Please I have some questions

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RainyOcean

RainyOcean

Member Since 2016
Ok. I just took Quentin in for is first blood sugar check since starting on his insulin, and it's UP! Last time it was checked it was in the 400's, and today it was 530. Now I know there are a number of different things that could have influenced this. It was a different time of day, there was a cat in the waiting room that stressed him out, etc..., but it scared me. The vet has me going up from 2 units of Lantus 2x a day to 3 units 2x a day. She also said I could try using the WD food if I wanted to. I told her I would think about the food, because I wanted to research it first. I can go back any time and buy it though if I decide to do it. Ok, so here are my questions:

1) Is the WD food the food everybody's always talking about that tends to be recommended for diabetic cats, but isn't actually good for them? I wasn't going to make any diet change just yet, but now I'm thinking I should. It doesn't have to be that though. I can go buy something else. I have four days off for the holiday, so I'm thinking of switching things up Thursday night, so I can keep an eye on him for four days while he makes this change. Which brings me to my next question.

2) I want to start testing his blood sugar at home. I was told by the lady in the vet's office that I need to be really, really careful doing this because there's a lot of veins in the ears, and if I do it wrong it might be hard to get him to stop bleeding. Any tips?

3) When looking for a low carb diet, what number should I be looking for? I mean, what is considered low and what is considered high?

3) Any other thoughts on what I should be doing? I'm worried about him.

Thank you to you all in advance. This forum has already been a great help to me.
 
- What are you feeding now? A low-carb canned is best. No reason for a prescription food. Here is a list of commercial low-carb canned
http://www.felinediabetes.com/FDMB/threads/shortcut-shopping-list-all-8-or-less-updated.117688/
- Here is a link to home testing blood sugar
http://www.felinediabetes.com/FDMB/threads/hometesting-links-and-tips.287/
I have been testing my various diabetic cats for over 15 years and only problem I had is when initially I tried using the lancet freehand (not in a lancet pen). When the end was in the ear Gray Ghost moved and ripped the ear tip a little. No real harm but there was a some blood that was thrown off the ear.

Many caretakers here use the WalMart's ReliOn Confirm or Confirm Micro human meters. The strips for those are very reasonable.

Vet stress can raise BG by 100 or more points. I would not increase dose with current diet. Depending upon what you are feeding now you may want to reduce the dose when changing to a lower carb diet.

Most of us here test our cat's blood glucose at home using a human meter. We test before each shot and periodically between shots. We record our reading and other info in a spreadsheet. See:
http://www.felinediabetes.com/FDMB/threads/fdmb-spreadsheet-instructions.130337/
 
RainyOcean said:
try using the WD food if I wanted to.
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If the WD is dry food, it's not recommended. The best food is canned low carb wet food as Larry said above. There are grocery store brands like Friskies and Fancy Feast (pates only) that many of us feed to our FD cats.
RainyOcean said:
I wasn't going to make any diet change just yet, but now I'm thinking I should
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If he's eating dry food now, you must learn to test BG at home so you can see where he is before going to low carb wet food. That's because removal of all dry food can have a significant impact on BG levels (lowering them) and your current insulin dose might be too high.
RainyOcean said:
I just took Quentin in for is first blood sugar check since starting on his insulin, and it's UP
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Blood sugar can be higher if the insulin dose is too low but also if the dose is too high and kitty's body compensates by dumping more glucose (stored in the liver in another form) into the bloodstream. The only way to get a clue about what's happening is by testing BG at home.
RainyOcean said:
I want to start testing his blood sugar at home
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The absolute best thing you can do to keep your guy safe! :) What you were told about it is nonsense. It's easy to learn and bleeding is stopped by simply holding the ear firmly between thumb and forefinger afterward. There are many tips and tricks we can share for this procedure. http://www.felinediabetes.com/FDMB/threads/hometesting-links-and-tips.287/

It would be very helpful to us if you went into your signature and added some info about Quentin so you don't have to answer the same questions repeatedly:
  • his age
  • date of diagnosis
  • any other health issues/meds he's on
  • insulin you're using
  • which blood glucose meter you're using (when you buy one)
  • which time zone you're in (so we have some reference when giving advice or flagging other members to help you - we're all over the world).
 
Hi everybody. I'm going to try and answer all the questions. For years he has been eating wellness brand canned food in the morning and blue brand dry food. I want to change it to make it low carb, but I haven't yet because the vet initially recommended against changing his diet until he was stable on insulin. But now that she's given the green light, I'm looking into it. I'm going to try and get the test meter tonight or tomorrow, and won't be changing his food up till the end of the week. When I do change his food up though, what is considered low carb? I appreciate all the suggestions on food, but just so I know what I'm looking at, what number/percent of carbs is considered good?

Also, I'll try to do the signature later when I get on my actual computer. But for now, he is 8, he was diagnosed about two weeks ago, he's been on 2 units of Lantus 2x daily, but will be going up to 3 units now. No other health issues that I know of. When he was a kitten he had a lot of colds, and the vet at that time said he had something (I forget the name) that would cause him to get colds frequently throughout his life. But then he stopped getting them, and hasn't had one since he was two. He also has some bad teeth and needs dental surgery, but again, the vet said she wanted to get his blood sugar under control before doing this.
 
Hi, RainyOcean.

RainyOcean said:
I just took Quentin in for is first blood sugar check since starting on his insulin, and it's UP! Last time it was checked it was in the 400's, and today it was 530. Now
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Quentin's higher BG level may have been due to vet stress but also I'm wondering whether the 2 unit initial dose might possibly have been a bit on the high side for his needs.

(Note: Whereas it's fairly intuitive that not enough insulin will result in high BG levels it is also possible for too much insulin to cause numbers to go higher because the body's defences react to raise blood glucose levels in order to try to protect the cat from hypoglycaemia. Without regular BG testing it's not possible to tell.)

What did Quentin weigh at the beginning of his insulin treatment? Was he overweight/ideal weight/underweight? What BG range was he running in at time of diagnosis?

RainyOcean said:
She also said I could try using the WD food if I wanted to.
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The dry w/d is like kitty cornflakes. The wet w/d is almost as bad carb-wise.

NB: Don't change to a low carb food until you can home test. BG levels can drop a great deal and very quickly right from the start of the transition and the insulin dose is likely to need to be reduced as a consequence.

RainyOcean said:
The vet has me going up from 2 units of Lantus 2x a day to 3 units 2x a day.
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This is too big a dose increase to do in one step.

Lantus is best adjusted in increments of 0.25 units, held for several days (provided numbers don't go too low after an increase) to allow the depot to adjust. The number of days for which the dose is held depends on the treatment method being followed. Daily preshot tests and at least 1 mid-cycle test will guide you as to how safe and effective any given dose is for Quentin. Increasing the dose in large steps can result in a 'good' dose being skipped over. Too high a dose increases the risk of a cat having a hypo event and may lead to BG levels going higher.

RainyOcean said:
He also has some bad teeth and needs dental surgery, but again, the vet said she wanted to get his blood sugar under control before doing this.
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????

Unresolved dental problems are an impediment to getting blood sugar under control.

It would be reasonable for your vet to want to start insulin treatment after initial Dx and to allow a little bit of time for the body to become accustomed to the insulin being used BUT one of the things that vets normally do as a priority for diabetic patients is address any infection or inflammation in the body because they can worsen BG levels and also put the diabetic patient at greater risk of developing ketones/going into DKA.


Mogs
.
 
To be perfectly honest, I can't remember what they said he weighed last time, and they didn't weigh him today. He was overweight in the past, but he'd been on a diet for a while and his weight was down. I don't think there's been much change since he started the insulin two weeks ago, but it's hard to say in a cat without actually weighing, so I'm not sure. I don't think my needles measure .25 increments for the Lantus, so I'm not sure what to say about that. As for the dental stuff, I don't believe he has an infection right now, but I see your point. I'll ask her again when I talk to her on Monday. I bought the home test kit tonight, so I'm going to start testing his sugar at home. Not making diet changes just yet, but hopefully soon.
 
RainyOcean said:
I managed to check his blood sugar at home for the first time. It's 9pm. He ate and had 3 units of Lantus at 7:00. The meter read 321. So still high, but it's down from the 520 he had yesterday afternoon.
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Testing was the hardest for me to learn. It definitely gets easier! My cats ears wouldn't bleed for me, now i probably get too much. It always stops. I have hit the vein a few times, but if it happens, i just keep applying pressure. (Cotton rounds are a heaven-sent!) Its not a major artery and your kitty will be fine.

:bighug::bighug::bighug:
 
Thanks guys! I'm gonna try and change his food up starting Thursday evening. What do you guys think I should do in terms of the insulin? Should I stop it at first and see what his blood sugar is like? Or just reduce it?
 
Keep testing to gather data and build up a picture of how the current dose is working. It would help us a great deal to help you better if you could record your preshot and mid-cycle BG test results in a shareable spreadsheet. Here are the links you need:

FDMB spreadsheet setup instructions

Understanding the spreadsheet

If you need assistance with setup just holler and we'll find someone to help you with it.

Before you start the transition post to ask members to review your spreadsheet and give you suggestions on how to proceed with dosing.


Mogs
.
 
I'll give it a try. Problem I'm having is that mid-cycle I am generally either at work or asleep. I have these four days off coming up, but then that's it for a while. And I'm afraid to switch his food around when I'm at work and can't keep an eye on him.
 
RainyOcean said:
I'll give it a try. Problem I'm having is that mid-cycle I am generally either at work or asleep. I have these four days off coming up, but then that's it for a while. And I'm afraid to switch his food around when I'm at work and can't keep an eye on him.
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A mid-cycle test doesn't have to be right in the middle of the cycle. Even if you can get a test in just before you go to bed at night a few hours after giving the PM dose it can shed light on how the insulin is working. Obviously the preshot tests are key to knowing it's safe to give the next dose, but any additional tests you can grab between doses is valuable. :)


Mogs
.
 
Ok, as of Thursday night I started him on a new diet and temporarily cut out the insulin to be safe. I'm having trouble getting lots of tests throughout the day (mainly because he hates it and fights me like crazy on it), but I have been able to get about two. I haven't had a chance to figure out how to start graphing them yet, but I am writing them down so when I get there I can fill them in. Prior to this his results were always between the 300's and 500's. Now he's been in the 200's consistently since we started this. Specifically, Thursday before dinner he was 253, and two hours after dinner he was 220. Yesterday (friday) I got a mid-range test, and it read 274, and an after dinner test that read 200. Today I got a mid range test that read 274. I have not done his evening test yet. Am I correct that this is still high and I need to get him a little lower still? Just based on the results I have so far, I mean. I know it's not a lot to go on.
 
RainyOcean said:
Specifically, Thursday before dinner he was 253, and two hours after dinner he was 220. Yesterday (friday) I got a mid-range test, and it read 274, and an after dinner test that read 200. Today I got a mid range test that read 274.
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Are those BGs with injecting insulin?
They are too high for prolonged period of time.
 
RainyOcean said:
Ok, as of Thursday night I started him on a new diet and temporarily cut out the insulin to be safe. I'm having trouble getting lots of tests throughout the day (mainly because he hates it and fights me like crazy on it), but I have been able to get about two. I haven't had a chance to figure out how to start graphing them yet, but I am writing them down so when I get there I can fill them in. Prior to this his results were always between the 300's and 500's. Now he's been in the 200's consistently since we started this. Specifically, Thursday before dinner he was 253, and two hours after dinner he was 220. Yesterday (friday) I got a mid-range test, and it read 274, and an after dinner test that read 200. Today I got a mid range test that read 274. I have not done his evening test yet. Am I correct that this is still high and I need to get him a little lower still? Just based on the results I have so far, I mean. I know it's not a lot to go on.
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You don't need to get lots of tests through the day. We recommend testing BG in the AM before feeding (no food prior to this test for at least 2 hours) and injecting and a second in the PM before feeding and injecting (again, no food for 2 hours before). This is to be sure the dose you're going to give isn't too high. One other test should be done somewhere between the injections, roughly in the middle. If it can't be done during the day because you're at work then a before bed test 3+ hours after the PM shot is OK. That's 3 tests a day. More can be done on days off.

The instructions are here: http://www.felinediabetes.com/FDMB/threads/fdmb-spreadsheet-instructions.130337/
If you need help there are techies here who can do that. The SS is how we can see your BG results in one place and be able to give advice. It also helps you see trends and have a reference to go to when trying to decide on a dose.

Were you still giving 2 u of Lantus twice a day? You said you stopped it to be safe during the food change. A dose decrease to 1 u might be safe for Quentin. It's difficult to know for sure without seeing your data on the SS.
 
They had told me to go up to 3 units twice a day. I did it but it didn't seem to be making a difference. I stopped it all for a day or two while switching foods on the recommendation of a friend, but I'm not opposed to giving him some if needed. Just want to get some data on his blood sugar while on the new food first. Is t weird that his blood sugar is higher before he eats than it is after even without any insulin? Or is that normal?
 
RainyOcean said:
They had told me to go up to 3 units twice a day. I did it but it didn't seem to be making a difference. I stopped it all for a day or two while switching foods on the recommendation of a friend, but I'm not opposed to giving him some if needed. Just want to get some data on his blood sugar while on the new food first. Is t weird that his blood sugar is higher before he eats than it is after even without any insulin? Or is that normal?
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I don't know the answer to that.
 
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