Question about first ever test.

[Toulouse & O’Malley]

Hi everyone! I’m brand new here, and to feline diabetes too. I just posted an intro post over in the other “introduction” area. I adopted my kitty Toulouse (14) just one month ago, and he was diagnosed with diabetes within a week of having him, based off of a senior blood panel that my vet did. This was on 1/29/18 and his glucose was 258. My vet switched him to DM food (mostly canned) and did a curve a week later (2/5/18). She then started him on 1 unit bid of PZI. Two weeks later (2/19/18) she had him back for another curve, after which she increased him to 2 units bid. I had asked her about home testing, but she said that she didn’t think it was necessary at this point. I tend to be kind of a worrier in general though, so I decided to start home testing anyway for my own peace of mind. I bought a ReliOn Confirm, and tonight was my first time testing! I was nervous, but Toulouse was really good and the testing seemed to go smoothly.

I gave Toulouse his breakfast this morning at about 7:30, then his morning injection of 2 units PZI at around 8. I was home from work today, so he got another small mid day meal around 2. At 7:30 this evening I tested him for the first time, planning on feeding him right after, and giving him his PM insulin at 8 PM. His BG when I tested though was only 99! I waited on feeding him and retested 30 mins later, and it was 124. At that point I went ahead and fed him and skipped his injection for tonight. I realize now that I probably should have tested him at least once more, to see if he kept going up. Did I do okay by not giving him his PM injection though?

I’ve read that a lot of people on here use the ReliOn Confirm. Before using it tonight I read the instructions that came with it carefully and thoroughly, and followed the setup step by step. I made sure that the meter and test strips were both the same code (F4), and I tried it on myself first, to get familiar with it. I read a lot about doing the test and watched a bunch of videos, and I’m pretty sure that I did the testing properly. My question is, can I assume that the meter should have been good to go, ready to use after setting it up? No calibration should have been necessary? The user manual gave instructions for how to calibrate it, but didn’t say that it necessarily needed to be calibrated before first use. (Instructions when straight from setting it up, to using it). So should I also assume that these numbers that I got were probably correct? If so, I’m a little horrified that I’ve been blindly giving him insulin for two weeks when his BG may not have even been that high (?). He has been okay, thank god, as far as I can tell. I plan to continue testing, at least twice per day before injections, but hopefully even more often than that. I’m anxious to see what tomorrow brings. Also I will work on getting a spreadsheet going soon.

Thanks for reading all of that!

 

[Kris & Teasel]

Welcome to you and Toulouse! Kudos to you for adopting a senior kitty and you're already doing so many things properly to keep him safe.

My vet switched him to DM food (mostly canned)

The DM canned pate style is about 6% carbs as fed and that's the proper level for a diabetic cat. The dry, while low as dry goes, is still a bit too high. The general recommendation is low carb wet food only. The DM is expensive and many of us feed Friskies or Fancy Feast pate style foods.

She then started him on 1 unit bid of PZI. Two weeks later (2/19/18) she had him back for another curve, after which she increased him to 2 units bid.

That 1 u BID dose is a good starting dose. You ran into the same issue as many of us did - vet curve on a stressed kitty (white coat syndrome!) with a full unit dose increase when BG testing at home probably would have shown a good response to 1 u.

I had asked her about home testing, but she said that she didn’t think it was necessary at this point.

Your instincts are right on. We would say that testing is a good idea right from the start.

I bought a ReliOn Confirm, and tonight was my first time testing! I was nervous, but Toulouse was really good and the testing seemed to go smoothly.

One of the popular meters around here because the test strips are affordable. Many vets will insist on a pet meter like the AlphaTrak 2 but the test strips are $$$. Sounds like you have a very cooperative kitty and that's great!

At 7:30 this evening I tested him for the first time, planning on feeding him right after, and giving him his PM insulin at 8 PM. His BG when I tested though was only 99! I waited on feeding him and retested 30 mins later, and it was 124. At that point I went ahead and fed him and skipped his injection for tonight. I realize now that I probably should have tested him at least once more, to see if he kept going up. Did I do okay by not giving him his PM injection though?

You did great! You were right to skip insulin on a BG that low. We have a basic testing schedule we recommend (details below) that will gnerate BG data to allow better assessment of his dose. The good dose right now might be 1 u or something between 1 u and 2 u. Data gathering will tell.

So should I also assume that these numbers that I got were probably correct?

Yes, those numbers are more than likely correct because you read and followed all the info on your meter.

Here's the basic testing routine we recommend:

1. test every day AM and PM before feeding and injecting (no food at least 2 hours before) to see if the planned dose is safe
2. test at least once near mid cycle or at bedtime daily to see how low the BG goes
3. do extra tests on days off to fill in the response picture
4. if indicated by consistently high numbers on your spreadsheet, increase the dose by no more than 0.25 u at a time so you don't accidentally go right past a good dose
5. post here for advice whenever you're confused or unsure of what to do.

The spreadsheet I refer to above is the one used by all of us here on FDMB. It can be seen by all members and it's the first thing we look at when you ask for help: http://www.felinediabetes.com/FDMB/threads/fdmb-spreadsheet-instructions.130337/

That should get you started.

 

[Kris & Teasel]

BTW - if you want insulin specific advice you can also post on the ProZinc/PZI forum.

 

[Becky & Baby Girl GA]

Welcome to the forum!! You sound like you’ve mastered a lot in a short time! I’m so glad that this kitty has a great human... meant to be I’d say! Start low & go slow... a great article to read is about the hypo events. It’s good to have the recommended items in your home if a hypo occurs! Kris is awesome with her guidelines & recommendations btw! Keep up the good work! I’m more of a newbie but wanted to say greetings! I love those little faces looking up at you in your picture! Sweet!

 

[FurBabiesMama]

You have already figure out that testing is important and that it's a good idea to drop the DM dry food. So, great job on both counts! The BG results the vet got on Toulouse were not really all that high, in the 200s, and that was in a stressful situation. So, he may not need a very high dose of insulin. Curves done at the vet are going to be off due to the stress factor, and as a result, vets can get a little too aggressive in dosing increases. The AAHA guidelines (link in my signature) warn about that and say that home testing is the best way to go.

If it was my cat, I would go with a 1 unit dose and start gathering testing results and recording them in the spreadsheet. Like Kris said, you want to always test before every shot, and get mid-cycle tests when you can. The pre-shot tests let you know it is safe to give the insulin, and the mid-cycle tests let you know the impact of the insulin dose. After giving the 1 unit dose a few days, I would do a curve (begin with AM pre-shot test and test every two hours until the PM pre-shot test - if you feel especially ambitious, you can continue it for 24 hours, until the next AM pre-shot test.) Then, you would get a better feel for the impact of the 1 unit dose without the stress factor at the vet. If the dose needs to be increased, I would do so by .25 or .50 a unit, not a whole unit. There can be so much difference with just a minor increase.

If you could take a minute to set up a signature (like you see under our posts), it would be helpful. Then, we will not have to ask you the same things every time you post.

 

[Toulouse & O’Malley]

Thank you all so much for your replies! I tested Toulouse this morning at 7:45, and he was 200 exactly. I stalled and tested again at 8:06 and he was at 208. Retested a third time at 8:23 and he jumped to 278! (Possibly stress from all this testing?) We got it done, but he wasn’t being as cooperative this morning. Very squirmy, really wanted his breakfast! I fed him and he’s eating now. I’m wondering is it safe now to go ahead and give him his insulin this morning? But drop back down to just 1 unit maybe? I feel so guilty not just following my vet’s instructions, but it seems his numbers really aren’t so high for a diabetic cat, and I’m afraid of him getting too low. It’s possible (even probable?) that because I was shooting blind for the first two weeks, that I have been shooting him at these levels, and he’s been fine; but no way to know.

 

[Kris & Teasel]

Thank you all so much for your replies! I tested Toulouse this morning at 7:45, and he was 200 exactly. I stalled and tested again at 8:06 and he was at 208. Retested a third time at 8:23 and he jumped to 278! (Possibly stress from all this testing?) We got it done, but he wasn’t being as cooperative this morning. Very squirmy, really wanted his breakfast! I fed him and he’s eating now. I’m wondering is it safe now to go ahead and give him his insulin this morning? But drop back down to just 1 unit maybe? I feel so guilty not just following my vet’s instructions, but it seems his numbers really aren’t so high for a diabetic cat, and I’m afraid of him getting too low. It’s possible (even probable?) that because I was shooting blind for the first two weeks, that I have been shooting him at these levels, and he’s been fine; but no way to know.

Yes, I think you can give 1 u. Try to get a test about 3 hours after the shot.

 

[Toulouse & O’Malley]

The DM canned pate style is about 6% carbs as fed and that's the proper level for a diabetic cat. The dry, while low as dry goes, is still a bit too high. The general recommendation is low carb wet food only. The DM is expensive and many of us feed Friskies or Fancy Feast pate style foods.

Thank you so much for your input! Regarding the DM food, I am weaning him off of the dry already, and once the canned DM that I have left is gone, I may not continue with it either. Thank you again!

 

[krazy4kritters]

I’m new to this as well. 200 is a safe number to shoot. If I were you, I would start at 1U twice a day (12 hrs apart). Get as many tests as you and kitty can do and adjust dose from there. Read the sticky notes. I learned so much from them. Also, posting questions in your insulin specific forum will help also. The folk in there have experience with that insulin and will be able to give more specific info to you.
You’re in the right place. I found “my people” when I joined FDBM!