? Shelley - is back on Caninsulin, hoping for views on doseage ?

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Diana&Tom said:
Sorry to hear that other issues are causing a headache for you, Anthony. It never rains but it pours, that's for sure.
It is very interesting that Shelley gave you a 12.9 this morning - a nice pre-shot number! The fact that she has risen since then suggests that she could have taken a small token dose, and certainly at +14 that 17.4 she should really have had a shot, as you say yourself... her numbers were definitely going up.
So as for whether you should have shot at usual shot time this morning after getting the 12.9 - in hindsight, after seeing the subsequent numbers, yes. But how much would have been the question as you haven't shot at that number before.
It probably comes down to gathering more data and that will give you more confidence shooting at lower numbers... you may have to work to a "sliding scale" which means you would vary the dose according to what pre-shot numbers you get. I wonder if @Elizabeth and Bertie can explain this better please?
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Thank you Diana,
I did speak to the vet and he was adamant that I should have shot 1.0u, as I had discussed with him yesterday. He also said that Caninsulin was not intended to be used in any other increments than 0.5 units? Eg 0.6, 0.75 etc shouldn't be used.
 
Anthony Morgan said:
Thank you Diana,
I did speak to the vet and he was adamant that I should have shot 1.0u, as I had discussed with him yesterday. He also said that Caninsulin was not intended to be used in any other increments than 0.5 units? Eg 0.6, 0.75 etc shouldn't be used.
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Hmmm. Not sure about that! Have just asked Eliz if she's around to pop in here and she says she will, just grabbing a bite to eat. Eliz is one of our most experienced UKers - actually THE most experienced I think - and I'm sure she will be able to fill in a few blanks for you.
 
Sootyca said:
Herbie sounds like a typical cat - seems ill until you get them to a vet when they then behave as if nothing is wrong :D

Your numbers for her suddenly seem to have dropped - can you remember what she ate yesterday? I'm clearly obsessed with food! Injecting at the +12 would probably have been okay - but maybe not at her usual dose. Sky can hold her insulin for 13 hours or so - numerous times I test at +12, I amend the dose and then it doesn't carry her through.
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Hi Karen,
If you see my reply to Diana, the vet said to stick at 1.0u. Shelley had mainly Felix, in fact. But her pre-shot number was lower as well last night.
Thank you!
 
Diana&Tom said:
Hmmm. Not sure about that! Have just asked Eliz if she's around to pop in here and she says she will, just grabbing a bite to eat. Eliz is one of our most experienced UKers - actually THE most experienced I think - and I'm sure she will be able to fill in a few blanks for you.
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Thank you, that's very good of you!
 
Anthony Morgan said:
He also said that Caninsulin was not intended to be used in any other increments than 0.5 units? Eg 0.6, 0.75 etc shouldn't be used.
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Although vets are unused to these kinds of measurements, many folks here do use these where they find them appropriate. And we have even subtler measurements, such as, for example, a 'fat' unit and a 'skinny' unit (!). And some here have cats on such tiny doses that they measure insulin in drops rather than units... :woot:
And some folks (including me) use 'sliding scale' insulin dosage, where we amend the dosage according to the pre-shot number (along with an approximate expectation of what the nadir (lowest number of the cycle) might be). So, for example, a cat may get .75 of a unit as a 'typical' dose; but that dose may be slightly raised or lowered (maybe 1 unit or .5 of a unit) if the pre-shot is higher or lower than is 'typical' . The specifics depend on the circumstances of the individual cat since, as we say around here, 'Every Cat Is Different'.

Anthony, I'm finding some of Shelley's numbers a tad perplexing. For example, on 1st March (am cycle) her numbers went down, then up, then down (quite a big drop for late in the cycle), and then a huge jump up an hour later. There may be something here that we're missing. And I do wonder if food is a factor in these fluctuating numbers. (Looking at the foods you've listed I think you may be using both low carb and medium/higher carb foods (but I'll look into that in more detail and will do some carb calculations for those foods..))... As Mary Ann says above, I wonder if it's possible to stick to just one food and see how the blood glucose numbers are with less variation in the diet..?

I also entirely agree with Janet that we ideally do need to be seeing lower numbers over all (if that can be done safely...)

Eliz
 
Thank you very much Eliz, I hope I am not taking up too much of your time. I know Felix is not a great food but I have stuck to that just to be consistent over the last 24 hours. It is also readily available and I haven't been able to travel too far as my car has been off the road. But Shelley's numbers have been lower in this period.
I can certainly see the advantage adjusting the doses and by small increments. My vet seems to think a more broad brush approach is best, but I don't necessarily agree.
Very grateful for your generous assistance!
 
Elizabeth and Bertie said:
As Mary Ann says above, I wonder if it's possible to stick to just one food and see how the blood glucose numbers are with less variation in the diet..?
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Actually that was Karen's advice about sticking with one food for now. I had copied and pasted her advice into my comment. I do think that using one food for a period of time is a good idea. It will at least rule out variables in the carb content so that a good working dose can be reached.

Anthony, as Elizabeth had advised smaller increments can and are used for measuring dosing. Many vets are "conditioned" to think only in 1/2 or even 1 unit changes, but especially on smaller doses small changes can make a difference. Once you get a dose that seems to be working well for Shelley then doing small changes may make a big difference in getting her back to regulation.

:bighug: :bighug:
 
Anthony, it is very good that you are taking all this on board and starting to question what the vets advise. The thing is, they have very little training in FD and if they are young and not long out of college they have probably not encountered enough cases of FD yet to realise just what can be achieved in its treatment if an owner is capable and willing to take on some work at home. Very few vets even suggest that owners should home test, yet it is vital if you are giving insulin. This board is global and there are hundreds of members, but I dread to think of all the people whose pets have FD and never find out about FDMB... the combined experience and knowledge here is an absolutely invaluable resource for many people every single day.

In other words, listen to your vet of course, but continue to learn for yourself here on this board and you will achieve a lot more for Shelley... and if you wish in the future, your knowledge can be passed on to others coming here with questions. Meanwhile, you do have some work to do with Shelley as far as studying her diet and collecting data is concerned... it does take a while so don't be disheartened that you're not where you want to be yet. As others have said, Shelley's numbers do need to come down... but it has to be done safely. Getting there is a process, a journey.
 
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Tuxedo Mom said:
Actually that was Karen's advice about sticking with one food for now. I had copied and pasted her advice into my comment. I do think that using one food for a period of time is a good idea. It will at least rule out variables in the carb content so that a good working dose can be reached.

Anthony, as Elizabeth had advised smaller increments can and are used for measuring dosing. Many vets are "conditioned" to think only in 1/2 or even 1 unit changes, but especially on smaller doses small changes can make a difference. Once you get a dose that seems to be working well for Shelley then doing small changes may make a big difference in getting her back to regulation.

:bighug: :bighug:
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Thank you very much, I am sure that is the best way forward.
Kind regards, Anthony
 
Diana&Tom said:
Anthony, it is very good that you are taking all this on board and starting to question what the vets advise. The thing is, they have very little training in FD and if they are young and not long out of college they have probably not encountered enough cases of FD yet to realise just what can be achieved in its treatment if an owner is capable and willing to take on some work at home. Very few vets even suggest that owners should home test, yet it is vital if you are giving insulin. This board is global and there and hundreds of members, but I dread to think of all the people whose pets have FD and never find out about FDMB... the combined experience and knowledge here is an absolutely invaluable resource for many people every single day.

In other words, listen to your vet of course, but continue to learn for yourself here on this board and you will achieve a lot more for Shelley... and if you wish in the future, your knowledge can be passed on to others coming here with questions. Meanwhile, you do have some work to do with Shelley as far as studying her diet and collecting data is concerned... it does take a while so don't be disheartened that you're not where you want to be yet. As others have said, Shelley's numbers do need to come down... but it has to be done safely. Getting there is a process, a journey.
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Thank you as always for your advice and encouragement. The FDMB is an incredible resource, I had no idea how much help was available here when I was directed here from Facebook and the people here are so kind and generous of their time and advice. It truly is invaluable!
 
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michaeldoc said:
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THIS POST HAS BEEN REPORTED AS SPAM. DO NOT TRY THE LINK
 
michaeldoc said:
Countless studies from scientists and doctors all over the world have proven that people with diabetes can normalize blood sugar,
increase insulin sensitivity, reduce neuropathy pain, lower risk of blindness, amputations and be taken off all diabetes drugs and insulin injections.

Visit this page to learn more ways to cure/revent diabetes i found it very informative to me

https://tinyurl.com/hurdxww
Click to expand...
Reported
 
Diana&Tom said:
Whoops sorry Mary Ann I have just reported it too not seeing your post!
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No problem, Any link that requires you to click something to get out of the page is always suspect. I close down my entire browser when I get those sort of links since there is always a chance of spyware/malware when you have to click to exit.
 
Just increased Shelley's dose tonight to 0.9u.
Pmps 22.1
+2. 17.1
+4. 14.9

These numbers are not low but Shelley has been very hungry in the last hour. She has got through 4 Felix pouches, she only eats the jelly but was eating ravenously.
Just concerned as abnormal hunger is the first symptom of hypoglycemia.
I wonder if anyone else has seen this when increasing the dose?
Thank you!
 
Unregulated cats are hungry because their body can't utilize the nutrients in the food properly, so they are often starving. Your cat isn't even close to hypo.
 
I feel you are dosing very conservatively. .9 is not enough of an increase from 0.75. I'd go at least 1.25-1.5 when the preshots are mid to high pink.
 
Thank you JanetNJ,
It was just that she normally eats small amounts frequently, she had eaten more in the last hour than she had the rest of the day and it was after she had a slightly higher dose. As she had a hypo before makes me worry!
 
Shelley's behaviour between +2 & +4 was very odd. She was eating ravenously. Her pupils were widely dilated and she was moving around a lot faster than normal, normal being quiet slow.
There have been a couple of tines before when she has appeared agitated in the night, but it did have me worried as she had received the slightly higher dose. This morning she seem to be her usual self.
Just wondering if any other members have experienced anything like this?
Thank you!
 
Hi Anthony
It's true that eating ravenously can be a sign of an impending hypo, but it can also be a sign - a very common and unsurprising one - that a cat is simply unable to use the nutrients from its food properly, as Janet says above. If Shelley is only licking the jelly and not actually eating the meat parts, that is almost certainly not going to satisfy her so she will be even more ravenous. I know the plan is to stick with one food for a few days while you tweak the insulin dose, but her numbers don't look vastly changed at present so you could mix the Felix with a little of one of Shelley's preferred foods and see if she will eat that. She really must have some food inside her when you are giving insulin.

I would be inclined to try to get her to eat her food properly and when she is doing so, up the dose as far as you dare... again as Janet says, these numbers are nowhere near hypo and as long as you are testing regularly, which you are, you can really afford to increase. I completely understand how scary it is but look again at your spreadsheet and see how far away these numbers are from where you want to be, and think also about how tiny the increments are that you've been trying... you may get to the point where you have to bite the bullet and increase - but do make sure she is eating and do test regularly, especially in the first half of the cycle.

Good luck and keep us posted.
 
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Thank you Diana for coming back to me on this.
Felix has been one of the foods she eats regularly plus Gourmet, Applaws, M&S, etc. But she generally eats perhaps a tablespoon or so every couple of hours.
The only one she has really tucked into recently, apart from the early hours of this morning, was Gourmet Solitaire Beef & Tomato. It is in a sauce and I have a feeling will be high in sugar?
So getting her the right amount of the best food for her tricky but yes mixing is an idea, I have tried before, will have a go.

Kind regards, Anthony
 
Yes, I think the Gourmet brands may have vegetable protein extracts and "various sugars", both of which can affect BGs in some cats... I can't see them on Elizabeth's UK foods list (click on the link at the bottom of her signature on her post above, for a comprehensive list) but if she's around today she might be able to tell you more @Elizabeth and Bertie

We're looking for foods that are low-carb (ideally in jelly, not gravy) and that Shelley will eat, so this may be a trial and error situation....
 
Thanks again Diana. Well I just fed Gourmet Ocean Fish pate, which seemed to be liked.
Amps19.4 inj.1.0u
See how that goes.

My vet said feed only RC Diabetes wet food. Leave it down, she will eat it if she is hungry. That doesn't seem to be the right advice.
Also wondering about low carb dry food, Shelley will eat dry food. Some of the others like Orijen and Acana?
I have got some Yarrah and Granata which I ordered on line. I have a feeling she won't like it. I have had all the German brands before. Most if it was wasted.
 
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I know how frustrating it is, Anthony. I think we have to bear in mind that Shelley is an elderly kitty and maybe her sense of smell isn't as good as it was, so she may prefer the stronger-smelling foods such as fish. I would try to stick to wet varieties if you can as most dry foods have a high percentage of carbs which is exactly what you have to avoid. The vet saying she will eat if she's hungry strikes me as rather a cop-out statement - she may not have much of an appetite so she not eat, in which case you're stuck for giving her insulin.

So she is 19.4 this morning and you've given 1 unit - we can only see what happens and it is at least worth a try because other doses haven't done enough. Keep an eye on her and now she's on a new higher dose, test at +2 onwards to make sure she isn't dropping too low... you never know with Caninsulin. You have high-carb foood and honey just in case, but don't panic if you get a number that is actually a "good" number! The thing then would be to try to keep her in better numbers until the end of the cycle... not always easy with Caninsulin. The way it usually works is to drop the BG quickly and sometimes steeply, and its effect is then more or less "used up" so the ascent begins again too early in the cycle. There are other insulins that have a gentler effect but vets need to see that Caninsulin isn't ideal before they will prescribe anything else.

Today could be interesting with the 1u dose. I will be offline for the middle part of the day but hopefully others might pop in to see how you're doing @Sootyca @Elizabeth and Bertie
 
Thank you very much Diana, that is very helpful, I appreciate you taking the time to reply very much. I am sure you have plenty to do.
Going to try and fit in a visit to Pets at Home but will take longer, car still not available.
Thanks again!
 
Anthony Morgan said:
Thank you JanetNJ,
It was just that she normally eats small amounts frequently, she had eaten more in the last hour than she had the rest of the day and it was after she had a slightly higher dose. As she had a hypo before makes me worry!
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I understand your fear of hypo, but you can't let that keep you from getting her in healthier numbers. Over time being 250+ can cause organ damage. You've gotta push her down into the low blues. When she hypoed the first time you weren't testing, correct? Well now you are, and can steer her up if she drops low too fast.
 
Thank you JanetNJ, yes that's right.
I have her on 1.0u today and am monitoring regularly. But no repeat of last nights unusual behaviour. Quite calm and sleeping most of the time at the moment.
Will see how it goes, I realise I am not helping her keeping her in higher numbers. So it will have to be done.
Kind regards, Anthony.
 
And I see an 8.4 at +4 Anthony, that's a great number.... keep an eye and see how she does now...
 
It is a biggish drop but that's how Caninsulin works... it drops quite fast amd steeply, and then is "used up" so there isn't much insulin left for the second half of the cycle. Try not to worry. She may be at her nadir (lowest point) now or she may go a little lower... we can but wait and see. Keep posting so we can check.
When she gets out of these really high numbers she will probably need less insulin to keep her in decent numbers. For now we do need to keep her in the blues for as long as possible and it may be that the only way to do that is give the 1u if her pre-shot number is high and if that drops her sufficiently.
 
Nice to see the blue!!
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YAH!!

Caninsulin is a mixture of 30% semilente insulin which acts quicker and brings the numbers down faster usually in the first 3-5 hours after the shot. The other 70% is ultralente insulin which gives a less dramatic coverage usually from 4-12 hours after the shot. Together this mixture should bring the numbers down faster in the earlier part of the cycle then slowly "wear off" as the cycle progresses. What you are seeing today is a very good response, with a decent drop but not too steep and then levelling out as the cycle goes along. It looks like the 1 unit is a good dose for now. Keep on getting some more tests to show how long the Caninsulin effect is lasting with Shelley. :bighug: :bighug:
 
Thanks Mary Ann! Useful info.
It looks as if the vet's suggestion of 1u was a good one... let's see how the rest of the cycle pans out but if as seems probable Shelley will start to rise now, it may be best to stick to the 1u this evening... assuming she doesn't get better than expected duration from this morning's dose and stay in these nice blues.
 
Duration with Caninsulin can range from 8-12 hours depending on the individual kitty's response to it. That is why getting tests through the whole cycle is valuable information. Of course no kitty stays the same all the time either...that would make it far too easy, but it gives a good baseline for what can be expected.
 
That is a nice flat surf Shelley is doing. It might be an idea to keep track of what foods and amounts you are feeding during the testing to see if there is any pattern to the slight rises you have gotten. Also if you can enter the recent numbers on the spreadsheet it is easier to follow the progression when they are all in one place. Thanks :bighug:
 
Shelley is getting great duration from that 1u. The 13.3 at +8 could have been a food spike, since she has come down nicely again. It will be very interesting to see if she can sustain this number for a while longer or if she suddenly starts going up...
Good work getting the testing, Anthony, and hopefully you can see that the 1u has done a good job.
 
Tuxedo Mom said:
That is a nice flat surf Shelley is doing. It might be an idea to keep track of what foods and amounts you are feeding during the testing to see if there is any pattern to the slight rises you have gotten. Also if you can enter the recent numbers on the spreadsheet it is easier to follow the progression when they are all in one place. Thanks :bighug:
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Thank you, I have just updated the spreadsheet and have been keeping a note of the foods.
 
Diana&Tom said:
Shelley is getting great duration from that 1u. The 13.3 at +8 could have been a food spike, since she has come down nicely again. It will be very interesting to see if she can sustain this number for a while longer or if she suddenly starts going up...
Good work getting the testing, Anthony, and hopefully you can see that the 1u has done a good job.
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Yes Diana, thank you. That small extra amount has made a big difference.
 
Anthony Morgan said:
Thank you, I have just updated the spreadsheet and have been keeping a note of the foods.
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Thank you. Since you are at +10 do not give any more food at this time. You should allow 2 hours before a preshot test with no food so that you can see where the numbers are at without food influencing them.
 
The next couple of tests and what dose you give could be very significant, Anthony. It's been a trying week for you but you have persevered, worked hard and stayed calm, and had the courage today to shoot the 1u. Now the task is keeping Shelley in nice numbers, and even a little lower, as the days go on. You may have to remain brave whilst being even more vigilant.
If you need urgent help or advice as the evening gets on, you could tag Mary Ann or Janet (in this thread) who are several hours behind the UK so will be up later. You know how to tag people? Just type @ followed by the user name, eg Mary Ann is Tuxedo Mom.
 
Tuxedo Mom said:
Thank you. Since you are at +10 do not give any more food at this time. You should allow 2 hours before a preshot test with no food so that you can see where the numbers are at without food influencing them.
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OK, thank you, will do that. Her next shot is due about 21.30, so I could test now and again in an hour.
 
Diana&Tom said:
The next couple of tests and what dose you give could be very significant, Anthony. It's been a trying week for you but you have persevered, worked hard and stayed calm, and had the courage today to shoot the 1u. Now the task is keeping Shelley in nice numbers, and even a little lower, as the days go on. You may have to remain brave whilst being even more vigilant.
If you need urgent help or advice as the evening gets on, you could tag Mary Ann or Janet (in this thread) who are several hours behind the UK so will be up later. You know how to tag people? Just type @ followed by the user name, eg Mary Ann is Tuxedo Mom.
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Thank you Diana, planning to test again now and then in an hour before the next shot.
 
Anthony Morgan said:
OK, thank you, will do that. Her next shot is due about 21.30, so I could test now and again in an hour.
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Shelley is on the way up which is normal with Caninsulin starting to fizzle out. You can wait until her next preshot to test again. It looks like the nadir (lowest number) is around +4 with some slight ups and downs after and the duration is about 9-10 hours, which is very typical with Caninsulin. These can of course change around but it gives a good starting base.

What you decide to shoot tonight will depend on how long you are able to monitor and how tired you are. The 1 unit seems to work well for Shelley, but you would need to get some tests in preferably up to +4 and possibly later. At some point you do need to sleep so I don;t know if this is possible for you.
 
Anthony

I just wanted to add in that Shellie's numbers today have been very promising on the 1 unit dose and in no way are concerning as far as the amount she dropped. However I know that you are hyper-vigilante about the hypos she had recently. You have done a wonderful job getting all the data today and Shelley has been so good about allowing all the pokies. :bighug::bighug::bighug: for you and
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for Shelley
 
Yay you got blues! Such a lot has been said since I last checked in but I would never give my cat a food that they didn't like and I don't subscribe to the theory of leaving the food down and they will eat it - both of mine would willingly starve before they ate some of the foods I have given them! As to her unusual behaviour, she's a cat - it's part of the job description to keep us on our toes! Have you tired Sheba fine flakes or Whiskas for Shelley? I know they aren't best foods in the world but the Sheba especially is really stinky so Shelley may like it.

The curvve you have done today is very promising. The 1 unit dose has done a good job today - will be interesting to see where she is on the next test and for the next few days. The drop is always scary when you aren't used to it but as others have said that is how it is supposed to work.

Well done today. Shelley is a star for putting up with it :)
 
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