Requesting Urgent Help About Tonights Insulin Dose

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Critter Mom

Critter Mom

Member Since 2014
I don't know what to do about Saoirse's insulin dose tonight. She tested at PMPS at 229 (12.7). Thing is she dropped from 382 down to 128 after this morning's insulin dose. I don't want to risk her going very low again like the other night.

I don't have an FMDB spreadsheet set up yet. Here are her recent numbers for her transition from dry to low-carb wet:

Feeding w/d Dry and some low-carb wet and Caninsulin


434 - +24.5 AMPS - Scheduled Dose 3 IU
376 - +3.25
353 - +6.5
391 - +11.25
371 - +4.5
302 - +11.5 AMPS - Scheduled Dose IU - WITHHELD (Saoirse inappetent)


Feeding Purina DM Wet exclusively and Caninsulin

428 - +15.5
324 - +19.25
351 - +23 PMPS - Scheduled Dose 3 IU
184 - +3
184 - +6
367 - +11.5 AMPS - Scheduled Dose 3 IU
167 - +3.5
160 - +5.25
176 - +6.25
328 - +9.5
310 - +11.5 PMPS - Scheduled Dose 3 IU
77 - +3.25
225 - +4.75
302 - +6.5
302 - +8.25 AMPS - Scheduled Dose IU - WITHHELD after last night's low BG
331 - +15.25
263 - +24.25 PMPS - Scheduled Dose IU - WITHHELD - could not stay awake.
400 - +35.5 AMPS - Scheduled Dose 2 IU
113 - +5
207 - +7.5
275 - +11.75 PMPS - Scheduled Dose 1 IU
157 - +3.25
205 - +6.5
382 - +24.25 AMPS - Scheduled Dose 1 IU
128 - +3
157 - +4
229 - +11.25 PMPS

==========

I'd be very grateful for any suggestions about how to proceed. I need to give her the insulin very, very soon (if at all).

(Edited @ 21:43 BST - bug in imported spreadsheet data - wrong data replaced by figures above.)
 
How about a .5? It looks like one unit might be fine, but since it is night and you probably can't monitor her, you might reduce it? Then during the day, when you can monitor, go back up - if the numbers are high enough.

Can I help you set up a spreadsheet? Just send me a pm.(small pm button in the right hand corner of my post)
 
Done. Phew!! Sending lots of appreciation vibes your way, Sue. :smile:

I already had the syringe loaded with a 1 IU dose. Squirted some out as best I could to 0.5 (tricky on the 40 IU syringe) and nipped over to the windowsill to give my little one her medicine. I am good to monitor her for the next few hours. She hits nadir around the +3 mark and after the scare the other night I at least know that her BG levels came up fairly quickly.

Now that Saoirse's on low carb wet food, my vet wanted me to only drop her dose down as far as 2IU, but she still needs a fair bit of coaxing to eat during the day, and sometimes she won't eat her early morning meal (due at about 4am). The pancreatitis is making things much trickier in that respect. I felt very nervous about going against my vet's advice, but after following the advice to keep her on 3 IU in spite of her diet being changed to low carb only and hitting the 77 (4.3) the other night I regretted doing what I was told. I just hope that I'm not doing her any harm by reducing to the 1 IU dose. This really is nerve-wracking.

I know that Saoirse's only adjusting to the low carb diet, but I can't get over just how big the drop is from peak to nadir even on the much lower dose of Caninsulin. Is that why the standard protocol is to feed the w/d dry high carb alongside the Caninsulin? If that's so then it seems like the idea is to try to fit the cat to the protocol and not the protocol to the cat???? I've learned here that EU regulations mean that Caninsulin must be the first insulin tried: I recognise that I'm very much the novice sugar kitty parent, but that approach seems absolutely nuts as a first course of action when there are other - potentially better and gentler - treatment protocols available.

My heart is being torn asunder seeing what my darling little puisín is going through at the moment: it seems so harsh on her. ((((Saoirse)))) I hope to God it gets better, and soon ... :cry:

Thanks, Sue, for the offer of help with setting up the spreadsheet. I've managed to get my template OK and I'm trying to gather the data together for it (not easy with PTSD - it has left me with the concentration capabilities of a mentally subnormal amoeba. :roll: ) I've definitely got some questions and I'd be very grateful if I could drop you a PM when I'm ready to go.
 
I don't understand why Canninsulin has to be the frist insulin in Europe either. It is clearly an insulin made for dogs. We do have a number of UK members who've been able to get ProZinc or Lantus, but only after they PROVE Canninsulin won't work.

No, it makes no sense to me to feed high carb and give more insulin, with any insulin. But I do think vets use that approach sometimes, when people aren't testing, because it's sort of a way to keep the cat in safe numbers. You were wise to reduce the dose; clearly the diet is making a difference. If the vet says anything, 1. You can show him the numbers and 2. You can just say you felt safer giving her less. She's your cat - you're the one who cares the most.
 
Thanks for the validation, Sue. It means a great deal to me: this is all so new, and so scary. I am so glad that Saoirse and I are not alone in this: it's overwhelming as it is.

I'm so grateful for you and all the people here for creating a place to come to learn, to get help and support, and to find the best ways to help our critter babies. The dietary advice here and on catinfo.org plus all the fantastic links to research and other educational resources probably saved Saoirse on Sunday night. I don't even want to think about what could have happened if I had not learned about carry-over from one Caninsulin dose to the next: I would not have known to test her at bedtime.

With regard to vets and home testing, I moved practices a couple of weeks after Saoirse's diagnosis because the vet that was assigned to treat her actively refused to give me any support in my (fervent) wish to home test and was completely closed to my attempts to open discussions about possible treatment options. By comparison, the vets at our new practice positively encourage home monitoring. They are also highly informative and seek to educate as well as treat. I now have proper dialogue about Saoirse's treatment choices with our new principal vet: it's a partnership, not a dictatorship. (I think it helps that he has a sugar kitty himself.) As you say, I am ultimately accountable for Saoirse's health and wellbeing, and I will fight as hard as I can to get her the treatment she needs. She has spent the past 8 years saving my life, now it's my time to protect her. (I have lost two furry children as a result of placing unquestioning trust in the veterinary profession and fearing to assert myself when my heart was telling me that something was wrong. Vets are not gods: they are just as fallible as the rest of us. And the price my little ones paid for me to learn that lesson will haunt me forever.
 
SITREP: All OK in the Shire.

155 (8.6) at +3.25
153 (8.5) at +5

I know I don't have much data yet, but from what I have gathered so far she may go a little bit lower over the next hour or so. She had some food just before the last test, so that's reassuring.

When the first vets were titrating up Saoirse's dose, she actually seemed better on the lower doses than the higher ones (she was restricted to 70g w/d Dry at that stage). She actually seemed to get progressively more poorly on the 3 IU and 90g w/d Dry (split into only 2 meals) that the first vet insisted upon. The feeding schedule had to be split into multiple smaller meals almost immediately because my poor little one started vomiting when she had nothing in her tummy.

Saoirse has been much more sociable and interested in getting fusses this afternoon and evening. She seemed to have a little more get up and go about her this evening. Her urine output is down by 50% over the last 2 days and the PD has subsided with the wet food. Her coat needs work, mind. (Baby steps ... )
 
Glad to hear little Saoirse is doing better.

Yes, it's tough when a vet won't work with you and you feel like you are fighting an uphill battle to get the best care possible for one of your beloved kitties. Sometimes, it does take going to a different vet practice to find the support you need. You did that and it sounds like you have a cooperative partnership instead of a dictatorship with the new vet. Congratulations!
 
Glad to hear little Saoirse is doing better.

Yes, it's tough when a vet won't work with you and you feel like you are fighting an uphill battle to get the best care possible for one of your beloved kitties. Sometimes, it does take going to a different vet practice to find the support you need. You did that and it sounds like you have a cooperative partnership instead of a dictatorship with the new vet. Congratulations!
 
Hey Deb, thanks for the encouragement.

Actually, I was quite sad in many ways about leaving the old practice. I first started going to them nearly 20 years ago. I've had my back to the wall financially for the last number of years, and they were very good to me when Saoirse needed treatment. The decision to move made more sense geographically as much as anything because the new practice is closer to me (key for possible emergency visits, especially given my agoraphobia). Thankfully the move was amicable on both sides. They did fantastic work for my furry childer down the years (includlng saving the sight in one of my cat's eyes after he got a thorn stuck in it. He even had a kitty contact lens while it was healing. Who'da thunk it!).
 
Aine, have you chatted to your new vet about switching to Lantus?

I don't think you would be eligible to go on the trial Angel is on (assuming you could travel there) because of the pancreatitis, but if you like I could e mail Ruth and ask what you should say to your vet to convince him/her to change insulin. I was actually getting pretty good control with caninsulin and I know some people get remission with it, but I wanted to know Angel was getting the best.

xx
 
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