Unable to give insulin at second shot time for 3 days?

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thatgirlblu

Member Since 2013
For three straight days now my cat was far too low to give insulin at the 12-13 hour mark after his last shot. Day 1 gave 1.75 units at night (Vetsulin) and 13 hours later for his next shot he was 117 so I couldn't shoot. Day 2 gave 1.50 insulin at night (figuring slightly lower was better at this point) he was 93 at the time for the next shot 12 hours later, so couldn't give it to him. Night came, only gave 1.0 unit, Day 3, today, I woke up slightly late so I checked him at 13 hours past again, he was 82. So I had to skip todays dose too.
Basically, I give it to him at night cause he's usually in the 290-350 range by then and I can't give it to him in the day now cause he's too low to get it. But he doesn't get there til like, 16+ hours after his last dose. Shouldn't it wear off after 12? It's a really low dose of Vetsulin, right? He did have a diet change again this week (now strictly fancy feast classic chicken twice a day, he has on blue buffalo wilderness chicken canned last) and funny thing is even when he gets to the higher numbers after the 16 or so hour mark, he doesn't show the signs (doesn't drink a lot, doesn't pee a lot, has a ton of energy still, etc) the highest he gets is 350. And that's usually when it's almost 18-20 hours after last insulin...I feel bad he's been only getting it once a day but every time I go to give his second shot he's too low to get it.
So now I don't know what to do?
My vet said this could be a sign he might go to remission soon cause he's needing so much less and less? But I'm so new at this, and the other vet (yeah I have 2 vets...long story but one I actually consult with for the most part, the other sells cheaper insulin and needles and is open 24/7 for emergencies, heh) said most cats never have remission earlier than several months of being on insulin (he's been a month maybe, more like 3 weeks)
I check him every few hours he has NO highs until the last 16-24 hours after insulin and even then they don't sky rocket either, he eats, after a couple hours he gets to 275-350 and stays there til the next shot. Next shot is given, he gets to the low 100's within a couple hours, and he stays there between 90-160 for at least 16 hours. It's so weird.
Obviously he NEEDS insulin otherwise he wouldn't be getting to the 300's after 16 hours, right?
Idk, help? Heh
 
I am confused by your numbers. can you confirm this is correct and what the PM readings were?

Day 1
PM 1.75IU ? what was the BG?

Day 2
AM 117 - skip
PM 1.5IU BG reading??

Day 3
AM 93 - skip
PM 1 IU.. BG readings??

Day 4
AM 83 -skip


thanks
Wendy
 
It sounds like when you do give a shot, you may be giving too much.

Ideally, you want to give the same dose am and pm.

Next time it is safe to shoot, only give 0.5 units and see how that works.
 
Oh and during the middles where he gets a little high when he had no insulin, it's cause I didn't know what to do whether wait for the regular night shot or what cause I can't give it at odd times every day, cause I work and stuff so yeah, like there are times when I have to skip it, but then 4 hours later he seems like he needs it then, but I'm like well then I'd have to stay up til 6 am to give another one so idk :/ My needles don't have .5 or .75 but my husband was big into chemistry and sciencey stuff and is OCD about accuracy so he looks at my needles to see if I am where it should be assuming there were a line for that dose, if that makes sense. my vet also said I could go "between" lines, like to give 1.5 I could go exactly between the 1 and the 2 line, etc, so that's why there's that (since we know the needles for vetsulin don't have half lines or quarter lines) and he always eats right after AMPS and PMPS
 
I agree on the 0.5u. We need to find a dose that you can give twice a day, roughly 12 hours apart to keep the numbers on a more even keel.

Your vet is wrong on how fast cats can go into remission, be diet controlled. We've seen it happen here in a couple of weeks sometimes.
 
Deb & Wink said:
I agree on the 0.5u. We need to find a dose that you can give twice a day, roughly 12 hours apart to keep the numbers on a more even keel.

Your vet is wrong on how fast cats can go into remission, be diet controlled. We've seen it happen here in a couple of weeks sometimes.
Click to expand...

Hey so last night I did what you said and went to 0.5u. and tested this morning at the 12 hour/AMPS mark. He was still only 94. I only gave him 0.5!!! LOL what do I do now? My needles are so small I am sure I would have a difficult time measuring anything below that, the lowest dose my needles go to is 1u. but I guess at the 0.5.

https://docs.google.com/spreadsheet/ccc?key=0Am_k4AYAKhWfdHV5b05Ed0JtOW1fNVRfZUtrNS1ZNXc#gid=0

^His chart. Yes I will put that in my signature at some point soon lol.

I'm wondering how he stays so low, so long...then gets back to the mid/high 200's and even low 300's 16-24 hours after shot. Hrmmm....
 
You'll have to eyeball the 0.25 as best you cat. No OTC syringes measure more finely than half units.

One tactic is to fill a used syringe with colored water to the first available mark and then see how many drops of the same size you can squeeze out of it. Practice until you can do it reliably. Then, you can dose in drops.

If the Vetsulin is U-40 concentration, you may want to make a cardboard reference gauge. Instructions are here

Alternatively, it is possible to use a U-100 syringe with a U-40 insulin, using a conversion chart. That lets you dose in 0.2 unit increments.
 
BJM said:
You'll have to eyeball the 0.25 as best you cat. No OTC syringes measure more finely than half units.

One tactic is to fill a used syringe with colored water to the first available mark and then see how many drops of the same size you can squeeze out of it. Practice until you can do it reliably. Then, you can dose in drops.

If the Vetsulin is U-40 concentration, you may want to make a cardboard reference gauge. Instructions are here

Alternatively, it is possible to use a U-100 syringe with a U-40 insulin, using a conversion chart. That lets you dose in 0.2 unit increments.
Click to expand...

So based on his chart you think 0.25 u is the best way to go?
 
He keeps giving you unshootable pre-shot numbers, lower and lower. He's aiming for getting off the insulin!
 
BJM said:
He keeps giving you unshootable pre-shot numbers, lower and lower. He's aiming for getting off the insulin!
Click to expand...

Yeah! Lookit, it's been 17 hours since his last dose of only 0.5 and he's still only at 156. Woo maybe this is a signnnn!!! I just updated his chart, will keep doing so.
 
Today's numbers, especially without insulin since last night, are awesome.


said most cats never have remission earlier than several months of being on insulin (he's been a month maybe, more like 3 weeks)
Click to expand...

Well, technically, that might be true? But then most cats aren't "here" either, and don't get the benefit of hundreds of kitties who have come here and gone on to remission. Most cats don't get put on a low carb, all canned diet. Or have caregivers who home test either.

My cat was on insulin for 10 weeks. Just my opinion, but your kitty is heading in the same direction as Bob and many others have gone... anti-jinx!

Most kitties don't do this well on Vetsulin. Fluffy is doing fantastic, and so are you. I really don't know that much about the insulin, but I did read up on it a couple days ago -
http://www.felinediabetes.com/FDMB/viewtopic.php?f=19&t=93937
According to the company, the proportions of the short-acting amorphous fraction and long-acting crystalline fraction have not actually changed, as compared to the original Vetsulin product. Instead, the new stated ratio (65% long-acting and 35% short-acting insulin) represents a more accurate reflection of the actual composition of both the original and updated Vetsulin product (10).
Click to expand...

I hadn't realized that it's sort of "2 insulins in 1" with both a short acting, and longer acting component. So it can have two separate "peaks" of action. To me, it looks like the longer acting part is working really well for Fluffy? You're getting some really longer cycles than we'd expect to see with Vetsulin. And it would seem that if you can manage to measure a smaller dose you could be able to shoot every 12 hours, just a tiny amount. That would keep insulin working in Fluffy all day and night, and should keep your numbers down overall.

If you can get some U-100 syringes with half-unit markings, and use the conversion chart that people have mentioned, it will make it easier to accurately dose amounts as low a .2u, which will give you much better control over how much insulin you're shooting.

Overall, things are looking really good!
 
For a U-40 insulin, there are 40 units in 1 mL
For a U-100 insulin, there are 100 units in 1 mL

Therefore, the U-40 has 40%, or 0.4 of the concentration of the U-100 insulin

If you use a U-100 syringe to measure a U-40 insulin, the marks on the syringe only measure 0.4 * the marking.
Like this:
U-100 syringe mark * 0.4 = U-40 dose
0.5 * 0.4 = 0.20
1.0 * 0.4 = 0.40
1.5 * 0.4 = 0.60
 
If he needs the insulin I will have to do that, yes. Figure out how to either do the cardboard thing someone said or get different needles for smaller doses. BUT if you check the chart now he's still 36 hours past last insulin shot (which was only .5u) and he's still only reading 101. Remission?
 
Very possible!

At this point, you may be chasing the glucose, ie waiting for it to get high enough to be able to shoot a small dose.

If you make it 14 full days with no insulin, he's officially off the juice.
 
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