New to BG testing, please help

heatherovka

heatherovka

Member
It is time for the PM feeding and Ember's BG is 86. Do I hold off on insulin AND food? Wait a few minutes and test again?
Thank you!
 
I think the Spreadsheet should be viewable now, sorry!

I just gave her food. No insulin. I know I'll have to wait at least two hours before testing again, correct? I did give her 2u this morning.

I haven't had a chance to enter the latest fructosamine results. If I understand how to read it correctly, the level on the scale is 207, there is a red number all by itself to the right of the scale that is 388. I think it has a corresponding date and time of 2/19 and 4:10pm.
 
Yes, the SS is visible now. Thanks. Good for you on starting to home test! That shows the 2U dose is likely too high for Ember.
Right now, without much test data, you're probably better off skipping the dose tonight.
IF, and ONLY IF Berger has not had DKA or ketones.

Especially since you are feeding dry kibble, which usually keeps the BG levels higher, I think it would be dangerous to give Bergie any insulin right now.
We don't use fructosamine tests in order to change the dose. BG (blood glucose) and fructosamine results are not the same thing.

Please take a look at the Sticky posts pinned at the top of this forum. Most definitely the one about our dosing methods.
Sticky PROZINC DOSING METHODS
 
Thank you so much. I admit, I kind of panicked because I wasn't expecting a low number. I have read that, but I am reading it over and really studying it again now. I'm absorbing so much information in a short amount of time my head is spinning.

Unfortunately, I don't know about the DKA or ketones. They have never been able to get urine from her at the vet and I am not confident I could get a sample here at home (I'm willing to try though). She did stop eating last Thursday and that's when they took the fructosamine and blood panel. Her NEU, LYM, EOS, and PLT were low.
 
Those first low numbers are scary, so panicking is perfectly understood. When you have just started home testing, they are even scarier.

I'm not one of those people that could give you feedback on the Low blood panel results and what they could mean.

There are BG monitors that can test for ketones in the blood. Ketones show up in the blood before they show up in the urine. Look for this type of meter in the drugstore/pharmacy/chemist where other testing supplies can be found. People use these meters if they are on a keto type diet. Tips for catching Urine.

If you have the chance, I highly recommend printing off a copy of the dosing methods document.

Do you have your hypo toolkit all stocked and ready, in case the BG numbers need to be brought back up?
Does Ember like canned (wet) food?

Did she stop eating when you tried to switch the food for her?
Is she eating better now?
I'm asking, because a cat that isn't eating well can have lower than normal BG levels. And they can develop ketones, from burning up their fat and muscle tissue to provide the energy they need.

Was there a glucose level included in the blood panel? Or only the fructosamine?
 
Thank you!

I do have all the things for the hypo toolkit, although they are scattered. I will work on pulling it all together this weekend.

She does like canned food. She has been on a higher carb one for the PM meal. I haven't tried to switch her over to low carb yet, I wanted to attempt to get somewhat of a baseline first. However I only have one can of the old stuff left.

She did not eat her last Thursday PM meal or the Friday AM meal. I took her in to the vet Friday morning and she was eating a little again by Friday night. Pretty much back to normal the next day. She had an antibiotic shot and a B12 shot at the vet. He wanted to do a pancreatitis test but they were out of them. Her appetite has been fine since.

Her glucose was 105 when I brought her in.
 
A BG level of 105 is within the normal range for a non-diabetic cat. Or for a cat that is diet controlled (aka in remission). Or for a cat that is very well controlled and still on insulin.

heatherovka said:
I do have all the things for the hypo toolkit, although they are scattered. I will work on pulling it all together this weekend.
Click to expand...
Good idea, because when you need the items in that hypo toolkit, you need them fast. Don't forget to include some sort of treat for yourself. I always liked to have some Dove Dark Chocolate in my kit, and plenty of test strips. I used to write the carb percentage on the top of the can with a black permanent marker. When you are scrambling to find a MC (medium carb) or HC (high carb) food, it's much easier to grab a pre-labeled can than to try and figure out the carb percentage when the BG levels are low.

I have one request. Could you make the name for the SS a bit longer please? It doesn't stick out well, and when you have an emergency situation, it's important for people that are helping you to be able to find the SS easily. Normally, we like to see the SS on a separate line, with the cats name at the front. So a change from SS to Ember's SS or Bergie's SS would be great. Thanks for considering this.
 
I tested her again and she is only 81 now! So I think I'll skip the evening dose. I'm so confused, now I'm wondering how I haven't been making her hypoglycemic all this time I wasn't testing and still giving her insulin. Or maybe she was, mildly, and was tolerating it? Hopefully the glucometer is accurate.

And yes, I will do that. Absolutely no problem!

Thanks for your help!
 
When I checked Ember's BG this morning, it was 89, and again at +6, it was 81. I still have not given insulin. I am so perplexed. How do I proceed from here? Continue to check AM, PM, and mid-cycle? Could this be indicative of some other problem like pancreatitis? Should I specifically request that be checked? Are numbers in the 80s anything to be concerned about?
 
heatherovka said:
When I checked Ember's BG this morning, it was 89, and again at +6, it was 81. I still have not given insulin. I am so perplexed. How do I proceed from here? Continue to check AM, PM, and mid-cycle? Could this be indicative of some other problem like pancreatitis? Should I specifically request that be checked? Are numbers in the 80s anything to be concerned about?
Click to expand...
Wow great! Maybe he will be diet controlled. Let's see what it is before the pm shot. 80's are great! Esp without insulin. Don't worry, he can't go hypo without insulin.
 
80's are normal numbers.
You may have a diet controlled kitty on your hands, but we don't know for sure yet.

Yes, please continue to test at your normal AMPS and PMPS times.

If BG levels are in the blue color range at the pre-shot test times, then test again at +3 to +4. If the numbers go down, it means his body is producing some insulin on it's own.
 
I hadn't changed her diet until today. That's why I don't understand why she was diabetic for a few weeks and now her BG seems normal. I feel like I never understand what is going on with her.

I figured since I had unexpected numbers yesterday anyway, I'd go ahead and start with the new food. She's less thrilled with me poking her ears today. I think she is realizing it is becoming habitual. :p
 
heatherovka said:
She's less thrilled with me poking her ears today. I think she is realizing it is becoming habitual.
Click to expand...
Treat, a small pure protein treat. Whatever you have on hand. Think of it as a "bribe" to get your cat to cooperate with the testing.

Clicker training in combination gets them to associate the sound of the clicking with a treat.
So click and bribe away.
 
heatherovka said:
Thank you so much. I admit, I kind of panicked because I wasn't expecting a low number. I have read that, but I am reading it over and really studying it again now. I'm absorbing so much information in a short amount of time my head is spinning.

Unfortunately, I don't know about the DKA or ketones. They have never been able to get urine from her at the vet and I am not confident I could get a sample here at home (I'm willing to try though). She did stop eating last Thursday and that's when they took the fructosamine and blood panel. Her NEU, LYM, EOS, and PLT were low.
Click to expand...

I'm right there with you. I've been doing this for about 5 months, and I'm still asking for advise on this great forum! I go longer between posts, but I still have questions! (and I've read and re-read, and then asked my significant other to read, and then discussed with him). And then it still comes down to ECID - Every Cat Is Different.
 
I see that Ember is still getting fantastic BG numbers, after being off insulin for 5 days.

Do you test for ketones at all? Even diabetic cats in good BG numbers can develop ketones, and the note on your SS about her vomiting on 2 separate days is concerning.

Try to see if there is a correlation with a particular flavor of food (and the type of protein) and her vomiting. Some cats are allergic to some types of protein. Beef is a common culprit. It could simply be the change from dry to wet food.

If Ember is gulping down her food too fast, that could cause vomiting also. You might try smearing the food out on a plate, so she has to lick it off. Or feed smaller quantities at a time, in several small meals.
 
Deb & Wink said:
I see that Ember is still getting fantastic BG numbers, after being off insulin for 5 days.

Do you test for ketones at all? Even diabetic cats in good BG numbers can develop ketones, and the note on your SS about her vomiting on 2 separate days is concerning.

Try to see if there is a correlation with a particular flavor of food (and the type of protein) and her vomiting. Some cats are allergic to some types of protein. Beef is a common culprit. It could simply be the change from dry to wet food.

If Ember is gulping down her food too fast, that could cause vomiting also. You might try smearing the food out on a plate, so she has to lick it off. Or feed smaller quantities at a time, in several small meals.
Click to expand...

Thank you, I apologize, I just now saw your post. She does tend to gulp and eat fast. I avoid beef and fish. About when I started testing we transitioned from 2 meals a day to 4 evenly spaced ones - I think it was a great decision. For a while she wasn't waking me up early, begging for food. Oh, and I think she has been having some issues with the change of season and hairballs.

I bought ketone strips but I'm not sure I'll be able to get a good urine sample. At one point I tried putting a little shallow container of dry beans hidden in her litter in her favorite pee spot to see if she would pee on them. She didn't. And she is a very, very low squatter, I don't think I have any chance of catching anything.

All was good until today. HUGE spike out of nowhere. I am pretty sad. In the process of getting an appointment with my new vet.
 
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Remember, you want to dose on the BG number at nadir, not only the pre-shot.
For Ember to have such a high BG, it's possible she got into some food she should not have, even people food up on a counter or in a cabinet, or another pets food.

You stopped testing for a month, so who knows what happened in that amount of time.

Most common causes of a cat falling out of remission are a change in food or treats, pancreatitis, infection/inflammation. Think bad teeth or UTI for example.

I suppose there could be a problem with your test strips also. Wouldn't hurt to test yourself, to see what your own BG level is.
 
Unfortunately I don't think she got into anything she shouldn't have.

I have still been testing daily in the morning - I did not stop. Most of the numbers are in the first column.

I did open a new container of test strips, I'll switch to a different container next time I check her. They are all old, actually. I will try testing myself first thing in the morning too.

Could you explain what you mean by dose at nadir? Are you saying to give her insulin at midday? At least when I first started, they told me AM and PM, 12 hours apart. Maybe I am misunderstanding you.
 
Well I think the problem is that most or all of my test strips are bad. I used three just now, each from a different container and got wildly different results. 289, 465, and 69. I feel like a big dummy.

I'll go to walmart tomorrow and get a new box of strips and probably a new meter too. All my stuff is years old, from when my nurse midwife thought I was developing GD. Lesson learned!
 
heatherovka said:
Well I think the problem is that most or all of my test strips are bad.
Click to expand...
Yes, test strips once opened are only good for a couple of months. Plus, they need to be kept away from heat and humidity.

Some old BG meters needed you to enter a code into the meter, to match the code on the test strip. So if your 3 different containers of test strips had different codes, and your meter was programmed with something different, then the results you got could be suspect because of that.

Newer meters often need a smaller drop of blood too. So you might want to consider that before you purchase a new meter.

heatherovka said:
I have still been testing daily in the morning - I did not stop. Most of the numbers are in the first column.
Click to expand...
I see the problem on your SS. You jumped from 4/13/21 to 3/14/21, so a mixup on the month when you entered the data for a couple of weeks. If you could correct that, it would make more sense on your SS.
heatherovka said:
Could you explain what you mean by dose at nadir? Are you saying to give her insulin at midday? At least when I first started, they told me AM and PM, 12 hours apart. Maybe I am misunderstanding you.
Click to expand...
No, you do not give insulin at mid-day. But you do base dose changes on how far a particular dose drops the BG level for your cat, over time. That low is the nadir.
Dosing protocols/guidelines use the nadir or low during the 12 hour cycle to figure out the dose changes. You don't use the pre-shot test to determine the dose, or when to adjust the dose up or down. Please see this sticky for what I'm talking about.

Sticky PROZINC DOSING METHODS

The pre-shot tests let you know if your cat's BG is high enough to give the dose, or if you need to stall, give a token dose, or skip the shot. The pre-shot tests are given a little bit of weight to determine what dose your cat gets, but it is the LOW or NADIR that tells you how far a particular dose drops the BG levels for your cat. It's also not a single cycles BG testing that determines what to do, but the trends over time.
 
Deb & Wink said:
Yes, test strips once opened are only good for a couple of months. Plus, they need to be kept away from heat and humidity.

Some old BG meters needed you to enter a code into the meter, to match the code on the test strip. So if your 3 different containers of test strips had different codes, and your meter was programmed with something different, then the results you got could be suspect because of that.
Click to expand...

They are all the same code, and were stored well, but still years old. When I began testing, I wanted to start as soon as I could and just used what I had.


Deb & Wink said:
I see the problem on your SS. You jumped from 4/13/21 to 3/14/21, so a mixup on the month when you entered the data for a couple of weeks. If you could correct that, it would make more sense on your SS.
Click to expand...

Whoops! I'm usually pretty sleepy when I test and record in the morning. I can't believe I kept repeating the wrong month. Thanks, I'll fix it.


Deb & Wink said:
No, you do not give insulin at mid-day. But you do base dose changes on how far a particular dose drops the BG level for your cat, over time. That low is the nadir.
Dosing protocols/guidelines use the nadir or low during the 12 hour cycle to figure out the dose changes. You don't use the pre-shot test to determine the dose, or when to adjust the dose up or down. Please see this sticky for what I'm talking about.

Sticky PROZINC DOSING METHODS

The pre-shot tests let you know if your cat's BG is high enough to give the dose, or if you need to stall, give a token dose, or skip the shot. The pre-shot tests are given a little bit of weight to determine what dose your cat gets, but it is the LOW or NADIR that tells you how far a particular dose drops the BG levels for your cat. It's also not a single cycles BG testing that determines what to do, but the trends over time.
Click to expand...

Oh I understand what you mean now, thank you for clarifying. I'll go over it.
I just got back from walmart with all new testing stuff. It will be interesting to see how far off the numbers are from the old meter and bad test strips.
Thank you!
 
Getting the diabetes under control and back to normal BG levels is the best thing you can do for the neuropathy. Methyl B12 can help too. Diabetic neuropathy is reversible.

What a difference fresh test strips can make! Ember is looking good, very good.
 
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