New diagnosis, questions about dry food and BG monitoring

Status
Not open for further replies.
L

lannister80

Member Since 2017
Alright, I believe I have a good handle on this, but I have a few questions regarding food and BG monitoring:

1) Our cats really, really like dry food. If we get them wet food, even one that seems like it would be a "treat", they usually just lick off the juice/moisture and leave the rest to dry up and get gross.

So, I figure I'll stick with dry food. Is the "Young Again ZERO" pretty much the gold standard people on this forum use? I have another non-diabetic cat (she's 11, diabetic girl is 13), I figure I'll feed them both the mature formula. Anyone have any other recommendations? They're used to free-feeding, so I'll stick with that method. 2 bowls, different parts of the house, always at least half full.

2) My vet sold me a stupid Vet GlucoGauge, which I'm going to take back because I haven't used it yet. Looks like the ReliOn Micro is the one everyone around here loves, so I'll give that a shot.

My main question: What numbers am I aiming for for "max" and "nadir"? I've read anything under 300 is OK for max, and anything above 100 is good for nadir? Does that sound right? I really have no idea what numbers I should be aiming for, vet just told me that the 400 she's testing at is too high (duh) and to give her one unit of VetSulin 2/day. But I want to get a decent curve so I can adjust her dose.

So what numbers am I aiming for? And if all meters read a bit different, how do I know if the numbers I'm looking at are useful?
 
lannister80 said:
Alright, I believe I have a good handle on this, but I have a few questions regarding food and BG monitoring:

1) Our cats really, really like dry food. If we get them wet food, even one that seems like it would be a "treat", they usually just lick off the juice/moisture and leave the rest to dry up and get gross.

So, I figure I'll stick with dry food. Is the "Young Again ZERO" pretty much the gold standard people on this forum use? I have another non-diabetic cat (she's 11, diabetic girl is 13), I figure I'll feed them both the mature formula. Anyone have any other recommendations? They're used to free-feeding, so I'll stick with that method. 2 bowls, different parts of the house, always at least half full.

2) My vet sold me a stupid Vet GlucoGauge, which I'm going to take back because I haven't used it yet. Looks like the ReliOn Micro is the one everyone around here loves, so I'll give that a shot.

My main question: What numbers am I aiming for for "max" and "nadir"? I've read anything under 300 is OK for max, and anything above 100 is good for nadir? Does that sound right? I really have no idea what numbers I should be aiming for, vet just told me that the 400 she's testing at is too high (duh) and to give her one unit of VetSulin 2/day. But I want to get a decent curve so I can adjust her dose.

So what numbers am I aiming for? And if all meters read a bit different, how do I know if the numbers I'm looking at are useful?
Click to expand...
The nadir needs watching because too low is dangerous: 50 is the warning on a human meter. Good numbers on a human meter are about 50 to 120. Too high is too high. You pay attention it is but a Vetsulin dose has to be judged on both numbers - high and low. Vetsulin acts fast and can drop a kitty low quite easily so I'd weight the nadir number more than the high pre shot number. Your vet started your kitty on a good dose of 1 u twice a day.

I suggest you set up a spreadsheet like the type we use here. It's viewable by all members and it's the first thing we look at when offering advice.
 
Kris & Teasel said:
The nadir needs watching because too low is dangerous: 50 is the warning on a human meter. Good numbers on a human meter are about 50 to 120. Too high is too high. You pay attention it is but a Vetsulin dose has to be judged on both numbers - high and low. Vetsulin acts fast and can drop a kitty low quite easily so I'd weight the nadir number more than the high pre shot number. Your vet started your kitty on a good dose of 1 u twice a day.

I suggest you set up a spreadsheet like the type we use here. It's viewable by all members and it's the first thing we look at when offering advice.
Click to expand...

Wait...on a human meter, I should be aiming for a max of 120 using cat blood? I thought the measurement ALL meters (human, pet, etc) output is mg/dL of glucose (plus or minus 20% error). So 120 mg/dL cat blood has the same sugar as 120 mg/dL human blood, right?

Vetsulin website says: "Obtaining blood glucose curve values in the desired range. Cats: 120–300 mg/dL over the course of the day, with a nadir between 100–125 mg/dL"

So I should be aiming for those numbers on *any* meter (pet, human, whatever)....correct?

One more question: What is AMPS? I keep reading that acronym but I'm not seeing it on other sites. ANSWERED: AM vs PM dose. Or is it measurement?
 
Last edited:
Lastly: How do people feel about Lantus? I see you're using that now, but 2x a day? My vet said that Lantus is "long acting" and you only need to dose once per day.
 
lannister80 said:
Wait...on a human meter, I should be aiming for a max of 120 using cat blood? I thought the measurement ALL meters (human, pet, etc) output is mg/dL of glucose (plus or minus 20% error). Right?

So 120 mg/dL cat blood has the same sugar as 120 mg/dL human blood, right?
Click to expand...
No, sorry if I confused you. The good range of BG numbers for a cat as measured with a human meter are roughly 50 to 120 mg/dL. Too high on a human meter might generate the word "HI" on the meter's screen. The meter is just telling you what it sensed as the glucose content of the blood. It doesn't know whether the blood is human, cat, dog, iguana. The reason that pet meters give more accurate numbers is that they're calibrated to read BG according to the way it's distributed in cat blood which is differerent from human blood (mostly in the plasma versus elsewhere in the blood - oversimplification here but adequate).

You'll drive yourself crazy if you try to convert human meter readings to what they'd be if you were using a pet meter. Choose one system and stick with it. There's no conversion factor to use. A less than perfect comparison (because there's a conversion factor) is using Celsius or Fahrenheit for temperature. In the US you know what sort of clothing you need outside based on the Fahrenheit temperature. You don't have to know what the temperature is in Celsius before you can decide what to wear. Make sense?
 
Last edited:
Kris & Teasel said:
No, sorry if I confused you. The good range of BG numbers for a cat as measured with a human meter are roughly 50 to 120 mg/dL. Too high on a human meter might generate the word "HI" on the meter's screen. The meter is just telling you what it sensed as the glucose content of the blood. It doesn't know whether the blood is human, cat, dog, iguana. The reason that pet meters give more accurate numbers is that they're calibrated to read BG according to the way it's distributed in cat blood which is differerent from human blood (mostly in the plasma versus elsewhere in the blood - oversimplification here but adequate).

You'll drive yourself crazy if you try to convert human meter readings to what they'd be if you were using a pet meter. Choose one system and stick with it. There's no conversion factor to use. A less than perfect comparison (because there's a conversion factor) is using Celsius or Fahrenheit for temperature. In the US you know what sort or clothing you need outside based on the Fahrenheit temperature. You don't have to know what the temperature is in Celsius before you can decide what to wear. Make sense?
Click to expand...

Thank you, that does make sense. So when I look at your spreadsheet with your Alpha Trak numbers, those are the "true" mg/dL for your cat. If you were to use a human meter, you would get a much lower reading...is that what you're saying? And a reading of 120 mg/dL on a human meter might be a "true" value of 250 mg/dL or something similar?

So you use the human meter exactly as you would use it *for a human* (minus the ketone warning)? And use the human scale? For example, even (well-managed) diabetic humans shouldn't see values much over 150 mg/dL at bedtime, whereas for a cat that's a pretty normal reading.

I know I *shouldn't* try to convert, but I want to understand how I'm supposed to use a human meter.
 
Kris & Teasel said:
I disagree. Lantus lasts about 12, maybe 14 hours in most cats. It needs to be dosed twice a day.
Click to expand...
No kidding. What are the advantages of it over VetSulin? I thought VetSulin was supposed to last 12 hours (or rather, 12 hours between doses)?

Man, maybe my vet is an idiot. Hope not...
 
lannister80 said:
Thank you, that does make sense. So when I look at your spreadsheet with your Alpha Trak numbers, those are the "true" mg/dL for your cat. If you were to use a human meter, you would get a much lower reading...is that what you're saying? And a reading of 120 mg/dL on a human meter might be a "true" value of 250 mg/dL or something similar?

So you use the human meter exactly as you would use it *for a human* (minus the ketone warning)? And use the human scale? For example, even (well-managed) diabetic humans shouldn't see values much over 150 mg/dL at bedtime, whereas for a cat that's a pretty normal reading.

I know I *shouldn't* try to convert, but I want to understand how I'm supposed to use a human meter.
Click to expand...
Yes, that's correct. If I suddenly converted my SS to human meter numbers they'd all drop lower but the drop would be less on low numbers and more on high numbers.
 
Ah, understood! Thanks. Glad to know this is tried/tested method. My vet was already like "No, you can't do that, blood chemistry is different so it'll read wrong". Which is correct, but able to be compensated for.
 
lannister80 said:
No kidding. What are the advantages of it over VetSulin? I thought VetSulin was supposed to last 12 hours (or rather, 12 hours between doses)?

Man, maybe my vet is an idiot. Hope not...
Click to expand...
Lantus is a depot insulin, meaning that a portion of every dose stays under the skin in crystalline form and is slowly released as it dissolves. This means a new dose is always overlapping slightly with the previous dose and that *should* produce a flatter curve by reducing the peaks and valleys. My cat is not a very good example of this because he's a bouncy guy. There are a few runs of nice numbers though.

Vetsulin is an "in and out" insulin with no residual effect once a dose wears off. It often lasts less than 12 hours in cats (8 to 10 hours is not uncommon). You inject it, it goes to work quickly, drops BG along a steep curve to nadir at about 4 to 6 hours after injecting, wears off, BG rises and you're back to square one at 12 hours (if you get ideal duration).

Many vets are more accustomed to treating diabetic dogs. Cats are very different in their responses. They metabolize insulin quickly and can be erratic and unpredictable. Vets rarely get much training in school on the management of diabetes so they can give less than perfect advice. There are people on this board who've lived FD 24/7 for years and have a wealth of experience few vets can match.
 
Long acting insulins such as Lantus work very well for cats when dosed twice daily. Cats metabolize insulin about three times as fast as humans.
 
lannister80 said:
I know I *shouldn't* try to convert, but I want to understand how I'm supposed to use a human meter.
Click to expand...
All our protocols here are designed to work with a human meter. There is no conversion. You cannot compare the pet-specific meters to human meters because the blood chemistry is different and the meters use different methodologies.
 
Squalliesmom said:
All our protocols here are designed to work with a human meter. There is no conversion. You cannot compare the pet-specific meters to human meters because the blood chemistry is different and the meters use different methodologies.
Click to expand...
I'm having trouble finding these protocols on this website. Can you link to them?

I guess I'm having trouble "believing" that I can just get a ReliOn Micro, take a reading, and use the "human" number guidelines to adequately take care of my kitty (which means keep it under 150 in "human numbers" if possible). When 150 is on the low end of normal for cats. I've read 120 to 300 (actual mg/dL) is the target range for diabetic cats.

So do I just "follow the pamphlet" that comes with the meter? As to what low/medium/high/danger is? I've never used a BG meter before, so excuse my ignorance as to what it provides you with other than a number which I'm scared to use without context.
 
lannister80 said:
I'm having trouble finding these protocols on this website. Can you link to them?

I guess I'm having trouble "believing" that I can just get a ReliOn Micro, take a reading, and use the "human" number guidelines to adequately take care of my kitty (which means keep it under 150 in "human numbers" if possible). When 150 is on the low end of normal for cats. I've read 120 to 300 (actual mg/dL) is the target range for diabetic cats.

So do I just "follow the pamphlet" that comes with the meter? As to what low/medium/high/danger is? I've never used a BG meter before, so excuse my ignorance as to what it provides you with other than a number which I'm scared to use without context.
Click to expand...
http://www.felinediabetes.com/FDMB/threads/vetsulin-caninsulin-user-guide.302/
This link is to the articles on the Vetsulin forum that gives more detail.

Yes, you really can use a human meter to take care of your kitty. Any time you doubt a reading or need help with dosing, post here for advice. There are NO silly questions. Ask anything. It's the way we learn here.

I recommend that you set up the online Google sheets spreadsheet we use here. That's how you can get the best advice from other members here.
http://www.felinediabetes.com/FDMB/threads/fdmb-spreadsheet-instructions.130337/
 
lannister80 said:
I've read 120 to 300 (actual mg/dL) is the target range for diabetic cats.
Click to expand...

Most vets (and the people that write up the "directions" in those pamphlets) usually say numbers like that because they're not used to people who are as dedicated as most of us are here and test multiple times a day

Most people are told to shoot X units of insulin and come back in 2 weeks....with NO mention of home testing!!...In those cases, it's safer for the cat to run in higher numbers, but here, we're more aggressive because we DO home test enough to keep our cats safe.

Cats have the unique ability to have their pancreas heal, but to do that, it needs to rest. The way it gets that rest is to be giving an adequate amount of insulin so the blood glucose stays in the "normal" range as much as possible (50-120 on a human meter)

With Vetsulin, it's not at all uncommon to see Pre-shot numbers in the 300's, with nadir numbers in the 100's (nadir is the lowest point in the cycle)....With Lantus, the curve is usually more "gentle", but when you first start with ANY insulin, there's likely to be large swings in the numbers.....It takes time to get the numbers to settle into any type of pattern (and some cats never do)

AMPS is the AM Pre-Shot ......the test you get before shot time....Now with Vetsulin, you want to test, feed, wait 20 minutes or so and then shoot so that when the insulin "hits", there are carbs on board. With Lantus, you Test/Feed/Shoot, all within about 5-10 minutes because the "onset of action" of Lantus isn't for several hours, so it's not as important that the cat eat a certain amount before the shot....just that they're willing to eat

PMPS is the PM Pre-Shot test

You always test before shooting to make sure they're high enough for insulin at all, and those Pre-shot tests should be without the influence of food for 2 hours.....then you want to test to find out how low the dose is taking your cat (the nadir)....it's OK if they eat in between the Pre-shot tests (up until 2 hours immediately before shot times)
 
@Chris & China : Thanks for the info! Looks like "free feeding" will have to go on hold for a while. But my diabetic girl eats fairly regularly around the clock, so she has some food in her most of the time. I currently have a wireless camera monitoring their feeding station; I'll make sure she's eaten in the last hour or so before shooting.

Now what about this special Young Again ZERO Meture food I just ordered? It has no carbs at all. Is that...OK to feed while using insulin?
 
lannister80 said:
Now what about this special Young Again ZERO Meture food I just ordered? It has no carbs at all. Is that...OK to feed while using insulin?
Click to expand...

Well, although they try to pass it off as zero carb, it's actually about 5%, but yes, it's one of only 2 dry foods that's below 10% carbs....BUT, if your cat will eat wet, it's better to avoid dry completely because for kibble to be used by the body, it first has to be re-hydrated, which means it has to pull water out of the body first.

Our kitties kidneys are already their weakest points (even non-diabetic!) so the more water we can get into them (and keep in), the better for those precious kidneys.

As for "free feeding", it can still be used in some cats ....it's just those 2 hours immediately before Pre-shot tests that you want to pick the food up. Now some cats will do better if they get all their food before nadir (so that as the insulin is naturally wearing off, you're not adding carbs) but some cats can eat all the way to +10 (10 hours after the shot) without problems.

Testing and seeing how your cat responds to food is the way to figure out which type of cat you have!
 
Chris & China said:
Now some cats will do better if they get all their food before nadir... Testing and seeing how your cat responds to food is the way to figure out which type of cat you have!
Click to expand...

That's what I did with my boy and how I learned the DM dry was impacting his BG levels more so he gets that right after his breakfast and usually eats most of it at that point. He gets a tiny lunch snack close to his nadir :cat:. Waiting for my YA sample because he makes me think he is starving between 30-60 mins before his PMPS. Hoping to see it help him stay more level (rather than the DM) and if so, he will be able to eat after lunch.

Like Chris and China said, you don't really want them to eat 2 hours prior to preshot so the results isn't food influenced.
 
Status
Not open for further replies.
Back
Top