Need some advise asap about BG test & first insulin shots / food changes

[Chris & China (GA)]

Here's something I wrote up for others that needed help with testing...maybe it'll help you too! (substitute "her" for "him"...LOL)

It can be really helpful to establish a routine with testing. Pick one spot that you want your "testing spot" to be (I like the kitchen counter because it's got good light and it's at a good height....it also already blocked 2 escape routes due to the wall and the backsplash) It can be anywhere though...a rug on the floor, a table, a particular spot on the couch...wherever is good for you. Take him there as many times a day as you can and just give his ears a quick rub and then he gets a yummy (low carb) treat. Most cats aren't objecting so much with the poking..it's the fooling with their ears they don't like, but once they're desensitized to it and learn to associate a certain place with the treats, they usually start to come when they're called! Or even when they hear us opening the test kit!

You also have to remember...you're not poking him to hurt him...you're testing him to keep him safe and understand what's going on inside his body. There's just nothing better than truly understanding what's going on inside your kitty's body and with this disease, the more knowledge you have, the more power you have against it. The edges of the ears have very few pain receptors, so it really doesn't hurt them. Also, if you're nervous and tense, it's going to make your kitty nervous and tense too. As silly as it might seem, try singing! It forces you to use a different part of your brain!

It's also important to make sure his ear is warm. A small sock filled with a little rice and microwaved or a small pill bottle filled with warm water (check temp against your wrist like you would a baby bottle) works well.

When you're first starting, it's also important to use a lower gauge lancet, like 25-28 gauge. Most of the "lancet devices" come with 33 gauge lancets and they are just too tiny to start with. The bigger lancets (that are lower numbers) make a bigger "hole". As you poke more and more, the ears will grow new capillaries and will be easier and easier to get blood from...we call it "learning to bleed"

Finding the right "treat" will be a great help too! Freeze dried chicken, bonito flakes, little pieces of baked chicken...whatever low carb treat you can find that he really enjoys will help him to associate the testing with the treat! China's Achilles heel was baked chicken, so I'd bake a piece, chop it into bite sized pieces, put some in the refrigerator and freeze the rest to use as needed. It didn't take long for her to come any time I picked up the meter!

 

[TanyaG]

when you first start, you hold the same dose for 5-7 days (unless she drops below 50)

Lantus craves consistency so you want to give the same dose both AM and PM

Maybe it would be better for me to stick with 1u then as vet said he wants me to do curve reading in 5-7 days to monitor how she's been doing on 1u a day. Also as its harder to see the 0.75u on the syringe I don't want to end up being inconsistent, whilst the 1u I can see clearly. What do you think?

 

[MrWorfMen's Mom]

Just wanted to be absolutely sure you knew where the lines were on the syringe. Mistakes do get made so better to be safe than sorry.

Right now stick with 0.75u. It's best to stick with a dose for a few cycles before making changes. This gives you a chance to accumulate some data and determine if a dose change is needed or not. Lantus likes consistency to work best.

HA HA! Chris beat me to it about the dose and now I sound like a parrot!

As for the testing, you don't scrape the blood bead onto the strip....you allow the strip to "sip" the blood. If you think the glucometer is going to spook Tinka, poke her and then carefully pick up the bead of blood onto a clean fingernail and test from there. Just make sure you wash your hands before using this method so the sample isn't contaminated with anything.

 

[TanyaG]

Great article Chris thank you

 

[MrWorfMen's Mom]

Tanya, what you could do is take one syringe and draw water into it (coloured with something to make it easily recognized as the sample) to where you eyeball the 0.75u. Keep that as a guide and then you can mimic the consistency by comparing your drawn up insulin to the sample.

It's up to you if you want to give 1u instead of the 0.75u because you hold the needle and the calculation using weight suggested just under 1u would be fine. We generally don't see vets working in as small dose increments as we do probably because they don't want to make things too complicated (I think many underestimate the ability of their pet parent clients) or because they don't think those mini dose adjustments mean much. We however have lots of members whose cats are testaments to the fact that those small dose adjustments often do make a difference.

 

[Chris & China (GA)]

Also as its harder to see the 0.75u on the syringe I don't want to end up being inconsistent, whilst the 1u I can see clearly. What do you think?

Towards the bottom of the Sticky on Handling and Drawing Fine Doses are some pictures of some of those smaller doses

It's not as important that you get exactly .75......just that wherever you decide .75 is as consistent as possible.

 

[TanyaG]

Just wanted to be absolutely sure you knew where the lines were on the syringe. Mistakes do get made so better to be safe than sorry.

Right now stick with 0.75u. It's best to stick with a dose for a few cycles before making changes. This gives you a chance to accumulate some data and determine if a dose change is needed or not. Lantus likes consistency to work best.

HA HA! Chris beat me to it about the dose and now I sound like a parrot!

As for the testing, you don't scrape the blood bead onto the strip....you allow the strip to "sip" the blood. If you think the glucometer is going to spook Tinka, poke her and then carefully pick up the bead of blood onto a clean fingernail and test from there. Just make sure you wash your hands before using this method so the sample isn't contaminated with anything.

Thank you for this helpful info, I will try to sip the blood Is it ok to do 1u as that was what vet recommended and it will be easier to see on the syringe? Or if 0.75 is a lot safer I can try do that its' just so tiny and there's no line so will be harder to see so I feel I may be more inaccurate then if I do the 1u with the line underneath. I haven't used the lancet, the vet taught me to use a needle and gently prick I vein on the edge of the ear. He said the lancet makes a noise that cats don't like. Instead he gave me the small needle to use and then a roll of soft tape on the other side so it gives a point to press against so needle doesn't poke your finger. Is this ok to do or does everyone use a lancet usually? The lancet does sound easier. I'm not sure is the accu-chek lancet the right size?

 

[Chris & China (GA)]

HA HA! Chris beat me to it about the dose and now I sound like a parrot!

@TanyaG ......you'll find that you'll hear the same things by lots of us.....we've all got the "company line" down.....LOL

 

[Chris & China (GA)]

Is it ok to do 1u as that was what vet recommended and it will be easier to see on the syringe?

Of course it's OK.....in the end, we can only advise you what we think is best.....as long as you're able to test though, you'll be able to keep Tinka safe.

Make sure you have a "hypo kit" put together....Some high carb canned food (like Fancy Feast Gravy Lovers or foods "with gravy"), Karo/honey/syrup and always keep a spare box of test strips (you'll find that these kitties of ours have an annoying habit of dropping too low at 2am on a Sunday morning when you can't get out to buy more strips!)

 

[MrWorfMen's Mom]

You can use whatever you feel most comfortable using to poke the ear but if you only have one needle, be aware that it will get dull after a couple of uses and develop tiny barbs so you risk more discomfort for Tinka or worse, tearing her ear. What gauge are the lancets you have? Most of us use a 28 gauge, at least in the early days. You really don't need to use the vein but rather poke just slightly more toward the outer edge of the ear. The vein is fine if you are desperate for a sample but capillary blood is preferred. Poking the vein can be a very messy proposition if kitty decides to do a little head shake at just the wrong moment. Been there.. done that and ain't gonna do it again! I had blood all over me, the floor, the wall, everywhere!

I am going to hit the sack after one more test of my little sugar kid so I will check tomorrow to see how things are going for you. Good night and sweet dreams everyone!

 

[Chris & China (GA)]

He said the lancet makes a noise that cats don't like

There's lancets (small pieces of plastic with a sharp metal point) and there's lancet devices (special device that holds the actual lancet and does the action of "poking" for you

It's true that the lancet devices can "click" and make a noise that cats might not like at first, but you don't have to use the special device....a lot of us just buy the actual lancets and freehand poke

The lancets are on the left.....an example of a lancet device is on the right in this picture

 

[TanyaG]

You can use whatever you feel most comfortable using to poke the ear but if you only have one needle, be aware that it will get dull after a couple of uses and develop tiny barbs so you risk more discomfort for Tinka or worse, tearing her ear. What gauge are the lancets you have? Most of us use a 28 gauge, at least in the early days. You really don't need to use the vein but rather poke just slightly more toward the outer edge of the ear. The vein is fine if you are desperate for a sample but capillary blood is preferred. Poking the vein can be a very messy proposition if kitty decides to do a little head shake at just the wrong moment. Been there.. done that and ain't gonna do it again! I had blood all over me, the floor, the wall, everywhere!

I am going to hit the sack after one more test of my little sugar kid so I will check tomorrow to see how things are going for you. Good night and sweet dreams everyone!

Thanks so much you are all fab, so appreciate your help! my lancet has different number settings on it from 0.5-5.5. Not sure what the overall size is will have to try search. I think it sounds easier to use the lancet if cats don't mind the little click noise. I shall try find out if my accu-chek is suitable. Good night sleep well

 

[TanyaG]

There's lancets (small pieces of plastic with a sharp metal point) and there's lancet devices (special device that holds the actual lancet and does the action of "poking" for you

It's true that the lancet devices can "click" and make a noise that cats might not like at first, but you don't have to use the special device....a lot of us just buy the actual lancets and freehand poke

The lancets are on the left.....an example of a lancet device is on the right in this picture

Thank you for clarying this for me! So I have both those in my kit. Just not sure what size my lancets are, will try find out. The vet basically gave me something similar to a lancet its like a small top part ofa syringe with a back on it and then to use the medical tape roller on the other side so I don't poke myself. I like the idea of a warm rice bag though first though. She's quite a finiky girl. I tried to make the chair the place where her ears get stoked/touched and then a pet so she is more prepared for tomorrow. She was not impressed even hesitated to eat her treat just cause I touched her ears. She's had a lot of ear drops in the past from infections so bit of a negative vibe but hopefully the treats will help. Thanks for all your help! I better hit the hay so I can be up early to test, feed and give her shot. Will be back on here tmrw with result. Sleep well too

 

[Critter Mom]

If you're up for some "light reading",

I heard that!



.

 

[Critter Mom]

Hi Tanya,

Hope Tinka's OK this morning. Would it be possible for you or someone else with you could get out to a pharmacy first thing this morning to get some ketone test strips to check Tinka's ketone status: it's really, really important for her safety to establish her ketone status.


Mogs
.

 

[MrWorfMen's Mom]

@Mogs, it's only 5:45am Tanya's time so as hard as it is, we are going to have to be patient. I'm hoping no post overnight is a good omen.

 

[Critter Mom]

@Mogs, it's only 5:45am Tanya's time so as hard as it is, we are going to have to be patient.

I know this, Linda! (You have no faith in me. )

As we all know the early days are very stressful and it's hard to remember everything so I thought it wise to post a reminder that Tinka's ketones still need to be checked. (As you can tell, I want her to keep safe and I'm really worried about her status.)

I won't be around for much of the day so instead of risking ketone status getting sidetracked by the (understandable) focus on correct insulin dosing I thought it best to post now so that the reminder would be 'lying in wait' ready for when Tanya logs on to check this thread today.




Mogs
.

 

[MrWorfMen's Mom]

Well you are a better woman than me, because I went looking for an update with my coffee in hand when I finally got moving this morning and then had to remind myself that it was too early for any update on Tinka yet. Good idea posting a reminder about the ketones. Oh how we worry about these kitties!

 

[Critter Mom]

Good idea posting a reminder about the ketones.

Confession: I have a memory like a string vest.

(I have had to learn to make a point of writing a note immediately I think of something because otherwise the thoughts just evaporate. It's a PTSD thang to do with damage to the hippocampus.)


Mogs
.

 

[MrWorfMen's Mom]

Probably be a good habit for most of us to use. I am a list/note maker but have a talent for misplacing them. I blame it on a two floor residence where I will carry a shopping list around to check cleaning, pantry, freezer needs and then leave the dang list somewhere along in my travels only to have to do another pass to find the blasted thing before I go to do the errands.

 

[TanyaG]

Good morning everyone thanks so much for your messages. So Tinka ate a bit more before bed which is good and I put some warm water in food which she drank too so hopefully she's a bit more hydrated. I couldn't get her out from under the bed this morning though, I don't like her hiding. Eventually got her out. She was so good when we did her BG. It tested at 13.3 mmal/L at 7:30am. She then got fed and ate a fair amount. We administered 0.75u of insulin. I wasn't sure I got it in the first time as its such a small amount but u must have. She got treats after and then ate some more

 

[TanyaG]

Well you are a better woman than me, because I went looking for an update with my coffee in hand when I finally got moving this morning and then had to remind myself that it was too early for any update on Tinka yet. Good idea posting a reminder about the ketones. Oh how we worry about these kitties!

Thank you, you are so so sweet and helpful much appreciated! Just posted my update on Tinka above. My mom will monitor her over the next 3 hours. What signs should we be looking for if she drops to low or anything else we should be watching for? Thanks!

 

[TanyaG]

Hi Tanya,

Hope Tinka's OK this morning. Would it be possible for you or someone else with you could get out to a pharmacy first thing this morning to get some ketone test strips to check Tinka's ketone status: it's really, really important for her safety to establish her ketone status.


Mogs
.

Hi Mogs, I just posted my update on Tinka. This morning went pretty well considering it was our first one. I was s big teary after the insulin shot just feel so sorry for my baby, want her to feel better. My mom is watching her now then will take her reading at 10:30am (so that's 3 hours after first BG test and 2hrs 45mins after her first insulin shot). She'll get the ketone test strips at 12pm after her meeting then I'll be back shortly after to test her then. So what's the best way to get urine? To put plastic over her litter bin? Will they pee on plastic? Thanks again!

 

[Critter Mom]

Well done with the testing and dosing, Tanya. I bawled my eyes out too when I first started.

Safety info:

How to treat hypos (print this out, read it through and keep it somewhere handy)

In addition to signs listed in the document here pay attention to vomiting or lethargy/unresponsiveness. Test BG if anything worries you; never any harm to make sure it's in OK levels. BG should not be allowed to go below 50mg/dL / 2.8 mmol/L on a human meter (you're using an Accu-chek, yes?) For a pet meter the action point is at 68 (US) / 3.8 (international). Note that the hypo guide uses reference numbers for a human meter.

Also check this for things to add to your shopping list:

Hypo toolbox

Another helpful link:

Urine testing tips


Mogs
.

 

[TanyaG]

Well done with the testing and dosing, Tanya. I bawled my eyes out too when I first started.

Safety info:

How to treat hypos (print this out, read it through and keep it somewhere handy)

In addition to signs listed in the document here pay attention to vomiting or lethargy/unresponsiveness. Test BG if anything worries you; never any harm to make sure it's in OK levels. BG should not be allowed to go below 50mg/dL / 2.8 mmol/L on a human meter (you're using an Accu-chek, yes?) For a pet meter the action point is at 68 (US) / 3.8 (international). Note that the hypo guide uses reference numbers for a human meter.

Also check this for things to add to your shopping list:

Hypo toolbox

Another helpful link:

Urine testing tips


Mogs
.

Thanks so much for this info I'll send it to my mom now and keep it on reference too. What's the best way to collect urine to put cling film over her cat litter and make a whole in the middle? I think she just used the bathroom unfortunately which I missed but hopefully she will go again before 12pm so I can test.

 

[MrWorfMen's Mom]

Congratulations on getting it all done this morning. The first few days are tough as you learn new skills and gain more knowledge but in a short time it will all simply be part of your routine. I shed an ocean of tears the first week after diagnosis, admonishing myself for not noticing symptoms earlier and so wanting my sugar to perk up. Wonderful that your Mom can keep an eye on Tinka for you this morning.

If Tinka has a favorite corner(s) or side(s) of her box you could put some plastic wrap in those spots hoping she will christen it for you or you can put plastic across the whole thing. Some cats will actually let you sneak up behind them and hold a ladle under their butt but I think they are the minority. You only need a very tiny sample so if you can snag any in the plastic wrap, just dip the strip in and wait according to the instructions to do the comparison with the colour scale. This I'm afraid is a bit of a trial and error proposition depending on how co-operative or fussy Tinka is about her toileting facilities.

 

[Critter Mom]

Thanks so much for this info I'll send it to my mom now and keep it on reference too. What's the best way to collect urine to put cling film over her cat litter and make a whole in the middle? I think she just used the bathroom unfortunately which I missed but hopefully she will go again before 12pm so I can test.

I use the cling film trick. Try to pick a 'favourite spot' in the box to cover with the plastic and push it down a little to make a sort of 'well'. (Gently - the film punctures easily.)

Sometimes kitties use the litter box just after eating. It might be a good time to see if Tinka will 'perform'!


Mogs
.

 

[TanyaG]

Congratulations on getting it all done this morning. The first few days are tough as you learn new skills and gain more knowledge but in a short time it will all simply be part of your routine. I shed an ocean of tears the first week after diagnosis, admonishing myself for not noticing symptoms earlier and so wanting my sugar to perk up. Wonderful that your Mom can keep an eye on Tinka for you this morning.

If Tinka has a favorite corner(s) or side(s) of her box you could put some plastic wrap in those spots hoping she will christen it for you or you can put plastic across the whole thing. Some cats will actually let you sneak up behind them and hold a ladle under their butt but I think they are the minority. You only need a very tiny sample so if you can snag any in the plastic wrap, just dip the strip in and wait according to the instructions to do the comparison with the colour scale. This I'm afraid is a bit of a trial and error proposition depending on how co-operative or fussy Tinka is about her toileting facilities.

Thanks for sharing your journey and experience it helps so much knowing from you all that I'm not alone in this, it's a great support! Tinka has been hiding under the bed so bad to be coaxed out. She's now in eyes view from my mom. Hope this whole hiding thing ends soon. It's probably exasperated s bit cause of us procking and prodding her this morning. She a pretty sensitive kitty. So what kind of numbers are we hoping for in the next BG test, the one about 3 hrs after insulin this morning? So I should only be concerned if it's below 3? I told my mom to call me if its anything less than 4. Thank you for the litter tips!

 

[TanyaG]

I use the cling film trick. Try to pick a 'favourite spot' in the box to cover with the plastic and push it down a little to make a sort of 'well'. (Gently - the film punctures easily.)

Sometimes kitties use the litter box just after eating. It might be a good time to see if Tinka will 'perform'!


Mogs
.

Thank you Mogs Hopefully she uses the litter tray soon I plastic wrapped it and made a whole. I recently switched to recycled paper in place of clumping litter as I was concerned that her chest was making a bit of a noise every time I picked her up for the past month and she never had that before. Made me concerned it was the dust from the clay litter and I read somewhere bentonite can be problematic. Not sure if it was problematic bit I switched just in case. Are any lung issues associated with diabetes? Vet said her lungs seemed find but I know they her lungs/chest/breathing is different when I pick her up then what it use to be. Anyways I sprinkled a little of the recycled paper pellet litter on top of the cling film wrap. If some happens to get in the litter will it contaminate it?

I also put down another new litter tray I got the other day with these black non absorbent beads in that the vet sold me to get the urine sample which we didn't end up using as they took a urine sample at the vets. So hopefully between the two I can get a urine sample to test her ketones. I'll also ring the vets later for a comparison of what her ketone itinerary results were the other day.

 

[TanyaG]

Thanks for sharing your journey and experience it helps so much knowing from you all that I'm not alone in this, it's a great support! Tinka has been hiding under the bed so bad to be coaxed out. She's now in eyes view from my mom. Hope this whole hiding thing ends soon. It's probably exasperated s bit cause of us procking and prodding her this morning. She a pretty sensitive kitty. So what kind of numbers are we hoping for in the next BG test, the one about 3 hrs after insulin this morning? So I should only be concerned if it's below 3? I told my mom to call me if its anything less than 4. Thank you for the litter tips!

Also when I do the readings at 3hrs and 6hrs after insulin does it matter if she's eaten? She is currently eating 4 times a day so I can feed smaller meals more often so she eats better and then she kind of takes a while to eat it sometimes. I can ensure that her pre-shot BG has had no food for 2 hrs before. Just checking that the other BG's in btwn don't also need to be away from food as that will be a challenge.

I'm planning to feed her and do her diabetic routine this week as follows. BG at 7:30am, BG taken just before then insulin just after food, then BG at 10:30am, BG at 1:30pm, then 2:30pm lunch feed. BG at 7:30pm, feed & insulin. BG at 10:30pm. Last feed for the day around 11pm. Do I need to do a BG between 2:30pm and 7:30pm? Also do I need to do one more BG after 10:30pm tonight? I could do one at like 12pm if needed? Need to be in bed by then if I'm up at 7am.

Is it necessary to do BG 3hrs after and 6hrs after every insulin shot every day? Not sure I can always be home to do that. Thank you!!

 

[MrWorfMen's Mom]

So what kind of numbers are we hoping for in the next BG test, the one about 3 hrs after insulin this morning? So I should only be concerned if it's below 3?

Ideally we see kitty slowly drop from the pre-shot number but some cats can be more dramatic than others. In the first couple of hours it's possible to see no change or a slightly higher number due to the food given at shot time. What we are looking for with the testing is when in the cycle kitty starts their drop, when they reach their lowest reading and what that lowest reading is. Until you have some data, it's hard to say how much to expect by 3 hours post shot but if kitty has gone down by 4 mmol or more by 3 hours post shot, the cycle is likely to be an active one and bears close monitoring.

Any reading of roughly 3 (technically 2.8) is a cue to you to start steering the BG by feeding a bit to help curb the drop but I doubt you will get any activity like that today.

 

[TanyaG]

Ideally we see kitty slowly drop from the pre-shot number but some cats can be more dramatic than others. In the first couple of hours it's possible to see no change or a slightly higher number due to the food given at shot time. What we are looking for with the testing is when in the cycle kitty starts their drop, when they reach their lowest reading and what that lowest reading is. Until you have some data, it's hard to say how much to expect by 3 hours post shot but if kitty has gone down by 4 mmol or more by 3 hours post shot, the cycle is likely to be an active one and bears close monitoring.

Any reading of roughly 3 (technically 2.8) is a cue to you to start steering the BG by feeding a bit to help curb the drop but I doubt you will get any activity like that today.

Thank you Linda, this is super helpful

 

[TanyaG]

So my mom just texted me her BG taken at 10:30am about 3 hrs after her 0.75u of insulin at 7:45am and it is 11.2 mmal/L. It was 13.3 mmal/L at 7:30am this morn. I'm assuming that's good to have a small drop. Any feedback? Thank you!

 

[MrWorfMen's Mom]

Tanya, that schedule looks fine but it kind of presumes that Tinka will reach her nadir at the same time every day and that is not always the case. Not only do cats each have their own time schedule for nadir but it can change a bit day to day. When you are working obviously the times you can test are going to be limited but on days off, it's a good idea to snag tests at other hours. The nadir for Lantus usually falls somewhere in the +5 to +7 hour period after the shot so testing at +6 is a good mid point to check but when possible but some cats nadir earlier and some later, so grabbing some tests at other times between +3 to +9 can also give you more insight into exactly what Tinka's pattern is. While each reading tells us what is happening at the moment, it's the patterns we see over time that allow us to determine dose adjustments and just how kitty is best dealt with for meal times etc. Feed Tinka today as you normally intend to do. She does not need to be fasting for mid-cycle testing. You only need to withhold food for 2 hours before each pre-shot test.

 

[MrWorfMen's Mom]

Yeah! That 11.2 is a great start to the cycle and makes me think the 0.75u to start was ideal.

 

[TanyaG]

Yeah! That 11.2 is a great start to the cycle and makes me think the 0.75u to start was ideal.

Yah that's great news thank you!!

 

[TanyaG]

Tanya, that schedule looks fine but it kind of presumes that Tinka will reach her nadir at the same time every day and that is not always the case. Not only do cats each have their own time schedule for nadir but it can change a bit day to day. When you are working obviously the times you can test are going to be limited but on days off, it's a good idea to snag tests at other hours. The nadir for Lantus usually falls somewhere in the +5 to +7 hour period after the shot so testing at +6 is a good mid point to check but when possible but some cats nadir earlier and some later, so grabbing some tests at other times between +3 to +9 can also give you more insight into exactly what Tinka's pattern is. While each reading tells us what is happening at the moment, it's the patterns we see over time that allow us to determine dose adjustments and just how kitty is best dealt with for meal times etc. Feed Tinka today as you normally intend to do. She does not need to be fasting for mid-cycle testing. You only need to withhold food for 2 hours before each pre-shot test.

I'm currently studying so I do have flexibility in my schedule so I can do different times on different days if that helps I unfortunately have chronic health issues myself so am often out at various doctors appointments btwn studies but will do my very best to test regularly. My mom can possibly help too. So typically how many times a day should I be testing her BG? What is a nadir? Thank you!

 

[MrWorfMen's Mom]

Nadir is a fancy word for the lowest point in the cycle.

When your schedule permits, change up your test times to get an overview of the cycle rather than the same hour(s) everyday. If you do a +4 one day, try for a +5 or +6 etc the next. If you look at most spreadsheets they don't have any coloured columns but rather look like puzzle pieces laid out on a table and in many ways that's exactly what they are.

Ideally you should aim for at least 4 tests per day (2 pre-shots and one mid cycle test in each 12 hour period. In the early days you may need to test more often occasionally as you try to hone in on the ideal dose for Tinka but 4 a day is more than sufficient in most cases. That said, I'd be inclined to monitor her more closely right now with ketones being a concern.

 

[Critter Mom]

So my mom just texted me her BG taken at 10:30am about 3 hrs after her 0.75u of insulin at 7:45am and it is 11.2 mmal/L. It was 13.3 mmal/L at 7:30am this morn. I'm assuming that's good to have a small drop. Any feedback? Thank you!

Great teamwork!

That's a nice, gentle drop to AM+3.

Regulation is a gradual process. Because the cat's body has become used to operating at high BG levels it needs to gradually get used to running in lower numbers in stages so a slow and steady approach needs to be used when it comes to insulin treatment.

Lantus is a depot insulin. With successive Lantus doses a little chemical 'tank' of insulin builds up in the kitty's body. It takes several 12-hour dose cycles for the amount of insulin 'in the tank' to adjust before the efficacy of the dose can be assessed (as shown by the BG data you gather from home testing) so one starts out at a small dose. Thereafter as required the dose is adjusted by a small increment (usually o.25IU Lantus), held for several cycles and re-evaluated. Then rinse and repeat.

BG testing helps to keep our kitties safe on insulin and also acts as a guide to optimising their treatment. Each day you need to do a preshot BG test in both morning and afternoon (to make sure it's safe to give the next dose) plus at least one BG test between doses - a mid-cycle test - to see how low the dose is taking the cat's BG. (Two mid-cycle tests - one in the AM and one in the PM cycle - would be better.)

Lantus dose adjustments are based on nadir BGs. The nadir is the point where BG is at its lowest in a 12-hour cycle.

I'm sorry to hear about your chronic health issues, Tanya. (In a similar boat myself.)


Mogs
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[TanyaG]

Just attached a pic. Are these the correct urine strips for testing ketones? They the same brand as my glucometer. This is the only ones they have in stock today. They'll be getting in the other ones similar to Chris's pic but only tmrw. Shall I go ahead and by the ones attached in pic today? Thanks!

 

[MrWorfMen's Mom]

Yes those will get the job done.

 

[TanyaG]

Nadir is a fancy word for the lowest point in the cycle.

When your schedule permits, change up your test times to get an overview of the cycle rather than the same hour(s) everyday. If you do a +4 one day, try for a +5 or +6 etc the next. If you look at most spreadsheets they don't have any coloured columns but rather look like puzzle pieces laid out on a table and in many ways that's exactly what they are.

Ideally you should aim for at least 4 tests per day (2 pre-shots and one mid cycle test in each 12 hour period. In the early days you may need to test more often occasionally as you try to hone in on the ideal dose for Tinka but 4 a day is more than sufficient in most cases. That said, I'd be inclined to monitor her more closely right now with ketones being a concern.

Thank you that makes sense I will try and take different readings to work on the puzzle. Is it s problem that mid cycle / 6hrs after her evening insulin at 7:45pm will be 1:45pm and I'll be asleep. With my health issues I need to get at least 7 hrs sleep. If I need to be up at 7 to do her testing and shot etc the latest I can probably do a mid cycle BG after her evening shot is maybe 4hrs after which is at 11:45pm. Would that work? Is there a safety concern after that? My hubby could maybe do a 12:45pm one if needed? Thanks!

 

[TanyaG]

Yes those will get the job done.

Fab thanks I'll get those so I can try get a sample tested today

 

[TanyaG]

Tha

Great teamwork!

That's a nice, gentle drop to AM+3.

Regulation is a gradual process. Because the cat's body has become used to operating at high BG levels it needs to gradually get used to running in lower numbers in stages so a slow and steady approach needs to be used when it comes to insulin treatment.

Lantus is a depot insulin. With successive Lantus doses a little chemical 'tank' of insulin builds up in the kitty's body. It takes several 12-hour dose cycles for the amount of insulin 'in the tank' to adjust before the efficacy of the dose can be assessed (as shown by the BG data you gather from home testing) so one starts out at a small dose. Thereafter as required the dose is adjusted by a small (usually o.25IU Lantus), held for several cycles and re-evaluated. Then rinse and repeat.

BG testing helps to keep our kitties safe on insulin and also acts as a guide to optimising their treatment. Each day you need to do a preshot BG test in both morning and afternoon (to make sure it's safe to give the next dose) plus at least one BG test between doses - a mid-cycle test - to see how low the dose is taking the cat's BG. (Two mid-cycle tests - one in the AM and one in the PM cycle - would be better.)

Lantus dose adjustments are based on nadir BGs. The nadir is the point where BG is at its lowest in a 12-hour cycle.

I'm sorry to hear about your chronic health issues, Tanya. (In a similar boat myself.)


Mogs
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Thank you Mogs Sorry to hear about toot health issues too, it's quite a challenge isn't it. But my fur baby and I bring each other a lot of joy still and my hubby is a trooper helping care for us both. At the moment I'm prioritising Tinkas health needs over mine. I can't rest well till I know she's fine. Praying we all get well soon

 

[MrWorfMen's Mom]

Tanya, you can test before you turn in for the night. That way you know what she's up to and can go to bed knowing she is fine. if per chance Tinka seems to be dropping fast, you can feed her and try to steer her to level her off. We can help you out when and if such a situation were to occur. Do you ever get up to use the ladies room? Some folks use that opportunity to get in another test. Getting night tests can be tough but if you can test up to about +4 post shot, that's generally quite sufficient. Even a +3 will often tell you if the cycle is going to be active or not and allow you to take action so you can get needed rest.

The motto around here is that you gotta look after yourself to be able to look after your kitty so try to find a happy mid road where you are not ignoring your needs for Tinka but rather meeting as many of both your needs as possible. There can be times when more testing during the night cycle is needed but if you dose slowly and methodically, test and ask for advice when needed, those situations can be avoided or at least kept to a bare minimum.

 

[Chris & China (GA)]

Is it s problem that mid cycle / 6hrs after her evening insulin at 7:45pm will be 1:45pm and I'll be asleep

You don't need to stay up.....just get a test "before bed"......if she's running low, you may have to set an alarm to get more tests later in the cycle (or get DH to do it)

 

[TanyaG]

Ok so I just took her approx 6 hr BG following her insulin this morning and it's now 7.8u. Is that ok?

Also I used a new needle. Is it ok to use the same needle to take her BG multiple times a day or not? Thanks!

 

[TanyaG]

Tanya, you can test before you turn in for the night. That way you know what she's up to and can go to bed knowing she is fine. if per chance Tinka seems to be dropping fast, you can feed her and try to steer her to level her off. We can help you out when and if such a situation were to occur. Do you ever get up to use the ladies room? Some folks use that opportunity to get in another test. Getting night tests can be tough but if you can test up to about +4 post shot, that's generally quite sufficient. Even a +3 will often tell you if the cycle is going to be active or not and allow you to take action so you can get needed rest.

The motto around here is that you gotta look after yourself to be able to look after your kitty so try to find a happy mid road where you are not ignoring your needs for Tinka but rather meeting as many of both your needs as possible. There can be times when more testing during the night cycle is needed but if you dose slowly and methodically, test and ask for advice when needed, those situations can be avoided or at least kept to a bare minimum.

Thanks so much that's really helpful. Trying to find the balance

 

[Critter Mom]

Ok so I just took her approx 6 hr BG following her insulin this morning and it's now 7.8u. Is that ok?

That is excellent! (And safe. )


Mogs
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[MrWorfMen's Mom]

That 7.8 is a beautiful sight to see! Go Tinka!

We generally advice a new needle or lancet for each test. They tend to dull up fairly quickly which if looked at microscopically, looks almost barbed. That can cause discomfort and even scratch or tear the ear. If you do re-use, I wouldn't do it more than 3 times at most. My girl has a little scar on her ear from the ER hospital re-using needles to test her. I use a new lancet each time and have never caused a bruise, scratch or tear. I think your lancets (that came with the meter) are either 31 or 33 gauge and you may find it harder to get a good bead of blood with those than the needle. Next time you are out, you could pick up some Gauge 28 lancets and just use them freehand as you do the needle.