One meter says hypo, pet meter doesn't

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Marleysgirl13

Marleysgirl13

Member Since 2020
Hi guys. This is my first post and I would love some advice. I'm from Canada, so will be using those numbers.

My older cat, around 12-13yrs a previous stray, was diagnosed with diabetes last week with his BG being 25.0 mmol/L. We took him because he was peeing upwards of 5 times a day. We started him on Caninsulin right away. I'm not sure how many units but on a U-40 needle, I have to go to the 3 line. They also thought that he might have an infection or an inflammation of the pancreas, so they gave him antibiotics for it, twice a day, that I just recently finished giving him.

When I spoke to the vet tech, they did not recommend home testing because the meter is very expensive and he is due for his first curve on Dec. 2 anyway. They did not feel it was necessary and didn't even mention a human meter. They also gave me the okay to switch his diet slowly over a week from wet food in the morning and dry food grazing to all wet food, without changing his insulin dose. So we've recently been on an all wet food diet of Fancy Feast and President's Choice Pate, 2.5 five oz cans throughout the day.

However, against the advice of my vet, I began hometesting. I got a Freestyle Lite Meter and testing strips. In Canada, the strips are very expensive and range to be $.80 - $1 a test.

Today I tested him in the morning for the first time and here were his results.

Freestyle Lite
AMPS - 6.8, gave him caninsulin
+2 - 5.8
+4 - 2.5, I tested him twice with the same result, gave him some fancy feast
+4.5 - 2.5

With the low reading, but no symptoms (maybe he's sleeping a lot, but he always sleeps a lot), I freaked out and borrowed an Alphatrak from a friend and tested both meters at the same time.

Freestyle Lite
+6 - 2.4

Alphatrak
+6 - 4.6

So taking into account whats normal numbers on both meters, the human meter is telling me he's hypo, while the Alphatrak is telling me he is fine.

Obviously, I hesitate to call my vet with human meter numbers because they may not encourage it.

Should I run a curve with the pet meter and then show my vet? Should I do a curve tonight or tomorrow?

PS- I know I need to set up my signature with a spreadsheet. I'm just a very sleep-deprived student who has no time and needs advice desperately.
 
I would be very worried giving any dose of Caninsulin on a PS number of 6.8 - we’d normally say don’t shoot below 11 so it’s not surprising that bg is going even lower and into hypo territory. Do please look at the hypo documents linked above and keep posting here if you need support.

Trying to think of a Caninsulin dosing expert who can come and help but for now you need to monitor very closely indeed.
 
Diana&Tom said:
I would be very worried giving any dose of Caninsulin on a PS number of 6.8 - we’d normally say don’t shoot below 11 so it’s not surprising that bg is going even lower and into hypo territory. Do please look at the hypo documents linked above and keep posting here if you need support.

Trying to think of a Caninsulin dosing expert who can come and help but for now you need to monitor very closely indeed.
Click to expand...
@Critter Mom
@JanetNJ
 
Diana&Tom said:
I would be very worried giving any dose of Caninsulin on a PS number of 6.8 - we’d normally say don’t shoot below 11 so it’s not surprising that bg is going even lower and into hypo territory. Do please look at the hypo documents linked above and keep posting here if you need support.

Trying to think of a Caninsulin dosing expert who can come and help but for now you need to monitor very closely indeed.
Click to expand...
Thanks for answering! Yeah, my vet told me absolutely nothing about this. I'm afraid of giving him no insulin when the human meter might be wrong.
 
Red & Rover (GA) said:
Waving from central Ontario.

Do a control on the FreeStyle Lite. Test yourself. The same range applies.

And here is some immediate reading for you.
I'm typing a longer response. Hang in there. You've got this.
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Thanks for the reassurance. He's not really showing any symptoms of hypo. He quickly responds when I wake him up and takes a few bites of wet food when put in front of him. He's the king of lazy cats and doesn't really get active until he goes outside.
 
Marleysgirl13 said:
Thanks for answering! Yeah, my vet told me absolutely nothing about this. I'm afraid of giving him no insulin when the human meter might be wrong.
Click to expand...

The meter may or may not be accurate but for now you have to assume that it is and be prepared to avert or treat a hypo. I hope not but you do need to be prepared...
 
[QUOTE="Red & Rover (GA), post: 2687483, member: 15119"FreeStyle Lite meter is accurate.


Cats with low numbers can go from having no symptoms to life threatening symptoms in the blink of an eye.[/QUOTE]

that’s what worries me.
 
Marleysgirl13 said:
Freestyle Lite
AMPS - 6.8, gave him caninsulin
Click to expand...
From: BEGINNER'S GUIDE TO CANINSULIN/VETSULIN
Q: Is my cat’s BG high enough for insulin?
For those NEW to treating feline diabetes, and/or those who don’t have much data about how their cat responds to insulin, we generally recommend that you post to either this forum or the Health board and ask for help if the pre-shot BG is below 200 mg/dL [11 mmol/L] on a human meter. Experienced members can walk you through the options of what to do if you have a lower than expected pre-shot number.
Q: It’s time for my cat’s shot, but the BG is a little too low. What now?​
    • If your cat’s BG is a bit below 200 mg/dL [11 mmol/L] on a human meter, consider ‘stalling’.
      • Stalling is waiting - without feeding your cat - for 20+ minutes, then retesting to see if the BG has risen to a suitable level.
      • You are looking for a number that is rising, not falling, and is high enough to give insulin.
      • If you have time, you can repeat the stalling process to see if the cat’s BG reaches a number you can shoot.
  • If you cannot stall do to time constraints, if numbers are continuing to drop or if you do not have a supply of strips and high carb food on hand, it will be safer if you skip the shot.
  • Note: As you gain experience with home testing and have gathered data to show how your cat responds to insulin, you will become more confident and better able to shoot progressively lower numbers.
  • Ask for help on the forum before giving insulin if you are unsure, as you can never ‘un-shoot’ insulin.
  • If your cat has history of ketones or DKA, or other health issues, or you are concerned, DO post on the Main Health forum for further advice.

Q: How low should my cat’s BG drop on Caninsulin/Vetsulin?
Usually it's best that newcomers aim for a nadir no lower than 90 mg/dL (5 mmol/L) as measured on a human glucose meter. This insulin can drop the BG quite sharply. Trying not to let the BG drop below this level as it gives an initial safety buffer while you are learning the ropes.
If you are using a pet meter you may want to intervene earlier since pet meters are calibrated differently and typically read higher than human meters.​
 
W
Red & Rover (GA) said:
Congratulations. You are not diabetic and the FreeStyle Lite meter is accurate.

Cats with low numbers can go from having no symptoms to life threatening symptoms in the blink of an eye.
Click to expand...
Well, at least I don't have to worry about another thing. lol
I'm keeping a strict eye on him and waking him up every once and a while. I'm just baffled by the difference in numbers between the meters, even when considering the pet one gives higher numbers.

Is there anything else I should do now?
 
Red & Rover (GA) said:
Can you wake him up and test using the FreeStyle Lite?
Do you have any honey, maple syrup, or corn syrup in the house? Any dry food left?
Click to expand...

I just tested him.

The alphatrak was 7.4, now a little high
The Freestyle Lite was 4.3, within the normal range.

Both of these would be +7.5

I do have dry food and high carb treats saved from before.
 
when you are ready...

  • under Settings, Click on Signature. This is where you will put information that helps us give you feedback.
    • There is a limit of two lines which may include two links; you may separate pieces with commas, dashes, | etc. This is where you paste the link for your spreadsheet, once it is set up.
    • Add any other text, such as
    • Caregiver & kitty's name (optional)
    • DX: Date
    • Name of Insulin
    • Name of your meter
    • Diet: "LC wet" or "dry food" or "combo"
    • Dosing: TR or SLGS or Custom (if applicable)
    • DKA or other recent health issue (if applicable)
    • Acro, IAA, or Cushings (if applicable)
    • Spreadsheet link. Please put the signature link on the bottom line of your signature information, on its own, so it is easy to find.
    • Please do not put any information about your location in the signature for security reasons. If you wish to add your country location, please add it to your profile.
Be sure to click the 'Save Changes' button at the bottom. If you need help urgently it is important we know these things at a glance. We don’t want to waste valuable time finding out information.

The information you enter will appear at the bottom of all your posts and will give everyone who comes to help all of kitties particulars. This can be life saving when time is of the essence.
 
Thanks for some reassurance now everyone!

I'm just very confused and overwhelmed. Because he went from such a high number to numbers so low I shouldn't even be giving insulin, all in the span of a week. My head is spinning.

Does anyone think doing the antibiotics and the insulin at the same time was a bad idea? Since they were both there to treat the same thing, the overpeeing.

Should I test with the pet or human meter for a few days and then tell the vet my numbers to see if he even needs insulin at all?

Thanks for your help.
 
Nan & Amber (GA) said:
Well, I think you've discovered that this is too much insulin for him!

So glad you were home testing!
Click to expand...

Yeah me too.

At what point should I talk to my vet about this?
Or should I keep home testing and not giving a shot in the normal range until his curve at the vet in a week?
 
jt and trouble (GA) said:
People here (that have AT meters) use the human meter for everyday use then use their AT numbers for their curve for their Vet.
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That makes a lot of sense and good for my crying pocket right now too. Do you think I should do my own curve in the next couple of days before he goes for one at the vet?

Sorry for all the questions btw. I'm just happy that there are answers somewhere. Due to covid, I wasn't even allowed in my vet office when they diagnosed him and had to ask everything over the phone.
 
Marleysgirl13 said:
Does anyone think doing the antibiotics and the insulin at the same time was a bad idea?
Click to expand...

Only in conjunction with your vet's advice not to home test! Just think if you were to continue to blindly shoot the 3U as instructed. Well done you for trusting your instincts!

Has anyone linked the BEGINNER'S GUIDE TO CANINSULIN/VETSULIN yet? Lots of information there to pore over.

As for what to do at this point, the main crucial advice is not to shoot numbers under 11, but he still may need insulin, unfortunately. I'll leave specifics about what to do about dose beyond that to those who know Vetsulin in and out.

By the way, this:

Marleysgirl13 said:
They also gave me the okay to switch his diet slowly over a week from wet food in the morning and dry food grazing to all wet food, without changing his insulin dose. So we've recently been on an all wet food diet of Fancy Feast and President's Choice Pate, 2.5 five oz cans throughout the day.
Click to expand...

probably had at least as big an effect on his insulin needs as the antibiotic! Once again, with feeling, sooooo glad you were testing!!!
 
Marleysgirl13 said:
We started him on Caninsulin right away. I'm not sure how many units but on a U-40 needle, I have to go to the 3 line.
Click to expand...
Three units is a huge starting dose. The general guidelines are to start with 1 unit and then increase by 0.25 units.
Caninsulin is not a good insulin for cats. It was designed for dogs who have a completely different metabolism and drops a cat hard and fast.
There are much better alternatives, Lantus being one. A 5-pack of Lantus cartridges run about $140CDN and should last you a year or so with proper handling.

Marleysgirl13 said:
They also thought that he might have an infection or an inflammation of the pancreas, so they gave him antibiotics for it, twice a day, that I just recently finished giving him.
Click to expand...
This alone could change the blood glucose numbers. Thank goodness you are testing.

Marleysgirl13 said:
they did not recommend home testing because the meter is very expensive and he is due for his first curve on Dec. 2 anyway. They did not feel it was necessary and didn't even mention a human meter.
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Yes, pet meters are expensive and the strips for them are astrionomical in Canada.
Would they or anyone give a child insulin without testing? No. Thank you for taking the initiative to keep your little guy safe.

There is a cheaper option than the FreeStyle Lite.
One is a One Drop subscription plan.
@Sam&Milo&Singha In N. Ontario had this to say about it.
I would recommend OneDrop subscription service for the meter and strips. After the initial amount for the meter (I think a little less than $100 for meter and 100 strips, if I recall correctly), it costs about $108 CAD for unlimited strips. I have been getting 300 2x month to stock up and make sure I never run out. Hopefully I can go to the cheaper plan of 100 strips/month after a while, as well. They get delivered usually pretty quickly. It pairs with your phone through their app. The great news is that with unlimited strips, you never have to make the choice of whether or not to test because you're almost out of strips or you don't have the $$ to get another batch. I don't hesitate; it's taken that stress away completely.
​
In a low numbers situation, you will go through more strips than you can imagine.

You can also save up your PC points and use them to buy strips. If you have a senior citizen handy, take advantage of Senior's Days.

Marleysgirl13 said:
They also gave me the okay to switch his diet slowly over a week from wet food in the morning and dry food grazing to all wet food, without changing his insulin dose.
Click to expand...
Well, your vet is half right.
Changing, however slowly, to a low carb diet can change blood glucose numbers overall by up to 5. The food switch is supposed to be done slowly so that the person can test to see if the dose needs to be lowered. It is blatantly obvious that the dose needs to be lowered. By how much, I'll leave to the Caninsulin users.

Marleysgirl13 said:
I'm from Canada, so will be using those numbers.
Click to expand...
FYI: to get US numbers, you multiply x 18.

Marleysgirl13 said:
Thanks for some reassurance now everyone!

I'm just very confused and overwhelmed. Because he went from such a high number to numbers so low I shouldn't even be giving insulin, all in the span of a week. My head is spinning.

Does anyone think doing the antibiotics and the insulin at the same time was a bad idea? Since they were both there to treat the same thing, the overpeeing.

Should I test with the pet or human meter for a few days and then tell the vet my numbers to see if he even needs insulin at all?

Thanks for your help.
Click to expand...
This I will leave to the Vetsulin experts. And sadly, vets get very little teaching about diabetes in animals.
Please give the hypo guidelines links above a read. (Karo is what Americans call corn syrup.)
Also
BEGINNER'S GUIDE TO CANINSULIN/VETSULIN

Welcome to the best place you never thought you would be. There is a wealth of information and experience here.

Off to rescue dinner.
 
Marleysgirl13 said:
Do you think I should do my own curve in the next couple of days before he goes for one at the vet?
Click to expand...

At a minimum, you want to test before each shot (if he's high enough to shoot), and at least once more during the cycle, moving the times around from day to day but concentrating on the first half of the day when the insulin is hitting, and then (of course) testing more if it looks like he's going low. You don't have to do a full curve every day, but having at least one to show your vet on a new dose if you change doses, or heck, having a "curve" of a day when he hangs out in normal numbers without a shot (if he does that :)) wouldn't be a bad thing at all!

jt and trouble (GA) said:
yes Kel posted it;)
Click to expand...

:banghead:

That's what I get for speed-reading through the thread! :facepalm:
 
Thanks for all this information everyone! I'm reading through all the links right now and it's all very helpful.

I'll make sure to test in 2 hours again, right before his shot. But I'm probably not going to give it to him tonight. Tomorrow if he needs a shot, I'll try my hand at doing a curve and just send it to my vet. Specifically in the pet meter so they can't say anything negative about my results.

I think the dose is too high as well by looking at some of the other users of the same insulin. But my vet specifically used the words 'such a small does, it shouldn't affect him' o_O Maybe because my guy is huge, but I'm starting to question their decisions.

Happy Thanksgiving to my downstairs neighbours. I totally forgot lol.
 
Marleysgirl13 said:
Thanks for some reassurance now everyone!

I'm just very confused and overwhelmed. Because he went from such a high number to numbers so low I shouldn't even be giving insulin, all in the span of a week. My head is spinning.

Does anyone think doing the antibiotics and the insulin at the same time was a bad idea? Since they were both there to treat the same thing, the overpeeing.

Should I test with the pet or human meter for a few days and then tell the vet my numbers to see if he even needs insulin at all?

Thanks for your help.
Click to expand...
I think the antibiotics are clearing up an infection that was making his bg high. It's a good thing.
 
Marleysgirl13 said:
Thanks for all this information everyone! I'm reading through all the links right now and it's all very helpful.

I'll make sure to test in 2 hours again, right before his shot. But I'm probably not going to give it to him tonight. Tomorrow if he needs a shot, I'll try my hand at doing a curve and just send it to my vet. Specifically in the pet meter so they can't say anything negative about my results.

I think the dose is too high as well by looking at some of the other users of the same insulin. But my vet specifically used the words 'such a small does, it shouldn't affect him' o_O Maybe because my guy is huge, but I'm starting to question their decisions.

Happy Thanksgiving to my downstairs neighbours. I totally forgot lol.
Click to expand...
When you say you are going to the 3 line, do you mean you are giving 3 units, or are there half unit markings and you are going to the third line which is 1 unit? (1 unit is the recommended starting dose, 3 units is a lot).
 
JanetNJ said:
When you say you are going to the 3 line, do you mean you are giving 3 units, or are there half unit markings and you are going to the third line which is 1 unit? (1 unit is the recommended starting dose, 3 units is a lot).
Click to expand...

My needle has a limit of .5 mL on one side and 20 i.u. on the other. I'm measuring from the i.u. side and go to the third line, 2 away from the one marked 5. I can send a pic if that's easier.
 
So you are giving 3 u? That's a really high dose to start at! I would back that down to just 1. The fact that your vet thinks 3 is a small dose is concerning to me. Many cats never need that much.
0F8476DB-A279-44DF-8078-D3630AA1F967.jpeg
 

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JanetNJ said:
So you are giving 3 u? That's a really high dose to start at! I would back that down to just 1. The fact that your vet thinks 3 is a small dose is concerning to me. Many cats never need that much. View attachment 58236
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Yes. I'm giving 3u then.

This is a picture of my insulin bottle packaging.

https://www.flickr.com/photos/191219328@N06/50650521047/in/dateposted-public/

My cat is like 20lbs tho. He's held that weight for entire 5 years I've had him. Would that factor in to the large dose?
 
Marleysgirl13 said:
Well, I guess that's another conversation I'll be having with the vet. I'm definitely not liking my experience so far with them. Thanks for the info!
Click to expand...

It may be helpful to share the 2018 AAHA Diabetic Guidelines with your vet: https://www.aaha.org/globalassets/02-guidelines/diabetes/diabetes-guidelines_final.pdf

These guidelines recommend Lantus or Prozinc as insulins for cats; but even with Vetsulin--3 units is the MAXIMUM recommended cat dose, not the starting dose.
 
THH said:
It may be helpful to share the 2018 AAHA Diabetic Guidelines with your vet: https://www.aaha.org/globalassets/02-guidelines/diabetes/diabetes-guidelines_final.pdf

These guidelines recommend Lantus or Prozinc as insulins for cats; but even with Vetsulin--3 units is the MAXIMUM recommended cat dose, not the starting dose.
Click to expand...

I love that idea. Mostly because I feel a little petty right now lol
But I'll definitely read through that to see where things are going wrong. Thanks :)
 
Marleysgirl13 said:
But my vet specifically used the words 'such a small does, it shouldn't affect him' o_O Maybe because my guy is huge, but I'm starting to question their decisions.
Click to expand...
From the manufacturer's guidelines for starting dose of Caninsulin/Vetsulin:

upload_2020-11-27_0-1-2.png


Maximum recommended starting dose per cat is 2 units, and nowadays is linked solely to degree of hyperglycaemia at time of diagnosis. (Note: In an older version of the Merck Caninsulin protocol, starting dose used to be linked to both degree of hyperglycaemia and weight, but even back then the maximum dose was still 2 units IIRC.)


Mogs
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