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Thanks Mogs. Woodsywife came to my rescue and cleared that up for me 'cause I thought it was 20 minutes and wanted confirmation or correction. Note to self done for future reference!
 
Critter Mom said:
An unregulated diabetic cat can look very poorly indeed both before and during the early days of treatment. The transformations that occur when cats start returning to good glucose regulation can be nothing short of amazing. For all the negative emotions that come with the diabetes diagnosis, there is much joy to be found on the journey back to wellness.
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This is sooo true...I was crying 4 months ago and now I am grinning at all the things Pimp is doing "again for the first time".
 
I was so ecstatic when Smokey started using a box again. Then the vomiting stopped once we figured out the feedings. Ah when he played with a toy for the first time in a year I couldn't believe what I was seeing. The best was when he started to purr. I never ever heard him do that. These "first" achievements are the best part of this disease.:kiss:
 
Food 'wait' - you're doing 2 things by waiting:

* Letting the food begin to start the digestive process
* Making sure he doesn't throw up

If there's not adequate food for the insulin, it will potentially cause numbers to drop significantly quickly....possibly into unsafe zones. There's really no 'safe' amount of time. I could shoot KT in 15 minutes, Dakota doesn't even start thinking about food until half an hour after he's eaten... :)

Don't get discouraged if you don't get blood in the beginning - that's not unusual at all. It takes a while for their ears to 'learn to bleed' - technically growing additional capillaries to that area being irritated by poking. 3 tries then a treat and try again later. Don't let it stress you out either, that translates to kitty stressing HIM just making matters worse...

HUGS! Welcome to the sugar dance!
 
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Alright, after sticking the poor cat three times, I finally got a reading that didn't have an error! Although, all it said was "HI," so I assume that isn't good news. I did it right before he ate dinner, so now I'm wondering...when am I supposed to check his BG? After feeding and before giving him insulin? If I have it in me, I might check him after I give insulin tonight just to see what happens with that HI number.
 
Congratulations on joining the Vampire Club!:)

I believe the protocol for Vetsulin is to test, then feed, then shoot about 30 minutes after feeding. You want to test before feeding so that you're not testing a food-influenced number, and Guido should not eat for 2 hours prior to the pre-shot test.

Definitely test later tonight if you can! It's the mid-cycle tests that will really tell us if the insulin is working for him or not.
 
Andy & Pimp said:
Congratulations on joining the Vampire Club!:)

I believe the protocol for Vetsulin is to test, then feed, then shoot about 30 minutes after feeding. You want to test before feeding so that you're not testing a food-influenced number, and Guido should not eat for 2 hours prior to the pre-shot test.

Definitely test later tonight if you can! It's the mid-cycle tests that will really tell us if the insulin is working for him or not.
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Correct shoot 30 minutes after eating. Getting a test later if you can is a good idea.
 
Update:
Day 2 into home testing and I'm finding this cat's blood sugar is all over the place. It's going from more than 600 in the morning to 139 tonight, a couple hours after I fed him dinner and gave him his shot. Everything with wet food and insulin is the same as it has been. The only thing I changed was limiting his dry food, which seems to be the obvious culprit for his high blood sugar. Now I'm sort of afraid that he will get too low, which has never been a concern!

My question is, is a drop like this (600ish to 139) throughout the course of a day something to be concerned about? I mean, the 130s is where I guess I would have hoped he'd be! I just wonder if I should be concerned about it dropping further overnight.
 
How long ago did you shoot? It would be a REALLY good idea to get a +1 and +2 test.
 
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I misread your post and commented without looking at the spreadsheet first, big mistake:facepalm: That is a great number at that time in the cycle. If you'll be awake, try to grab a +4 or +5.
 
Andy & Pimp said:
I misread your post and commented without looking at the spreadsheet first, big mistake:facepalm: That is a great number at that time in the cycle. If you'll be awake, try to grab a +4 or +5.
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Sorry, I'm still unclear as to what the +1, +2 numbers, etc. mean. Is that how many hours after I give him his shot?

I was worried about the 139 number going into overnight, so I gave in and gave him a tiny bit of dry food. Dang it! I should have waited, if that's a decent number!
 
rnbullis said:
Sorry, I'm still unclear as to what the +1, +2 numbers, etc. mean. Is that how many hours after I give him his shot?
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+1 would be one hour after the shot, +2 is 2 hours after, etc. Your pre-shot test always goes in amps or pmps no matter what time of day it is.

What time did you shoot, and what time did you get the 139?
 
I'm so sorry Rachel I didn't realize no one explained the spreadsheet to you.

AMPS= A.M. Pre-shot
PMPS= P.M. Pre-shot

You test before every shot, these go in the PS column. the U column is for units given which you have figured out and we just discussed how the clock works. if you want to record times, feedings, etc you can use the "notes" function of the spreadsheet (left click cell to add) or in the "remarks" column on the right.
 
rnbullis said:
My question is, is a drop like this (600ish to 139) throughout the course of a day something to be concerned about?
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To a point. It is possible that Guido is "bouncing" from low numbers. Going too low during a cycle can make a big number show up later. It's really important to test him before every shot, and if he's below 200, I would not shoot.

Not sure if you're still online or not....
I'm not quite clear on when you tested the 139 in relationship to the shot tonight. I'm afraid that you misunderstood the spreadsheet and you shot insulin into the 139. If that is the case, you did the right thing by giving the dry food. Please test Guido's BG again and if it is anything under 90 give him high carb wet food and/or karo. and be sure to leave dry food out.

If the 139 was 3 hours after the shot, then that's perfect.
 
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Andy & Pimp said:
To a point. It is possible that Guido is "bouncing" from low numbers. Going too low during a cycle can make a big number show up later. It's really important to test him before every shot, and if he's below 200, I would not shoot.

Not sure if you're still online or not....
I'm not quite clear on when you tested the 139 in relationship to the shot tonight. I'm afraid that you misunderstood the spreadsheet and you shot insulin into the 139. If that is the case, you did the right thing by giving the dry food. Please test Guido's BG again and if it is anything under 90 give him high carb wet food and/or karo. and be sure to leave dry food out.

If the 139 was 3 hours after the shot, then that's perfect.
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The 139 was 3 hours after his PM shot, so it's good to know that's ok. Thanks for clarifying the spreadsheet a bit! He was high again this morning, so I think I will leave out the dry food now. It seems to be the culprit!
 
rnbullis said:
The 139 was 3 hours after his PM shot, so it's good to know that's ok. Thanks for clarifying the spreadsheet a bit! He was high again this morning, so I think I will leave out the dry food now. It seems to be the culprit!
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I'm sure the dry food has an effect. You'll want to make sure you're testing before shots if you're starting to remove it.
Please ask if you have any more questions!

:)
 
rnbullis said:
...The 139 was 3 hours after his PM shot
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Hi Rachel,
That 139 is, in itself, absolutely fine. However, it shows a very steep drop of blood glucose by +3 (3 hours after the shot).

If his preshot was 400 (and let's suppose that it may have taken an hour for the insulin to get into his system) then it's possible that he's dropped 260 points in about 2 hours. That is toooo fast.
If his blood glucose continued to drop at a similar rate until the peak of the cycle then he could have got into very low numbers...
Many of us have found that Caninsulin/Vetsulin reaches the peak of the cycle (ie lowest number) between maybe 4 - 5.5 hours after the shot (but 'your mileage may vary' ;) )

So well done you for catching that, and for giving food to slow the drop and raise the blood glucose level. It's wonderful that you have started hometesting! :bighug:

Some folks find that feeding a snack/mini-meal 1.5 to 2 hours after the shot can help to slow the rate of blood glucose drop.

The speed of that blood glucose drop may well cause a 'bounce' (ie. the body may release stored glucose to keep the blood sugar from dropping too low, and this can cause a huge upswing in numbers.)
A cat's blood glucose level can also 'bounce' when it drops to a level that the cat's body has become unaccustomed to (ie. because the cat been in high numbers for quite a while and has got used to those). Even perfectly normal healthy numbers (and slightly higher) can trigger bouncing.

I think there is a strong likelihood that Guido's insulin dose is too high. (It's not that the 139 was too low, it's that there was the potential (and time) to drop even lower had you not intervened.)
If this were my cat I would be trying a reduced dose at this point, maybe cutting back to one unit to see how that works.
And as Andy & Pimp said above we generally recommend that - initially - no shot is given if the blood glucose is below 200 at preshot (immediately prior to giving insulin). That's just until the caregiver is comfortable with hometesting and has gathered a bit of data to show how the insulin is working in their kitty.

Does Guido have any history of ketones or ketosis?
Has he had steroid treatment recently?
And what exactly are you feeding him at the moment?

Eliz
 
Elizabeth and Bertie said:
Does Guido have any history of ketones or ketosis?
Has he had steroid treatment recently?
And what exactly are you feeding him at the moment?

Eliz
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Thank you for all the info! I'm learning so much from this forum, truly.

Guido has not been tested for ketones for months, so I wouldn't know right now what his status is there. At the time he was tested, the vet didn't say much more than the fact that he had some. I didn't get anything as far as a solution for that at the time.

He has not had any steroid treatment, ever, as far as I know.

I'm currently feeding him Friskies pate, at least half a can each feeding, twice a day.

His latest numbers have been more in the 375-475 range before feedings, rather than "HI" (which I understand from my glucometer manual to mean upwards of 600). I haven't been able to test him a few hours after morning feedings since I've been at work, but I can check today. All I can say is that he already seems so much more like his old self in the last couple of days, so that is very encouraging! A lot less drinking of water (he was out of control there), more active and playful, crawling in our laps, etc.
 
Update: Just tested him 2 hours after his shot and he's at 288, about 100 down from his pre-shot test.
 
Rachel, your spreadsheet indicates the 288 was at +3 hours after the shot. A hundred points in 2 hours is a lot steeper drop than in 3 hours so it's important to know whether that reading was 2 or 3 hours post shot. Just want to make sure which info is correct so those helping you can do so accurately. :)
 
Linda is spot on with her last comment. Please make sure the spreadsheet is accurate, it can make quite a big difference.
rnbullis said:
His latest numbers have been more in the 375-475 range before feedings, rather than "HI" (which I understand from my glucometer manual to mean upwards of 600). I haven't been able to test him a few hours after morning feedings since I've been at work, but I can check today. All I can say is that he already seems so much more like his old self in the last couple of days, so that is very encouraging! A lot less drinking of water (he was out of control there), more active and playful, crawling in our laps, etc.
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I would attribute these positive signs to the skipped shots :)
Shooting a lower number can cause a "bounce", that is- when Guido's BG goes too low, it causes his liver to send out hormones and stored sugars to raise it back up. The effects can last up to 3 days. I believe that has been the source of the super high numbers you've been seeing.


Getting those extra tests in today will really give us a good idea what's going on with him.

You're doing a great job;)
 
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I'm still not sure how to use the spreadsheet, I guess. I test him right before feeding, which generally happens between 6 and 7 each morning, then he gets his shot about a half hour later. But, because of my schedule, it doesn't happen the same EXACT time every day, so I'm not sure how to reflect that in the spreadsheet. It fluctuates within an hour on a given day, I'd say. I also don't know if it's important to include his food intake or not, since it's the same every time.

Today, I tested him a little before 7, fed him, and gave him his shot around 7:30. The next time I tested was about 2 hours later.

Testing is getting sort of frustrating. I have to poke him 3-4 times each time, it seems, because he struggles and hates it. His ears are ravaged at this point. I feel sorry for him, but I know it's important. It's enough of a chore that I find myself not wanting to do it more than right before a feeding and then later, if I have to.
 
I'm sorry you're getting frustrated with testing, Rachel. :bighug: The ones you've mentioned are the important ones, and if it keeps you a little sane there's no real reason to test more.
Edit to add: The before meal/shot tests are the big ones. If you're shooting a 325 preshot you probably don't need to test later in the cycle. However if you decide you want to shoot a 225 preshot, I would definitely get a test a bit later.

Are you warming the ear first? I found that to make quite the difference in the beginning. It should feel almost hot to the touch. Also, thicker lancets make a bigger hole to let bleed easier. 26 or even 24 gauge if you can find it is preferred. (Smaller number = bigger needle).
A dab of neosporin+pain relief GEL can help the pokes heal up quickly and take the soreness out. You, Guido and his ears will all get used to it soon enough:)

As far as the spreadsheet- AMPS and PMPS are always the last reading before shot, no matter what time it is. We know you're waiting a bit after that test to give the shot, because of the insulin you use. All that matters to the peeps here is how long after the shot the readings come. Does that make sense?
 
Andy & Pimp said:
I would attribute these positive signs to the skipped shots :)
Shooting a lower number can cause a "bounce", that is- when Guido's BG goes too low, it causes his liver to send out hormones and stored sugars to raise it back up. The effects can last up to 3 days. I believe that has been the source of the super high numbers you've been seeing.
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I haven't skipped any shots, or given him any lower dose than he has normally had. I took away his dry food, but that's really the only difference.
 
rnbullis said:
I haven't skipped any shots, or given him any lower dose than he has normally had. I took away his dry food, but that's really the only difference.
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:oops: SOrry....trying to help too many peeps at once and was thinking of a different kitty:)
 
Andy & Pimp said:
Are you warming the ear first? I found that to make quite the difference in the beginning. It should feel almost hot to the touch. Also, thicker lancets make a bigger hole to let bleed easier. 26 or even 24 gauge if you can find it is preferred. (Smaller number = bigger needle).
A dab of neosporin+pain relief GEL can help the pokes heal up quickly and take the soreness out. You, Guido and his ears will all get used to it soon enough:)

As far as the spreadsheet- AMPS and PMPS are always the last reading before shot, no matter what time it is. We know you're waiting a bit after that test to give the shot, because of the insulin you use. All that matters to the peeps here is how long after the shot the readings come. Does that make sense?
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I'm just warming his ear by rubbing it, but once I start that, he knows what's coming next and tries to get away from me. The lancets I have are 26 gauge, I think. I'll try the Neosporin when I can, thanks for that tip.

I adjusted the times on the spreadsheet to fit what usually happens a little better. It makes sense about the shot coming a half hour after testing, but it's weird not to have that on the spreadsheet, it seems. I think that's what might have me confused.
 
Rachel, take some deep breathes. Guido's ears will learn to bleed better with time. If Guido doesn't like having his ears fussed with, try just messing with his ears at non test times to get him more accustomed to it and to not expect a poke every time they are touched. And most of all, take those deep breathes and calm yourself before testing. Kitties pick up on our stress and mimic it which might be making him struggle against you more right now.

On your spreadsheet, please move the 288 reading into the +2 column since that was actually 2 hours after his shot. You don't need the times on the spreadsheet and I seriously think that is only going to confuse things more. I'd try to get another reading around +4 (might be about now if I am calculating time differences correctly) . I know you don't want to and I understand:bighug: but we need to figure out how long the insulin is lasting for him and how low he goes on this dose. Once you get some mid cycle tests it will be easier to figure out how to help you help Guido.

To heat up his ear, try a pill bottle with fairly warm water in it, held on his ear for few seconds. Sometimes they actually like that. Just make sure it's Ok temperature wise on your ear first!
 
rnbullis said:
I'm just warming his ear by rubbing it, but once I start that, he knows what's coming next and tries to get away from me.
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I saw one member here that had their kitty sit under a desk lamp for the bulb to warm it:confused:

If you can catch him for a test when he's been sleeping curled up, sometimes the ears are nice and warm. Or if sleeping by a heat vent/radiator.

Try rubbing ears and giving treats without testing, just to get him used to the fondling with no chance of pain.
If you freehand the lancet, sliding the lancet in gently at an angle works much better than jabbing/stabbing straight on.
If you're using the lancet device, mabye try freehand.

more tips

library of links

:)
 
Andy & Pimp said:
The before meal/shot tests are the big ones. If you're shooting a 325 preshot you probably don't need to test later in the cycle. However if you decide you want to shoot a 225 preshot, I would definitely get a test a bit later.
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Since you just recently removed dry kibble from the diet I think some checks early in the cycle after the pre-shot tests are stll needed right now as it may take a bit of time before all the effects of the higher carb dry food are out of his system and that could result in lower numbers mid way when the insulin peaks.
 
MrWorfMen's Mom said:
Since you just recently removed dry kibble from the diet I think some checks early in the cycle after the pre-shot tests are stll needed right now as it may take a bit of time before all the effects of the higher carb dry food are out of his system and that could result in lower numbers mid way when the insulin peaks.
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Good point! Absolutely agreed, just don't want Rachel - or Guido - to get fed up!
 
rnbullis said:
Testing is getting sort of frustrating. I have to poke him 3-4 times each time, it seems, because he struggles and hates it. His ears are ravaged at this point. I feel sorry for him, but I know it's important. It's enough of a chore that I find myself not wanting to do it more than right before a feeding and then later, if I have to.
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I hear you, Rachel...
It's very frustrating when tests are difficult to do. And I say this even after 9 years of testing my own cat.
Mostly, Bertie is very easy to test these days, but there are still times when he's a complete 'turnip head' and I'd swear there is NO blood anywhere to be found in there... Aaargghhh!! :arghh:

I do try to ensure that his ears are warm prior to testing (but that's not always possible despite our best efforts...)
If he's in 'turnip head' mode I automatically prick the ear twice, close together, rather than try to get enough blood from a single ear prick.
Massaging immediately below the ear prick/s will 'milk' more blood out; very often that will be sufficient for a test.
A teensy weensy smear of vaseline on the outer edge of the ear will stop that precious blood disappearing into the fur.
Some people reward their cats after the test is done. I crumble low carb treats and test Bertie while he is eating them.
Rachel, you will find a way that works for you and Guido. Really, you will.... ;)

And I do wonder if you need to step back a bit and re-start the process, rewarding Guido along the way, so that he comes to associate the process with yummy things....? With 'positive reinforcement' many things become possible....
.
 
You've got your signature and spreadsheet set up, so you're ready to start posting in Feline Health with further questions you may have.
 
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