? Orangie Help Please

[OrangiesMom]

Hello I just had my cat diagnosed with diabetes about a month ago and glad I finally found this forum. His glucose was 450 at the time.They vet was not very helpful and recommended Hills Multi Benefit Prescription Diet Dry food to eat and 1.5 units of Vetsulin 2 times a day. He never mentioned anything about shaking the insulin bottle before giving the shot so I don’t think he has been getting a full dose for the last month. He pretty much just lays by the water bowl all day but is still eating and going to the bathroom.

I took him back Tuesday July 7th and his glucose was 540 and we gave him his 1.5 unit dose a couple ours before the appointment. The vet was wondering if he even got a shot that morning. So he upped his dose to 3 units 2 times a day.

Well yesterday July 11th at 6:30pm we took his glucose before his shot and it was 494 and switched his food to Fancy Feast Classic Pate after searching this forum.

This morning we realized we were suppose to be shaking the insulin bottle the whole time and did it for his first shot of 3 units at 6:30am his glucose was 446. We checked again at 10:00am after we feed him a can of Fancy Feast and his glucose was 242.

Now we just checked it again at 2:30pm and it is down to 164. He has to have his next shot of 3 units at 6:30pm and am worried that it might be too high of a dose since I think we are actually administering the insulin correctly now. We are going to check his glucose again at 6:30pm and that is when he eats and gets his next shot.

My question is should we give him another shot of 3 units if his glucose is still in the 150ish range? Or should we lower the dose or not give a shot at all?

Any help would be appreciated thanks!

 

[Connie & Parker & Moonie]

Hi there! Welcome!

I’m too new to be giving dosing advice but I can point you to some general guidelines that we use on the forum.

Beginners without a lot of data on how their cat responds to insulin are advised to ask for dosing advice at 150 which is the number you indicated.

Something that you can do is stall without feeding for 20-30 mins and see if your kitty’s blood glucose number naturally rises from there to a level you’re comfortable shooting. It’s important to do this without feeding because you won’t want the results to be food influenced - if your cat’s blood glucose is naturally rising you know that the prior dose’s impact is done and you’re shooting into a rising number that should go up more with food.

Also I’d suggest you use the dropdown menu by the title to indicate “?” so that the experienced members know to prioritize your post.

Finally when you get a chance I’d suggest going through the two methods - TR and SLGS - and pick one that works for you, as well as make a spreadsheet. People will change their advice based on which method you pick and they will be able to give you better advice if they have the data in your spreadsheet!

Sticky - New? How You Can Help Us Help You!

Sticky - Dosing Methods: Start Low, Go Slow (SLGS) & Tight Regulation (TR)

https://felinediabetes.com/FDMB/threads/how-to-create-a-spreadsheet.241706/

 

[squeem3]

Don't shake insulin That's a surefire way to ruin the whole bottle. For insulins that need to be mixed before using, just gently roll the bottle between your hands.

Vetsulin is no longer a recommended insulin to use for cats. It's too short acting for most cats. In other countries, it's called Caninsulin and is for dogs. The best insulins to use for cats are Lantus (glargine) or ProZinc.

Here are two recent guides to managing diabetes that you can read through and share with your vet:
2025 iCatCare consensus guidelines on the diagnosis and management of diabetes mellitus in cats
2026 AAHA Diabetes Management Guidelines for Cats

Is your vet an older person? Some older vets are set in their ways and aren't interested in keeping up with the newest treatments.

If Vetsulin just isn't working for your cat, then switch to a different insulin.

Are you testing blood glucose levels every day before giving insulin? For members to better help you, you should set up a Google spreadsheet to track your cat's numbers. The instructions are here: https://felinediabetes.com/FDMB/threads/how-to-create-a-spreadsheet.241706/ You can also share it with the vet.

Insulin doses are increased slowly and usually by no more than 0.25 units at a time. Your vet doubled your cat's dose from 1.5 units twice a day to 3 units twice a day because the in office blood test was 540?? A stressed out cat will have super high blood glucose levels. What was the blood glucose level right before you gave insulin that morning?

Are you using U40 syringes with the Vetsulin?

 

[OrangiesMom]

I checked his glucose just now and it was 333. I feed him normally with a can of Fancy Feast Pate and gave him 2.5 units instead of 3 because I was afraid of giving him too big of a dose.

Yes our vet is an older guy and is not the best of help he just says bring him back every 2 weeks to get checked and doesn’t offer any other help.

I have also read online that you are supposed to shake Vetsulin, but not any of the other brands. It is weird ever since I started shaking it he has been acting more lively and is moving around a lot more so I think it might be working? We didn’t shake it for a month before and this is the most normal he has looked in a while.

Also he hates getting his ear poked. Is there any other place to draw blood from?

 

[Shelley & Jess]

Hi there,

Vetsulin dosing information can be found here: BEGINNER'S GUIDE TO CANINSULIN/VETSULIN

I’d suggest going through the two methods - TR and SLGS - and pick one that works for you,

TR is a specific dosing method for Lantus users. Lantus is a depot insulin and works differently than Vetsulin - an 'in-and-out' insulin.

Hills Multi Benefit Prescription Diet Dry

Hills website lists this at 36% carbs on a dry matter basis. With the Vet doubling the dose and if you've stopped all dry and are feeding low carb FF only please monitor closely. Vetsulin can be a harsh insulin and drop the BG fast. Make sure to get a test or two early in the cycle (+2,3,4ish) to try and catch the onset please. We don't know how long it will take for the effects of the dry food to leave his system.

 

[squeem3]

I checked his glucose just now and it was 333. I feed him normally with a can of Fancy Feast Pate and gave him 2.5 units instead of 3 because I was afraid of giving him too big of a dose.

Yes our vet is an older guy and is not the best of help he just says bring him back every 2 weeks to get checked and doesn’t offer any other help.

I have also read online that you are supposed to shake Vetsulin, but not any of the other brands. It is weird ever since I started shaking it he has been acting more lively and is moving around a lot more so I think it might be working? We didn’t shake it for a month before and this is the most normal he has looked in a while.

Also he hates getting his ear poked. Is there any other place to draw blood from?

Many newbies have had to switch vets because the old one wasn't familiar enough or up to date on diabetes treatment. It's perfectly ok to change vets. You don't need to give a reason why to the old vet. Some people like cat-only vets. Others prefer internal medicine vets. A "regular" vet is fine as long as they are familiar with diabetes and is willing to work with your on how to best manage the diabetes.

Vetsulin is a suspension of two different components, like oil and water. You have to mix the components together before using. If you don't mix up the insulin first, you're only giving part of the total mixture which is probably why you weren't seeing much improvement with numbers. Gently rolling is better than vigorous shaking. Insulin isn't salad dressing A few gentle inversions of the bottle and a couple rolls is plenty.

If Vetsulin just doesn't work for your cat, then switch to a better insulin. There are cats who have come to FDMB using Vetsulin but ended up switching to ProZinc or Lantus and had much better glucose control.

A paw pad is another place to get blood from. One of the large pads, not the toe ones.

Few cats like being tested but learn to more or less hold still for it. Low carb treats and lots of patience help.

Hometesting Links and Tips

There is a CGM that sticks onto the cat's shaved skin and reads blood glucose levels for up to 2 weeks. The readings are sent to an app on a phone that you keep near the cat or you could manually scan the CGM. The downside is that a CGM is expensive and you'll need to keep a few on hand as back ups, it is known to fall off or malfunction, and you still need to know how to manually test if the reading is LO or if you don't have an extra CGM as a replacement.

Getting Started With Continuous Glucose Monitors (CGMs) for Diabetic Cats