numbers not coming down - advice please

Status
Not open for further replies.

P-P-Piers

Member Since 2017
It's been a good couple of months since Piers was diagnosed and has been on Caninsulin twice a day.
He started on 1 unit BID and after a few weeks had a fructosamine test at the vet; as a result the vet advised increasing him to 1.5 units AM and sticking with 1.0 unit PM. I started doing that but then - suspecting he was bouncing - have gone a little more cautious and he's currently on 1.75 am and 0.75 pm, so 2 units a day total.

Unfortunately, his readings don't seem to be improving very much, or at all. He does respond to the insulin as can be seen when I've tested him for a curve or at other times around the expected 8-hr action of this insulin. However it doesn't seem to last very long and seems to make him extra-hungry.

He is still drinking/peeing excessively and is eating more than ever - I'm probably feeding him about half a small can or pouch of wet food about 6 or 7 times a day, plus treats. He's very thin but vet's observation is that he is in good condition for a diabetic cat. He seems hungriest between +1 and +4 at both ends of the day.

When tested with ketostix he is always (so far) negative or trace ketones, and occasionally I'll smell it on his breath.

The main things I'm wondering about:

1. The best run of numbers we've had was just before his fructosamine test when he was still on 1 unit BID. Did it upset things to increase his dose at that point?

2. I had to go away for a couple of days recently and he was fed on his normal schedule but had no insulin for about 48 hours (with my vet's knowledge). On returning home I tested his BG expecting it to be mega-high but it was 350 - better than a lot of the time on insulin. His other symptoms had worsened but I was really surprised at this?

3. He often has really high AM readings despite daytime being when he eats most and gets most insulin. On the suspicion that he was bouncing on the overnight dose, I have been giving him a snack in the night around 1-2am, that is +7/+8 - at first that seemed to bring the AM numbers down, but not so sure now.

I'm a bit stuck as to what to do next or whether I just need to keep a consistent dose and be patient/alter feeding, or what? Maybe go back to 1 unit each injection rather than giving more by day? Would there be any reason to consider caninsulin 3x day? Could he be bouncing day and night?

If anyone has any advice or can see something about this that I'm missing, I would be very grateful. My s/s is up to date.

Otherwise I'm 100% sure his next fructosamine test is also going to be disappointing, and I'm not sure where we would go from there - one comment the vet made to me was 'when we had him in we started him on 2 units and that wasn't right for him'. That sort of implies P went too low on that dose.

thanks in advance.
 
Sorry you're having trouble. Can you get some more mid cycle tests to see what's going on? @JanetNJ has experience with your insulin and can help you with dosing.
 
I agree that you need more data in the +3 to +7 range to know what's happening. Caninsulin (Vetsulin) causes many cats to drop fast and low, creating a BG curve that would look like a very deep "smile" shape on graph paper. The preshot numbers can be high while the middle numbers can actually be very low. The low numbers can then cause a sort of rebound driving BG high at the end of the cycle. Another factor with Caninsulin is that its duration is only 8 to 10 hours in many cats so it has worn off before the end of the 12 hour dosing cycle.
 
Last edited:
Yes, I'll get on it.

Thank you.

To clarify - last curve I did was about 10 days ago, from that and other tests he seems to respond pretty predictably and in line with how this insulin works, ie drops fast between +1 and +4, nadirs around +7/+8.

We have had a lot of red numbers in last few days though and I can't see a reason for it, so some more frequent tests might be in order.
 
Last edited:
exactly what Kris said.... Unless you can get a few numbers in the middle... vetsulin peeks between 4-6 post shot... my cat always peeked at 5 or 6. we have no way of knowing how low he's going. It could be the dose needs to be raised or lowered but can't really say for sure. Next time you are home for the day do a curve... take a reading every two hours.... this will paint a clearer picture of what's happening.

Fructosamine tests are not an indicator of how low the cat is going, it just gives you the average. Your cat could be going super low in the middle, and super high on the ends... fructosamine is just going to give you an average. At home curves tells you a whole lot more information.

what specifically are you feeding him? most "pouches" are gravy and high in carbs. what "snacks"? low carb freeze dried is ok but not kibble.

The insuline needs of a cat fluctuate. while 1 unit may have been enough in the beginning, he may have different needs now. Can you please get mid cycle readings whenever possible over the next few days, then we'll be able to comment more.
 
I will do that. Thank you. I'm out of the house tomorrow but will be able to get readings later today and from Wednesday onwards.


Food (I am in UK so any Uk-ers please yell if you can see anything too carb-y here. I checked Eliz's list but there are some newer food varieties that aren't on the list - in which case I am totting up moisture, protein etc percentage and it's usually about 97-98% - so if 2-3% is carbs it's ok - is that correct?)
No dried kibble
No gourmet gravy tins

He does get any of the following - I try to vary it as he can be very fussy:
Hilife chicken pouches
Country Hunter/Nature's Menu pouches - these are good-quality, high meat foods, not high carb
Encore/applaws small tins - fish varieties
Gourmet savoury cake
Gourmet pate
Lily's kitchen organic (he has really gone off these although it's a good food)
Thawed frozen prawns (rinsed & drained)
Tinned tuna in spring water (drained)
Raw turkey or beef mince
Whiskas casserole pouches (his latest craze. From what I can find out, the carb content is ok but the protein content is significantly lower than most of the other stuff he gets. We have never bought Whiskas before but he, Mr Picky Eater, loved the free sample that came in the post. I may not re-purchase this!)

As treats/snacks/stuff he helps himself to - Thrive freeze-dried chicken, or home-dehydrated canned tuna/cooked chicken flakes. The odd scrap of cheese/cream/butter or a bit of chicken/beef/fish from our dinners. The herb pots on the kitchen windowsill.
 
Status
Not open for further replies.
Back
Top