Hi there!
Saoirse started on Caninsulin (UK brand name for Vetsulin) and her vet at the time prescribed a very, very high carb food (Hills w/d dry) for her to support that amount of insulin. As Melanie advised above, the tests that you have done show that there is a response to the Vetsulin (some of the numbers are less than 200). Also, it does take time for the cat's body to acclimatise to the foreign insulin and Vetsulin is really harsh. Saoirse's lethargy was worse in the first few weeks of Caninsulin treatment than it had been before she was diagnosed.
I don't give dosing suggestions but I am a bit concerned about the 2 IU am / 3 IU pm dosing being quite high for a recently diagnosed cat, doubly so with the low carb food. What's your cat's ideal body weight and how much does she weigh at the moment? I'd be very much inclined to discuss the dose amounts with my vet, especially because too much insulin can have the same effect as too little. Both can cause high BG readings. If the dose is too high, the cat's body will start dumping glucose into the bloodstream to counteract potential hypoglycaemia. Also, if the Vetsulin drops are very steep (and they usually are) a fast drop to a low but safe BG concentration can be misinterpreted by the cat's system as a dangerous number, simply because the body has become used to operating at higher numbers and again the liver will dump glucose into the bloodstream in order to protect the cat.
I know that you're finding testing tricky at the moment (it does get easier!), but the sooner you can get mid-cycle numbers - and preferably a full curve - the better you'll be placed to see how the Vetsulin is working for your little one, and also whether the current doses are safe.
Will you be at home over the weekend? If you are, then I'd recommend getting tests at AM +1, +2, +3 and +4 to see if your kitty has an early onset for Vetsulin - sometimes the numbers can plummet in the first few hours after injection time. These drops can then trigger higher numbers later in the cycle through a combination of the Vetsulin wearing off and possibly counter-regulatory hormones kicking in if the drop has been very steep earlier in the cycle (and fast, steep drops are a hallmark characteristic of Vetsulin's action profile). If you're having trouble with getting BG tests, observe your cat's behaviour closely in the hours after the injection (keep in the room with you if at all possible). If your cat suddenly starts looking for food in earnest, that can be a clinical sign of the Vetsulin kicking in and dropping the BG. If you can test at that point, it might give you a better idea of how low and how rapidly the BG drops at onset. Until you know what the BG is doing, if your cat starts looking for food while on Vetsulin, if she were mine I'd give her food to keep her safe. Adding tests at 1 hour and 2 hours after onset can be a good way to catch the first Vetsulin nadir (even if food has been given in the meantime, the BG can go lower anyway). A +7 test can help to identify if your cat gets a second Vetsulin nadir (when the crystalline portion of the insulin is at peak effect).
As Melanie stated above, because it can put kitty on a real BG roller coaster Vetsulin can make some cats feel really dreadful. Saoirse used to try really hard to hide somewhere very inaccessible when it came time for injections and was depressed, lethargic and would spend much of each cycle hiding when she was on that insulin. If your cat is feeling icky because of the insulin type, that could be a contributing factor to your current testing difficulties. Saoirse was much more comfortable when she was switched to Lantus, a longer-acting and gentler insulin than Vetsulin. She still grumbled a bit at injection time, but did not attempt to avoid the injection altogether. She was also much less withdrawn. The problem with Vetsulin - as you have seen already - is that it can leave kitty in unregulated numbers for over half the hours in each cycle. If you were to compare typical BG curves for a cat on Vetsulin versus a cat on a longer-acting, gentler insulin it would be like looking at a cross-section of the Himalayas versus a cross-section of gently rolling hills.
Cats are smart cookies and, although they probably think that we humans are absolutely bonkers for seemingly wanting to use their ears for pincushions, they can very quickly associate the testing activity with feeling better and, once that connection is made, the testing can get much easier in a relatively short space of time. Giving lots of praise, fuss and - most important of all - freeze-dried protein or other FD-friendly treats as part of the BG test routine is a great way to make it far less stressful for both you and your kitty. Some cats (my own included) actually start hovering around their test stations looking for treats once they get used to the routine. Indeed, in many cases the ritual of testing can markedly intensify the bond between cats and caregivers, because they know the testing has something to do with feeling better. They learn that it is being done out of love. cat_pet_icon
Secondary monitoring helps enormously when BG testing is tricky. I see from your post that you're monitoring fluid intake/output. That's a very useful (though not precise) yardstick for assessing how well/poorly your cat is regulated. BJ's signature link has great tips on tools to help you with other monitoring methods.
Finally, it's worth noting that regulation doesn't usually happen overnight. Most kitties need time for their bodies to get used to operating at healthy BG numbers again. Slow and steady is the name of the game. :smile:
