But how do I know what level she should be at? How much insulin do I give her depending on her numbers? That's my biggest question
Hello Rosie's Mama, and welcome to FDMB
The normal blood glucose range for a non-diabetic cat is approximately 60 - 12o mg/dL (3.3 - 6.7 mmol). And some kitties will naturally run a little higher or lower than this.
Many cats who are newly diagnosed will have blood glucose levels in the 400's (20's) or above.
The aim of treatment may depend on a number of factors including the insulin that is being used and how the cat
responds to that particular insulin. We have a saying here that 'Every Cat Is Different'.
Here is some info from the FDMB FAQ's:
6. REGULATION
Q6.1. What is regulation?
A6.1. There are different definitions of regulation. As hometesting becomes more common, we've been getting a better understanding of what cats and their humans might be capable of. Janet & Fitzgerald propose the following "regulation continuum":
·
Not treated [blood glucose typically above 300 mg/dl (16.7 mmol/L), poor
clinical signs]
·
Treated but not regulated [often above 300 (16.7) and rarely near 100 (5.6), poor clinical signs]
·
Regulated [generally below 300 (16.7) with glucose nadir near 100 (5.6), good clinical signs, no hypoglycemia]
·
Well regulated [generally below 200-250 (11.1-13.9) and often near 100 (5.6), no hypoglycemia]
·
Tightly regulated [generally below 150 (8.3) and usually in the 60-120 (3.3-6.7) range, no hypoglycemia, still receiving insulin]
·
Normalized [60-120 (3.3-6.7) except perhaps directly after meals -- usually not receiving insulin]
There may also be an extra category of "mostly above 300 (16.7) but with good clinical signs" which occurs with some cats who are getting insulin. We don't know why it happens, but such a cat probably should not be considered to be regulated. On the other end of the spectrum, it is possible for a cat who is not getting insulin to have blood glucose as low as 40 mg/dl (2.2 mmol/L) on a home glucometer. If you have a non-diabetic cat, try testing her with the same meter to get a safe comparison figure.
Q6.2. Which definition of regulation should be my goal?
A6.2. That depends on your individual situation. Generally, it's thought that a cat will suffer less long-term organ and nerve damage if his average blood glucose is lower rather than higher. However, because preventing hypoglycemia is a top priority, it may not be practical to try for normal numbers. The ability of your cat to respond to food and insulin in a consistent manner and your own ability to monitor your cat are both important factors in setting your goal. For most cats who are receiving insulin, "regulated" is a reasonable first goal, after which you can try for "well-regulated". For the lucky minority who can be diet-controlled, normalization is often achievable. It’s important to realize that some cats never consistently stay in regulation range in spite of all efforts, and yet they can be happy and healthy anyway. Ultimately, you should tailor your goals to your cat's individual situation, and you should always consider your cat's quality of life as well as the numbers as you evaluate how well your treatment protocol is working.
..........
The above info comes from this document:
http://binkyspage.tripod.com/faq.html#general
For those
new to dealing with feline diabetes we recommend that no insulin is given if the blood glucose level immediately prior to the insulin shot is below 200 (11).
That's just until the caregiver has gathered some data to show how the insulin is working in the cat's body. After that it is usually possible to give insulin at lower blood glucose levels.
Insulin dose adjustments are made mainly on the basis of the
lowest number of the cycle. If the testing data shows that the kitty isn't dropping into sufficiently low numbers the dose
may be increased. If the data shows that the kitty is in danger of dropping too low the dose should be
decreased.
As others have said, that 3 units is quite a high dose (though some cats do need higher doses). And removing the dry food could reduce the BG (blood glucose) level quite a bit, in which case the current dose could well be too much. I would strongly suggest that you monitor your kitty's BG very closely and be prepared to reduce the dose as needed. You may also consider reducing the dose
at this point while switching the diet over.
It is important to have some higher carb foods available (types in gravy are good), and some source of sugar such as karo/honey/glucose syrup, in case your kitty's BG drops too low and you need to raise the level.
Does Rosie have any history of ketones?
Eliz
