1st insulin shot this morn, BG is 40 right now?!

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Good morning!!!!! Hope you both got a good night's rest last night!

Clarification:

1) Best to keep the two hour window before the pre-shot test free of food, so that the number is definitely not food-influenced. You don't have to feed two hours before, just remove any available food at that time so you have a clear picture of the pre-shot status.

2) After you have the pre-shot test number and have decided it's a shootable number, feed. Then, for Novalin N, you want to wait at least 30-40mins after the meal before doing the actual shot-- that way, the fast-acting insulin isn't hitting on an empty stomach.

3) If you aren't sure about the pre-shot test number, post for advice with regards to feeding and shooting-- generally the advice is to stall a bit on a low number to see if it goes up a bit on it's own, but the more experienced folks should be consulted in this situation after yesterday's drama. I wouldn't actually expect a low number this morning after the drama, but you never know!

Hope this helps, and congrats again on getting through yesterday!
 
And I want to give the shot earlier today than yesterday, as earlier am and pm works better for me. How important is it to be at the exact same time each day, to give insulin?

Also, what do you all think about .5U this morning? That's what the vet had said to do today, although that's when he thought id given 1U yesterday and was puzzled by the big drop. More? Less?
 
If you're giving insulin go with the 0.5IU dose.

Just to reassure you about dose measurement, the plunger of the syringe should be right down near the needle end. Click on the link below, scroll down the page a bit and look at the pictures of syringes showing very small doses. That's the sort of area the plunger of your syringe should be in when you're measuring a o.5 unit dose. (It's a teensy amount. :) )

http://www.felinediabetes.com/FDMB/...insulin-info-handling-drawing-fine-doses.151/

Sashi's Mama said:
And I want to give the shot earlier today than yesterday, as earlier am and pm works better for me. How important is it to be at the exact same time each day, to give insulin?
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Novolin N is an in-out insulin and it doesn't build up a store of insulin in the body. Because you skipped the dose last night you should be OK to give the dose earlier this morning. HOWEVER, thereafter you need to stick to giving a dose every 12 hours (provided it is safe to do so - your BG testing will guide you and you can always ask your vet and post here for help).

After giving this morning's dose I suggest getting a BG check in today at +1.5 hours after the dose was administered to see where the cycle is heading. Call your vet and post here for help if you need it.

Wishing you both a smooth, stress-free day in nice, safe numbers (and please give my best to your wonderful friend for me!).

:bighug:


Mogs
.
 
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MrWorfMen's Mom said:
In Canada human meters must produce readings within 15% of the lab values and in the US within 20%. I am not sure what the regulations are in the UK or elsewhere but they are likely the same as I don't believe there is any meter available anywhere that can reproduce lab values to within 10% yet. Hopefully one day there will be.



The 50 reading on a human meter is the warning number at which one must be vigilant and intervene to avoid having the cat's BG go any lower. That 50 is considered to be the equivalent of 68 on a pet meter which reads animal blood like lab values (within 20%). You should base your actions on the type of meter you are using and NOT try to make a guess of what that human meter reading means in terms of animal lab results. To do so could have devastating results. With insulin on board, you do not want kitty to be on the brink of a hypo episode so these reference numbers have a little bit of wiggle room built in.

A reading of 40 or even slightly lower on a human meter may be normal for a non-diabetic cat but is not a safe number for a cat on insulin. Your cat may not have shown outward symptoms of hypoglycemia at a reading of 25 but that doesn't mean the cat is not hypoglycemic or in serious danger of it. Some cats do not display symptoms and suddenly go into seizures. Every cat is different.

So if you are using a human meter, you may want to do a comparison with the lab values to get a feel for how your readings and lab values will compare going forward when you have blood drawn but on a daily care basis, the safest thing to do is to use the human reference reading of 50 as your cue that action and close monitoring is needed to keep kitty safe.
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This is where calibrating your own meter against the vet's lab values is of value too. Then you know how yours is off since the different meters can vary (and according to my vet, vary even within the same model of meter - he is the one who suggested doing this - he even suggested I leave my meter and he'd check it each time he drew blood on anyone's cat - I have a nice vet. Cost me $20 in test strips and $30 in his fee but I got a really nice chart back). Mine was off different amounts depending on how low or high the reading was (off less with lower blood sugar, much more with higher). I cared the most how it was off with low numbers since that is where the immediate danger is (eg hypoglycemia). You could also see the variation within meter even with cat lab readings that were very close to each other (this is normal to happen and within FDA specs). He said I couldn't use my calibration chart and assume it would be the same for all other meters of this brand and model; that he had seen variations even in that. He is the one who told me expired strips can cause a reading that is too low and that too little blood on the strip also gives a reading that is too low. it is really too bad that the cat meters are so incredibly expensive.

Plus or minus 10% is the same as being 20% off. (eg 10% higher plus 10% lower = 20% off)
 
kidsandliz said:
Plus or minus 10% is the same as being 20% off. (eg 10% higher plus 10% lower = 20% off)
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The FDA rules are such that meters can read 20% higher or 20% lower. It's not 20% in total.....it's actually 40% overall using your math.

Meter readings are not an exact measurement and neither are lab values for that matter. BG is a constantly changing entity so if you test twice with the same meter or lab equipment even on the same drop of blood, chances are the readings will not be precisely the same. I agree with your vet about the meter variance not only by brand but also same meter, same brand. Some meters will be more accurate at low ranges, some at moderate ranges, and some across the board etc. but all must conform to the regulations set out by the government health agencies as far as variances are concerned.

Some meters will error out if the sample is too small, some won't read at all if the sample is too small and some will give you false readings. It's important to know how your particular meter functions in those situations. When a low number is encountered, it's a good idea to double check it. I see nothing wrong with comparing your meter with the vet's lab results to get a "feel" for how different the readings are BUT when dealing with low readings on a human meter, I don't see any positive value in trying to assume what that number means in lab values before taking action. There is a bluffer built into the human meter references given here so whether my meter reads 2 or 10 points different than the lab values, doesn't matter to me. At 50 on a human meter I am going to take action because I have no way of knowing if that reading really is 40 or 60. If I make the assumption it's 60 and take no action and it's really 40, I am putting my cat into serious danger.

All sorts of things can effect the results from glucometers. Expired strips, bad strips, low battery power, temperature, sample contamination etc. Manufacturers generally recommend checking the meter using test solution each time a new vial of strips is started to ensure the strips and meter are functioning properly. If you follow this advice, and ensure the sample is not contaminated by washing your hands before testing, you can be pretty confident that your meter is functioning correctly and trust the readings using the appropriate reference numbers without questioning them. If at some point you suddenly get an unexpected reading, double checking is advisable.
 
Had to step away to go do chores. He threw up shortly after his breakfast, which is not an unusual occurrence for him. Lifelong sensitive tunmy, and I think I gave him a little too much of the ZiwiPeak along with his usual FF chicken classic. He'd had the ZiwiPeak yesterday with no issues so I was fooled into letting him have more this morning than I should have. He got some fresh FF chicken classic right after puking and ate it all up. Behaving totally normally this morning, purring, happy, snuggling, hungry.

I went suuuuuper conservative on the insulin, shooting about 1/10U. Because I'm totally paranoid now. I checked the syringe multiple times to be sure it was that little, and it was as I barely depressed the plunger. So it may make little difference, but I figured better to be safe after the overdosing yesterday and work up the higher .5 dose. Have my alarm set to test him at +1.5. Will keep you all posted for sure!
 
Baby steps. As you see what the insulin does, and see some proper numbers in front of you, you will gain confidence.
I'm not around much today but there is almost always someone on the forum.

If you could set up a spreadsheet (including yesterday's adventure), that would be great. It will let you and others see patterns that will help with the dosing. Instructions here:
http://www.felinediabetes.com/FDMB/threads/fdmb-spreadsheet-instructions.130337/

btw: you were great yesterday.
 
Kris & Teasel said:
So he's gone from 454 to 277 in 3 hours on a miniscule dose that you estimated was much less than 0.5u. Whew! This is exactly that insulin sensitivity post hypo that we mentioned yesterday. He probably won't go too low but keep testing and posting for us to have a look.
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I was just talking to my mom and she said the exact same thing. Keeping an eye on him for sure! I'll also certainly be asking if I should dose him tonight, depending on how his levels look then.
 
+4.5 is 304.

He is getting tired of needle sticks but I'm trying to get him into the "hey this isn't that bad" mode by giving treats right after. Plus he's been poked an awful lot in his ears lately for the first time ever!
 
Looks like he is on the uptick again. I think you can safely give his little ears a rest and maybe test again around +6 or +7 {when the second component of the Vetsulin starts to click in unless of course he gives you any indication of being off. This second drop is usually much subtler and sometimes unperceivable but worth checking for.}

ETA. I got mixed up between cats and their insulins typing here so please ignore my last rant. Thus the strikethrough text.
 
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Doing it right now Mogs! :p I think I've got Vetsulin on the brain these days! And that's embarrassing after all the excitement here yesterday. I should have know better. Maybe I can blame my little stinker who has decided to nadir (and very well I might add) early today which is making me antsy because I can't be stalling her PMPS shot right now due to a time crunch this weekend and I don't want to have to resort to 18 hour or such scheduling and lose ground. Still hoping though that this is a sign of another dose decrease in the offing. Fingers crossed! :rolleyes:
 
Ok, his PMPS (I've guessed that that means PM pre-shot, is that right?) is 357. I'm leaning towards either no insulin, or as small a dose as I gave this morning, because I will not be able to stay up to monitor him later than about an hour after I'd give the dose (which would be in about 30-40 minutes, as he's very happily eating right now).

That's total guesswork on my part, based on what happened with him yesterday and that he dropped quite a bit again this morning after his low AM dose. Steer me! Thoughts? Suggestions? More handholding, please? :)
 
Sashi's Mama said:
(I've guessed that that means PM pre-shot, is that right?)
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You're right!!

Sashi's Mama said:
Thoughts? Suggestions?
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I think you'd be good to go with the same dose you did this morning

Can we get you to start a new thread tomorrow? This one's getting pretty long!!....If you need some help setting up your spreadsheet, I'd be happy to help you! Just click on my name and send me a private message ("Start Conversation") and I'll be happy to do it!

We also need you to fill out your signature (the information we all have under our comments)...it keeps us from having to ask the same questions over and over again. Just click on your sign on name and choose "Signature"....a new box pops up for you to enter information like

Your name/cats name, age, sex, date of diagnosis, type of insulin, type of meter, type of food, any other health issues? and maybe a general location....and when you're spreadsheet is up and running, you'd put the link to it into your signature too so people can quickly go see how he's been doing
 
Hope you've managed to recover a bit since the 'excitement'. After your baptism of fire I'd say you were exhausted afterwards.

Hope that Sashi is feeling good.

:bighug:


Mogs
.
 
sophie said:
How are you guys doing? Would like to hear from you. You don't have to do all the paperwork before posting. All Ok?
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We're wonderful! Update here: http://www.felinediabetes.com/FDMB/threads/sashi-update.169702/

Critter Mom said:
Hope you've managed to recover a bit since the 'excitement'. After your baptism of fire I'd say you were exhausted afterwards.

Hope that Sashi is feeling good.

:bighug:


Mogs
.
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He is, and so am I! Thanks so much for asking. :) New thread update here: http://www.felinediabetes.com/FDMB/threads/sashi-update.169702/

Marlena said:
When can we start talking about change of insulin? Novolin is pretty useless for kitties.
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I'm curious about this. Why is it useless?
 
Sashi's Mama said:
I'm curious about this. Why is it useless?
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Novolin N insulin is a very rapid harsh type of insulin which is not really suitable for treating feline diabetes as cats have a different metabolism than humans and they metabolise insulin much quicker therefore they need a very long lastin one. If you use short acting insulin like Novolin you would not be able to keep your cat's BG at stable level during the cycle. It can drop cat's BG like crazy very quickly and the effect wears off too quickly giving too much of up and down effect which is very detrimental to feline health.
Long lasting insulin provide a much smoother curves of BG. That's why Lantus, Levemir or ProZinc (PZI) is more appropriate drug to use for cats. They last very long in humans and not so long in cats therefore twice a day injections are required.
There is also a dog's insulin (for dogs) Vetsulin (Caninsulin) and some people use this with some success but again it is not ideal because in most cats it does not provide a 12 hour duration meaning that it wears off too quickly.
If you would like to consider another insulin which I highly recommend if you want best for your kitty please read anything you can find on the subject and ask questions, we are very happy to help you with that decision.
 
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