As you've already observed, that is not always the case with a cat in hypoglycaemic numbers. Also if your vet is advising you that 50 is the number to worry about then this is also may be incorrect. The 50 threshold is typical of results seen on
human meters used to test a pet's blood glucose (they read lower than if the sample was tested in a lab). You need to get confirmation of the correct reference range to use with your pet meter.
Important Note: You may see the number 68 quoted on the forum as being the bottom of the normal BG range when measured on an Alphatrak pet meter. We have some basis for using this number for an Alphatrak meter but we have no way of knowing if this reference number is OK for the meter you're using. If I were in a similar situation, as a safety precaution I would look to not let my cat go below 80 until I could get proper confirmation of the correct blood glucose reference range to use with the meter (and I'd get confirmation of the reference range as soon as possible).
Thank you for posting the BG test results. I'm very glad that you are home testing and that you asked for help with it. I agree wholeheartedly with Chris that, even with this small amount of data, there is strong indication that your cat is receiving too high a dose of Vetsulin. The blood glucose mini curves are upside-down (i.e. BG is higher when insulin dose is at peak effect).
Insulin Dose Times: 8am & 8pm
FRIDAY
8:00am - 6 units Vetsulin
1:30pm (AM+5.5) 608
SUNDAY
8:00am - 6 units Vetsulin
6:00pm (AM+10) 105
8:00pm - 6 units Vetsulin
10:30pm (PM+2.5) 641
If you look at Friday's AM+5.5 result, that is slap bang in the middle of the period of peak effect of Vetsulin (typically 3-8 hours after injection time). The same goes for Sunday's PM+2.5 reading.
Here's what I'm particularly worried about. Vetsulin tends to drop BG levels rather hard at the beginning of the cycle. Again typically, there's about an hour and a half or thereabouts before you notice the Vetsulin dose starting to 'kick in' (often observable as an uptick in appetite where cat looks for food). In such cases testing at +2 - +3 hours after the injection was given is a good time to catch how low the dose is taking the cat. Typically, the lowering effect happens over the first few hours, the cat's BG stays lower for a few hours then starts to rise a good bit as the dose wears off (a cup-shaped curve). However ... every cat is different and sometimes Vetsulin can kick in
much earlier. My cat's a case in point. Sometimes it might take as little as 45 minutes for a dose to really kick in, reach the lowest point in the cycle less than 2 hours after the dose was given, and for BG to be
rising by the time a test is done at +3 hours after injection time.
I think you need to contact your vet as a matter of urgency to decide on a suitable dose reduction. I can't suggest a suitable dose reduction for you but if it were my cat I would not be comfortable with giving any further doses at 6 IU.
I strongly suggest that you keep to the following for the time being:
1. Sort out a dose reduction ASAP.
2. Get a preshot test 30 minutes before every insulin dose then give Garfield a good feed (so that there are some carbs in the system for the insulin to work on when it kicks in).
3. Where possible monitor for clinical signs of onset of the Vetsulin dose (e.g. obvious sign of food-seeking).
4. Test at +1, +2 and +3 hours after each insulin dose wherever possible so that you'll be able to see what the Vetsulin dose is doing earlier in the cycle (and possibly catch lows that are driving the bounces).
5. ALWAYS get a before bed test for Garfield to make sure he'll be safe while you're sleeping.
6. For the time being, if Garfield was mine I would ensure that he had free access to foods with a reasonable carb % if I had to leave him unattended (e.g. leaving the house for whatever reason).
Those clinical signs indicate that Garfield is not properly regulated. If your vet's response to your concerns is to advise you to increase the dose (happens) I suggest you seek a second opinion from another vet with a better appreciation of how to treat feline diabetes; one who recognises that the effect of too much insulin can look like too little (i.e. both can result in BG going too high).
Finally, just in case you've not found these forum stickies yet, here is advice on things to look for and how to treat hypoglycaemic episodes:
How to Treat Hypo (print this out and keep it somewhere it's easy to lay your hands on in an emergency)
Hypo Tool Kit
Please keep posting and letting us know how things are going, and ask about anything you're unsure of. We'll do all we can to help you and Garfield.
Mogs
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