wet food / insulin and testing

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Hi
background: my cat was diagnosed as diabetic 3 years ago and has been eating dry diabetic food ever since,twice a day - and 3 units of caninsulin twice a day - this has been stable for 2 years - was up and down in the first year. due to what turned out recently to be a sore mouth, different vet at the practice suggested wet diabetic food - which she is loving. she is so much perkier and actively wants to be fed at the normal 2 x mealtimes. I have read on here that the wet is much lower in carbs - so until the test kit arrives I have reduced her to 2 units twice a day. i realise I am guessing but I am thinking better to give slightly less than too much - coupled with the fact she seems so much better and perkier in herself. what I am really wondering is - after reading all the testing you guys on here do - why/how was she maintaining or appearing to be maintaining a level of 5.6 which vet said was near perfect at each test time- and only being tested 3 or 4 times a year by the vet - no home testing ?

 

[CassWTribby]

Cats are very good at hiding how they are feeling. This protected them in the wild and carries through to today. So even though she appeared to be ok she may have been having some issues with her bgl. I could be wrong but 3u of caninsulin seems like A lot.
I have been testing since my cat was diagnosed and it really has helped. I ran out of test strips one weekend and was terrified to give her insulin not knowing where her bgl was at. She only got 1u of caninsulin but I gave half that when I couldn't test.
So many things can affect bgl, illness, injury, what they have been eating or going to eat and how much, medications or supplements they are on etc etc.
Testing is overwhelming at first but you get the hang of it quickly. The benefits for me far outweighed any cost of time or money. Also if your kitty went into remission you wouldn't know unless you were testing. Giving insulin to a cat that doesn't need it could have fatal consequences. Unfortunately some vet's do not recommend testing at home. I bet these vet's don't have diabetic cats at home.
You would never dream of giving insulin to a human without testing first.
At first it was hard but almost a year into it I could test with us both blindfolded!

 

[Elizabeth and Bertie]

after reading all the testing you guys on here do - why/how was she maintaining or appearing to be maintaining a level of 5.6 which vet said was near perfect at each test time- and only being tested 3 or 4 times a year by the vet - no home testing ?

Hmmm.... It's quite extraordinary that the test results (done at random times?) should be so similar... In my (almost) 11 years here I've never ever come across that before in a cat that was on insulin. In cats that aren't on insulin this wouldn't be so surprising, but you'd still expect to see some variability.

With cats on insulin the levels will change throughout the course of the insulin cycle. The blood glucose level will (typically) be highest prior to the insulin shot, and will then drop over a period of hours until the 'peak' of the insulin cycle (lowest blood glucose of the cycle), which with Caninsulin is quite often around 4 - 4.5 hours after the insulin shot (but your cat's mileage may vary). After the peak of the cycle the blood glucose will rise again. If plotted on a graph the test results will ideally make a 'smile' shape, but may make a 'v' shape if the blood glucose drops and rises steeply.
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Hmmm.... It's quite extraordinary that the test results (done at random times?) should be so similar... In my (almost) 11 years here I've never ever come across that before in a cat that was on insulin. In cats that aren't on insulin this wouldn't be so surprising, but you'd still expect to see some variability.

With cats on insulin the levels will change throughout the course of the insulin cycle. The blood glucose level will (typically) be highest prior to the insulin shot, and will then drop over a period of hours until the 'peak' of the insulin cycle (lowest blood glucose of the cycle), which with Caninsulin is quite often around 4 - 4.5 hours after the insulin shot (but your cat's mileage may vary). After the peak of the cycle the blood glucose will rise again. If plotted on a graph the test results will ideally make a 'smile' shape, but may make a 'v' shape if the blood glucose drops and rises steeply.
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the tests are always done 6 hours after her 1 st - at exact mid bwteen the 2shots

 

[Elizabeth and Bertie]

the tests are always done 6 hours after her 1 st - at exact mid bwteen the 2shots

It's remarkable that the blood glucose level has been the same each time. Maybe your cat is that extremely rare animal that does have a predictable response to insulin.
Also many cats would have higher blood glucose readings at the vets because of the stress of being at the vet (I wonder what it would be if you tested at home...?)
It would be interesting to know what her blood glucose is prior to the insulin shots, to see how much she's dropping on that dose. Do you have any idea?
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It's remarkable that the blood glucose level has been the same each time. Maybe your cat is that extremely rare animal that does have a predictable response to insulin.
Also many cats would have higher blood glucose readings at the vets because of the stress of being at the vet (I wonder what it would be if you tested at home...?)
It would be interesting to know what her blood glucose is prior to the insulin shots, to see how much she's dropping on that dose. Do you have any idea?
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no I dont unfortunately . it has been at that level for the last maybe 4/5 times - spread out over more than a year. prior to that it would sometimes be a bit higher which I felt could be attributed to the fact we had been waiting in a surgery with a number of large and unruly dogs in it for 20 minutes or so. I know you say there is no way of converting a reading from a human test kit to a cats reading - so how can I know what a good reading is for her. many thanks

 

[Elizabeth and Bertie]

I know you say there is no way of converting a reading from a human test kit to a cats reading - so how can I know what a good reading is for her. many thanks

The 5.6 result was a beautiful number, and it looks like this has 'possibly' been around the peak of the insulin cycle.

The normal range (for a non-diabetic) on a human meter is approximately 2.7 to 6.6 mmol (50 – 120 mg/dL).
But pet meters and vet/lab results usually measure slightly higher. At my vet's clinic, for example, the top of the normal range is given as 8.3 mmol (150 mg/dL), and this seems not to be uncommon.
And the potential 'hypo' range using human meters is below 2.7 mmoL (50 mg/dL), whereas for the pet meter Alphatrak the range is below 3.6 mmol (65 mg/dL).
So, if we extrapolate that info the normal range on a pet meter might be considered as approximately 3.6 to 8.3 mmol (65 - 150 mg/dL). But this is just a 'guesstimate'.... What really matters is what any given reading means for the individual cat, and it's important to always err on the side of caution...


As to what is possible for cats on insulin, here's some FDMB info on 'Regulation':

"The initial aim of treating diabetes is to get the cat into a better and more stable BG range (‘regulated’). In the FDMB FAQs the degrees of regulation are suggested as follows (based on data from human glucose meters; pet meter numbers would typically be a little higher). But your cat may not fit exactly into one of these ranges. Feline diabetes can be very variable.

Not treated - BG typically above 300 mg/dL [16.7 mmol/L]. Poor clinical signs.
Treated but not regulated - BG often above 300 mg/dL [16.7 mmol/L] and rarely near 100 mg/dL [5.6 mmol/L]. Poor clinical signs.
Regulated - BG generally below 300 mg/dL [16.7 mmol/L] with glucose nadir near 100 mg/dL [5.6 mmol/L]. Good clinical signs. No hypoglycemia.
Well regulated - BG generally below 200-250 mg/dL [11.1-13.9 mmol/L] and often near 100 mg/dL [5.6 mmol/L]. No hypoglycemia.

There may also be an extra category of "mostly above 300 (16.7) but with good clinical signs" which occurs with some cats who are getting insulin. We don't know why it happens, but such a cat probably should not be considered to be regulated.

On FDMB you may read about a cat’s BG being ‘Tightly Regulated’. The aim of Tight Regulation (TR) is to keep the cat’s BG in normal levels for as much of the time as possible. But we don’t recommend attempting TR with Caninsulin (Vetsulin); this insulin can drop the BG very steeply and fast, and there could be a danger your cat’s BG may dropping too low."

That info is from a page put together by FDMB members to help those new to using Caninsulin/Vetsulin.
Beginner's Guide to Caninsulin (Vetsulin)
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