Reduce dosage?

Status
Not open for further replies.
Jessicaallynn

Jessicaallynn

Member Since 2022
Hi, my cat Sergio is newly diagnosed. We’re on 1unit of Vetsulin twice daily. So far so good with only a few minor bumps in the road. Can someone look at my spreadsheet and see if it’s okay that I reduced dosage today (skipped last night entirely)?

Sergio has always been extremely picky with wet food and prefers dry. However he will eat maybe half a 3oz can at breakfast and dinner. Lately I’ve been adding friskies and FF to the lineup (due to pro plan senior being low stock). PLUS I transitioned from blue Buffalo dry to Epigen (not 90) over the past week.

The friskies seemed to upset his stomach (he’s always had a sensitive stomach) and he doesn’t seem to be interested much in the Epigen. So the past week or so he’s been eating much less overall.

Last night he was nauseous (licking lips and swallowing constantly along with drooling. He hid under the bed at dinner time). Since he didn’t eat I didn’t shoot. And I didn’t want to upset him further by trying to get a glucose reading. This morning he was relatively low in the AM. So I gave half a dose. He only had a very little bit of wet for breakfast (back to pro plan senior). He didn’t eat any dry at all today. And again very little wet at dinner (along with boiled chicken which he really seems to like). So I only gave half again. I don’t think he would drop dangerously low if I gave him the full but I’m not sure.

I go back to work tomorrow so is it okay to continue at .5u if this trend of not eating a lot continues? I worry he will hypo while I’m at work. Thank you so much.

https://docs.google.com/spreadsheets/d/1eXLPe9XkwpcZ4DfERDdYf6jtN985YWnhvSDh5ZneI6I/edit
 
Welcome Jessica and Sergio
We cannot see your spreadsheet you need to

To set spreadsheet sharing permission:
* At the top right of the spreadsheet screen click on Share.

* In the pop-up dialog box click on the Get Link section.

* Change link access from 'Restricted' to 'Anyone with the link' and make sure that the permission on the right hand side is set to 'Viewer'.

* Click Done to save the changes.

Also we need you to set up your signature , it's information about Sergio
Just click in the blue link here
Here is a link helping us to help you link. If you noticed, our members have some basic information about their cat's in their signature. This helps us to not pester you by asking the same questions (your cat's name, insulin type, date of diagnosis, etc.) repeatedly. We also have a link to our spreadsheet in our signature. We are very numbers driven. The spreadsheet is a record of your cat's progress. By linking it in your signature, we can follow along and provide feedback should you need the help.
 
Diane Tyler's Mom said:
Welcome Jessica and Sergio
We cannot see your spreadsheet you need to

To set spreadsheet sharing permission:
* At the top right of the spreadsheet screen click on Share.

* In the pop-up dialog box click on the Get Link section.

* Change link access from 'Restricted' to 'Anyone with the link' and make sure that the permission on the right hand side is set to 'Viewer'.

* Click Done to save the changes.

Also we need you to set up your signature , it's information about Sergio
Just click in the blue link here
Here is a link helping us to help you link. If you noticed, our members have some basic information about their cat's in their signature. This helps us to not pester you by asking the same questions (your cat's name, insulin type, date of diagnosis, etc.) repeatedly. We also have a link to our spreadsheet in our signature. We are very numbers driven. The spreadsheet is a record of your cat's progress. By linking it in your signature, we can follow along and provide feedback should you need the help.
Click to expand...
Okay thank you I think I fixed the spreadsheet and added more to my signature.
 
Couple of thoughts:
- I certainly understand the difficulty of a picky/inappetant cat, but the variable carbs will make it very difficult to find/predict trends. If/when possible, try to stick to similar carb %
- I suspect yesterday he may have gone lower than that 137, hard to say. it might be wise to reduce his normal dose by 0.25U for at least a week to see how he does.
- Yes you were wise to do a temporary reduction based on unreliable appetite and a lower than usual number. When new we say you can shoot your normal dose over 200, BUT(1) we're not sure it's a good/safe dose yet and (2) they really need food on board with Vetsulin to slow the drops. Unfortunately, there isn't enough data for me to say if 0.5U is safe in this situation. The downside to skipping is that if he has an underlying infection/stress/inflammation you risk ketones/DKA. It's a delicate balance of hypo vs ketones. I would say if he's above 200, 0.1-0.25U is hopefully a happy medium - but I am not 100% confident in that recommendation, so please go with your gut.
- what is current feeding "schedule"? There are things you can do to strategically slow those dives and try to get some longer duration

Is nausea typical for him?

Are you testing ketones at home?

Does he fast 2 hours before shot? Do you feed 39 mins before shot?
 
FrostD said:
Couple of thoughts:
- I certainly understand the difficulty of a picky/inappetant cat, but the variable carbs will make it very difficult to find/predict trends. If/when possible, try to stick to similar carb %
- I suspect yesterday he may have gone lower than that 137, hard to say. it might be wise to reduce his normal dose by 0.25U for at least a week to see how he does.
- Yes you were wise to do a temporary reduction based on unreliable appetite and a lower than usual number. When new we say you can shoot your normal dose over 200, BUT(1) we're not sure it's a good/safe dose yet and (2) they really need food on board with Vetsulin to slow the drops. Unfortunately, there isn't enough data for me to say if 0.5U is safe in this situation. The downside to skipping is that if he has an underlying infection/stress/inflammation you risk ketones/DKA. It's a delicate balance of hypo vs ketones. I would say if he's above 200, 0.1-0.25U is hopefully a happy medium - but I am not 100% confident in that recommendation, so please go with your gut.
- what is current feeding "schedule"? There are things you can do to strategically slow those dives and try to get some longer duration

Is nausea typical for him?

Are you testing ketones at home?

Does he fast 2 hours before shot? Do you feed 39 mins before shot?
Click to expand...
Hi, thank you for looking everything over. We normally eat wet food around 615am and 615pm. But I leave out dry for the remainder of the day. He used to graze when it was the old food but I haven’t seen him eat much of it since switching to Epigen.
I work M-F an hour away from where I live. I get up and test, feed, and then shoot before I leave for work. I don’t get home until 545pm so I haven’t been able to pick up the dry food two hours prior to pm testing. But I do pick it up on the weekends (starting last weekend).
Nausea like that isn’t typical. However, I’ve had him since he was 8weeks old and as long as I can remember he’s always had the softest stool of all my cats. And he also throws up much more often than my other cats. Although in the past three weeks since diagnosis he only threw up maybe once
He was actually diagnosed because I brought him in for diarrhea twice in a week and they did bloodwork.
I usually only wait 15 minutes after eating to shoot.
We did test ketones today and I’m 95% sure it was negative. It’s hard to tell between negative and trace. He was negative at the vet on 2/23/22 when he was diagnosed.
 
Ok what you'll want to aim for then is a curve once a week on whatever day you're home, so testing every other hour, just to make sure he's not going too low. Since his numbers are a bit lower at this 0.5U, I'm thinking the 1U may have been too high, but I can't say for sure. You can always hold the 0.5U until you can do a curve.

I always worry a bit about pancreatitis when I hear things like nausea and inappetence, so just keep an eye on him. Not sure if you've dealt with it before, but it's basically just treating symptoms (nausea, pain, inappetence)...sounds easier than it is unfortunately :/

What test did they do? Fructosamine? What was result?
 
FrostD said:
Ok what you'll want to aim for then is a curve once a week on whatever day you're home, so testing every other hour, just to make sure he's not going too low. Since his numbers are a bit lower at this 0.5U, I'm thinking the 1U may have been too high, but I can't say for sure. You can always hold the 0.5U until you can do a curve.

I always worry a bit about pancreatitis when I hear things like nausea and inappetence, so just keep an eye on him. Not sure if you've dealt with it before, but it's basically just treating symptoms (nausea, pain, inappetence)...sounds easier than it is unfortunately :/

What test did they do? Fructosamine? What was result?
Click to expand...
I’m not sure what else was tested when they did the blood test, I will call and ask for the results. I think it was called a young wellness test? But I could be wrong.
I haven’t had any experience with pancreatitis. He ate about a half of a 3oz can this morning once I topped it with some of the flakes from the freeze dried treat bag. Plus I think he could eat plain boiled chicken all day long if I let him. He had that this morning as well. So I feel it might just be pickiness? But he also won’t eat more than that 1/2 can. I offered him more and he was not interested. I never used to worry if he didn’t want wet because I knew he’d always have dry if he was hungry enough but he just doesn’t seem interested much in the Epigen (though he did the first two or three days). But you’re right the nausea definitely makes me nervous. Are there any other signs of pancreatitis to look out for? He doesn’t seem to be in any pain but I know cats are good at hiding pain.
I should be able to do a curve this weekend. He also has one scheduled for the 25th at the vet. Maybe I should ask the vet to check for pancreatitis while he is there?
 
So the hallmarks of pancreatitis are inappetence, nausea, and pain (meatloaf position, hiding, staying curled up vs splaying out). There are two tests - snapfPl and specfPl. The snap is a quick one that just tells you normal vs abnormal and isn't necessarily a concrete diagnosis, but many of us use it as such. The specfPl is more specific, but also more expensive.

I wouldn't bother paying the vet for a curve since you can do it at home, they're usually elevated from stress at the vet anyway. I'd only test for pancreatitis if he's really having issues - like barely eating/drinking at all, not moving about much, not social. Or if you just have a gut feel it goes beyond pickiness and something else is going on.

Can you try to track total calories the next 2-3 days? Has he been losing weight?
 
FrostD said:
So the hallmarks of pancreatitis are inappetence, nausea, and pain (meatloaf position, hiding, staying curled up vs splaying out). There are two tests - snapfPl and specfPl. The snap is a quick one that just tells you normal vs abnormal and isn't necessarily a concrete diagnosis, but many of us use it as such. The specfPl is more specific, but also more expensive.

I wouldn't bother paying the vet for a curve since you can do it at home, they're usually elevated from stress at the vet anyway. I'd only test for pancreatitis if he's really having issues - like barely eating/drinking at all, not moving about much, not social. Or if you just have a gut feel it goes beyond pickiness and something else is going on.

Can you try to track total calories the next 2-3 days? Has he been losing weight?
Click to expand...
Okay, I’ve been debating on cancelling the curve since I can do it at home. I’m just not sure how to approach the vet about it. She seems very nice so I think she would look at my sheets for me and not try to guilt me into bringing him in for a curve.
I will keep an eye on him the next two weeks and then decide if I should get the pancreatitis test. He played with me and the rest of the cats yesterday for a little while so he seems to be moving around. He lost two pounds since December due to the diabetes. But I weighed him on the 6th and 12th and he seems to be holding steady around 13.8 pounds but I will continue to monitor this week. I really appreciate you taking the time out to help me today.
 
FrostD said:
So the hallmarks of pancreatitis are inappetence, nausea, and pain (meatloaf position, hiding, staying curled up vs splaying out). There are two tests - snapfPl and specfPl. The snap is a quick one that just tells you normal vs abnormal and isn't necessarily a concrete diagnosis, but many of us use it as such. The specfPl is more specific, but also more expensive.

I wouldn't bother paying the vet for a curve since you can do it at home, they're usually elevated from stress at the vet anyway. I'd only test for pancreatitis if he's really having issues - like barely eating/drinking at all, not moving about much, not social. Or if you just have a gut feel it goes beyond pickiness and something else is going on.

Can you try to track total calories the next 2-3 days? Has he been losing weight?
Click to expand...
Hi again, Sergio seems to be eating back to normal. It’s still not a lot of food at once but he’s always been like that. He had 1/2 of a 3oz can of purina pro plan senior and a handful of boiled chicken. He was 210 preshot. I go to work so I only gave .5u of Vetsulin. Do you think he will drop too low? Should I have only given .25? There is Epigen dry out for him, but that’s if he decides to eat it. Yesterday he was in the 300s when I got home at 6pm and I had only given him .5u when he was at 264 the AM. I hate being so far from home I can’t run to check in on him. Thanks again for your help.
 
I would keep 0.5U as your new normal dose.

I think shooting it this morning was ok, I probably would have been more cautious with 0.25U. I don't think he'll go too low, hopefully he'll seek out food if he feels a drop.
 
FrostD said:
I would keep 0.5U as your new normal dose.

I think shooting it this morning was ok, I probably would have been more cautious with 0.25U. I don't think he'll go too low, hopefully he'll seek out food if he feels a drop.
Click to expand...
Thank you for replying. I had my mom stop over my house at 3.5+ to check on him and she said he seems to be acting normal. I’m watching him on my camera also and he seems to be doing the usual of napping all day on my bed with his brother. I will keep .5u as the new dosage and maybe even .25 in the mornings I have to work if his amps stays around 200. Thank you so much.
 
Status
Not open for further replies.
Back
Top