Doing a Curve - Weird Result, What to Do?

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PamJV

PamJV

Member Since 2017
I normally have not been testing Ricky's blood glucose. It was decided to try putting him on 6 units twice a day of Lantus back in January and I did one curve then. Since it has been so hard to test him, my vet and I discussed it and decided as long as he looked stable and ate the same thing all the time that this was fine. Especially since I was not attempting to bring his BG down so low that I'd have to worry about it getting too low then close monitoring wasn't necessary.

Well things began to change when they discontinued EVO and even when I still had some left he started to not like it, and was having some urination out of the box issues. So I've been dealing with trying out new foods, plus he needed a big dentistry and some teeth removed in March. All in all though Ricky has looked good and his plantigrade gait went away completely. His weight looks perfect and his fur is nice and silky.

Now a couple of weeks ago my vet suggested trying RC Glycobalance dry food for Ricky. This was because we thought he was developing crystals. It turns out he didn't have crystals but had a UTI. That aside he really liked the RC Glycobalance which IMO is fine as long as he looks good etc. It is such a struggle to get him to eat anything like YAZ.

My vet asked me to do a glucose curve now to check how his status is on this food. I began today and discovered I was going to run out of test strips because of the fact that it's so hard to test Ricky and get a nice blood drop, I was foolishly trying to test when there was just a trace of blood. So I wasted some strips today. You can look at his chart and see the spreadsheet for today. It's very odd. It started at 372 at 9:00 am and has been going down all day and at 7:00pm (9+ hours) his BS was 138. I only have one test strip left and am planning to test him at 9:00pm when I would normally give him his insulin again.

I am wondering what to do based on the reading I will get at 9:00pm. If it's still going down, I would not give any insulin, and call the vet in the morning. But what do I do if it's raised just a bit, say back up to 200? Normally I'd expect his BG to have a bell curve and raise back to the same reading he got in the morning at the 12+ hour mark. I'm afraid if I give him 6 units when he's only at BG 200 or so that would make a drop too low in the night time.

UPDATED .... Waited until 10:00 PM and his BG was 40 ! So did not give insulin. He looks OK but I gave him some Caro Syrup since this is a scary low reading. I wonder if it's even accurate.

Will definitely show this to the vet tomorrow, or go to ER if he becomes ill looking.

Thanks, Pam
 
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I can't advise on dosing, sorry. But I'm wondering if you have tried transistion to wet/canned food diet, low carb. We put Idjit on low carb wet food and he now does not need insulin.It's my understanding that it's best to always test before injecting insulin, especially if you change the diet.We also used the Alphatrak, but the cost and immediate unavailability of more strips prompted us to get a human meter, Relion Confirm, so we always have strips. There's information on diet, testing etc in the yellow tags on the top of the forums. Good luck with Ricky he's a handsome dude.
 
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Idjit's mom said:
I can't advise on dosing, sorry. But I'm wondering if you have tried transistion to wet/canned food diet, low carb. We put Idjit on low carb wet food and he now does not need insulin.It's my understanding that it's best to always test before injecting insulin, especially if you change the diet.We also used the Alphatrak, but the cost and immediate unavailability of more strips prompted us to get a human meter, Relion Confirm, so we always have strips. There's information on diet, testing etc in the yellow tags on the top of the forums. Good luck with Ricky he's a handsome dude.
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Ricky was on dry EVO which is low carb. But that was discontinued. He had also been on what the vet recommended Purina DM. RC Glycobalance is formulated for diabetics also. No he's never eaten wet food he's always refused that. I can't stress him now with trying that transition. Recently I have been trying some of the low or zero carb dry foods but he wouldn't eat those. For me success is just stability.....if he stays on insulin for the rest of his life that's fine with me as long as he looks good and acts happy. He can't handle daily testing.

The thing right now his BG is lower than usual while on this glycobalance. That's what is strange. I've never seen his BG as low as 138 before

AND just now at 10:00 his BG is 40 ! Definitely never saw that before. Obviously did not give any insulin tonight.
 
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Pam, editing your post does not bump it to the top of the forums, and get noticed. 40 is hypo! And needs to be monitored. Make another post, let you them know you need help!
 
Idjit's mom said:
Pam, editing your post does not bump it to the top of the forums, and get noticed. 40 is hypo! And needs to be monitored. Make another post, let you them know you need help!
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RICKY GOT A READING OF 40 TONIGHT AT 10:00 PM ! NO INSULIN GIVEN

Gave him Caro Syrup.

It's pretty late so I don't think I'll get answers now. I'm all out of test strips. The reason I use Alpha Trak is my vet told me the Relion meter was giving me readings over 100 points too low in error. We tested both meters comparing them to the vet office machine before.

Ricky looks calm, but he's been sleeping a lot so it's harder to tell. He's not drooling or wobbly or any of that. But normally he'd be getting up walking around more than what he's doing. I will be trying to decide if he needs to go to ER. ER is an hour's drive so that's not something I do lightly at this time of night. If he were yowling in distress I'd go right away.
 
Do you still have the Relion? Got any strips for it??

It's not unusual for a human meter to be that much different at high numbers....it's the low ones that are most important and the human meter is usually pretty close to the pet meter at the lower numbers
 
Forget the test strips right now, it's better to be high than low.
Caro syrup is good, if you don't have any you can use honey or corn syrup (basically the same as Caro).
Don't over do it though, just rub small amounts with your finger on his gums.
He won't yowl like it's pain if hypo is the case. Watch for a glazed/stoned look, do not let him fall into a deep sleep. Anything he eats is good.
Call emergency and see if they'll at least give you some advice. An hours drive can be a nightmare, speeding, flat tire etc.
STAY WITH US.
 
Noah & me (GA) said:
Forget the test strips right now, it's better to be high than low.
Caro syrup is good, if you don't have any you can use honey or corn syrup (basically the same as Caro).
Don't over do it though, just rub small amounts with your finger on his gums.
He won't yowl like it's pain if hypo is the case. Watch for a glazed/stoned look, do not let him fall into a deep sleep. Anything he eats is good.
Call emergency and see if they'll at least give you some advice. An hours drive can be a nightmare, speeding, flat tire etc.
STAY WITH US.
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OK, I wasn't sure how much Caro Syrup to give, so it might have been too much. The ER always tells us to bring the cat in, they never give advice over the phone. He is resting with his head upright right now.
 
All I know is 68 on Alphatrak is hypo, and dangerous. Idjit hit a 60, and I was scared. It you can, dig out that relion meter if you have strips. It will at least let you know something.
 
Chris & China said:
Do you still have the Relion? Got any strips for it??

It's not unusual for a human meter to be that much different at high numbers....it's the low ones that are most important and the human meter is usually pretty close to the pet meter at the lower numbers
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No don't still have it.
 
Idjit's mom said:
All I know is 68 on Alphatrak is hypo, and dangerous. Idjit hit a 60, and I was scared. It you can, dig out that relion meter if you have strips. It will at least let you know something.
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We have another meter called True that belongs to my husband but all the strips are old, expired ones.
 
Where is the sticky for hypos? Could someone post the link please.
Pam, where are you? I'm on Eastern time so it's midnight here and when I get tired it's lights out. I don't want to just bail out on you.
Idjits mom is in Washington so she's got 3 hours on me. My "well known member" thing doesn't mean anything medically.
 
I don't know the specifics, but I've heard strips are good long after their expiration date.

Any food with some carbs in it that you could get him to eat would be helpful.

Since your riding this out, just keep an eye on him. Maybe engage in some play or luvins. Watch for a glazed look or any confusion.

Once it passes its probably time for a curve and possibly an adjustment in his dose.
 
Play is a good idea. See if he'll make a usual jump like onto the sofa and watch to see if his feet clear by 1/100 inch like a typical cat. Is his tail in the air like a happy cat?
 
Chris & Lucy said:
I don't know the specifics, but I've heard strips are good long after their expiration date.

Any food with some carbs in it that you could get him to eat would be helpful.

Since your riding this out, just keep an eye on him. Maybe engage in some play or luvins. Watch for a glazed look or any confusion.

Once it passes its probably time for a curve and possibly an adjustment in his dose.
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Chris, can you post link to hypos? I can't do it on my kindle
 
Noah & me (GA) said:
Where is the sticky for hypos? Could someone post the link please.
Pam, where are you? I'm on Eastern time so it's midnight here and when I get tired it's lights out. I don't want to just bail out on you.
Idjits mom is in Washington so she's got 3 hours on me. My "well known member" thing doesn't mean anything medically.
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Tracey linked the hypo post. Thanks again for jumping in. I'm staying on, it's only 9 here. Sleep well!
 
This is the text from the HYPO sticky. Now you won't have to keep going back and forth. Sorry about the length but it's not my place to edit something so important.
I'm falling asleep, will see you BOTH tomorrow and the sun will be shining.

Hypoglycemia or low blood sugar is a dangerous condition that must be treated immediately. Also known as insulin shock or insulin reaction, hypoglycemia occurs when there is too much insulin in the body potentially leading to neurological damage and/or death.
Knowing how to respond to a hypoglycemic event whether or not symptoms are present can save the life of your diabetic cat. The following general guidelines are intended for those who home test the blood glucose levels in their cats. These guidelines are not intended to replace the advice given by your Veterinarian. It is very important that you discuss any and all treatment options with your cat’s physician BEFORE an event has occurred.
SYMPTOMS
Some cats may have NO symptoms whatsoever, but here are the most common ones:
MILD HYPOGLYCEMIA
Sudden ravenous hunger
Shivering
Weak or lethargic
MODERATE HYPOGLYCEMIA
Disorientation
Trouble with vision... bumps into furniture
Poor coordination, such as staggering, walking in circles or acting drunk
Changes in head or neck movements
Restlessness
Urgent meowing
Behavioral changes, such as aggressiveness
SEVERE HYPOGLYCEMIA
Convulsions or seizures
Unconsciousness
TREATMENT
During treatment for hypoglycemia, try to test every 15 - 20 minutes until you see the bgs begin to rise. Then continue to test until you are satisfied that the cat is out of danger.
VERY LOW NUMBERS – WITHOUT SYMPTOMS
Retest glucose using a large blood sample to make certain you have enough blood, and if you still get a very low number (under 40 mg/dL or 1.9 – 2.2 mmol/L) administer a teaspoon of corn syrup, liquid glucose, pancake syrup or honey, or INSTA-GLUCOSE and follow with food until the blood glucose numbers rise to acceptable levels. The syrup can be mixed with wet food or poured over dry if the cat will eat the mixture. If using liquid glucose, dilute with water for a thinner consistency.
LOW NUMBERS – WITHOUT SYMPTOMS
Retest glucose using a large blood sample to make certain you have enough blood, and if you still get a low number (40 – 60mg/dL or 2.2 – 3.3mmol/L) give food or treats until the blood glucose numbers rise to an acceptable level. If the cat refuses to eat even his/her favorite foods, you can syringe feed or administer a small amount of syrup.
LOW NUMBERS – MILD SYMPTOMS
Try feeding first or give a little syrup or honey followed by food until the blood glucose numbers rise to an acceptable level and the symptoms disappear. The syrup can be mixed with wet food or poured over dry if the cat will eat the mixture. If the cat will not eat, syringe feed. If your cat will eat dry food. the high carbs will help to increase his/her bgs quickly, but remember the effects of dry food usually takes longer to clear kitty's system once the crisis has passed. Feeding a high carb canned food is preferable to feeding a high carb dry food because the effects will clear kitty's system faster. You can then follow with his/her favorite canned food. Keep in mind that giving syrup (Karo, etc.) or honey is not enough because the effects wear off quickly. You need to follow with food.
IF IN ANY DOUBT, TELEPHONE YOUR VETERINARIAN.
LOW NUMBERS – MODERATE SYMPTOMS
Give a tablespoon of syrup, a teaspoon of liquid glucose, a tablespoon of honey or a tablespoon of sugar syrup followed by food and continue doing so until you see the blood glucose numbers rise to an acceptable level and all symptoms disappear. The syrup, honey, or glucose can be rubbed against the inside of the cat’s cheeks or on the gums for quick absorption. You can also mix the syrup with wet food or pour over dry if the cat will eat it. Continue to give syrup and food as needed and observe your cat for signs of recurring hypoglycemia. Keep in mind that giving syrup (Karo, etc.) or honey is not enough because the effects wear off quickly. You need to follow with food.
IF IN ANY DOUBT, TELEPHONE YOUR VETERINARIAN.
LOW NUMBERS – SEVERE SYMPTOMS
Rub syrup, honey, or glucose on the gums and cheeks if your cat will allow it. Another option for administering syrup, diluted liquid glucose, honey or sugar syrup to a cat who is seizing is to fill a needleless syringe with the mixture and insert via the rectum.
NEVER TRY TO SQUIRT SYRUP, HONEY, OR GLUCOSE TO A CAT WHO IS SEIZING AS THE CAT COULD CHOKE ON IT! RUSH TO EMERGENCY.
AGAIN! ANYTIME YOU CAT IS SEIZING OR LIMP, RUB KARO, GLUCOSE OR HONEY ONLY ON GUMS OR ADMINISTER RECTALLY AND GET TO EMERGENCY OR YOUR NEAREST CLINIC IMMEDIATELY!!!
Remember that syrup or any other sugared syrup/preparation will spike the blood glucose ONLY for a short period of time, so food is really important with mild and moderate symptoms. Dry food (high carbohydrates) will keep the blood glucose numbers elevated longer.
After a hypoglycemic episode cats may be more sensitive to insulin, so a reduction in dosage is generally required, especially considering too much insulin – whether due to dosage, inadequate food intake, or the cat’s changing insulin requirements – caused the hypoglycemic event in the first place. With moderate to severe episodes, your Vet may have you skip the next injection altogether.
IT IS VERY IMPORTANT THAT YOU DISCUSS YOUR CAT’S HYPOGLYCEMIC EVENT WITH YOUR VET, SO TOGETHER YOU CAN DECIDE UPON THE NEXT COURSE OF ACTION.
Always keep in mind that with low blood glucose and no symptoms, the BG you get is not as important as where it is headed. In other words, if you get a BG of 100 mg/dL or 5.6 mmol/L or less and there are still several hours or more before the insulin peaks, your need to watch your cat (and the numbers) carefully and take appropriate steps. With very low numbers and NO SYMPTOMS, a cat can be fine one moment and seizing the next.
 
@PamJV Prayers going out for Ricky and both you and DH

I seriously think he may be on way too high a dose. 6 units is a HUGE dose for a cat....even a big one!

I understand your concern about using a human meter, but I assure you that there have been tens of thousands of cats through here that have been managed with human meters that have done just fine. Remember, the existence of pet meters is relatively new to the picture....before they were invented, everybody used a human meter because it's all anybody had!

It may not tell you the same exact number, but it will show you "trends"....how Ricky is responding to his insulin dose....and it'll keep him safe.

The "time for action" on human meters is 50....On pet meters it's 68, so as you can see, at the really important numbers (the low ones), they are quite close.

Please update us when you can. We all care!!
 
Chris & China said:
@PamJV Prayers going out for Ricky and both you and DH

I seriously think he may be on way too high a dose. 6 units is a HUGE dose for a cat....even a big one!

Please update us when you can. We all care!!
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Thanks. Just got back home at 3:30 am. By the time he got to the ER his BG was 400 with their testing, and then they used my meter to check and it tested at 404. The ER vet said it would be unusual that Caro syrup would raise the BG that much in a couple hours time going from 40 to 400. But then again some of that 400 could have been nervousness going to ER ! She instructed me to test him in the morning (she gave me some AlphaTrak Strips) and if he eats and his BG is not low to then give him his insulin and to check with my vet about doing another Fructosamine test.

I agree that his dosage could be too high now. Back in January he was testing in the 300's and 200's, which was normal for him. I never expected him to have low numbers like this. And on top of that it's very odd to have a this kind of a curve where it just keeps going lower over 12 hours.
 
Hi Pam I am so happy that all is well with Ricky, that must have been very scary for you.:bighug::bighug::bighug:

PamJV said:
unusual that Caro syrup would raise the BG that much in a couple hours time going from 40 to 400. But then again some of that 400 could have been nervousness going to ER !
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I think it is most likely the rise in BG could be attributed to a number of things/ or rather a combination.
  1. Stress (ER visit)
  2. Karo
  3. Bounce (his liver dumped glucose into his bloodstream because of the fast drop/his BG was lower than usual/or he dropped to low, he may bounce for up to 3 days, this might mean that you see high numbers for a while, or, and this could be fairly likely, since it looks like he may be on too much of a dose, he clears the bounce quickly)
From the sticky in the lantus forum
  • Bouncing - Bouncing is simply a natural reaction to what the cat's system perceives as a BG value that is "too low". "Too low" is relative. If a cat is used to BGs in the 200's, 300's, or higher for a long time, then even a BG that drops to 150 can trigger a "bounce". Bouncing can also be triggered if the blood glucose drops too low and/or too fast.The pancreas, then the liver, release glucogon, glycogen and counter-regulatory hormones. The end result is a dumping of "sugar" into the bloodstream to save the cat from going hypoglycemic from a perceived low. The action is often referred to as "liver panic" or "panicky liver". *Usually*, a bounce will clear kitty's system within 3 days (6 cycles).


I know you have said that he is really difficult to test,

PamJV said:
and to check with my vet about doing another Fructosamine test.
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You cannot base an insulin dose on a fructosamine test because of the bouncing, you may get a high fructosamine result which indicates poor control, but it doesn't give you the reason for that poor control. The isuslin dose for lantus needs to be based on the nadir, on how low a particular dose is getting Ricky, the fructosamine test will not give you that.

Taken from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3440050/

Serum fructosamine concentrations provide a quantitative indirect assessment of diabetic regulation in both dogs and cats.7,8 The fructosamines are a group of serum proteins, primarily albumin, which have undergone glycation/glycosylation while in the circulation. An elevated fructosamine concentration indicates persistent hyper-glycemia over the previous 2 weeks. There are published target levels for canine and feline diabetics, although alterations in serum protein levels or increased protein turnover can impact the accuracy of this test.9 For example, serum fructosamine concentrations in cats with hyper-thyroidism are often lower than expected due to their catabolic state and may not appropriately reflect glycemic status.10 If stress hyperglycemia prevents accurate BG measurement in a cat, serum fructosamine concentrations can be a useful monitoring tool. A low concentration suggests insulin overdose, probably due to the onset of diabetic remission. Elevated levels in either species indicate poor diabetic regulation but do not indicate the cause. In fact, some patients receiving too much insulin have high fructosamine levels due to the Somogyi effect.
(lets ignore the fact that they are talking about somogyi, we know that has been disproved, but bouncing gives rise to the same problem making it an unreliable way to determine a good insulin dose)

As it seems that something has changed with Ricky I would strongly encourage you to over the next week to monitor his BG, you don't need to run curves every day, but amps and pmps and at least one other test in each cycle (maybe more if you catch him dropping like he did today), that would help you and your vet determine a safe dose for Ricky, something the Fructosamine test will not do.
 
PamJV said:
I've been dealing with trying out new foods, plus he needed a big dentistry and some teeth removed in March.
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I have seen many cats go down the dosing ladder after a dental. He may only need half that insulin dose now, or even less. I also want to encourage you to test more often, and to keep posting here.
 
PamJV said:
Thanks ! We made it home.
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See! Like I said last night "will see you BOTH tomorrow and the sun will be shining". It's nice having friends isn't it? I know you're not completely in the clear but now you can make up for the lost sleep. Have a good weekend and take good care of yourselves. :bighug: :)
 
Well definitely earned a reduction for sure. I always have 200+ strips in house and extra battery. Sometimes the strips are bad themselves. So if you get an unusual number, take another test.

Just the other day, Olive had a 63 amps, no way. Retested and it came out HI, again no way. Waited 10 minutes and got a normal for reading.

Glad it all worked out for you.
 
I'm happy we even have meters but the amount they can legally be off by is shocking. In Canada meters are free, you just fill out a short form and don't need a doctors note. I had a Bayer meter pushed on me, just an absolute piece of junk that I didn't even want to donate to a shelter.
This is what people used in the 70's. Nice AC adapter too, what did you do if the power went out?
meter02.JPG
 
Gill & George said:
Hi Pam I am so happy that all is well with Ricky, that must have been very scary for you.:bighug::bighug::bighug:

I think it is most likely the rise in BG could be attributed to a number of things/ or rather a combination.
  1. Stress (ER visit)
  2. Karo
  3. Bounce (his liver dumped glucose into his bloodstream because of the fast drop/his BG was lower than usual/or he dropped to low, he may bounce for up to 3 days, this might mean that you see high numbers for a while, or, and this could be fairly likely, since it looks like he may be on too much of a dose, he clears the bounce quickly)
From the sticky in the lantus forum
  • Bouncing - Bouncing is simply a natural reaction to what the cat's system perceives as a BG value that is "too low". "Too low" is relative. If a cat is used to BGs in the 200's, 300's, or higher for a long time, then even a BG that drops to 150 can trigger a "bounce". Bouncing can also be triggered if the blood glucose drops too low and/or too fast.The pancreas, then the liver, release glucogon, glycogen and counter-regulatory hormones. The end result is a dumping of "sugar" into the bloodstream to save the cat from going hypoglycemic from a perceived low. The action is often referred to as "liver panic" or "panicky liver". *Usually*, a bounce will clear kitty's system within 3 days (6 cycles).
I know you have said that he is really difficult to test,
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His BG of 40 came about at the 13+ hour. Would that be a sharp drop then. Of course it was abnormally low. My vet just instructed to take the insulin down to 5 units, and then do another curve next week. Right Ricky is hard to test. I find it so hard to get a blood drop. He flicks his ear as soon at the lancet needle gets near. Even when I do think I'm poking often there is no blood and I have to poke many times. So it's not a good experience at all. Yesterday I even tried the foot pad but got no blood with that either.
 
Dyana said:
I have seen many cats go down the dosing ladder after a dental. He may only need half that insulin dose now, or even less. I also want to encourage you to test more often, and to keep posting here.
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His dental was April 13th. Would that still be affecting him? He's also had Convenia injections....one in April and one in May.
 
Noah & me (GA) said:
See! Like I said last night "will see you BOTH tomorrow and the sun will be shining". It's nice having friends isn't it? I know you're not completely in the clear but now you can make up for the lost sleep. Have a good weekend and take good care of yourselves. :bighug: :)
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Yes, thanks to all of you so much. Exhausted today !
 
Glad and relieved everything turned out well and everyone is OK.

I've had similar experiences with Lucy when her dose was too high and the insulin would last well over 12 hours. It's always a possibility of a cumulative effect of shooting low numbers that you could be unaware of. The overlap throws off the relatively flat curve of the Lantus and by coming up from such low numbers at shot time and at the peak that a PS number can be surprisingly low. I've skipped low PS numbers just to find that in the 4 hours or so it takes the Lantus to start to take effect on Lucy, she has risen to a shootable number.
 
Noah & me (GA) said:
I'm happy we even have meters but the amount they can legally be off by is shocking. In Canada meters are free, you just fill out a short form and don't need a doctors note. I had a Bayer meter pushed on me, just an absolute piece of junk that I didn't even want to donate to a shelter.
This is what people used in the 70's. Nice AC adapter too, what did you do if the power went out?
View attachment 36242
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In the US I believe Medicare gives free meters to humans with diabetes. That's all I know. My husband has been sent a couple of them, but only used them a handful of times. He's just borderline and doesn't take insulin.
 
Chris & Lucy said:
Glad and relieved everything turned out well and everyone is OK.

I've had similar experiences with Lucy when her dose was too high and the insulin would last well over 12 hours. It's always a possibility of a cumulative effect of shooting low numbers that you could be unaware of. The overlap throws off the relatively flat curve of the Lantus and by coming up from such low numbers at shot time and at the peak that a PS number can be surprisingly low. I've skipped low PS numbers just to find that in the 4 hours or so it takes the Lantus to start to take effect on Lucy, she has risen to a shootable number.
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That sounds very possible. My head is spinning. My vet said to go down one unit dropping the dosage to 5 units. He said maybe we could go down to 4 units after a week. Will have to try curves each week to see what is happening.
 
Hi Pam - probably a lot of us watching the thread, there were already enough helpers. Glad to see that you got Ricky through the hypo episode.

Some cats have late nadirs. Leo is an example. Sometimes his nadir is +8. But often his nadir is AMPS+10 or +12.

Many of us know the anxiety of a hypo. Leo's last hypo was in February while I was on travel. Both Theresa and I were up on the phone until about 2:30am. But we were prepared, so we were able to avoid the emergency vet trip. Anyhow, I bet you will sleep real good tonight!
 
Glad to see that Ricky is ok after your wild adventures last night.

Testing is your friend and it may take awhile for Ricky's ears to learn to bleed with consistent testing. What size lancet are you using?
 
Tracey&Jones said:
Glad to see that Ricky is ok after your wild adventures last night.

Testing is your friend and it may take awhile for Ricky's ears to learn to bleed with consistent testing. What size lancet are you using?
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I just switched to a 33 gauge lancet.
 
JeffJ said:
Hi Pam - probably a lot of us watching the thread, there were already enough helpers. Glad to see that you got Ricky through the hypo episode.

Some cats have late nadirs. Leo is an example. Sometimes his nadir is +8. But often his nadir is AMPS+10 or +12.

Many of us know the anxiety of a hypo. Leo's last hypo was in February while I was on travel. Both Theresa and I were up on the phone until about 2:30am. But we were prepared, so we were able to avoid the emergency vet trip. Anyhow, I bet you will sleep real good tonight!
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If the nadir is +12 then how can one give the 2nd dose at night?
 
Tracey&Jones said:
Have tried a 28 for a bit...gets you a bigger hole. I started with the 28 and now use the 31 as Jones bleeds pretty good as long as his ears are warm.
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I was using the lower gauge lancet before but they were not resulting in blood drops. I'd have to poke and poke as mulch as 8 times just to get a tiny bit of blood, I was thinking the 33 gauge might be sharper and poke better. Keep in mind I'm not using a lancet device, I just hole the lancet myself
 
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