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back up to 118 now, and I haven't I haven't fed her since the last time I checked her. I think she must drop early in the cycle
 
Terrelle said:
the 118 was right before her does and it was 12 hours after the morning dose, I just wrote it wrong. My vet said to administor it anyways because she's usually high in the morning.

My sitter will not be able to get any mid cycle readings unfortunately. The only reason I can is because I work ridiculously close to home

She's on Caninsulin which from what I've gathered drops quickly and climbs slowly
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What was her pre-shot# this morning (is blank in the SS).
 
Elizabeth and Bertie said:
'7' is a normal blood glucose number number for a cat.
Normal blood glucose numbers are approximately 50 - 130/2.7 - 7.2 (although some cats will naturally read a tad lower or higher than this.)
It not advisable to give insulin at normal numbers (there are some exceptions to this rule, but they don't apply here).

The general rule here is that, for those new to dealing with diabetes, no shot is given if the blood glucose is below 200/11. That is to allow some buffer of safety while the caregiver gathers some data to work out how their kitty is responding to insulin.
And with shorter acting insulins like Caninsulin it is especially important to have an understanding of how the kitty responds to insulin before attempting shots at lower preshot numbers.

What exactly is Terry eating now?
If you are getting preshot numbers that are too low to shoot (and I think you are...) then you could try holding off on the insulin and switching Terry to low carb wet at this point.
The change in diet could make a considerable difference to her blood glucose levels. And it may be that she doesn't actually need insulin while you are away. She may be lucky and head into remission (ie. become diet-controlled).
Let's see what others think...

Eliz
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Thanks elizabeth, I actually asked my vet about this and she is worried because it climbs so high usually by morning she doesn't want me to skip a dose. Keeping her other eye healthy is a big worry for us and when she sits around 14 it starts to not dilate properly
 
Elizabeth and Bertie said:
'7' is a normal blood glucose number number for a cat.
Normal blood glucose numbers are approximately 50 - 130/2.7 - 7.2 (although some cats will naturally read a tad lower or higher than this.)
It not advisable to give insulin at normal numbers (there are some exceptions to this rule, but they don't apply here).

The general rule here is that, for those new to dealing with diabetes, no shot is given if the blood glucose is below 200/11. That is to allow some buffer of safety while the caregiver gathers some data to work out how their kitty is responding to insulin.
And with shorter acting insulins like Caninsulin it is especially important to have an understanding of how the kitty responds to insulin before attempting shots at lower preshot numbers.

What exactly is Terry eating now?
If you are getting preshot numbers that are too low to shoot (and I think you are...) then you could try holding off on the insulin and switching Terry to low carb wet at this point.
The change in diet could make a considerable difference to her blood glucose levels. And it may be that she doesn't actually need insulin while you are away. She may be lucky and head into remission (ie. become diet-controlled).
Let's see what others think...

Eliz
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She's on Hill's w/d and I plan on transitioning her to a low carb food next week when I'm back and can monitor her really closely
 
Robin&BB said:
You're kidding me! You really do need to check before you shoot a kitty with insulin. I have to disagree with vet on that one ...
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I could see not checking if the kitty was on a regular schedule for a long time but it's only been a week and I also am far more comfortable checking. Although I hate doing it, I'd much rather poke her ear than have to worry.

Also I'm pretty sure she didn't go low after her morning dose because she was in a great mood all day, super energetic and even played for a little bit which she hasn't done since her lens detatched:)
 
Do you guys think trying 1/2 a iu if its between 7-11 is a safer route and no does if it's under 7?
 
Terrelle said:
I could see not checking if the kitty was on a regular schedule for a long time but it's only been a week and I also am far more comfortable checking. Although I hate doing it, I'd much rather poke her ear than have to worry.
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Even then, you must check. You simply never know when a cat is going to pop a wonky pre-shot #. And even though we can sometimes "guestimate" what their patterns usually are after being on insulin for quite some time, kitties can always throw us curve balls. Without the data, some of those curve balls can be dangerous. Case in point: My cat is on only <0.15 U, as needed based on pre-shot #. More often than not lately, she does not need even that tiny dose. Yet TWICE this month - on just under 0.15U of insulin - she hypo'd on me at +3.5 to +4. So there's that ...

So, Terrelle, keep on testing!:bighug: (Sorry if this posts twice; I keep ketting JavaScript error messages. Arrrgh!)
 
Start the food transition when you can monitor throughout the day. Do you have weekends off? That would be a good time. The combo of w/d and Caninsulin may mean a big drop in insulin requirements from the start of the transition.
 
Terrelle said:
Keeping her other eye healthy is a big worry for us and when she sits around 14 it starts to not dilate properly
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(((Terrelle))) that must be so distressing for you....

I'm wondering if your vet doesn't want you to skip a dose because s/he thinks this is type 1 diabetes (and she thinks the pancreas won't produce any insulin and therefore the situation is 'stable'). However, the data that you've collected shows that Terry's blood glucose numbers seem to be improving. You are getting preshot (before insulin) numbers that are completely normal. This is very encouraging news in terms of Terry's diabetes. But I do understand that it may be causing challenges for you because you want to follow what your vet has suggested. ...Does your vet know that Terry's numbers have improved and that she is often in the normal range now?
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Sorry, Terrelle ... but I really must pop off to bed now (midnight-thirty here), but you are in very good hands with Elizabeth & Aine.
Goodnight, all! zzzzzzzz
 
Just had a look at Terry's spreadsheet. It might be an idea to chat with your vet about giving her 0.5 IU for a couple of cycles before you go away to see how that works. As Eliz says above, Terry has been in pretty much normal numbers for the last few cycles.

Also re the food change, I would urge even greater caution. With those numbers, just changing a small portion of Terry's diet to low carb could see her dropping too low with insulin on board. Indeed, if Terry is still in normal numbers at the time of the food change, I'd be inclined to discuss with my vet the possibility of skipping insulin when the low carb food is introduced. w/d is stuffed with carbs. Replacing even some of that food may see Terry not needing insulin at all (based on her current numbers).
 
Thanks so much guys, the plan is to transition her food when I get back and can monitor it.

I just tested her again and she's at 9.9... this is why my vet doesn't want me to skip any doses :S I really don't know what to do
 
Terrelle said:
I just tested her again and she's at 9.9... this is why my vet doesn't want me to skip any doses :S I really don't know what to do
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Terrelle,
I'm sorry that none of us were able to respond to you sooner. (That pesky 'life' thing gets in the way of FDMB stuff sometimes. Darn it! ;) )

That 178/9.9 is a bit of a jump up. Had she had any food shortly before that test?
 
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Terrelle said:
Hi Guys, I'm new around here and it's been a rough week. My baby Terry who is 12 yrs old had enucleation surgery was diagnosed with type 1 diabetes. Apparently this is why her lens ruptured. Terry is finally home after a 4 day vet stay but now I have to adjust to giving her insulin, antibiotics and pain medication along with closely monitoring her glucose. At the moment her levels are about 11-14 in the mornings but fine in the evenings and she is getting 1 iu 2x a day. Any suggestions for a newbie?

I am going on vacation next week and am afraid to leave her but I have a friend who is a vet assistant who has agreed to come and feed and take care of her. Do you guys think I should cancel my trip?[/QUOTE

Welcome Terrelle, I am rather new too and your post caught by attention especially since your baby had enucleation surgery. My Bubba is looking at that down the road too. His eye problem is a different cause, Iris disfussed melanoma. Two week after he was DX with diabetes, the eye specialist wanted to take his eye out as preventative and biopsy to see if it is cancer. I am desperately trying to get his diabetes under control first. I feel your pain......
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Elizabeth and Bertie said:
Terrelle,
I'm sorry that none of us were able to respond to you sooner. (That pesky 'life' thing gets in the way of FDMB stuff sometimes. Darn it! ;) )

That 178/9.9 is a bit of a jump up. Had she had any food shortly before that test?
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I gave her food 4 hours prior but only some dry w/d
 
Terrelle said:
Thanks so much guys, the plan is to transition her food when I get back and can monitor it. I just tested her again and she's at 9.9... this is why my vet doesn't want me to skip any doses :S I really don't know what to do
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So you gave her some w/d dry right after her she popped that 60 at +2, is that correct?
 
Okay, that's what I thought. So ... in an earlier post, you'd said your vet wants Terry's BG below 14 (=252 here in the U.S.).
That rise last night to 178 @ +5 was in no way horrible/dangerous; is to be expected after a little of the higher-carb w/d dry food.
(Is no where close to 14/252 - see what I mean?)
And this morning's AMPS was @ 205 - also not a horrible #. (You're doing great with her newly on insulin, btw.)

Remind me: When are you leaving town? Is there any way you can get in a daytime curve, say today or tomorrow? I suggest this only because with a little more data on what she does throughout a 12-hr. cycle when she's been shot @ around 200 may ease your mind a little re: worries about too high a spike in BG as relates to her eye problem.

Is understandable why you're feeling anxious about this: Vet wants you to protect Terry's eye. But as Elizabeth had said a few posts back, it really does not appear that Terry has type 1 diabetes; perhaps your vet was just making an assumption there, but her responsiveness to insulin and rapidly improving #s would make it appear more likely that she's type 2 (like most diabetic cats are). But regardless, she was above 14 only once so far, and that was back @ AMPS on the 23rd.

I would get some more data today, if you can, to ease your mind (and your vet's).
 
Robin&BB said:
your vet wants Terry's BG below 14 (=252 here in the U.S.).
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Your vet is aiming to keep Terry's blood glucose levels below the renal threshold, by the look of things. Nowt wrong with the reasoning there.

Maybe you could have a chat with your vet about your imminent trip, explain about the sitter, tell her about Terry's very good numbers and maybe come up with a situation where Terry is below the renal threshold for at least most of each cycle. If you could come up with a dosing strategy along those lines it might give a better safety margin for the sitter.
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I can only check her at noon and then after five cause I have to work. I just talked to my vet and she said to give her the dose and Then keep checking her but my sitter can't do that :(. I really like my get and I don't want to disobey her but I'm really worried, and I'm pretty sure there was a test she did that was difinitive to prove Terry is type 1 but I'm not certain
 
Hi, again, Terrelle - Gee, is nothing quite like feeling you're stuck between a rock and a hard place, huh!
How many days left before you leave town?
 
Is there anyone else you know nearby who could possibly come in and test for you while you're gone? (In addition to your vet assistant friend, I mean.)

Because your conundrum is pretty obvious here: You don't want Terry rising too high because of her eye; nor do you want her BG bottoming out when no one can be around to monitor/steer with food (a real possibility if you allow your friend to shoot her @ under 200.)

If you can't get another helper in, the only other way I can see that you could possibly handle this is to have Terry stay at the vet's while you're gone - which, as we all know, is a pretty darned expensive option.

Anyone else here have some ideas/alternatives???
 
Sometimes one needs to go with the cat's numbers, not the vet's advice. The most important thing is Terry's safety.

I'd suggest talking to your vet asap about giving a 0.5 IU dose tonight to see if it keeps Terry in safer numbers. There's no guarantee of that with any dose, but it would at least give you some data to work with and share with your vet tomorrow.

What do others think?
.
 
Critter Mom said:
Sometimes one needs to go with the cat's numbers, not the vet's advice. The most important thing is Terry's safety.

I'd suggest talking to your vet asap about giving a 0.5 IU dose tonight to see if it keeps Terry in safer numbers. There's no guarantee of that with any dose, but it would at least give you some data to work with and share with your vet tomorrow.

What do others think?
.
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I tried to talk to her and she just said to not give the dose and then check the numbers every two hours :S
 
If this was my cat, I would cut the dose while I was away, whatever the vet said. Better safe than sorry. (There were times I did tell me vet that I wasn't comfortable dosing at her recommended amounts.)

With no one there to test or observe Terry mid-cycle, I would reduce to .5 units while gone. Terry's numbers are so good after such a short period of time that one week on a half dose really shouldn't hurt her in the long run. One week of slightly higher numbers should be be easy to get back down again, while going hypo with no one there to catch could be very serious. There is a saying here that goes something like this "better too high for a day than too low for a minute".
 
Debby has a real point here.

And the problem with your vet telling you to "skip the dose" tonight (if that's what she meant) is that you're leaving in the morning, right? And then you've left someone else with the daunting responsibility of a kitty who may need a dose of insulin next cycle after a skipped dose "to see what she does" ... (someone who cannot regularly monitor for nadir drop, mid-cycle spike, etc.) when that skipped dose could set Terry up for a bouncing episode after the next shot of insulin. (Just sayin'...)
 
Maggies Mom Debby said:
If this was my cat, I would cut the dose while I was away, whatever the vet said. Better safe than sorry. (There were times I did tell me vet that I wasn't comfortable dosing at her recommended amounts.)

With no one there to test or observe Terry mid-cycle, I would reduce to .5 units while gone. Terry's numbers are so good after such a short period of time that one week on a half dose really shouldn't hurt her in the long run. One week of slightly higher numbers should be be easy to get back down again, while going hypo with no one there to catch could be very serious. There is a saying here that goes something like this "better too high for a day than too low for a minute".
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Thanks, After talking to my mom (Who is a pharmacist) I'm going to cut it to .5 while i'm gone just to be safe :)
 
Terrelle said:
Thanks, After talking to my mom (Who is a pharmacist) I'm going to cut it to .5 while i'm gone just to be safe :)
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You might consider starting that 0.5 unit reduction tonight after PMPS ck; you might well see a softer drop with the reduced dose than the 60 you got at +2 last night with 1.0 unit. Maybe won't require any steering #s with food, either, tonight. Will have fingers crossed for you!:)
 
Robin&BB said:
You might consider starting that 0.5 unit reduction tonight after PMPS ck; you might well see a softer drop with the reduced dose than the 60 you got at +2 last night with 1.0 unit. Maybe won't require any steering #s with food, either, tonight. Will have fingers crossed for you!:)
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Thanks! That's the plan, cause at lunch today she was 4.4 and that's from 11.4 this morning so I just don't feel comfortable giving her a full iu tonight
 
How long will you be away?

Here are some other things I would consider in your circumstances. Depending on Terry's numbers:

1. Only give ONE 0.5 IU dose per day.

2. Only give 0.5IU every other day.

Terrelle said:
at lunch today she was 4.4 and that's from 11.4 this morning so I just don't feel comfortable giving her a full iu tonight
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Because of drops like that, the lowest pre-shot number I gave Caninsulin to Saoirse was at 10/180 (Alphatrak). Even then with a small dose it still took her right down to the hypo threshold.
 
Ok so she was at 118 so i gave her .5 iu so I can watch her cycle with it before I leave tomorrow night... depending on what numbers she reach I guess I'll decide if I want it to be only in the mornings or evening and morning. I know I'm not supposed to does under 200 but last night she didn't drop below 60 and that was with 1iu on the same reading

Does that sound like I'm doing the right thing?
 
Terrelle said:
Ok so she was at 118 so i gave her .5 iu so I can watch her cycle with it before I leave tomorrow night... depending on what numbers she reach I guess I'll decide if I want it to be only in the mornings or evening and morning. I know I'm not supposed to does under 200 but last night she didn't drop below 60 and that was with 1iu on the same reading

Does that sound like I'm doing the right thing?
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Hopefully, that redux to 0.5U will give you a lower drop tonight, since it's half as much ... I'll keep my fingers crossed while waiting to see what #s you get later in cycle. :)
 
Also do cats generally react to the medicine the same way most of the time? is that how curves work?
 
@Robin&BB - Glad you're here to check in to see how Terry's doing this evening (I'm about to pass out).

@Terrelle - There's no guarantee where any dose will take a cat. 118 is a low preshot for Caninsulin (and a bit more so for an evening cycle when more cats tend to run low). The data you get for the half unit dose tonight will hopefully be a very valuable guide for decision-making tomorrow before you leave. I'll check in tomorrow morning (passing out here) to see Terry's results for tonight and I'll post again (I'm in the UK so it will be there for you in the a.m.).

EDITED TO ADD:

Cats bodies are living systems, as are our own bodies. Bodies adapt minute by minute to changes in the environment - food, cold, thunder, affection, fright, light, dark, exercise, etc. When bodies are working properly the pancreas and the liver work in harmony to keep up a constant supply of glucose so that cells can use it as fuel. With a diabetic, insulin production gets screwed up so we give 'foreign' insulin to compensate. Unlike a healthy pancreas, foreign insulin doesn't come with an off switch so it will keep on working until it's used up. This happens on top of all the other variations in the body, so no two cycles will be identical.

The purpose of our recording our kitties' data is to determine a pattern of response to a given dose of insulin so that we can make things as safe as possible.

It's great that you're getting data on the 0.5 unit dose before you depart.
 
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Critter Mom said:
@Robin&BB - Glad you're here to check in to see how Terry's doing this evening (I'm about to pass out).

@Terrelle - There's no guarantee where any dose will take a cat. 118 is a low preshot for Caninsulin (and a bit more so for an evening cycle when more cats tend to run low). The data you get for the half unit dose tonight will hopefully be a very valuable guide for decision-making tomorrow before you leave. I'll check in tomorrow morning (passing out here) to see Terry's results for tonight and I'll post again (I'm in the UK so it will be there for you in the a.m.).
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Thanks so much.

Yah I know it is a low preshot but I really want to get an idea of what it will do while I"m here to monitor her.
 
Terrelle said:
Also do cats generally react to the medicine the same way most of the time? is that how curves work?
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Nope! Not only is every cat different (you'll see the cautionary acronym ECID around here a lot), but even when a kitty has a pretty well established pattern on spreadsheet on a particular dose, there's always a possibility that kitty will throw you a curve ball somewhere in the cycle. This is why BG testing - including a mini-curve or full curve every now and then - is so very important.

Something as simple as seeing a bird or squirrell outside the window can spike a cat's BG; a dosage shift can result in a wider swing either way (sometimes hypo zone with dose increase); transitioning from high-carb food to low-carb can dramatically reduce the need for insulin. Some cats take several cycles to "settle in" to a particular dose; others don't. This is why we all think that a vet who says someone with a kitty on insulin "...doesn't need to monitor the cat's BG @ home" is not all that well-versed in treating feline diabetes.

Make sense to you? It's good that you ask questions! I like to think of it as: "Curiosity heals the (diabetic) cat."
 
Robin&BB said:
Nope! Not only is every cat different (you'll see the cautionary acronym ECID around here a lot), but even when a kitty has a pretty well established pattern on spreadsheet on a particular dose, there's always a possibility that kitty will throw you a curve ball somewhere in the cycle. This is why BG testing - including a mini-curve or full curve every now and then - is so very important.

Something as simple as seeing a bird or squirrell outside the window can spike a cat's BG; a dosage shift can result in a wider swing either way (sometimes hypo zone with dose increase); transitioning from high-carb food to low-carb can dramatically reduce the need for insulin. Some cats take several cycles to "settle in" to a particular dose; others don't. This is why we all think that a vet who says someone with a kitty on insulin "...doesn't need to monitor the cat's BG @ home" is not all that well-versed in treating feline diabetes.

Make sense to you? It's good that you ask questions! I like to think of it as: "Curiosity heals the (diabetic) cat."
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Thanks,

my vet did say she' liked the idea of home monitoring she was just worried that the ear testing would upset terry while her eye was healing...

Also, if they don't react the same every time then what is the point of monitoring their glucose so closely? Just curious because I thought the reason was to adjust as necessary but if you don't know how they will react at all then how does it help? Aside from attempting to prevent hypo of course
 
@Critter Mom - Good grief; is it 4:30 am where you are? Did you have to pull an all-nighter? Small wonder you're about to pass out!
Pleasant dreams, Aine! (zzzzzzzzz)
 
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