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

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Anthony Morgan

Anthony Morgan

Member Since 2017
Having received a great deal of help and advice on my previous thread, I am now hoping for member's views on how things are going, as I try to bring Shelley's diabetes under control again.

The following paragraph from my original thread, explains why I was here to start with:

http://www.felinediabetes.com/FDMB/...insulin-after-hypo.173338/page-2#post-1906674
Shelley has had diabetes for 6 years which has been controlled with Caninsulin with no problems and a most recent dose of 1.8 units. Last week she had a hypo and her blood sugar fell to 1.1. She was in hospital for 2 days when she had another hypo after the vet injected 1.5 Caninsulin units. The hypos happened about 4 hours after the injection. So her insulin was stopped in the hospital and her glucose curves were normal over 24 hours, suggesting remission and no glucose was present in her urine. Since she came home I have been testing with Alpha Track and getting readings between 17 and 25, without insulin and glucose is present again in her urine.

I now have a spreadsheet showing how things are progressing and I would be very grateful for any comments.
Thank you, Anthony
 
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Hi Anthony, I don't give dosing advice, but I wanted to bump your post up so others can see it. You may want to put a link to it in your other thread so the people that were helping you will see it.
 
Hi Anthony, hopefully more will chip in.

Personally I would keep her on the 0.75 morning and night for at least another day so she has had 3 full days on a steady dose. If her numbers don't drop by the fourth day - so Thursday - I would then increase her to 1 unit morning and night (with a little bit of testing at +4/5/6) and then keep her at that dose for another few days to see the impact it has. Obviously if she drops too low for you to be comfortable you could reduce it. The key would be getting the testing done if you do increase.

I'm fairly sure you will need to increase her insulin to at least 1 unit, possibly even higher but doing it slowly will find what she needs. She has been on less than 1 unit now for 10 days and hasn't really dropped to what I would call nice numbers- I don't like reds! I like my starting colours to be yellow.

The drop between morning and evening today is quite interesting - possibly food related. I'm glad that you have recorded what she has eaten so you can compare back next time she eats similar food and see if she responds the same way. I know I've mentioned before Sky is sensitive to certain foods and when they were removed from her diet her BG dropped considerably.

Karen
 
Anthony Morgan said:
Having received a great deal of help and advice on my previous thread, I am now hoping for member's views on how things are going, as I try to bring Shelley's diabetes under control again.

The following paragraph from my original thread, explains why I was here to start with:
Shelley has had diabetes for 6 years which has been controlled with Caninsulin with no problems and a most recent dose of 1.8 units. Last week she had a hypo and her blood sugar fell to 1.1. She was in hospital for 2 days when she had another hypo after the vet injected 1.5 Caninsulin units. The hypos happened about 4 hours after the injection. So her insulin was stopped in the hospital and her glucose curves were normal over 24 hours, suggesting remission and no glucose was present in her urine. Since she came home I have been testing with Alpha Track and getting readings between 17 and 25, without insulin and glucose is present again in her urine.

I now have a spreadsheet showing how things are progressing and I would be very grateful for any comments.
Thank you, Anthony
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You started at a low dose so my guess is these high numbers are because the dose needs to go up rather than being too high and causing bouncing. I would try 1 u next and hold it for 3 days to assess its effectiveness.
 
Thank you very much for your comments. Things have gone a bit wrong this morning. I did the test and was shocked to get a reading of 5.4. I immediately fed Shelley and then half an hour later tested again and got 19.1 but didn't know if this was a result of the food or was the 5.4 just an error reading?
So I dare not inject. It does worry me if her levels are too high and she has lost some weight since this all started but I think all I can do now is just test and monitor today and if levels run as they have been, start injecting again this evening.
Thanks again for your input, it is much appreciated and helps with my worries!
Anthony
 
Sharon14 said:
Hi Anthony, I don't give dosing advice, but I wanted to bump your post up so others can see it. You may want to put a link to it in your other thread so the people that were helping you will see it.
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Thank you very much, that seems to have worked.
Kind regards,
Anthony
 
Anthony Morgan said:
Thank you very much for your comments. Things have gone a bit wrong this morning. I did the test and was shocked to get a reading of 5.4. I immediately fed Shelley and then half an hour later tested again and got 19.1 but didn't know if this was a result of the food or was the 5.4 just an error reading?
So I dare not inject. It does worry me if her levels are too high and she has lost some weight since this all started but I think all I can do now is just test and monitor today and if levels run as they have been, start injecting again this evening.
Thanks again for your input, it is much appreciated and helps with my worries!
Anthony
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. Next time you get an unusual reading, stall for 20 min without feeding and recheck the number.
 
Thank you Janet NJ, I just felt a bit worried because the last time I had a very low number was when she had the Hypo, so I thought I better feed her. But I would obviously have got a clearer picture without the food.
Kind regards,
Anthony
 
Anthony Morgan said:
Thank you very much for your comments. Things have gone a bit wrong this morning. I did the test and was shocked to get a reading of 5.4. I immediately fed Shelley and then half an hour later tested again and got 19.1 but didn't know if this was a result of the food or was the 5.4 just an error reading?
So I dare not inject. It does worry me if her levels are too high and she has lost some weight since this all started but I think all I can do now is just test and monitor today and if levels run as they have been, start injecting again this evening.
Thanks again for your input, it is much appreciated and helps with my worries!
Anthony
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Gosh yes, that 5.4 must have been a shock, Anthony. It does look like a rogue error reading. The 19.4 sounds more likely to be correct but it is unnerving not knowing. I'm not sure what to say about dosing now other than err on the side of caution until you are reasonably sure that her numbers are consistently high. From recent numbers it was looking likely that she could handle a dose of 1u to get her down into not-too-high and not-too-low numbers, if you see what I mean, but I do appreciate that an out-of-the-blue low is disconcerting. If I were you I'd just monitor closely today and see what happens, just as you say yourself... instinct is very useful in a situation like this.
If you do test again during the day and get more "wonky" numbers it might be worth putting a call in to the vet to see what they say. Again, just being cautious.
Let's hope this was just a minor blip.
 
That's a really steep rise in a half hour. I'm wondering if your blood sample was too small causing the meter to read wrong.
 
Diana&Tom said:
Gosh yes, that 5.4 must have been a shock, Anthony. It does look like a rogue error reading. The 19.4 sounds more likely to be correct but it is unnerving not knowing. I'm not sure what to say about dosing now other than err on the side of caution until you are reasonably sure that her numbers are consistently high. From recent numbers it was looking likely that she could handle a dose of 1u to get her down into not-too-high and not-too-low numbers, if you see what I mean, but I do appreciate that an out-of-the-blue low is disconcerting. If I were you I'd just monitor closely today and see what happens, just as you say yourself... instinct is very useful in a situation like this.
If you do test again during the day and get more "wonky" numbers it might be worth putting a call in to the vet to see what they say. Again, just being cautious.
Let's hope this was just a minor blip.
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Thank you Diana, that's what I'm thinking. Kind regards, Anthony
 
I just did another test and got 23.8. So it looks like the 5.4 was an error? Oddly she has been brighter today than usual.
 
Yes almost certainly an error.
So is your plan to wait until this evening to test and shoot? That's ok if you want to do that but it would mean that Shelley would be without insulin and in high numbers for a long time. An alternative would be to give her a small dose now - say 0.5u - and see what duration she gets from that... if she drops and then rises again by usual shot time, you can reconsider your plan at that point, or you can tweak shot times, ie instead of shooting at 9am and 9pm or whatever you do, shoot at 11am and 11pm.. it is hard to know what to suggest to you because some owners are naturally and understandably cautious, while others want to get going with the numbers ASAP! So it's your call... but I would try to forget that low number, it was clearly off.
 
Hi Diana,
thank you for coming back to me. I have just been wondering what is best to do. I had decided to give her a shot but was thinking about the timing but as you say I can change it for now and can always gradually come back to my usual time.
 
Anthony Morgan said:
Hi Diana,
thank you for coming back to me. I have just been wondering what is best to do. I had decided to give her a shot but was thinking about the timing but as you say I can change it for now and can always gradually come back to my usual time.
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Yes that's the thing, Anthony... Caninsulin is traditionally dosed at 12-hour intervals but there are circumstances in which you have to tweak that. If a cat needs insulin, she needs insulin, don't wait until the clock says it's shot time. So if you're at home and are able to be flexible with dosing schedule, do so... just gradually of course, as you say.
 
Thank you Diana. As the last 2 numbers were what I have be seeing lately, I decided to stick to 0.75 to try an get some consistency, hope I'm not wrong. But as you say the 5.4 can't have been right. The advice on here has been such a great help, because I find there is usually a long wait to speak to a vet. I suppose there is always going to be the odd incident with this illness. Strangely, Shelley is brighter and more awake this morning than for a while?
 
I think .75u will be fine, test again in another hour to see what effect that has if you can.
Ref the vet, yes they are rather elusive because they are often consulting, I suppose, but if you ring and ask to speak to someone as a matter of urgency they should call you back as soon as they can. I'm sure they know the owners who are responsible enough to ring only when it's really necessary.
As for Shelley being brighter - could be any of a number of reasons not necessarily to do with BG. Most cats sleep more when it's cold, and some are affected by the moon and goodness knows what else... every cat is different and we never really know what goes on in that respect. But if you're keeping a diary of her BGs, food intake, behaviour etc you might like to note when she looks brighter than usual. Sometimes you can link it back to something specific.
I'm off to work now but wish you and Shelley a good day! I'm sure others will be around on and off so keep asking questions if you're concerned.
 
Thank you! My vets used to be locally owned and I had a very good reltionship with one of the directors who I had known for 17 years. But it was sold to a big company and now you see a different vet, usually inexperienced, nearly every time. And, Richard, to whom I am referring would try and keep costs down because he new I was helping stray or abandoned cats, whereas the new vets seem to want to get you to spend as much as possible.
Still, I am glad they are there when I need them.
I hope you have a good day too and thank you again, you have been a great help!
 
I'm not sure if anything I've said has been "a great help" at all, Anthony... this is a tricky situation and it's hard to know what to say for the best except carry on as you are, monitoring and dosing as you think appropriate. It is certainly best to stick with a dose for a few days before changing it, but (not including this morning's "rogue" low number) Shelley's numbers generally are still high and we do need to get them down which would normally mean a higher dose. There is also ketones to consider if she is consistently high and is not getting enough insulin, and we don't want to go there!
Keep posting whatever numbers you get (I know you said the spreadsheet is slow, don't have any answers to that I'm afraid) but you can add updates in this thread if you think any number you get is significant (eg lower than you thought).

FD can be a very frustrating business but if you can get Shelley's highest numbers down by a few points, that would be progress. So once we have established that she is giving you more "normal" (at this stage) numbers, you may have to consider upping the dose a tad... I completely understand your reluctance but it may be what's needed to turn a corner.
 
Diana&Tom said:
I'm not sure if anything I've said has been "a great help" at all, Anthony... this is a tricky situation and it's hard to know what to say for the best except carry on as you are, monitoring and dosing as you think appropriate. It is certainly best to stick with a dose for a few days before changing it, but (not including this morning's "rogue" low number) Shelley's numbers generally are still high and we do need to get them down which would normally mean a higher dose. There is also ketones to consider if she is consistently high and is not getting enough insulin, and we don't want to go there!
Keep posting whatever numbers you get (I know you said the spreadsheet is slow, don't have any answers to that I'm afraid) but you can add updates in this thread if you think any number you get is significant (eg lower than you thought).

FD can be a very frustrating business but if you can get Shelley's highest numbers down by a few points, that would be progress. So once we have established that she is giving you more "normal" (at this stage) numbers, you may have to consider upping the dose a tad... I completely understand your reluctance but it may be what's needed to turn a corner.
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It is a great help to get a second opinion when I am unsure what to do for the best, especially from someone with a lot more experience in this than myself. I am using the spreadsheet, it's not so bad just enetring a few numbers. It just seemed to be a bit slow entering the older details in one go.
I do think a small increase is warranted and all being well, that will be soon.
Thanks again, Diana
 
OK Anthony, see how the PM number is and do post here with that info if you're unsure.
You're doing a grand job and you're very calm which is always an advantage!
 
Hi Anthony @Anthony Morgan
I am SO sorry if I've forgotten this (I'm an old fart with diminishing brain cells..) but can you remind us exactly what you're feeding Shelley? And how often are you feeding her?
Thanks!

Eliz
 
Hi Eliz,
Thank you for coming back to me. The vet recommended RC Diabetes wet. I did try it but Shelley wasn't eating much of it. So I have gone back to her usual food; Felix Pouches, Gourmet Solitaire Pates, Applaws Chicken in Jelly and other Applaws flavours, Marks & Spencer Foil Trays, Game, Mackeral & Beef flavours. Also fresh chicken.
She really likes Gourmet Solitaire Beef in Tomato but I have a feeling that will be high in sugar. Her appetite isn't as good as it was. She usually is asking for food every couple of hours but only eats a small amount. I am trying to leave as long as possible between the am/pm food and tests. When first diagnosed she weighed about 6.5 kg but now is about 4.5.
Regards, Anthony
 
Hi Anthony
I'm up early this morning catching up on various things and have just had a peek at your spreadsheet... that 11.9 last night must have been a surprise, then the 24 at pre-shot just an hour later? I'm beginning to wonder if some of Shelley's numbers are food spikes or otherwise connected with food intake in some way...you say she is a grazer or eats little and often? This, or specific foods, might cause her BGs to go up and down during the cycle. I wonder what Elizabeth @Elizabeth and Bertie thinks about this, and the foods you are feeding Shelley? Some of the even high-quality brands have more carbs than you might imagine.
 
Hi Diane,
Very good of you to have a look at the spreadsheet. You are quite right, I wasn't sure what to do, so just injected 0.05.
Did a test at +2 = 18.4 and +9 = 22.6. I am wondering if she drops more than expected when she has not eaten. On the day of the Hypo she had a longer gap in eating than usual. I don't think she ate much when she was hospitalised after the Hypo and her curves where normal without insulin? But now numbers are up again. She did seem hungry after the 11.9 test?Could it have been another error test? Two or three more hours before I can inject again.
It's all rather confusing.
Thanks again, Anthony
 
It is all very confusing, Anthony, I agree... it could be food related or it could be that Shelley is one of those cats who might produce her own insulin at unpredictable times - such an instance could have caused the hypo if she was also being given exogenous insulin at the time, ie she simply had too much insulin in her system. This is called a "sputtering pancreas" - look it up for more info. I'm by no means saying that this IS the case, but it could come into play in a situation like this.

I am reluctant to suggest you raise the dose when the numbers you're getting are still quite variable, and I'm not great at looking at spreadsheets to see patterns at the best of times. There are people on this board who are much better than me at that! Hopefully Elizabeth will be around later to give you her comments, and meanwhile I am tagging Mary Ann @Tuxedo Mom who is another long-standing, experienced member who will also hopefully take a look and offer her opinion.

As you're seeing and have already commented, FD is tricky to treat. You will probably have to persevere with testing on a regular basis and maybe also look closely at the content of different foods... some innocent-looking foods may actually raise BGs significantly in some cats. Elizabeth has detailed info about UK foods and again, may have some useful input here.

Sorry I can't be more specifically constructive than that. See what the others say, and if you start to get too stressed about what's going on you could perhaps ring the vet and ask if it's possible to email the link to your spreadsheet so they can take a look.

Will pop back later.
 
Personally I would now increase to 1 unit and not worry to much about the intermediate readings. If you hadn't tested an hour before her PM shot you wouldn't have known about it being an "odd" result and would have given her the 0.75 dose as normal. Sky throws out odd numbers every now and then but I only really base her injection number on the one at 12 hour when the insulin should be out of her system (and her appearance during the day if she is low).

Is there any way you can keep to one particular type of food for a few days and rotate around - so for 2 or 3 days feed Gourmet, then felix etc just to see if you can pinpoint any food reactions? If you can rotate the food I would keep to the same dose of insulin so you know that it is more likely to be food related rather than insulin.

It seems clear that the 0.75 isn't bringing her down to a better level. She has been in the reds now more often than not so I think an increase is in order.
 
Anthony, I don't disagree with Karen about upping the dose but I know it's hard to overcome the fear of hypo so an increase depends on how brave you're feeling. Very good idea of Karen's to try to pinpoint specific food reactions in which case yes, stick to the same insulin dose... one of the golden rules of FD treatment is to change one thing only at a time, so you start to get a clearer picture.
You do want to get Shelley out of these reds so why not take a deep breath and give 1u a try on the next morning shot (when you are more likely to be around during the day to keep an eye?)
 
Anthony

I just want to cover a couple of very basic points first. How old is the Caninsulin and do you keep it refrigerated? Some people have found that this insulin tends to lose some of its effect after a month of so. Also are you properly rolling the insulin before injecting? What site are you using for the injections? Some people find a poorer absorption from the scruff than from the flank or abdomen. Also are there any health issues such as poor teeth? Dental issues can cause higher glucose levels and more difficulty with good regulation. I know you have been doing this for years, but I always like to clear out the basics first.

A hypo of 1.1 (20 US) is indeed a scary episode to go through and I can see your concerns about having another hypo when the last one came out of nowhere. You have received a lot of good advice from people since you first posted. Tracking your food type and amount is a good idea to see if there is some correlation with the food and the readings. As has already been stated, preshot tests should be done when there is at least 2 hours with no food and with Caninsulin Shelley should have eaten a good meal about 20-30 minutes before the shot. The "usual" effect of Caninsulin is a steeper drop with 2-3 hours after the shot and a nadir ( lowest reading) around 4-6 hours after the shot although every kitty is different in how they react. Shelley's spreadsheet shows a fairly smooth curve with no major drops. You are doing lots of testing so my thought is that she may need to have an increase. But as Karen suggested trying to see if the food type is part of the problem first may be a good approach. As she usggested "Is there any way you can keep to one particular type of food for a few days and rotate around - so for 2 or 3 days feed Gourmet, then felix etc just to see if you can pinpoint any food reactions? If you can rotate the food I would keep to the same dose of insulin so you know that it is more likely to be food related rather than insulin." If you can try this for a few days and see if the food type is affecting the numbers then you can look at the dose next. It may also be that it may be time for a change to a different insulin. But first the other potential issues need to be ruled out.


This may already have been posted but @Elizabeth and Bertie put together a food list of UK low carb foods:

https://docs.google.com/spreadsheets/d/1J5JpMe6TDXrHq_aTl9hUtHy6Gs9oRBqlz4nPGKxtySA/pubhtml

I know how frustrating this must be to have had Shelley regulated for so long and then have the hypos and then higher readings, but by ruling out any potential problems hopefully you can get Shelley back to good regulation again. :bighug: :bighug:
 
Anthiny

When Shelley went to the hospital for the hypo did you take your own insulin in for them to use or did they use insulin they had at the clinic?

Still trying to put together the two hypos and then the run of higher numbers.
 
Tuxedo Mom said:
Anthony

I just want to cover a couple of very basic points first. How old is the Caninsulin and do you keep it refrigerated? Some people have found that this insulin tends to lose some of its effect after a month of so. Also are you properly rolling the insulin before injecting? What site are you using for the injections? Some people find a poorer absorption from the scruff than from the flank or abdomen. Also are there any health issues such as poor teeth? Dental issues can cause higher glucose levels and more difficulty with good regulation. I know you have been doing this for years, but I always like to clear out the basics first.

A hypo of 1.1 (20 US) is indeed a scary episode to go through and I can see your concerns about having another hypo when the last one came out of nowhere. You have received a lot of good advice from people since you first posted. Tracking your food type and amount is a good idea to see if there is some correlation with the food and the readings. As has already been stated, preshot tests should be done when there is at least 2 hours with no food and with Caninsulin Shelley should have eaten a good meal about 20-30 minutes before the shot. The "usual" effect of Caninsulin is a steeper drop with 2-3 hours after the shot and a nadir ( lowest reading) around 4-6 hours after the shot although every kitty is different in how they react. Shelley's spreadsheet shows a fairly smooth curve with no major drops. You are doing lots of testing so my thought is that she may need to have an increase. But as Karen suggested trying to see if the food type is part of the problem first may be a good approach. As she usggested "Is there any way you can keep to one particular type of food for a few days and rotate around - so for 2 or 3 days feed Gourmet, then felix etc just to see if you can pinpoint any food reactions? If you can rotate the food I would keep to the same dose of insulin so you know that it is more likely to be food related rather than insulin." If you can try this for a few days and see if the food type is affecting the numbers then you can look at the dose next. It may also be that it may be time for a change to a different insulin. But first the other potential issues need to be ruled out.


This may already have been posted but @Elizabeth and Bertie put together a food list of UK low carb foods:

https://docs.google.com/spreadsheets/d/1J5JpMe6TDXrHq_aTl9hUtHy6Gs9oRBqlz4nPGKxtySA/pubhtml

I know how frustrating this must be to have had Shelley regulated for so long and then have the hypos and then higher readings, but by ruling out any potential problems hopefully you can get Shelley back to good regulation again. :bighug: :bighug:
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Thank you very much for your comments. Sorry for the delay in replying, it's been a busy day.
I used to use one vile of insulin each month. It is kept refrigerated and I always mix it gently before use. I inject in the scruff but changing positions each time. Shelley hasn't got many teeth left but has no issues with those remaining. She has been diagnosed with pancreatitis but that doesn't seem to be bothering her and she is on Amodip for high blood pressure.
I have been to see the vet today and his advice was to increase the dose to 1u and feed only RC Diabetes wet.
So I think I had better increase the dose, I am not too happy about the RC and would prefer to go with Karen's idea.
When Shelley was in the hospital they used a new vile of insulin.
Very grateful for your time and interest.
Kind regards, Anthony
 
Diana&Tom said:
Anthony, I don't disagree with Karen about upping the dose but I know it's hard to overcome the fear of hypo so an increase depends on how brave you're feeling. Very good idea of Karen's to try to pinpoint specific food reactions in which case yes, stick to the same insulin dose... one of the golden rules of FD treatment is to change one thing only at a time, so you start to get a clearer picture.
You do want to get Shelley out of these reds so why not take a deep breath and give 1u a try on the next morning shot (when you are more likely to be around during the day to keep an eye?)
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Hi Diane,
Thanks again!
I have been to the vets today and his advice was to increase to 1u and feed only RC Diabetic food. Not so sure about the food as Shelley was hardly eating it but certainly happy to try Karen's idea. So that will be the plan for tomorrow.
Regards, Anthony
 
Sootyca said:
Personally I would now increase to 1 unit and not worry to much about the intermediate readings. If you hadn't tested an hour before her PM shot you wouldn't have known about it being an "odd" result and would have given her the 0.75 dose as normal. Sky throws out odd numbers every now and then but I only really base her injection number on the one at 12 hour when the insulin should be out of her system (and her appearance during the day if she is low).

Is there any way you can keep to one particular type of food for a few days and rotate around - so for 2 or 3 days feed Gourmet, then felix etc just to see if you can pinpoint any food reactions? If you can rotate the food I would keep to the same dose of insulin so you know that it is more likely to be food related rather than insulin.

It seems clear that the 0.75 isn't bringing her down to a better level. She has been in the reds now more often than not so I think an increase is in order.
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Hi Karen, thank you for your comments. Have been to the vets today and he has told me to increase to 1u and feed only RC Diabetic food. Not sure about the food, I would rather try your idea. Going to have try it and hope all goes well.
Regards, Anthony.
 
I wouldn't feed specialist diabetic food either unless there was no option. I think you will find when you increase her dose and look into the food a bit more the numbers will come down.

I can't remember - do you feed Felix? I think I have said before that removing Felix from Sky's diet really caused her numbers to drop - I'm sure it was linked to the vegetable protein extract. I now avoid anything that has that in it - so she is pretty much on Sheba (fortunately they do lots of flavours and she loves them all). Have a look on the food you are giving Shelley to see if they have vegetable protein or vegetable derivatives and maybe stop that food first - regardless of the low carb content she could be one of the ones that it affects without you realising. I don't want you thinking I'm telling you waht to do (lol) but once I realised what it was it was such a simple fix! Lots of cats have felix with no problems so it may not be.

Just copied a paragraph from Diabetic Cat Care website

"Wet cat food with a lower than 10% carbohydrate count based on dry matter (which is not indicated on the label) is best for cats with FD and is required when practicing TR. Avoid foods containing grains such as rice, wheat and corn, glutens, starches, sugars and syrups, gravies and those containing vegetables and fruits. Foods containing soy and/or ‘vegetable protein extract’ can raise the BG even if the percentage of calories from carbohydrates is below 10%. These species inappropriate ingredients can render the liver useless to do its job of protecting the brain in the event of low BG, potentially resulting in clinical hypo and are not at all recommended for cats when starting TR as explained in The Liver's Job sticky."

I bet you feel like it is a neverending struggle at the moment to get her to numbers lower but you will get there. :)
 
Thank you very much, Karen. I haven't found it easy trying to determine which food is best. I look at the tables and a lot of the preferred foods are not readily available. I did get a consignment of the German brands but none of my cats liked it.
But that's a helpful tip, I will check on that.
 
Anthony

Thank you for your reply to the questions I had asked. It sounds like there is no problem with the efficacy of the insulin and there are no obvious other medical issues at this point that could be causing the higher numbers. From what I can see it either comes down to the food or to needing a higher dose. I am not familiar with the RC Diabetes wet food as far as the carb count. The one thing I wonder about is that Shelley had two hypos on a dose of 1.5 unit and she had been fairly well regulated for a long period of time. What sort of numbers did you get when you started home-testing. I tend to be leery of fructosamine tests since they are only an average of a 2-3 week period and if there were highs and lows the average could still look good even though the numbers may have been a bit of a roller-coaster.

My two thoughts are that the food could be playing a factor, especially when you look at the numbers from yesterday. With Caninsulin it is unusual ( but not impossible) that readings would drop towards the end of the cycle such as your +11 and then zoom up for the PMPS. whether this is a food issue or a need for more insulin is hard to judge. I am hoping that some others will weigh in with their opinions. In the meantime if you are increasing the dose make sure that you get adequate tests in (which I can see that you usually do). That hypo you had and the following hypo at the clinic are concerning,

Hoping that you can get this all sorted out, as it must be very concerning to have such a big change out of the blue. :bighug: :bighug:


ETA In case you missed it this link has a list of UK low carb foods as researched by @Elizabeth and Bertie who is a UK member
https://docs.google.com/spreadsheets/d/1J5JpMe6TDXrHq_aTl9hUtHy6Gs9oRBqlz4nPGKxtySA/pubhtml
 
Those numbers are too high. We need to get her into the blues.


I personally would do 1 unit when the preshot is in the 300's and try 1.25 when the preshots are in the 400's. (You may have to go higher, but right now you aren't even hitting high blues.).
 
Sootyca said:
I wouldn't feed specialist diabetic food either unless there was no option. I think you will find when you increase her dose and look into the food a bit more the numbers will come down.

I can't remember - do you feed Felix? I think I have said before that removing Felix from Sky's diet really caused her numbers to drop - I'm sure it was linked to the vegetable protein extract. I now avoid anything that has that in it - so she is pretty much on Sheba (fortunately they do lots of flavours and she loves them all). Have a look on the food you are giving Shelley to see if they have vegetable protein or vegetable derivatives and maybe stop that food first - regardless of the low carb content she could be one of the ones that it affects without you realising. I don't want you thinking I'm telling you waht to do (lol) but once I realised what it was it was such a simple fix! Lots of cats have felix with no problems so it may not be.

Just copied a paragraph from Diabetic Cat Care website

"Wet cat food with a lower than 10% carbohydrate count based on dry matter (which is not indicated on the label) is best for cats with FD and is required when practicing TR. Avoid foods containing grains such as rice, wheat and corn, glutens, starches, sugars and syrups, gravies and those containing vegetables and fruits. Foods containing soy and/or ‘vegetable protein extract’ can raise the BG even if the percentage of calories from carbohydrates is below 10%. These species inappropriate ingredients can render the liver useless to do its job of protecting the brain in the event of low BG, potentially resulting in clinical hypo and are not at all recommended for cats when starting TR as explained in The Liver's Job sticky."

I bet you feel like it is a neverending struggle at the moment to get her to numbers lower but you will get there. :)
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Great post from Karen! Anthony, I hope your vet's recommendation has given you the confidence to try the 1u dose which does seem in order now. It is important that Shelley eats her usual amount of food, so if she refuses the RC the vet suggests, give her one of the other wet varieties - checking the ingredients if you can as above. Sometimes the packaging is comprehensive, other times you may have to go to the supplier's or manufacturer's websites and look there.
Best of luck! We are all rooting for you and Shelley!
 
Tuxedo Mom said:
Anthony

Thank you for your reply to the questions I had asked. It sounds like there is no problem with the efficacy of the insulin and there are no obvious other medical issues at this point that could be causing the higher numbers. From what I can see it either comes down to the food or to needing a higher dose. I am not familiar with the RC Diabetes wet food as far as the carb count. The one thing I wonder about is that Shelley had two hypos on a dose of 1.5 unit and she had been fairly well regulated for a long period of time. What sort of numbers did you get when you started home-testing. I tend to be leery of fructosamine tests since they are only an average of a 2-3 week period and if there were highs and lows the average could still look good even though the numbers may have been a bit of a roller-coaster.

My two thoughts are that the food could be playing a factor, especially when you look at the numbers from yesterday. With Caninsulin it is unusual ( but not impossible) that readings would drop towards the end of the cycle such as your +11 and then zoom up for the PMPS. whether this is a food issue or a need for more insulin is hard to judge. I am hoping that some others will weigh in with their opinions. In the meantime if you are increasing the dose make sure that you get adequate tests in (which I can see that you usually do). That hypo you had and the following hypo at the clinic are concerning,

Hoping that you can get this all sorted out, as it must be very concerning to have such a big change out of the blue. :bighug: :bighug:


ETA In case you missed it this link has a list of UK low carb foods as researched by @Elizabeth and Bertie who is a UK member
https://docs.google.com/spreadsheets/d/1J5JpMe6TDXrHq_aTl9hUtHy6Gs9oRBqlz4nPGKxtySA/pubhtml
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Hi,
Looking back, July 2016, fructosamine test showed only fair control and dose increased from 1.5 to 2.00.
August home testing,
13.7, just after am shot
17.7 +2
13.6 +4
14.1 +6
16.9 +10
24.2 pmps

November 2016

+2 14.4
+4 3.6
+6 8.2

+8 13.7

Pmps 19.0

So there was a change and the December fructosamine indicated excellent control.
Thank you very much for your valued comments.

My replies may be a little late at the moment.
One of my other cats, Herbie is unwell, so I am taking him to the vets this morning.
Anthony
 
Diana&Tom said:
Great post from Karen! Anthony, I hope your vet's recommendation has given you the confidence to try the 1u dose which does seem in order now. It is important that Shelley eats her usual amount of food, so if she refuses the RC the vet suggests, give her one of the other wet varieties - checking the ingredients if you can as above. Sometimes the packaging is comprehensive, other times you may have to go to the supplier's or manufacturer's websites and look there.
Best of luck! We are all rooting for you and Shelley!
Click to expand...

Thank you Diane. Yes, I do feel more confident to try that now. I appreciate your encouragement! Unfortunately, Herbie cat is unwell today. Back to the vets shortly.
 
JanetNJ said:
Those numbers are too high. We need to get her into the blues.


I personally would do 1 unit when the preshot is in the 300's and try 1.25 when the preshots are in the 400's. (You may have to go higher, but right now you aren't even hitting high blues.).
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Thank you JanetNJ. That is the plan now, going to start on 1.0 today.
I appreciate your input!
 
Thank you Diana and Karen,

Your good wishes are very much appreciated. Although Herbie is around 15 years old he is in excellent health and very active usually. But I noticed last night, that he had been in one postion for a while and when I stroked him he growled and he wasn't eating or drinking. He seemed much the same this morning so I decided I had better get him checked over.
As soon as I put him in his basket he brightened up considerably and seemed pretty well when we got to the vets. They decide to do a blood test and I am hoping for the results tomorrow. Once back home he has eaten a little but still seems quieter than usual.

So today hasn't gone to plan.
I tested Shelley's blood sugar at +12 and got a reult of 12.9. She had not eaten for the past 2 hours.
Two minutes later it was14.5
So I didn't inject and tested again at +13 = 13.2, after a meal of Felix

I know this is not the prefered food but I decided to limit her to this to start with as I am not able to get to the shops so easily at the moment as my car is in for repair, just to add to the complications!

I decided to give it another hour and at +14=17.4
I probably should have injected at this point but I just thought I will leave it another hour just to see the trend.
So at 0.75 she seems to be keeping low for up to 13 hours when she hasn't eaten for a while.
I would apprecite any thoughts as perhaps I am mistaken and should have injected at + 12 anyway?
Thanks again for reading!
 
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.
 
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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