didn't have experience with Lantus. Frankly, a lot of cat owners don't want to treat a diabetic cat - my vet was thrilled I wanted to treat. But it also meant she had more experience with diabetic dogs than cats. My girl got up to 5 units of Caninsulin, and wasn't doing great. I wanted to switch to Lantus (was reading here and elsewhere) but vet was reluctant due to lack of experience. I started looking around at other vets. I found another one who'd had a diabetic cat on Lantus, and I was all set to switch, in spite of liking my vet, when I found out the other's vet's cat had died from a hypo. About that time, I saw a locum vet at the original clinic and he got me on Lantus and ended up being a permanent vet at that clinic. Skip forward a couple months, my cat's thirst for insulin was higher than many. People here suggested I get my cat tested for a couple conditions that mean they need higher doses. The vet though it was too early. I had to ask her to humour me. She finally ordered the tests. I was right, more specifically, the people here were right. My vet started learning more, along with me. And diagnosed another cat in her clinic with the same condition as Neko. We became team Neko. Bottom, if a vet is willing to learn and work with you, they are keepers.
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FrostD
Member Since 2020
Just wanted to clarify that I recommended an ever further reduction, ideally down to 0.5U only if above 200, based on some further data in the post + some test results today + testing restrictions. Along with ketone monitoring. I know there's a lot in this thread just wanted to keep recent stuff at the bottom to help avoid confusion.
If he stays below 200, we'll have to consider a variety of things but will cross that bridge when we get there
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Agree with Melissa (FrostD).
Beachlover
Member Since 2022
Ok. The new vet is seeing Piper Monday. And seems to agree with Rebecca & Max's logic above.
And to completely stop the insulin.
Thank you to everyone for all the postings and help.
Beachlover
Member Since 2022
The new vet has told us to completely stop the insulin.
Beachlover
Member Since 2022
You know what's funny, I copied your signature and changed the info to my info. So had you listed the meter, I would have too. Notice how the "/Vetsulin"& "Classic Pate" is exactly the same
FrostD
Member Since 2020
That is also fine, just be sure to monitor ketones.
I think either way he was going to stay below 200 and we'd have arrived at the same spot of skipping shots anyway ha
FrostD
Member Since 2020
Hers does, the ReliOn prime
Beachlover
Member Since 2022
In the end, this is exactly what the new vet is saying to do.
Beachlover
Member Since 2022
I wasn't above begging, considering the urgency conveyed.
Beachlover
Member Since 2022
Ahh, didn't know that was a meter. Thought that had something to do with the pancreatitis
Beachlover
Member Since 2022
I went back and can confirm that was done, since it's on the original invoice of Mar 25th. But can't confirm seeing the results.
FrostD
Member Since 2020
Ok. New vet will probably want to do one as well.
If they haven't already asked you for it, I would bring as much info as you can. So:
Symptoms
Any prior labs you have (hopefully your old/current vet will be good and send them...not always the case unfortunately)
Date diagnosed
Date insulin administration started, dose, and timing (i.e. 12 hrs apart)
Date diet change started, and date completed (as well as what food to what food)
Any dose changes
Any BG readings and their dates (and also how long after the shot it was)
If you are going to completely stop insulin, I'd suggest the odd spot check of the blood sugar over the weekend, which would probably be useful data for the vet in determining what to do next.
Bron and Sheba (GA)
Member Since 2015
I would also test daily for ketones in the urine now that you are not going to be giving any insulin.
To do this you will need a bottle of Ketostix from Walmart or a pharmacy and follow the directions on the bottle.
There should be no ketones in the urine.
I would also make sure he is eating well.
To do this you will need a bottle of Ketostix from Walmart or a pharmacy and follow the directions on the bottle.
There should be no ketones in the urine.
I would also make sure he is eating well.
Suzanne & Darcy
Member Since 2020
I am very relieved. I was very worried about your Piper. I hope the new vet will be better.
- Status