Great job setting up the spreadsheet (sorry I don't know your name)!
So I'm seeing a lot of reds (400+) and blacks (500+). Those numbers, especially blacks, are usually indicative of bouncing. Here is a more in-depth summary of bouncing so you can understand what it is.
Bouncing is a phenomenon that occurs when the body experiences (or at least thinks it does) hypoglycemia. Luckily the body uses bouncing as a defense mechanism against this where it attempts to compensate the low blood sugar by dumping excess glucose provided by the liver in an attempt to raise blood sugar back to “normal” numbers. Unfortunately, “normal” is a relative term according to the body. For a diabetic whose body has been untreated for so long that it considered very high numbers to be the new normal, lower numbers can often make the body overreact in attempt to save itself, even if it’s not in danger.
A cat who has been suffering from diabetes for some time may at the point of diagnosis have a new “normal” of 400. When insulin is introduced and brings it down, even to 200 (still diabetic levels), the body thinks it is in danger, dumps excess glucose, and thus the blood sugar skyrockets up to the 400-600s. After enough time has passed, the body will eventually realize that 200 isn’t such a bad number, and bouncing will happen less often. Note some cats are extremely bounce-prone and a switch to Lantus/Levemir is needed.
There are three main causes of bouncing: when blood sugar drops too low (hypoglycemia), drops lower than the body is used too, or by dropping too much too quickly. Typically if a cat drops more than 50% of their blood sugar a bounce is likely to happen, or if they drop 100 points within an hour.
While bouncing can be considered as a safety net in the instances of hypoglycemia, it can look very confusing on paper.
Wriggley's numbers are more than likely from bouncing and/or Vetsulin not last long enough to last the full 12 hours, making his BG high by pre-shot test. It's a little too soon to tell what Wriggley's ideal dose is right now - would you be willing to get in some early tests for us to look at? Vetsulin usually only lasts 3-5 hours before burning out ... however I see he had an 87 last month 7 hours into the cycle, so he may have slightly longer duration than most cats.
This depends on your schedule of course, but it would be helpful if you got some tests in at +1, +3, +5, and +7 for a couple cycles. That way we can see how the insulin fully affects him. Right now we only have a couple tests to go by which is only part of the full picture. We may see that Wriggley dips hard and fast 1-3 hours in and by +5 when you usually get his test, he's on his way up again. That behavior would be normal for Vetsulin if it did. If the numbers stay high for a few days it might indicate needing more insulin. If the numbers are high for a couple days and then go down again, that would indicate he was bouncing and was "clearing the bounce".
Some housekeeping tips, ignore if you already know all this but one can never assume:
- Test BG, feed, wait 20-30 minutes, then give insulin. Food must be on-board before shooting because of how fast Vetsulin hits the system.
- Give a small snack of his regular food about an hour after giving insulin. This will help slow the drop of BG so it doesn't drop so fast.
- Feed small meals throughout the day, not just at shot-time. Big meals twice a day are very hard on the pancreas, cats are naturally grazers.
- Leave food out at night - cats drop lower then. You can do this by using an autofeeder and/or freezing chunks of food to leave out.
Now this is a cost issue with the food and testing meter you're using. Purina DM wet is low in carbs but it is mostly liver; most cats will tire of it quickly. Either way, most of us feed commercial low-carb food such as Fancy Feast Classics or Friskies Pate, however ANYTHING that is below 10% carbs and wet is suitable. Even Special Kitty or 9 Lives wet, which are considerably cheaper. We have a chart
here where you can see all the wet food carbs, calories, etc. at once. Again, DM wet is fine, but if you need something more affordable, there's plenty of higher quality, cheaper options out there.
The Alphatrak is a good meter, however as I'm sure you're aware, the test strips are very expensive. About $1 each. When you test even the bare minimum with pre-shots, that's $2 a day. Above I asked if you could get an additional 4 tests in if possible - that's an extra $4 though! Yikes! Vets like to use Alphatraks because they are designed for pets, however human meters have been used in cats and other animals for several decades now, long before the Alphatrak came onto the market, and they work just fine. The human meters run a little lower than pet meters, but we compensate it by just knowing what the acceptable BG range for felines is as read on a human meter (50-120). Again, nothing wrong with using the Alphatrak, but most of us just can't justify the cost so we go with human meters. You are in the US, so if you want to consider a human meter, I'd recommend the ReliOn Prime from Walmart. The meter is $9, strips are $18 for 100. Versus I think the Alphatrak is around $45 with strips $50 for 50.
I hope that's helpful! I do definitely recommend switching either to Prozinc or Lantus. Lantus is a depot insulin that works a bit differently than in-and-out insulins such as Vetsulin and Prozinc but there is an incredible rate of success in cats on Lantus. Lantus is very expensive in the US; about $400 a bottle, however most of us buy from Marks' Marine Pharmacy out of Canada at a third of the price. We also buy them in 5-pen packs, I think with overnight shipping and everything it runs about $200 altogether, but the pack will last you 1-2 years. That makes it cheaper than both Prozinc OR Vetsulin.
