Our first curve- wondering what your thoughts are.

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Amanda

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I was wondering if anyone would mind looking at my spreadsheet and offering up some advice/knowledge. It seems to me that on .50 she drops into nice numbers, but she dropped to 60 from the 260 so I am hesitant to give her .50 at anything lower than that. If I give .25 it doesn't seem to be enough to keep things in check. The needles I have start at a 1 unit measurement so its hard for me to eyeball things.

She is on vetsulin currently and we've been at this about a month though I just started hometesting recently. I was going to switch to lantus but then she seemed to be getting decent numbers so I was holding off changing things up... I am guessing on a lot of this so opinions/help are much appreciated!

Thank you in advance!
 
Hi Amanda,

Looking at your spreadsheet can see your dilemma.

Firstly-are you aware there has been an FDA warning on the use of vetsulin?
Don't panic but the FDA and the company that makes vetsulin have recommendd cats are transitioned to other insulins (Lantus an excellent choice)
Reason is-there is an anomaly in the 'stability' of vetsulin. If you click on the vetsulin isg you can read the sticky on it at the top of the list.
What they have found is that it has become unpredictable-they can not guarantee onset, peak or duration.

This may account for your sudden drop from 300 or it may just be the way Kazi has responded to the insulin. There is no way of knowing.
With vetsulin, you usually have to sacrifice a higher preshot number to get a nice valley curve. We couldn't get any regulation with it, swapped to Levemir (almost identical to Lantus) and got beautiful tight regulation.

If your not around to monitor, think you need to stick with your lower dose.Also need to let dose settle for 3 days. Effectively your dose hopping (undersatndably as you don't have the data and numbers all over).
Would recommend getting 1/2 unit markings syringes-Hocks.com I think is the site that is recommended.
30g needle (thinnner the needle, less painful for kitty)

Also if go for Lantus you want the cartridges (come in a 5 pack-can't remember if their 3 or 5ml)-if you go to the Lantus isg you can read the stickies at the top of the page and there is loads of info available.
If Lantus used within 6 months of diagnosis-83%? (think that's right, definitely over 80) cats went into remission in their study.
Majority of cats are actually type 2 diabetes, but unlike humans still need a level of insulin to go into remission (become diet controlled)

Btw-have you been consistent in the food you give? Carb content of food can have dramatic impact on bg numbers.
 
Yes- food is one of the options on the list here. She is giving me a hard time on and off with eating enough, but eating better now on the wet than she was on dry.

I am a little confused as to how it all works I guess. If I have 300 one day and 220 the next how does shooting the same amount not send her bg spiraling too low?
 
Sorry, different time zones.

Normally, the difference in numbers is because the dose is settling. Your looking for what is often referred to as the breakthrough dose. This is when kitty suddenly does start dropping lower and lower and you have to start reducing the doses.By closely monitoring bg's and getting regualrl spot checks (sc's) you can see (usually) patterns in your cat and make some better educated 'guesses' as to how s/he is going to respond.

As I said in my previous post, the problem with vetsulin is it's efficacy. You don't know if it's the insulin itselfiscausing this lower number or because the dose is natuarlly settling.

When you get more info, what happened yesterday morning, a reduced shot would have been the way to go. This means your at least giving some insulin to work on the bg's.

Vetsulin 'peters' out at +10 hence the high preshot numbers when not had insuli for 24 hrs. Although you got a high number, you probably did the right thing skipping (tho not ideal) as you couldn't (I assume?) get any other tests.

She also needs to eat, particularly important with vetsulin as is a fast acting.

She doesn't show any signs of nausea does she?
Smacking her lips at her food but then turning her nose up at it?

Fancy Feast appears to be a favourite here. Maybe try varying the wet a little (under 10%, tho I favour under 5% as this is what a cat would get from a mouse in the wild, their normal food source). If she's losing weight, could offer fresh boiled chicken shreds. As this is virtually pure protein, very good for kitty. :-D
 
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