? Shelley - going back on Caninsulin after hypo?

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I have injected just under 1.0. The Amps was 24.9. I don't think she was as bright as usual yesterday and is much less vocal than usual.
 
High BGs may well be making Shelley feel off, Anthony, and it does seem that the higher dose was warranted. Keep an eye on her of course, and do what tests you can in the early part of the cycle, but on a high AMPS like that she shouldn't drop too low.

No, FD isn't an easy thing to manage and does require ongoing commitment, but you're doing all the right things and hopefully more of a pattern will emerge as time goes on. Food changes can certainly make a difference in BGs, as can infection and other conditions, and stress... some people even find that their cat's BG is affected by the weather so Shelley might even have been sensitive to the dreadful conditions yesterday.

By the way, you don't specifically mention it but you are getting through a lot of strips... are you getting supplies through your pet insurance if you have it? Strips can be very costly. Many people buy from reputable sellers on ebay.

Hope today is better.

Diana
 
Diana&Tom said:
High BGs may well be making Shelley feel off, Anthony, and it does seem that the higher dose was warranted. Keep an eye on her of course, and do what tests you can in the early part of the cycle, but on a high AMPS like that she shouldn't drop too low.

No, FD isn't an easy thing to manage and does require ongoing commitment, but you're doing all the right things and hopefully more of a pattern will emerge as time goes on. Food changes can certainly make a difference in BGs, as can infection and other conditions, and stress... some people even find that their cat's BG is affected by the weather so Shelley might even have been sensitive to the dreadful conditions yesterday.

By the way, you don't specifically mention it but you are getting through a lot of strips... are you getting supplies through your pet insurance if you have it? Strips can be very costly. Many people buy from reputable sellers on ebay.

Hope today is better.

Diana
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Hello Diana,
It's very good to hear from you. An hour or so since the injection and I think she is a little brighter already and has just meowed for my attention.
As well as everything else I think she is fed up with the testing, especially when it takes numerous attempts. Earlier in the week I was getting the blood easily.
Sadly, I don't have insurance. Having 5 cats it didn't seem cost effective. I just got some strips from the vet this week, 50 at £86.00. I have seen them at less than half that on the internet so I will order the next ones on line. I think the vets are a bit unfair to charge so much. If one of my cats is poorly, I do whatever the vet suggests and never worry about the cost but the prices have risen a lot in the last few years. Shelley's 2 days in hospital cost nearly £1000.00.
Thanks again,
Anthony
 
Wow that's a lot of money, Anthony, but of course we all do whatever we can within our means for our beloved pets.
Those strips are VERY expensive though so have a look around and see what you can find... you may even find it more cost-effective to buy a different meter that takes cheaper strips... this an instance where "expensive" doesn't necessaeily mean "best".

I'm tagging a few other UKers to see what meters they use and where they get their strips @Elizabeth and Bertie @Marlena @Sootyca

ETA - by the way, when testing, are you making sure the ear is warm? That helps to produce blood. And also give Shelley a treat at test time so she comes to associate it with something nice. Treats don't have to mean Dreamies - small pieces of cooked chicken, ham or cheese usually go down well too.

Good luck!
Diana
 
Thank you Diana, that is very helpful. I got the Alpha Track kit from the vets, that was over £100.00. I have followed their advice when I should have done my own research but I didn't know about all the wonderful help available here then.
I do try to warm her ear with my fingers, I will spend a bit more time on that. She usually has a little food afterwards, I will try the chicken and cheese, she loves cheese.
Thank you!
Anthony
 
Crikey, I thought my vet was expensive at £65. Animed do them at £40.

I haven't tried them but someone suggested that Freestyle lite strips give close readings and are significantly cheaper:

http://www.felinediabetes.com/FDMB/...e-vs-alpha-trak-2-strips.172666/#post-1889701

http://www.felinediabetes.com/FDMB/threads/alpha-trak-2-question.172927/#post-1893524

Sky bleeds much better when she has been asleep with her head tucked under so she is warm, or she has been toasting in front of the fire - has to be really warm to make a difference to her. She also come running when she sees the test kit - bless her - as it means she is going to get fed afterwards :D
 
Thank you Karen, Sky is obviously well trained! I will have to do some research to try and make this a bit more economical for me. My vets were independent until a few years ago and are now part of a national company. I guess they have to generate as much as they can to satisfy the corporation. I know everything is monitored. One of the original directors told me his new job was to audit underperforming branches.
Regards, Anthony
 
These are today's numbers;
Amps 24.9 Injected just under 1.0
+3. 20.9
+4. 14.6
PMPS. 21.4 Injected 0.75

Shelley has been much more her usual self today as a result of the higher dose. Decided to reduce the pm one due to a lower PS number.
 
Nice :) I would still have been tempted to leave her at a 1 unit before the evening dose but it's a real balancing act. I think you probably have enough data to let go a little of your fear of another hypo :) You are beginning to see real patterns now in how she reacts to her doses which will help you work out what to give her in future. She seems to drop about 7 points on a 0.5 unit and 10 points at +4 on a 1 unit and her nadir is probably about +5 based on the earlier numbers you put up so she possibly dipped slightly lower during the day. It will be interesting to see where she is tomorrow morning after a slightly smaller dose this evening.

Have you started a spreadsheet? It really makes seeing patterns a lot easier.

My plan for tomorrow is a curve - Sky won't like me as the vet said every hour - nearly told them to provide me with all the test strips!!!! I had a tough call tonight - she was at 20 this morning, gave her a 1 unit and tonight she was at 8.9! I fed her and retested before injecting and she had increased slightly so gave her more food and a tiny dose. Going to test again in an hour to see where she is. Just to spite me she will be high!

My vets did the same - became part of a bigger group (without making it known to anyone!) and since then prices have rocketed and service hasn't improved.
 
Thank you Karen, I probably should have done, it's just looking at that syringe and wondering which way to go.
I started to look at preparing a spread sheet but it didn't work out on my tablet. I will try on my laptop.
I think an hourly curve is quite tough. Shelley sleeps a lot and just being disturbed every hour is a stress. Luckily when I did the last curve I was getting the samples easily, today again its been harder.
Hope all goes well,
Anthony
 
Good luck today, Karen and Anthony - Karen with Sky's hourly curve and Anthony with the spreadsheet. (Anthony, do you have the link to the spreadsheet used here? I can't link it myself but if you don't have it or have problems getting it set up, let us know and we will tag the experts here who will get you up and running in no time.)

Diana
 
Thank you very much Diana, I will have a go and let you know if I have a problem.
Shelley's Amps was lower than usual, 18.9, so I only used 0.6 insulin.
+ 4 was 13.3

Kind regards, Anthony
 
I have been trying to put together a spreadsheet. My laptop and connection are very slow, so its been a long job. I can't see on the spreadsheet though how you save the information. Is this automatic?
Thank you, Anthony
 
Elizabeth and Bertie said:
Hi Anthony, are you also buying syringes from your vet, or are you buying them online?
Just in case nobody has given the link (and they may well have done!) the VetUK U40 syringes here are a very good price:
http://www.vetuk.co.uk/insulin-syri...nsulin-syringe-with-needle-box-of-100-p-11335
.
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Hi Eliz,
Thank you for that. That is what I pay for 30. I can't understand why the vets charge so much more. I just paid £86.00 for 50 Alpha Trak strips but I now know I can get them for half that on-line. I appreciate the information.
Kind regards, Anthony
 
Anthony Morgan said:
Thank you for that. That is what I pay for 30.
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Hi Anthony, these are the 'generic' ones made by VetUK (rather than the branded 'Caninsulin' ones). But, not only are these cheaper, they also have half-unit markings (which I think the Caninsulin ones don't?) ...This makes it a lot easier to measure doses that aren't in whole units.
.
 
Supplies are generally MUCH cheaper online than from vets... vets put a hefty mark-up on everything to add to their profits, while online suppliers do not of course have overheads or middlemen in the same way so can make a better "offer". I don't think there's much in the way of FD supplies that you can't buy much more cheaply online - except insulin, of course.
 
Elizabeth and Bertie said:
Hi Anthony, these are the 'generic' ones made by VetUK (rather than the branded 'Caninsulin' ones). But, not only are these cheaper, they also have half-unit markings (which I think the Caninsulin ones don't?) ...This makes it a lot easier to measure doses that aren't in whole units.
.
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I think they may be the same as the ones the vets have supplied lately as they do have the half markings. They haven't been able to get the Caninsulin ones for some reason.
 
Diana&Tom said:
Supplies are generally MUCH cheaper online than from vets... vets put a hefty mark-up on everything to add to their profits, while online suppliers do not of course have overheads or middlemen in the same way so can make a better "offer". I don't think there's much in the way of FD supplies that you can't buy much more cheaply online - except insulin, of course.
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Thank you, I am beginning to realise.
 
I think I will have to have a word with my insurer to see if they will accept a claim with internet receipts for Sky's supplies.
 
Shelley's numbers were looking better today then suddenly had a steep increase?
Amps 18.9. Inj 0.6
+4. 13.3
+8 12.5
Pmps. 25.7. Inj. 0.6

+5, +6, Shelley was in a very deep sleep so I didn't disturb her. I didn't increase the dose due to earlier lower numbers. Was eating just before the test. Also got a much larger blood sample at pmps, earlier ones very small. Don't know if this affects it?
 
How soon before you tested did she eat? Food can increase the BG - I think the general "rule" is no food for 2 hours before injection. I'm not sure how fast acting on BG food is but could be fairly fast as the general recommendation is to inject the insulin 20-30minutes after eating.

I think you did right not to increase as it could be a food related increase.
 
The amount of blood shouldn't make any difference tomthe reading. As long as the meter doesn't give you an "error" reading, it should be correct.
That IS a big jump from +8 to PMPS and it certainly shows how some cats can rise fast when they are completely out of insulin, which most cats on Caninsulin usually are after a few hours. I'm sure you were disappointed to get the 25.7 after those nice mid-teen numbers - but it does show that those numbers can be achieved... and hopefully you can continue to tweak the dose until you see numbers in the teens at every test... and then carry on monitoring until you start to see gradually lower numbers... It is a commitment but Shelley will feel much better for it and that of course is your reward.
 
Sootyca said:
How soon before you tested did she eat? Food can increase the BG - I think the general "rule" is no food for 2 hours before injection. I'm not sure how fast acting on BG food is but could be fairly fast as the general recommendation is to inject the insulin 20-30minutes after eating.

I think you did right not to increase as it could be a food related increase.
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Hi, it was about half an hour. I did read somewhere that it was good for the cat to have some food in their stomach when you injected but I am sure you are right.
Thank you.
 
Diana&Tom said:
The amount of blood shouldn't make any difference tomthe reading. As long as the meter doesn't give you an "error" reading, it should be correct.
That IS a big jump from +8 to PMPS and it certainly shows how some cats can rise fast when they are completely out of insulin, which most cats on Caninsulin usually are after a few hours. I'm sure you were disappointed to get the 25.7 after those nice mid-teen numbers - but it does show that those numbers can be achieved... and hopefully you can continue to tweak the dose until you see numbers in the teens at every test... and then carry on monitoring until you start to see gradually lower numbers... It is a commitment but Shelley will feel much better for it and that of course is your reward.
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Thank you Diana, I hope so. I cant help wondering, if in being too cautious I am not really helping Shelley as her blood sugar stays high for too long. I can only persevere and hope it works out.
 
Anthony Morgan said:
Thank you Diana, I hope so. I cant help wondering, if in being too cautious I am not really helping Shelley as her blood sugar stays high for too long. I can only persevere and hope it works out.
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It's a tough one, Anthony. You aren't wrong to be cautious but it does look as if Shelley will need a higher dose to get her down from these numbers...so yes, all you can do is persevere. You don't want to increase the dose too fast, but the doses you're giving at the moment aren't enough to drop her as much as we'd like. See what her AMPS is and if she's still in the 20s give a little more insulin...I know the hypo incident will always be in your mind but she should be able to tolerate a higher dose at these pre-shot numbers.
Give yourself some credit - you're doing well.
 
Thank you Diana, it makes such a difference being able to share my concerns here. The help and advice from yourself and everyone else is so much appreciated!
 
Anthony Morgan said:
Hi, it was about half an hour. I did read somewhere that it was good for the cat to have some food in their stomach when you injected but I am sure you are right.
Thank you.
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Yes, you should have food in them before injection but not before testing. I'm fairly sure that your PM number would have been food influenced if she ate 30 minutes before you tested.

Test, Feed, Shoot. :) Sky hates the testing before food as she really wants her breakfast but have to do it that way to be accurate on the numbers.

http://www.felinediabetes.com/FDMB/threads/vetsulin-caninsulin-user-guide.302/

I think Diana has it right - the numbers you are getting suggests she could take more insulin but do small increases - or keep her at 1 unit but make sure you do it morning and night UNLESS her evening number plumets. I know Hypo will always be in your mind but she is quite a way from that territory at the moment. You have a lot of testing done to show how she reacts. Shelley is very lucky she has you.

I didn't get round to doing an hourly curve today but going to have to tomorrow as the tests I did do surprised me with a very slow decrease and then a sudden drop at 6 hours and then she stayed low until +12 despite having eaten. It's definitely not a curve!!!
 
I'm glad you got the SS issues worked out but send me a private message if you still need help. I'm out of town but can possibly do minor fixes.
 
Sootyca said:
Yes, you should have food in them before injection but not before testing. I'm fairly sure that your PM number would have been food influenced if she ate 30 minutes before you tested.

Test, Feed, Shoot. :) Sky hates the testing before food as she really wants her breakfast but have to do it that way to be accurate on the numbers.

http://www.felinediabetes.com/FDMB/threads/vetsulin-caninsulin-user-guide.302/

I think Diana has it right - the numbers you are getting suggests she could take more insulin but do small increases - or keep her at 1 unit but make sure you do it morning and night UNLESS her evening number plumets. I know Hypo will always be in your mind but she is quite a way from that territory at the moment. You have a lot of testing done to show how she reacts. Shelley is very lucky she has you.

I didn't get round to doing an hourly curve today but going to have to tomorrow as the tests I did do surprised me with a very slow decrease and then a sudden drop at 6 hours and then she stayed low until +12 despite having eaten. It's definitely not a curve!!!
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Thank you Karen, that is very helpful. The Amps today was 24.3, so I have injected very slightly under 1.0.
Hope today's curve goes better.
Kind regards, Anthony
 
Marje and Gracie said:
I'm glad you got the SS issues worked out but send me a private message if you still need help. I'm out of town but can possibly do minor fixes.
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Thank you, that's very good of you. I did make some progress yesterday, still need to finish off, but I will bear your kind offer in mind.
Kind regards, Anthony
 
Diana&Tom said:
It's a tough one, Anthony. You aren't wrong to be cautious but it does look as if Shelley will need a higher dose to get her down from these numbers...so yes, all you can do is persevere. You don't want to increase the dose too fast, but the doses you're giving at the moment aren't enough to drop her as much as we'd like. See what her AMPS is and if she's still in the 20s give a little more insulin...I know the hypo incident will always be in your mind but she should be able to tolerate a higher dose at these pre-shot numbers.
Give yourself some credit - you're doing well.
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Thank you Diana, the Amps today was 24.3. I injected just slightly under one, so will see how this goes.
Anthony
 
Yes, see how that dose goes. And if you can keep your spreadsheet up to date, you might like to start a new thread asking for other comments... it never hurts to get other opinions!
Hope today goes well.
 
I have managed to get the spreadsheet running. Today's numbers have been better with the higher dose. Shelley does sleep a lot usually but has been asleep even more today, I don't now if this is because she feels more comfortable.
 
Good job Anthony! I'm not great at instantly translating US numbers into international ones (ie the ones we use in the UK) but I can see that you have a nice 11 there mid-cycle which is great and does show that the higher dose was both safe and justified.
If I were you I would now start a new thread and give it a title to get more eyes looking at your spreadsheet... other members may have some specific advice for you, although I'd say you're doing well as it is by increasing very gradually and testing frequently. Hopefully you really are on the right road now!
 
Diana&Tom said:
Good job Anthony! I'm not great at instantly translating US numbers into international ones (ie the ones we use in the UK) but I can see that you have a nice 11 there mid-cycle which is great and does show that the higher dose was both safe and justified.
If I were you I would now start a new thread and give it a title to get more eyes looking at your spreadsheet... other members may have some specific advice for you, although I'd say you're doing well as it is by increasing very gradually and testing frequently. Hopefully you really are on the right road now!
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Thank you Diana, you may not agree but I only gave 0.6 tonight due to the lower numbers. I am sure you are more familiar with the spreadsheet than I but I seem to be able to switch between the different measures by clicking the blue icons just below the spreadsheet title.
I am in the UK, Kingston upon Hull, by the way. Yes, I will start a new thread, to see what other members think. Regards, Anthony
 
I wouldn't disagree with your dosing decisions, Anthony, you're Shelley's caregiver and have an instinct for her treatment, which is how it should be. As I said, you are on the right road - it may take a while to reach the perfect dose and this may vary over time - you understand how it all works better now so hopefully things will gradually improve.
FD is an ongoing condition, as you know - some lucky cats (and their owners) go into remission (ie don't need insulin) - but for most it is part of daily life. Don't hesitate to post here any time, either within an ongoing "general" thread you've started or a new one if you have a very specific question or urgent concern.

Will be interesting to see what other people think!
 
Diana&Tom said:
I wouldn't disagree with your dosing decisions, Anthony, you're Shelley's caregiver and have an instinct for her treatment, which is how it should be. As I said, you are on the right road - it may take a while to reach the perfect dose and this may vary over time - you understand how it all works better now so hopefully things will gradually improve.
FD is an ongoing condition, as you know - some lucky cats (and their owners) go into remission (ie don't need insulin) - but for most it is part of daily life. Don't hesitate to post here any time, either within an ongoing "general" thread you've started or a new one if you have a very specific question or urgent concern.

Will be interesting to see what other people think!
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Thanks again, Diana, much appreciated!
 
Depending on her level tomorrow morning I would consider keeping a higher dose at night but that would just be my thought as her evening number is still quite hte high. As Diana says though, you are her caregiver and have to comfortable with that. You are the one holding the needle :)

Her pattern is clear though - when she was on a 0.5 unit both morning and night her AM and PM number was very similar. When the dose varies you are getting more variation in numbers - especially in the morning when she has had a lower dose in the evening.

My hunch is you will have a red number tomorrow morning.

May be worth thinking about a 0.75 dose morning and night for a few days and see if the morning and evening readings level out. The 0.6 doesn't seem to be as effective as the 0.75. It's a real balancing act. You are doing so well getting all the data and looking after her.
 
Sootyca said:
Depending on her level tomorrow morning I would consider keeping a higher dose at night but that would just be my thought as her evening number is still quite hte high. As Diana says though, you are her caregiver and have to comfortable with that. You are the one holding the needle :)

Her pattern is clear though - when she was on a 0.5 unit both morning and night her AM and PM number was very similar. When the dose varies you are getting more variation in numbers - especially in the morning when she has had a lower dose in the evening.

My hunch is you will have a red number tomorrow morning.

May be worth thinking about a 0.75 dose morning and night for a few days and see if the morning and evening readings level out. The 0.6 doesn't seem to be as effective as the 0.75. It's a real balancing act. You are doing so well getting all the data and looking after her.[/QUOTE.




Thank you, its very good of you to take the time to look at Shelley's numbers, as I'm sure you must be very busy with Sky.
That's an idea, will bear that in mind tomorrow.
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Thank you, its very good of you to take the time to look at Shelley's numbers, as I'm sure you must be very busy with Sky.
That's an idea, will bear that in mind tomorrow.
 
Just looking in quickly before I go to work - you had some nice mid-cycle numbers yesterday but the dose wasn't quite enough to keep her in those numbers for the second half of the cycle so you got a higher AMPS... good idea to try 0.75u this morning to see how she goes on that. I suspect that you may have to continue to increase slowly with the aim at the moment of keeping numbers in the teens... not saying I would be hiking up the dose too quickly either, it is always best to err on the side of caution. But things are looking good!
 
Hi Diana, it's very good of you to check. These small differences do seem to have a marked affect and of course it is a bit if guess work with just the 0.5 increments.
Thank you!
 
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