Should I not be shooting today?

Diagnosed 4 months ago with numbers up to 30.

My cat was on 3iu of insulin. He was getting a ndar of 3. Preshot 23

I reduced him down to 2.7, and that went well. Lows of 4, insulin lasting 10 hours. Preshot of around 20.

Now a week later his low is 2.8. And this morning 12 hours after last shot his number was 11. Fed him ff and an hour later he is up to 12.

I'm not sure what is going on here and when to shoot. I feel uneasy shooting 2.7iu when his numbers are less than 18. But I'm not sure if I'm just being stupid because the rise means caninsulin is on its way out so it will be fine?

Sorry no spreadsheet it's still broken for me

 

Vetsulin dose is based on the nadir, not the preshot values.

These numbers are correct? You are seeing nadirs of 2.8mmol on a dose of 2.7U?

Is he completely low carb?

If those nadirs are correct, you should immediately reduce the dose to 2.5U, possibly even 2.25U. Any time you see a number below 5 mmol, it's an immediate 0.25U reduction.

Reason being - Vetsulin can be very harsh and sometimes unpredictable. Seeing nadirs of 2.8mmol like you're seeing is playing with fire - it doesn't leave you any cushion/protection against hypo. So one day it may be fine and drop to 2.8mmol which is usually ok....then the next it's 2mmol and all of a sudden you're in big trouble.

The higher preshots are pretty common on Vetsulin, especially when the duration isn't 12 hrs. Those numbers do eventually come down over time, so I wouldn't worry about those too much.

That said, if you're not getting the 12 hr duration form Vetsulin and the preshots don't come down over time, a longer lasting insulin would be a better choice (such as ProZinc or Lantus).

 

Thank you for replying!

That makes sense re preshot numbers. Does this mean that if he is in his 12th hour it is ok to shoot regardless of preshot? Today his numbers climbed right back up to 18 in hours 13 and 14, I waited for the numbers to go back up before giving him his shot, might this be unnecessary if the caninsulin was already out of his system?

He was 100% on raw mixed with fancy feast pate and has been since the week he got diagnosed, the hills glucose support is what brings him up fast if he goes low :/.

Yep that nadir is correct. I had given him some dry food to offset it, and it got back up to 10 within an hour. I'm concerned because when I reduced his insulin from 3 he started to bounce all over the place before smoothing out, is this to be expected? Although the 2.8 nadir from 2.7iu is only a week after reducing down to 2.7iu. I definitely am going to reduce his dose tonight.

At present we are getting 11-12 hours out of caninsulin, and with his preshots numbers coming down, and him needing less insulin, I'm wondering if I should stick with it a little longer? My vet seemed to think he had the majority of cats reach remission with caninsulin, but some do better on the others so just left it up to me. Today that 12th hour 11 made me optimistic that it's giving him good duration.

Thanks so much for helping me!

 

I have to admit it's a little hard to track without seeing the spreadsheet, but -

We generally recommend a cutoff of 11.1mmol for the shot. Above that, full dose. Below that, stall without feeding for 20-30 minutes and post for advice (the Feline Health forum gets more foot traffic, so I recommend that for any immediate help you may need).

In your case I have to be more conservative given that I'm not sure you're at the right dose. I think it's too high, so even the 11.1 mmol cutoff may not be safe.

It is common for "weird" things to happen when first starting a new dose, usually takes about 2-3 days to even out a bit.

His numbers are actually pretty darn good for Vetsulin. I'd really like to see the spreadsheet to see the shape of the curve you're getting. Because if it's pretty gradual I'd say stick with it, but if he's dropping hard towards/rising sharply after nadir I might reconsider.

Can you post in the spreadsheet area of the forum to have someone help you fix the spreadsheet?