Where to Start?

AmandaE

AmandaE

Very Active Member
Hi Everyone,

This is about my third thread after i joined the Forum. Mowgli will FINALLY be arriving at my house tomorrow afternoon! His vet has sent some scattered BG testing data and Caninsulin dosage information which I have filled into his sheet.

I was wondering if you guys could have a look at his SS in order to determine where you think I should start with dosing (By all accounts from my previous thread the dosage should be WAAAAY lowered). I can't really see any sort of rhyme or reason (based on the information that they provided) which shows the logic determining their final dosage prescription of 5 units twice daily.

Any advice would be greatly appreciated
 
I don't have advice but wanted to offer my support and encouragement on this new adventure. The Caninsulin experienced members here are going to be a wonderful resource for you and the rest of us are behind you all the way! :cat:
 
Idjit's mom said:
I don't have advice but wanted to offer my support and encouragement on this new adventure. The Caninsulin experienced members here are going to be a wonderful resource for you and the rest of us are behind you all the way! :cat:
Click to expand...

Thanks @Idjit's mom !

I think I can provide a consistency for Mowgli that the vet wasn’t able to based on their case loads and their Tech’s work schedules.

Although I hope I don’t get discouraged looking for quick results I’m feeling super positive about Mowgli’s prognosis since I’ve stumbled across this forum.

Thanks for cheering us on :)
 
First of all kudos for getting the data from the vet onto the spreadsheet before Mowgli has even arrived. You've got this and are going to be a great Mom for your extra sweet kitty. :joyful:

The data from the vet definitely sets off a few red flags for me. A starting dose of 3u is very high for a newly diagnosed cat. It appears they wobbled a bit with the dose initially and the rationale behind the "wobble" is not clear at all i.e. 3u given at a reading of 160 :nailbiting: and then no pre-shot reading the following night and a dose of 1u even though it appears likely pre-shot would have been higher than the night before. It also appears they were dosing blindly for many cycles and obviously were doing precious little in the way of mid cycle testing to see how low any particular dose was taking Mowgli.

Insulin is not a medicine. It is a hormone and therefore doesn't behave the same as medicine. More is not always better or more effective and too much insulin can look exactly the same as not enough. Totally counter intuitive and something we see a lot here from vets not understanding how insulin works.
The high numbers Mowgli has had so far could be/likely are from too much insulin. Only by starting at a low dose and slowly increasing can one be sure they have not skipped right over the ideal dose.

Since Mowgli will be in a strange environment upon arrival, he may not eat as well as he usually does and he may be a little stressed out by the travel etc. so I would expect he may suffer a bit of BG elevation from stress in the first couple of days. There is also a learning curve for you to get comfortable testing Mowgli and we have no idea how co-operative or un-co-operative he might be in that regard (I have to wonder if Mowgli had anything to do with the lack of testing at the vet knowing full well any lack of co-operation on his part might have been due to the strange and probably noisy environment). Many of us have cats who come and tell us when it's test time but sometimes it takes a bit of bribery/time to get kitty to that point.;)

Do you know if Mowgli was tested for ketones or has any history of ketones or DKA? Anything in the vet records?
If not, I think the dose should immediately be dropped to 1u twice daily. If there is a history of ketones or DKA, then let us know and we'll work on a plan to reduce a little more carefully.

I think your main goal right now should be getting Mowgli acquainted and comfortable in his new environment and making sure he is eating, peeing, pooping, preening and hopefully playing a bit. I would not change his diet immediately. Let him settle in for a few days and make changes slowly to avoid any GI upset or general stress.

We advocate testing before every shot and also getting a mid cycle test as often as possible. Obviously you have to sleep so we recommend making it a habit to test before bed every night so that you have some data from the night cycle because a lot of kitties go lower at night than they do during the day.

We have lots of tips and tricks to share to help you get going on this journey and before long it will be a short routine you and Mowgli share that will only serve to bond you and your little fur baby all the more.:)
 
MrWorfMen's Mom said:
First of all kudos for getting the data from the vet onto the spreadsheet before Mowgli has even arrived. You've got this and are going to be a great Mom for your extra sweet kitty. :joyful:

The data from the vet definitely sets off a few red flags for me. A starting dose of 3u is very high for a newly diagnosed cat. It appears they wobbled a bit with the dose initially and the rationale behind the "wobble" is not clear at all i.e. 3u given at a reading of 160 :nailbiting: and then no pre-shot reading the following night and a dose of 1u even though it appears likely pre-shot would have been higher than the night before. It also appears they were dosing blindly for many cycles and obviously were doing precious little in the way of mid cycle testing to see how low any particular dose was taking Mowgli.

Insulin is not a medicine. It is a hormone and therefore doesn't behave the same as medicine. More is not always better or more effective and too much insulin can look exactly the same as not enough. Totally counter intuitive and something we see a lot here from vets not understanding how insulin works.
The high numbers Mowgli has had so far could be/likely are from too much insulin. Only by starting at a low dose and slowly increasing can one be sure they have not skipped right over the ideal dose.

Since Mowgli will be in a strange environment upon arrival, he may not eat as well as he usually does and he may be a little stressed out by the travel etc. so I would expect he may suffer a bit of BG elevation from stress in the first couple of days. There is also a learning curve for you to get comfortable testing Mowgli and we have no idea how co-operative or un-co-operative he might be in that regard (I have to wonder if Mowgli had anything to do with the lack of testing at the vet knowing full well any lack of co-operation on his part might have been due to the strange and probably noisy environment). Many of us have cats who come and tell us when it's test time but sometimes it takes a bit of bribery/time to get kitty to that point.;)

Do you know if Mowgli was tested for ketones or has any history of ketones or DKA? Anything in the vet records?
If not, I think the dose should immediately be dropped to 1u twice daily. If there is a history of ketones or DKA, then let us know and we'll work on a plan to reduce a little more carefully.

I think your main goal right now should be getting Mowgli acquainted and comfortable in his new environment and making sure he is eating, peeing, pooping, preening and hopefully playing a bit. I would not change his diet immediately. Let him settle in for a few days and make changes slowly to avoid any GI upset or general stress.

We advocate testing before every shot and also getting a mid cycle test as often as possible. Obviously you have to sleep so we recommend making it a habit to test before bed every night so that you have some data from the night cycle because a lot of kitties go lower at night than they do during the day.

We have lots of tips and tricks to share to help you get going on this journey and before long it will be a short routine you and Mowgli share that will only serve to bond you and your little fur baby all the more.:)
Click to expand...

I thought the dosages seemed a little arbitrary.

When they were diagnosing Mowgli nothing came up in his blood / urine tests other than high blood sugar. They used that info combined with the fact he was having bladder control issues and drinking massive amounts of water to diagnose him with diabetes. He has no other negative health history other than this.

This weekend I will have no problem staying up to get some midnight samples ( due to work I’ll be sampling 6am and 6pm) since my sister will be out visiting.

I will try Mowgli on 1u caninsulin twice daily and hope for the best!

I will definitely be taking advantage of all the tips and tricks offered on this site... what a source of info! And relief!!
 
Just keep asking questions as they come up. We've all been through this and understand that the early days can be a bit of whirlwind. You're making great strides already so don't worry....you've got this and you have all the support you want or need right here.:)
 
Diana&Tom said:
Hi Amanda - you've got some great advice here and I echo all that's been said. I think you'll be just fine. I would ignore pretty much what the vet did - sorry, vet! - and start again. Have you read the beginner's guide to Caninsulin? It was written by some of us on this site and contains pretty much everything you need to know:

http://www.felinediabetes.com/FDMB/threads/beginners-guide-to-caninsulin-vetsulin.186099/
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@Diana&Tom,

I've looked through it a couple of times, but I do plan to look at it more seriously once I have more of a "real life" experience with it.

I also read a little on the Caninsulin web page for felines... I think that my vet must have read the start equation of 0.5u/kg with BG > 20mmol/L without reading the note that says that you shouldn't go above 2u of insulin within the first 2-3 weeks of diagnosis :nailbiting:. The vet tech did tell me that they chose Mowgli's initial dosage based on the companies starting dosage recommendations... so that's how I imagine that they got so carried away with dosage amount. 5kgs * 0.5u = 2.5u insulin = initial dose of 3u. The instructions, however; stated you should always round down not up... a little concerning... Poor Mowg!

And I agree... great advice so far... it definitely has me amped up to take over and get Mowgli on the right track!:woot:
 
AmandaE said:
@Diana&Tom,

I've looked through it a couple of times, but I do plan to look at it more seriously once I have more of a "real life" experience with it.

I also read a little on the Caninsulin web page for felines... I think that my vet must have read the start equation of 0.5u/kg with BG > 20mmol/L without reading the note that says that you shouldn't go above 2u of insulin within the first 2-3 weeks of diagnosis :nailbiting:. The vet tech did tell me that they chose Mowgli's initial dosage based on the companies starting dosage recommendations... so that's how I imagine that they got so carried away with dosage amount. 5kgs * 0.5u = 2.5u insulin = initial dose of 3u. The instructions, however; stated you should always round down not up... a little concerning... Poor Mowg!

And I agree... great advice so far... it definitely has me amped up to take over and get Mowgli on the right track!:woot:
Click to expand...

In the mean time... I'm just thankful that the vet diagnosed him and we know what's wrong.
 
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