Vetsulin advice... seems to last longer than 12hrs... what should I dose now

[Amanda Whitehead]

Hi all
In November my boy was on 2 units of vetsulin twice a day we didn't see much improvement with this amount so we pushed him up to 2.5 units. We then had to board him in December at our vets while we went away so we decided to go back to 2 units, however this time 2 units was having a different effect. Our vets had to skip shots as he kept getting low levels. Since he has been back from boarding I can't seem to figure out what the best dose is for him. I can't go by the previous readings because seems the insulin is having a better effect now. Last night I had to stay up as after 2 units he was dropping see below readings:
PMPS 9.57pm 372
11.55pm 322
1.45am 184
251am 111
4.39am 85
6.00am 114
9.47am 97

At 6am last night I stopped testing and went to bed as I thought he'd reached nadir and his level was increasing. Only to find this morning he had gone lower. Now I'm concerned that he reached hypo range between 6am-9.47am.

Is it possible from his chart that he could be going into remission. His diabetes was steroid induced.

My thoughts are to try 1.5units and see how we go with that. I don't want to keep skipping shots because he seems to go back into the 300's when we skip.

I appreciate any help, I'm lost and worried about hypos. I also start a job in Feb and I won't be able to do this much testing.

Thanks all

 

[Amanda and a Loudogg]

I feel your pain. My buddy Lou used to react beautifully to insulin, and now it's a battle to even try to get him regulated. He used to nadir at +4 or +5, and now he usually peaks anywhere from +6 to +8 (usually at +7 or +8). It makes things so hard to dose properly for the next cycle because he goes up before he starts coming back down. Since Oscar's diabetes was steroid-induced, it is definitely possible that his pancreas is trying to help more, sending out random flares of insulin... and throwing things off in the process. I think it may be beneficial to lower the dose and see if his numbers stabilize so you can shot both am and pm cycles. In looking at his spreadsheet, I think that 1.5u insulin would be a good place to start. I would try to hold that if you can for at least 6 cycles, and see if the wild swings even out. If he seems to go to low during that trial, I would lower to 1.25u and try again. Hopefully we can get a better picture of what's going on after he settles and we can see what the next step is.

PS - Oscar is such a handsome boy!! But then I think I'm biased to those black and white beauties.

 

[Amanda Whitehead]

I feel your pain. My buddy Lou used to react beautifully to insulin, and now it's a battle to even try to get him regulated. He used to nadir at +4 or +5, and now he usually peaks anywhere from +6 to +8 (usually at +7 or +8). It makes things so hard to dose properly for the next cycle because he goes up before he starts coming back down. Since Oscar's diabetes was steroid-induced, it is definitely possible that his pancreas is trying to help more, sending out random flares of insulin... and throwing things off in the process. I think it may be beneficial to lower the dose and see if his numbers stabilize so you can shot both am and pm cycles. In looking at his spreadsheet, I think that 1.5u insulin would be a good place to start. I would try to hold that if you can for at least 6 cycles, and see if the wild swings even out. If he seems to go to low during that trial, I would lower to 1.25u and try again. Hopefully we can get a better picture of what's going on after he settles and we can see what the next step is.

PS - Oscar is such a handsome boy!! But then I think I'm biased to those black and white beauties.

It was so much better when I knew his nadir was around 6hrs after because then I could sleep and wake and test him at that time. Now I'm up all night and worried that soon I won't be able to do that with starting work. I am glad its not just me thats struggling with vetsulin I have considered changing to ProZinc. Thanks for your help, I think like you say I'll try 1.5 units today and see how that goes. Aww thanks yes hes a handsome fella and so is Lou.... black and white kitties are the cutest . I find he gets a bit of a yellow tone to his white fur now and I was told thats because of the sugar in his saliva, do you find the same?

 

[Amanda and a Loudogg]

It was so much better when I knew his nadir was around 6hrs after because then I could sleep and wake and test him at that time. Now I'm up all night and worried that soon I won't be able to do that with starting work. I am glad its not just me thats struggling with vetsulin I have considered changing to ProZinc. Thanks for your help, I think like you say I'll try 1.5 units today and see how that goes. Aww thanks yes hes a handsome fella and so is Lou.... black and white kitties are the cutest . I find he gets a bit of a yellow tone to his white fur now and I was told thats because of the sugar in his saliva, do you find the same?

I have been considering a change lately as well, but I'm not sure if his issues stem from the Vetsulin, or if he has an underlying issue that we haven't figured out yet that's keeping things weird. We'll keep our fingers and paws crossed for you two that lowering the dose helps even things out.

I've never heard about that with the saliva! I haven't noticed any yellowing with Lou, so it's either really subtle or not an issue. Hmmm, I may have to check him over more closely when I get home to be sure, haha.

 

[Elizabeth and Bertie]

Is it possible from his chart that he could be going into remission. His diabetes was steroid induced.

If you are seeing low numbers at the end of the cycle with Vetsulin that can indeed be an indicator that the pancreas is producing insulin of its own, and is able to hold the numbers down.
However, in a minority cats, this can also be caused by the dose being too high. (While many cats' BG will drop steeply and then bounce if the dose is too high, it can occasionally happen that the higher dose seems to extend the cycle.)

Your kitty's numbers have certainly improved over time, and I see that you have had to miss quite a few shots due to low preshot numbers. Reducing the dose may level out the numbers a bit so that the preshots are not too low too shoot.

Keeping fingers and paws crossed for continued improvement....
.

 

[Amanda Whitehead]

If you are seeing low numbers at the end of the cycle with Vetsulin that can indeed be an indicator that the pancreas is producing insulin of its own, and is able to hold the numbers down.
However, in a minority cats, this can also be caused by the dose being too high. (While many cats' BG will drop steeply and then bounce if the dose is too high, it can occasionally happen that the higher dose seems to extend the cycle.)

Your kitty's numbers have certainly improved over time, and I see that you have had to miss quite a few shots due to low preshot numbers. Reducing the dose may level out the numbers a bit so that the preshots are not too low too shoot.

Keeping fingers and paws crossed for continued improvement....
.

Thanks for your advice. I hope I keep seeing improvement. Today hes drinking a lot but I had to skip AM because number was so low.

 

[Critter Mom]

Reducing the dose may also help raise the nadirs a little (helps to have a wide safety cushion with Vetsulin).


Mogs
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[Amanda Whitehead]

Reducing the dose may also help raise the nadirs a little (helps to have a wide safety cushion with Vetsulin).


Mogs
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I have reduced to 1.5 units now but he's still too low at next shot time. For some odd reason his nadirs seem to be around next shot time. This morning I gave him 1 unit to see how that goes. I think he needs less units at nighttime because for some reason he drops low at night times. Poor sugar mum is getting very tired from being up every two hours to test at night lol

 

[Critter Mom]

Hi Amanda,

A lot of cats tend to run lower at night. That said, you're getting insanely long duration for Vetsulin now (possibly because the crystalline fraction may be having more effect now that Oscar's insulin needs seem to be reducing - speculating here!). I think your further dose reduction was a good move. Be sure to test more regularly for ketones now you're reducing the insulin dose.

Be sure to keep us updated with developments.


Mogs
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