Kittys Original Blood Work and Updates.

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Sev

Sev

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So as you can see my adventure started on Nov 10.
The vet said the results of the initial blood work was not bad. Some levels were a little off but not to such an extent that it should cause worry.
Does anybody see anything that should be addressed?

So to recap from my first thread.
I have completely changed Kitty's diet.
I have gotten rid of all the dry food. He is now on a diet of Fresh Pet Select Roasted meals, Merrick and Wellness brands. All of as %Kcal are between 1-6 carbs.
The FreshPet is the only one I am not sure of. Based on a calculation it should be just under 7 carbs.
% As Fed for all the foods are ranging between .28-2.10.

Since the 10th Kitty has been on 1 unit of Prozinc.
As you can see on the charts his initial glucose level was 474. The second test is was at 275 and today's was at 324.
His levels may have been influenced by a 5:00 AM snack that was fed to him by my better half. He was also a little more agitated once the he was on the table at the vets.

Since switching Kitty's diet his water intake has dropped substantially and it seems to be consistently less.
He wrestling with the Main Coon Cat Kitten we have. Sounds like the cat WWF some nights. So he is getting exercise. I am watching to see if he starts playing with the toys again.
Last night was the last round of antibiotics for a gum infection.
I am looking to bring him in for teeth cleaning after the Thanksgiving weekend.

Tonight I start the first round of 2 units of insulin.

So where do I go from here?
It has been suggested strongly that I do home testing. Where and what should I be looking for?
Other information I should be boning up on???

Thanks you in advance.

Sev
 
Sev said:
...Tonight I start the first round of 2 units of insulin. ...
Click to expand...

When the total dose is less than 2 or 3 units, we suggest that dose increases be kept small, such as 0.25 unit (you'd have to eyeball it on a U-40). If you are going to be home to monitor and blood test, moving 0.5 units up may be done. Its generally a good idea to be home to monitor response when the dose is changed.

What we mean by home testing?
1) Doing blood glucose tests with either a peripheral ear vein sample, or a paw pad sample, using a glucometer (human or animal specific) to make sure giving insulin is safe.
2) Doing urine testing for ketones (and sometimes glucose) or, if affordable, doing blood testing for ketones. Blood testing gives you real time values; urine test values represent several hours previously.
 
BJM said:
Sev said:
...Tonight I start the first round of 2 units of insulin. ...
Click to expand...

When the total dose is less than 2 or 3 units, we suggest that dose increases be kept small, such as 0.25 unit (you'd have to eyeball it on a U-40). If you are going to be home to monitor and blood test, moving 0.5 units up may be done. Its generally a good idea to be home to monitor response when the dose is changed.

What we mean by home testing?
1) Doing blood glucose tests with either a peripheral ear vein sample, or a paw pad sample, using a glucometer (human or animal specific) to make sure giving insulin is safe.
2) Doing urine testing for ketones (and sometimes glucose) or, if affordable, doing blood testing for ketones. Blood testing gives you real time values; urine test values represent several hours previously.
Click to expand...

What testing equipment gives the best bang for the buck?
 
Mystery said:
Why are you planning to increase his insulin so much?
Click to expand...

I am going by the vets recommendation.
Currently I am not testing at home.
Is the amount a problem?
 
Sev said:
Mystery said:
Why are you planning to increase his insulin so much?
Click to expand...

I am going by the vets recommendation.
Currently I am not testing at home.
Is the amount a problem?
Click to expand...

An increase of 100% sounds like a lot, don't you think? Particularly if you don't know yet how Kitty's system is adjusting to insulin. You only have the results of two BG tests since November 10, correct?
 
His levels may have been influenced by a 5:00 AM snack that was fed to him by my better half. He was also a little more agitated once the he was on the table at the vets.

Yes, his levels were probably up not only from stress but a snack. I certainly would not up him to 2 units. I would keep him at his current dose and get thee to a Walmart and buy a ReliOn meter, test strips, lancets, ketostix, etc. A lot of members use that meter. I still use my favorite.......regular One Touch Ultra.....not the mini.

You have been so focused on food, carbs, etc. that time has been lost......you could've been testing him all along.....especially with the food change. I would get the testing going ASAP and then you can continue to do food research.
 
Mystery said:
Sev said:
Mystery said:
Why are you planning to increase his insulin so much?
Click to expand...

I am going by the vets recommendation.
Currently I am not testing at home.
Is the amount a problem?
Click to expand...

An increase of 100% sounds like a lot, don't you think? Particularly if you don't know yet how Kitty's system is adjusting to insulin. You only have the results of two BG tests since November 10, correct?
Click to expand...

That is correct.

I am still getting my legs under me on this.
Personally I was wondering about a full unit. However the vet is probably going by the unit increases on the syringe.
I am sure I could eyeball a .5 increase pretty accurately.
However and dont take this the wrong way, I would like more input prior to going against the doctors recommendations.
 
I am with Hope here....you've done a lot of work on the diet but without testing at home you are really missing a lot of data.

Regarding the blood work, I'd be asking your vet about the elevated albumin as that isn't what we usually see in an uncomplicated diabetes diagnosis (that I can remember)....slight ALT yes.
 
Hope + (((Baby)))GA said:
His levels may have been influenced by a 5:00 AM snack that was fed to him by my better half. He was also a little more agitated once the he was on the table at the vets.

Yes, his levels were probably up not only from stress but a snack. I certainly would not up him to 2 units. I would keep him at his current dose and get thee to a Walmart and buy a ReliOn meter, test strips, lancets, ketostix, etc. A lot of members use that meter. I still use my favorite.......regular One Touch Ultra.....not the mini.

You have been so focused on food, carbs, etc. that time has been lost......you could've been testing him all along.....especially with the food change. I would get the testing going ASAP and then you can continue to do food research.
Click to expand...

Thanks for the confirmation. Its good to know my assumption was correct.

I am completely unfamiliar with diabetes testing equipment.
The only thing I know are some names from commercials.
 
Sev, even though it sounds like a small increase, from 1 unit to 2, insulin can kill. Even .5 can make a big difference so we always increase in small amounts. One of my own non-diabetic cats tested over 300 from stress alone when at the vets. Why not buy a meter today, start testing, and then do an increase if numbers at home prove it is needed?
 
Jen & Squeak said:
I am with Hope here....you've done a lot of work on the diet but without testing at home you are really missing a lot of data.

Regarding the blood work, I'd be asking your vet about the elevated albumin as that isn't what we usually see in an uncomplicated diabetes diagnosis (that I can remember)....slight ALT yes.
Click to expand...

More detail on this please.
What is the significance of this?

Would a gum infection elevate this?
 
Hope + (((Baby)))GA said:
Sev, even though it sounds like a small increase, from 1 unit to 2, insulin can kill. Even .5 can make a big difference so we always increase in small amounts. One of my own non-diabetic cats tested over 300 from stress alone when at the vets. Why not buy a meter today, start testing, and then do an increase if numbers at home prove it is needed?
Click to expand...

So I have been informed. I have a bottle Karo on the shelf just in case there is an incident.

I need some info on meters. Which is the most accurate?
 
Not all cats will show hypo symptoms.....they can just start seizing. Hometesting will tell you how low the numbers are going. If one of mine even looks at me weird, or throws up, I test. I always do a late nite test before going to bed too. I want to be able to sleep with peace of mind

People all have their favorites when it comes to meters but as far as money and least expensive, ReliOn from Walmart. The OTU I use is more expensive when it comes to strips.
 
I just looked it up as well, thanks Hope. I was thinking liver but its not necessarily and likely just dehydration in this case.
Albumin is the major protein found in the body. It carries various substances through the blood and is important in maintaining pressure within the vessels. High levels indicate dehydration. Low levels indicate chronic inflammation, liver disease, kidney disease, starvation and blood loss.

There are several good meters and it comes down to a couple factors...cost and reliability. If cost (usually the strips are the $$), then bayer or one touch ultra are some of the gold standards. But walmart relion appears to be quite reliable as well, and is much cheaper. The cost of strips can really add up, usually you can get a free meter with purchase of strips.
 
A note on the dehydration.

Kitty was still on dry food when the blood test was taken.
Also he was drinking quite a bit of water and going to litter box.
He is drinking far less and not going to the box as often. So perhaps with the change of diet and the insulin that is or will come back to normal???
 
Yup. its likely just one of those things (like the slightly elevated ALT) to watch for next time he gets blood work done.
 
For the meters, accuracy, reliability and ease of use are the important factors for me.
Once I am comfortable with the testing I can start looking for something that is more economical.
What am I looking at expense wise? I am floating on an ocean of ignorance here.
 
I buy my OTU strips at http://www.diabeticcare.com for 37.50 for 50 strips. Meter usually runs about 65. Strips are more expensive in a regular store but I know I can at least buy them if I run out. I use the OTU, not the Ultra 2 or the Mini, and it was only 8 points off from lab report when I did testing comparison. It gives err reading if not enough blood, counts down in 5 seconds, easy to see blood being sipped in, can pull out an reinsert if you run out of time and haven't gotten blood yet, gives 14 and 30 day averages. I put the strip in, grab an ear, stick and sip. I am a confirmed OTU user. Don't buy anything that starts with True.
 
Sev,
Meter - I use a Relion Micro. $9.
Box of 50 strips $20 (less per strip if you buy 100)
Box of lancets for poking I think $4 or less. Recommend 28g to start, and you'll probably be able to go with a smaller (33g) later, but they all cost the same.

Ketone strips - Don't know how much they cost. I test for blood Ketones, and the strips are outrageously expensive (2-5 dollars each unless you can find them on ebay. Box of test strips is probably 50 cents a strip tops, but I have never bought any so not sure.

The knowledge that by home testing, you can save your kitty's life - priceless.

Dose - doubling the dose without testing is playing russion roulette with his life. You can't even be sure at this point in time that the 1u you have been shooting blind is safe. No, he hasn't hypo'd that you are aware of, but you really have no idea how low he's going. Also, upping the dose will most likely cause bounces or rebound. Kitty goes too low, his liver dumps glucose into the blood, and BG goes up in an instinctive effort to avoid hypoglycemia. It screws up his numbers, and makes treatment that much more difficult.

I would not increase dose AT ALL until you have been testing his BG for at least two or three days so that you have hard data that shows what the 1u dose is doing. It could potentially be too high a dose already, and already causing rebounding/bouncing. No matter how he appears to be doing, you don't really know. Kitty's are masters at hiding illness and pain. My cat went down to 44 once. He didn't display a single symptom. But he was in fact "hypo" at the time. Another 10 points and he might have been in a coma.

It's a safety issue. A life and death issue actually. The easiest way to understand it is this. Make believe that he is your infant son, who just came home from the hospital diagnosed with diabetes. He can not tell you how he feels, if his sugar is high, or his sugar is low. His life depends on safe and appropriate dosing. The only way to know if it is safe to give him insulin and how much is to poke his little finger at least twice a day to see what his BG is. He's your son. Are you going to shoot without knowing for sure it is safe?
No difference with your cat. He can't tell you how he feels, and you don't know how the insulin is going to work. We can it "shooting blind", and it can kill.

So yeah, next stop Wally World, Sev. And then come back and we'll walk you through the process.

Carl
 
Sev said:
That is correct.

I am still getting my legs under me on this.
Personally I was wondering about a full unit. However the vet is probably going by the unit increases on the syringe.
I am sure I could eyeball a .5 increase pretty accurately.
However and dont take this the wrong way, I would like more input prior to going against the doctors recommendations.
Click to expand...

Definitely get more input - I just ask questions, I don't have answers! The only things I know for sure are it's safest to start low and go slow with dosage increases, and home testing has saved many a kitty. I believe it saved mine, and might save yours at some point. Just pick up one of those recommended by the folks here and start today, then as you get more information you can change if you don't like the one you start out using. But you need to start testing today. Yesterday, even!
 
carlinsc said:
Sev,
Meter - I use a Relion Micro. $9.
Box of 50 strips $20 (less per strip if you buy 100)
Box of lancets for poking I think $4 or less. Recommend 28g to start, and you'll probably be able to go with a smaller (33g) later, but they all cost the same.

Ketone strips - Don't know how much they cost. I test for blood Ketones, and the strips are outrageously expensive (2-5 dollars each unless you can find them on ebay. Box of test strips is probably 50 cents a strip tops, but I have never bought any so not sure.

The knowledge that by home testing, you can save your kitty's life - priceless.

Dose - doubling the dose without testing is playing russion roulette with his life. You can't even be sure at this point in time that the 1u you have been shooting blind is safe. No, he hasn't hypo'd that you are aware of, but you really have no idea how low he's going. Also, upping the dose will most likely cause bounces or rebound. Kitty goes too low, his liver dumps glucose into the blood, and BG goes up in an instinctive effort to avoid hypoglycemia. It screws up his numbers, and makes treatment that much more difficult.

I would not increase dose AT ALL until you have been testing his BG for at least two or three days so that you have hard data that shows what the 1u dose is doing. It could potentially be too high a dose already, and already causing rebounding/bouncing. No matter how he appears to be doing, you don't really know. Kitty's are masters at hiding illness and pain. My cat went down to 44 once. He didn't display a single symptom. But he was in fact "hypo" at the time. Another 10 points and he might have been in a coma.

It's a safety issue. A life and death issue actually. The easiest way to understand it is this. Make believe that he is your infant son, who just came home from the hospital diagnosed with diabetes. He can not tell you how he feels, if his sugar is high, or his sugar is low. His life depends on safe and appropriate dosing. The only way to know if it is safe to give him insulin and how much is to poke his little finger at least twice a day to see what his BG is. He's your son. Are you going to shoot without knowing for sure it is safe?
No difference with your cat. He can't tell you how he feels, and you don't know how the insulin is going to work. We can it "shooting blind", and it can kill.

So yeah, next stop Wally World, Sev. And then come back and we'll walk you through the process.

Carl
Click to expand...

Well it seems I have my marching orders. ;-)

So just to be clear.
The recommendation is to get diabetes testing equipment meant for humans?
 
Hope + (((Baby)))GA said:
I buy my OTU strips at http://www.diabeticcare.com for 37.50 for 50 strips. Meter usually runs about 65. Strips are more expensive in a regular store but I know I can at least buy them if I run out. I use the OTU, not the Ultra 2 or the Mini, and it was only 8 points off from lab report when I did testing comparison. It gives err reading if not enough blood, counts down in 5 seconds, easy to see blood being sipped in, can pull out an reinsert if you run out of time and haven't gotten blood yet, gives 14 and 30 day averages. I put the strip in, grab an ear, stick and sip. I am a confirmed OTU user. Don't buy anything that starts with True.
Click to expand...

Checking out the site now.
I like the idea of the meter giving running averages. Saves the buttons on my calculator.
Going to head down to Wally World and see what I can find.
 
almost all of us use meters and testing equipment meant for humans! You can debate this to death, or you can get on to treating your diabetic cat. If you decide you want to make a switch in meters later on then nothing holds you to a particular meter...I know I have 2 diabetic cats but I have 3 different meters. Each cat has their own meter and then I have one that I only use as a back up. It really doesn't matter which meter you use they all measure blood glucose.

Mel, Maxwell, Musette & The Fur Gang
 
MommaOfMuse said:
almost all of us use meters and testing equipment meant for humans! You can debate this to death, or you can get on to treating your diabetic cat. If you decide you want to make a switch in meters later on then nothing holds you to a particular meter...I know I have 2 diabetic cats but I have 3 different meters. Each cat has their own meter and then I have one that I only use as a back up. It really doesn't matter which meter you use they all measure blood glucose.

Mel, Maxwell, Musette & The Fur Gang
Click to expand...

Got it.
Just want to be clear so I dont make any missteps.
 
OK.
Here is what I got.

1 Reli On-Micro.
110ct of Reli-On Confirm/Micro test strips.
50ct Reli-On Ketone
210ct Reli-On 30g Lancets.

And the cat is hungry.
 
The meter is all set up.
I see the lancer has an adjustment for depth of penetration. (There is a joke in there somewhere. :roll: )

Sooooo what depth for a cat ear?
 
Sev,
Sorry, didn't mean to be so blunt. I haven't been here long, 6 months or so. About 4 months ago, I started posting a lot in this forum, sort of the unofficial "welcome wagon", greeting new people, calming down frayed nerves, trying to get people past the "newbie" sense of being scared, overwhelmed, etc.
Look back at 99% of my posts in those threads, and I'm the nicest, sweetest, most calming person in the world. I've probably rolled out the red carpet for close to 100 people it seems like, sometimes 4 and 5 in one insane night or another.

Very rarely, "blunt" works. Or at least I hope so. I'd much rather emulate Mr. Rogers than Bill O'Reily :lol:

So, glad your shopping trip was a success. Ready for the first attempt at joining the vampire club?

Carl
 
Set it about half way.
Sometimes it is a good idea to just set it, hold it close to the ear, and click it a few times to see how/if he reacts to the noise.

If halfway doesn't work, set it for "higher" penetration. You can also try it on your finger. To see if it works, and to reassure you that it really doesn't hurt him.
Carl
 
carlinsc said:
Set it about half way.
Sometimes it is a good idea to just set it, hold it close to the ear, and click it a few times to see how/if he reacts to the noise.

If halfway doesn't work, set it for "higher" penetration. You can also try it on your finger. To see if it works, and to reassure you that it really doesn't hurt him.
Carl
Click to expand...

Setting 3 it is.
No reaction. Except to give me that 'What are up to now look".

Now where exactly to I nail em???

Test strip is in the unit.
 
And just to let you know - the FDA ruled that so long as the meters were within 20% of the lab value, that was good enough for home testing. This means the reading you get may be 20% lower or 20% higher than the true value ( 100 = from 80 to 120, etc).

The general idea is that the reading gives you a clue, not an absolute answer. If its preshot time and the cat is under 200 ... we suggest you delay or skip until the next shot time. When you get more data, that 200 may be lowered - it just depends on how your cat responds to the dose.

Always test before giving insulin.
Aim to get 1 or more tests in between the shots on 1 or more days, at least at the likely lowest glucose value time (nadir); some folks set a clock and get up at night to do this.
When you've changed a dose and held it for 3-5 days, do a curve where you test evey 2 hours until the next shot is due. The curve helps determine how well the insulin is working for the cat.
 
Here's a pic that shows the area you want to hit



Carl
 

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The test site most of us use is just outside the vein that you may see along the outside edge of the ear.

Fold up a tissue or something a bit firm to place under the ear - you won't poke yourself as easily.

If the fur is dark, look at the underside of the ear, maybe use a flashlight.

See the vein very near the edge? You're aiming between it and the edge.

Have the meter ready with the test strip inserted firmly.

Some cats get very startled - please have a towel to gently wrap around the cat, and cuddle firmly against you while testing.

Its very quick using the lancet pen. Freehand, I see a bit better and just gently push it in.

As the blood beads up, pick up the meter and put the edge of the strip in the droplet.
If the cat is struggling a lot, you can scrape the blood drop onto a fingernail and test off that.

I use the folded tissue to press on the nick firmly to help it clot while waiting for meter results.

Low carb treat and praise every time you test, even if it doesn't work.
 
BJM said:
The test site most of us use is just outside the vein that you may see along the outside edge of the ear.

Fold up a tissue or something a bit firm to place under the ear - you won't poke yourself as easily.

If the fur is dark, look at the underside of the ear, maybe use a flashlight.

See the vein very near the edge? You're aiming between it and the edge.

Have the meter ready with the test strip inserted firmly.

Some cats get very startled - please have a towel to gently wrap around the cat, and cuddle firmly against you while testing.

Its very quick using the lancet pen. Freehand, I see a bit better and just gently push it in.

As the blood beads up, pick up the meter and put the edge of the strip in the droplet.
If the cat is struggling a lot, you can scrape the blood drop onto a fingernail and test off that.

I use the folded tissue to press on the nick firmly to help it clot while waiting for meter results.

Low carb treat and praise every time you test, even if it doesn't work.
Click to expand...

Got it. No struggle. A little flinch as I did the vein and not the edge of the ear.
 
Hope + (((Baby)))GA said:
forgot to mention......PRAISE, KISSES and HUGS and maybe a treat. No matter the years of testing, always praise the kitty and give kisses.
Click to expand...

He gets em all the time. :smile:
 
Hope + (((Baby)))GA said:
Did he eat before testing?
Click to expand...

Not that I saw.
I have not done the evening feeding yet.

So its a lot higher than I thought it would be.
Not sure what do do with the dosage now.
 
See what 1 unit does - its data!

You can add more; you can't take it out once its in!
 
You're on Prozinc, so feed first, then shoot (about 15 minutes after feeding)
 
bare minium...is before each shot and then again at right around +6 to try to find the nadir (lowest point).

Mel, Maxwell, Musette & The Fur Gang
 
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