? Fuso - Testing Trend

JanaFuso

JanaFuso

Member Since 2020
Hi. Hope you can help me look at Fuso's data and help me see where we are headed. First, I'm still having a tough time getting the tests done. And haven't been able to complete a curve. He's really fighting me no matter which technique I try. But, he's not mad at me as he still sits on me all the time. He comes running for treats at our designated testing sight too.

In any case, the tests that I've been able to get in the last few days have me nervous to give him his dose, I skipped the evening one twice. But today my gut said to give him a little. I was able to get a test at +2 and it was 58. As you can see his numbers are trending down. He's got a vet appointment on Friday as a follow up to him going on insulin May 20, 2020. At that time he was at 530.

FOOD: He's eating Fancy Feast Pate. He's also had Friskies Pate. He's been on canned food since mid May.

INSULIN: He's on one unit of Prozinc 2x Day.

have https://docs.google.com/spreadsheet...v-BgO1A6Iiv90R2GOuMH0vWW3BPTRzfjgt0rJ/pubhtml

What do you think I should do about the insulin dosage. I know we need to keep trying to get better testing done. Note I haven't been able to get one in the morning.

Thanks in advance for any advice.
 
JanaFuso said:
I was able to get a test at +2 and it was 58.
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What does that -1 mean on your SS? Do you mean 0.1U? If so, you should put 0.1 in the U (units) column on the SS.

That low BG level of 58 is an automatic dose reduction, by at LEAST 0.25U.
It's really important when your cat is that low, that you give him some food and retest again to make sure the BG levels aren't dropping even more, into hypo territory.

In the last 3 days, Fuso has had mid-cycle BG numbers that earned him dose reductions.

Please, please do not give Fuso more than 0.25U of insulin, maybe even only 0.1U. DO NOT increase the insulin level back any higher than that for now, unless the BG levels start to creep up and stay up, more than just bouncing. You need to hold this lower dose for at least 3-6 cycles EXCEPT if Fuso drops below 90 mg/dL again. If he drops <90, then he "earns" another dose reduction. Fuso is dropping dangerously low and may not need insulin anymore. If the BG's start to creep up, you would only increase by 0.25U at a time.

If you can't get that AM pre-shot test, you don't know if Fuso is so low that his BG levels will drop into dangerous territory. Do you have your hypo toolkit and the instructions on what to do printed out? You are risking his life, by not getting that AM pre-shot test.

Please link that spreadsheet directly into your signature. With only having it in the post like you did, we can't see updates. When the SS is in the user id signature, we can have a real time "view only" link to your spreadsheet.

The food change to low carb food may have been enough to lower Fuso's BG levels and he may not need insulin anymore.
 
Hi. Thanks for the feedback. I'm having a tough time getting that morning reading. I did give him a .75 unit this morning. The -1 was my way of indicating that I gave him less than 1 unit. I got a reading tonight before feeding at 78. I haven't fed him just get, what dosage should I give him? .75? I do have a hypo kit ready. I'm hoping that the food was enough. He is not happy with me in getting the ears pricked. I'll just have to work at it.
 
With that low of a pre-shot test, the 78, you should stall and see if it's rising at LEAST 20-25%. I don't think you have enough test data, to shoot a pre-shot BG of <99 mg/dL. Hope you skipped the insulin tonight.

Any time you are doing so many skipped shots, it's important to get a ketone test in. To make sure those ketones are NOT forming because of too little insulin and not enough food and an infection/inflammation (think bad teeth, UTI).

What is the main issue with getting the morning test? Perhaps we could brainstorm, and come up with some ideas that may help you get that AMPS.

Are you giving him a little treat, some kind of pure protein, when you test him?
 
Whew. I got him this morning. He's at a 91 AMPS. I'll feed him, but should I give him insulin. I didn't give him insulin last night.
 
Chris & China (GA) said:
I wouldn't shoot at 77. Better to skip tonight I think.

If he's not above 120 in the morning, I'd plan on skipping again.

He may still need a little insulin support but right now he's looking pretty great!
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Thanks. I've been a little nervous since my data is skimpy. I've come to the conclusion it takes two of us to get his samples. He's eating well. And he still likes me. I appreciate the help.
 
JanaFuso said:
I've come to the conclusion it takes two of us to get his samples
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Do you test in the same place every time? Does he get a treat whether successful or not? Cats react much better if the routine is the same every time.

You might try taking him to his "testing spot" several times a day, just give his ear a quick rub and then he gets a yummy treat. It usually doesn't take long for them to put 2 and 2 together! "If I let the crazy human fool with my ear, I'll get yummy food!"

China came running every time I started opening the testing supplies. She'd even occasionally jump to her testing spot and give me a look like "hey mom...I'm here! Where's my treat"?...LOL
 
We've got a place. He knows about it. Comes running. Then just as I'm about to poke he jerks and struggles. Then its down hill from there. I've got freezed dried chicken and he loves that. I also used real chicken...he loves that too. I think I need to get faster at doing it. And its a two person job. Tonight my husband held him, while I poked. Than let him settle with a treat and then he held him just long enough for me to get the blood. The vet appointment was already set up as a follow up from his initial precription of insulin. I feel like I still want to keep that even though I understand that his numbers might be higher due to the stress. Might not be a bad idea to have someone check him out. I do think he's gained some weight back too.
 
We got an AMPS of 91. So, I'm not going to shoot. It took the two of us to get the sample. Had to poke him twice. My husband holds him. I poke. then we release him and give a treat. Then my husband holds him, I get the sample. we realeas him and he gets a treat. Maybe have a system.
 
Deb & Wink said:
Those BG levels you've been getting under 100 mg/dL are too low to shoot insulin. Better to skip for now.

Have you seen the •Ear Testing Psychology• document? It's in the Health Links/FAQ's forum in the Index sticky, in the Hometesting Links and Tips - includes numerous links, instructions, pictures, & videos section.
Click to expand...

Thanks for suggesting that article. That makes me feel better. Its a work in progress. I think that one of the most frustrating things as a newbie is the lack of blood when poking. Seeing that it may take time to get blood helped know we're normal.
 
JanaFuso said:
We got 75 at PMPS. I guess I'm not shooting tonight either?
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No, you're not shooting tonight either.

Are you warming the ear first? With the rice sock?

Now you can see why the pre-shot tests are so important.

p.s. If you have read our reply, if your click on the "Like" button in the lower right hand corner at the bottom of the post, it let's us know you have read it.
 
Deb & Wink said:
No, you're not shooting tonight either.

Are you warming the ear first? With the rice sock?

Now you can see why the pre-shot tests are so important.

p.s. If you have read our reply, if your click on the "Like" button in the lower right hand corner at the bottom of the post, it let's us know you have read it.
Click to expand...

Hi, have a rice sock. He swated at it in the begining. But we seem to have some success today. Its a two person job. And freezed dried chicken treats help too. I added the vasiline to the ears too. It only took one poke tonight. Looks like we may be on to something. Now to concentrate on his neuropathy. He's on Zobeline.
 
Best thing for the neuropathy? Get the BG levels under control. But the methylcobalamin in the Zobaline won't hurt and may help. The neuropathy takes time to resolve. Nerve damage is slow to heal.

Wish I had thought to take video of Wink's neuropathy. He had it bad, but it did resolve in a couple of months. After 4-5 months, you'd never know he had a problem walking and jumping and negotiating stairs when I first fostered him. The picture of him to the left in my avatar, is him up on my kitchen island counter, and he got up there all by himself.
 
Ready to try an OTJ trial? Fuso's getting the numbers for one, if you are interested. He's basically been on an OTJ trial, since 6/16/20 AMPS, so 3 days so far. Tomorrow would be day four of the OTJ trial. Some cats, the switch to low carb food and short course of insulin support does the trick. Looks to me like Fuso is one of those cats.

OTJ Trial Guidelines (These are the criteria we use when following an OTJ Trial.)

Here are the instructions for an OTJ trial: If on Lantus or Levimir, depot has to drain first before trial starts, about 3 days or 6 cycles. No depot with in and out type insulins (NPH, Vetsulin/Caninsulin, Prozinc). The trial starts when numbers are in the range of a healthy cat (50 - 80 mg/dL), but under 100 overall... with only occasional readings in the 100 - 120 range. Start the trial on the next green pre shot.

If you are posting in the Lantus/Levimir forum, please start a new thread each day which says ‘[Cat name] OTJ trial Day 1 BG xx’ (where xx is the BG reading for that cycle PM), then day2,3 etc. If you are posting in the Main Forum, we don’t require you or need you to do that separate post for each day. In fact, if you have never posted before over in the Lantus/Levimir forum or use a different insulin, you are fine staying in the Feline Health (Welcome & Main Forum). Or in the specific ISG (Insulin Support Group) for your insulin. We’ll cheer you on!

1. Test at your normal AMPS and PMPS times. Remember, you want a 2 hour fast before those AMPS and PMPS test times. Feed multiple small meals throughout the day as much as possible (small meals are less likely to overwhelm a newly functioning pancreas). The morning test is now called the AMBG. The evening test is now called the PMBG.

2. If your cat is green (0-99 mg/dL human meter, 0-130 mg/dL pet meter, 0-5.5 mmol/L) at your normal test times, no need to test further until the next "PS" time, just feed small meals and go about your day. If the numbers are blue or higher (100-199 human meter, 130-230 petmeter, 5.5-11 mmol/L), feed a small meal and test again after about 3 hours. Food raises BG's. So if the number is lower 3-4 hours after a meal, then the pancreas is working!

3. Your cat may have a sporadic blue number. Don't panic but post before you decide whether to shoot so we can have a discussion.

4. After 2 weeks, 14 full days, if everything is looking good, we have a party!

Sometimes, the trial doesn't work the first time and we have to give a little more support by starting the cat with a tiny dose of insulin again. I had to do that with Wink. We simply start the cat back on a tiny dose of insulin to support the pancreas with healing for a bit longer. Our goal is a strong remission and it's better to be safe now then sorry later that you rushed it. With just a little more time we will probably get that strong remission we are looking for.

Are you game to try? It means getting those AM and PM pre-shot tests consistently for the next 11 days. And getting a +3/+4 if the BG is in the blue range at pre-shot. Think you could do that?
 
Deb & Wink said:
Ready to try an OTJ trial? Fuso's getting the numbers for one, if you are interested. He's basically been on an OTJ trial, since 6/16/20 AMPS, so 3 days so far. Tomorrow would be day four of the OTJ trial. Some cats, the switch to low carb food and short course of insulin support does the trick. Looks to me like Fuso is one of those cats.

OTJ Trial Guidelines (These are the criteria we use when following an OTJ Trial.)

Here are the instructions for an OTJ trial: If on Lantus or Levimir, depot has to drain first before trial starts, about 3 days or 6 cycles. No depot with in and out type insulins (NPH, Vetsulin/Caninsulin, Prozinc). The trial starts when numbers are in the range of a healthy cat (50 - 80 mg/dL), but under 100 overall... with only occasional readings in the 100 - 120 range. Start the trial on the next green pre shot.

If you are posting in the Lantus/Levimir forum, please start a new thread each day which says ‘[Cat name] OTJ trial Day 1 BG xx’ (where xx is the BG reading for that cycle PM), then day2,3 etc. If you are posting in the Main Forum, we don’t require you or need you to do that separate post for each day. In fact, if you have never posted before over in the Lantus/Levimir forum or use a different insulin, you are fine staying in the Feline Health (Welcome & Main Forum). Or in the specific ISG (Insulin Support Group) for your insulin. We’ll cheer you on!

1. Test at your normal AMPS and PMPS times. Remember, you want a 2 hour fast before those AMPS and PMPS test times. Feed multiple small meals throughout the day as much as possible (small meals are less likely to overwhelm a newly functioning pancreas). The morning test is now called the AMBG. The evening test is now called the PMBG.

2. If your cat is green (0-99 mg/dL human meter, 0-130 mg/dL pet meter, 0-5.5 mmol/L) at your normal test times, no need to test further until the next "PS" time, just feed small meals and go about your day. If the numbers are blue or higher (100-199 human meter, 130-230 petmeter, 5.5-11 mmol/L), feed a small meal and test again after about 3 hours. Food raises BG's. So if the number is lower 3-4 hours after a meal, then the pancreas is working!

3. Your cat may have a sporadic blue number. Don't panic but post before you decide whether to shoot so we can have a discussion.

4. After 2 weeks, 14 full days, if everything is looking good, we have a party!

Sometimes, the trial doesn't work the first time and we have to give a little more support by starting the cat with a tiny dose of insulin again. I had to do that with Wink. We simply start the cat back on a tiny dose of insulin to support the pancreas with healing for a bit longer. Our goal is a strong remission and it's better to be safe now then sorry later that you rushed it. With just a little more time we will probably get that strong remission we are looking for.

Are you game to try? It means getting those AM and PM pre-shot tests consistently for the next 11 days. And getting a +3/+4 if the BG is in the blue range at pre-shot. Think you could do that?
Click to expand...


We got the confirmatin from the vet today. While I don't have the data or report yet. Verbally we were told he doesn't need to be on insulin anymore. But looking at your OTJ steps, we'll just keep testing to make sure. So, we'll keep at for now and see it this is real or not. I'm so glad that I've been testing all along before the vet visit today.
 
Won't hurt to do more testing and follow our "Official" OTJ testing guidelines. Glad you vet agrees with us on Fuso not needing insulin right now.;)

Then at the end of 14 days, we have some Tips to help your cat stay OTJ. Interested in seeing them now? or do you want to wait?
 
Deb, LOL, there's more! Yes, of course I want to see the tips. I need to get ready. This has all been so surreal. The whole vet thing during a pandemic where you hand off your cat at the curb, never see the vet. Have a few phone calls, then the tech teaches me how to do the insulin out on the sidewalk. It all seems like "did that just happen". He still has the neurapathy as a reminder. I giving him the Zobeline. Is there anything else that I should be doing about that. I see that it could take a couple of months to resolve. Does it really resolve, or is it just something that resolves for some and doesn't for others. Thank you so much for the tips and advice. I've been pretty level headed about this, but this site gave me a lot of confidence. You guys rock.
 
Wink had diabetic neuropathy really, really bad. Took some time, but it did completely resolve. Can't say if that is the case for all cats.

Here are some tips to stay OTJ (off-the-juice, insulin being the juice)
1. Never feed dry - not even treats. (freeze dried is ok, Dr. Elsey's chicken flavor is ok.) If you change wet food types, be 100% sure the new food is also low carb and same low carb % as your current food. Some cats are very carb sensitive and an increase from 3-6% to 8-10% can spike the BG’s. Don’t feed if you aren’t sure!
2. Weigh every 2 weeks to 1 month to watch for weight changes. Too much of a weight gain can cause loss of remission. Too much of a weight loss alerts you to other issues, such as hyperthyroidism.
3. Measure blood once a week, indefinitely if possible. You want to catch a relapse quickly. Some people only do checks every 2 weeks to a month. BG checks can sometimes alert you to other issues.
4. No steroids or oral meds with sugar - remind your vet whenever giving you any medication. Always double check. (Steroids may be needed for other medical issues. But remind your vet your cat is a diabetic, diet controlled.)
5. Monitor food intake, peeing and drinking. If increasing, a sign of losing remission. Or another medical condition like Hyper-T or kidney disease.

6. Regular vet checks for infection such as dental , ear or UTI. And get them treated quickly!

7.Continue to ketone test even if your cat is OTJ. Ketones can develop if the cat’s pancreas is not producing enough insulin, or burning off too much fat if your cat is not eating properly and other reasons.

If your cat does fall out of remission you need to be more aggressive and resolve issues/ back on insulin as soon as possible as the window for a second remission is tight if any. Pancreatitis, hyperthyroid, dental issues are the most common reasons cats fall out of remission.

"Once a diabetic, always a diabetic." They are simply diet controlled.
JanaFuso said:
This has all been so surreal. The whole vet thing during a pandemic where you hand off your cat at the curb, never see the vet. Have a few phone calls, then the tech teaches me how to do the insulin out on the sidewalk. It all seems like "did that just happen".
Click to expand...
Surreal. That is a good word to describe this whole situation.
 
@JanaFuso Has your vet discussed weekly b-12 shots for neuropathy? My previous cat who was diabetic (went into remission) had neuropathy. We did weekly b-12 shots and she did improve, but not 100% before she passed from cancer. Congrats on your low numbers and starting your OTJ trial.
 
The B-12 shots that are given at the vet are usually cyanocobalamin, a different form of B-12 and doesn't help diabetic neuropathy like methylcobalamin does.
 
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