Mr. Hendrick had a curve at the vet today

[Hendrick Cuddleclaw]

We have not yet successfully performed a hometest so I let the vet go ahead and do a curve.

He got his 1u Lantus at 6:30a, dropped off to vet at 7:30. His BG ran high most of the day and they called it at about 2pm when he was just staying high (400-500 i think she said).

They are recommending a half-unit increase. They are also going to try and help us learn how to do home BG test, we are told to bring our meter (AT2) and pick him up in about an hour. I plan to ask them for his specific numbers they got throughout the day when they tested.

They also said per their records he went DOWN from 10.5 pounds at discharge on 1/10 to 10.23 pounds today. I thought he had gone up, could have sworn they told me 9.8 lbs at discharge. So annoying that I didn't get any half-unit syringes yet, the huge box our vet had us order at dx does not have half-unit markings. What do I do, just eyeball it? I ordered some from Chewy but of course don't have them yet.

 

[Hendrick Cuddleclaw]

I successfully got a good ear prick and blood droplet at the vet! But...there was no vaseline on his ears and we lost the droplet as I tried to get it on the test strip. We tried to massage up a new one, no luck

BUT it was the most successful I've ever been so I am encouraged. I don't have all the curve numbers yet, sounds like he's doing the best about 3-4hrs after shot when he was in the 200s...but never lower than that. Went up after that and stayed up in the 4-500s

 

[Diane Tyler's Mom GA]

What do I do, just eyeball it? I ordered some from Chewy but of course don't have them yet.

Yes you will have to eyeball it, we usually increase or decrease by 0.25 units at a time.
You should actually set up our spreadsheet to enter his BG on, it's very hard for member to go back to your previous posts to see what any past BG numbers you have
I'll give you the link
https://felinediabetes.com/FDMB/threads/how-to-create-a-spreadsheet.241706/
If you need help setting it up just ask
Please see How to Use the Spreadsheet
When I tap on your profile this is what it says
Feline Diabetes Message Board - FDMB - Error
This member limits who may view their full profile.
So we can't go back to all your previous posts
You can also read about the 2 dosing methods to choose one
These will tell you when you need to increase or decrease the dose
https://felinediabetes.com/FDMB/thr...-low-go-slow-slgs-tight-regulation-tr.210110/
By linking your spreadsheet tonyour signature, we can follow along and provide feedback should you need the help.

 

[Bron and Sheba (GA)]

I successfully got a good ear prick and blood droplet at the vet! But...there was no vaseline on his ears and we lost the droplet as I tried to get it on the test strip. We tried to massage up a new one, no luck

BUT it was the most successful I've ever been so I am encouraged. I don't have all the curve numbers yet, sounds like he's doing the best about 3-4hrs after shot when he was in the 200s...but never lower than that. Went up after that and stayed up in the 4-500s

Well done!
I would go out and buy some 1/2 unit syringes… make sure they are the correct ones.
You can use the ones you have for the times you dose a whole unit and use the others for when you give the smaller doses….that is what I did when I had both sorts of syringes,. I would also only go up 1/4 unit in dose. Curves are always higher at the vet due to vet stress

 

[Hendrick Cuddleclaw]

Yes you will have to eyeball it, we usually increase or decrease by 0.25 units at a time.
You should actually set up our spreadsheet to enter his BG on, it's very hard for member to go back to your previous posts to see what any past BG numbers you have
I'll give you the link
https://felinediabetes.com/FDMB/threads/how-to-create-a-spreadsheet.241706/
If you need help setting it up just ask
Please see How to Use the Spreadsheet
When I tap on your profile this is what it says
Feline Diabetes Message Board - FDMB - Error
This member limits who may view their full profile.
So we can't go back to all your previous posts
You can also read about the 2 dosing methods to choose one
These will tell you when you need to increase or decrease the dose
https://felinediabetes.com/FDMB/thr...-low-go-slow-slgs-tight-regulation-tr.210110/
By linking your spreadsheet tonyour signature, we can follow along and provide feedback should you need the help.

Thank you I was thinking the same thing -- going up to 1.25 at most. And then doing our own curve in a week assuming we've got hometesting functional by then. Only reason I don't have the spreadsheet going yet is we have no hometest data just yet.

I will unlock viewing my profile for old posts good call, thanks for the heads up!

Well done!
I would go out and buy some 1/2 unit syringes… make sure they are the correct ones.
You can use the ones you have for the times you dose a whole unit and use the others for when you give the smaller doses….that is what I did when I had both sorts of syringes,. I would also only go up 1/4 unit in dose. Curves are always higher at the vet due to vet stress

thank you, good idea

 

[Diane Tyler's Mom GA]

Only reason I don't have the spreadsheet going yet is we have no hometest data just y

When you get the numbers of his curve done by the vet you can add them to the spreadsheet. Good luck with the home testing, you will get the hang of it in no time

Here is the link from your previous post
https://felinediabetes.com/FDMB/threads/new-member-so-glad-i-found-you.257798/#post-2901245

 

[Hendrick Cuddleclaw]

Thanks I didn't want to keep adding messages to that one, it is over 70 replies. I will get the sheet going and add the vet's curve into it.

Question: the vet's instruction on doing a curve is: test before AM food, then meal and shot then test every 2 hours for 12 hours.

Is that what members here have done? Every two hours for a full cycle?

 

[Diane Tyler's Mom GA]

Thanks I didn't want to keep adding messages to that one, it is over 70 replies. I will get the sheet going and add the vet's curve into it.

Question: the vet's instruction on doing a curve is: test before AM food, then meal and shot then test every 2 hours for 12 hours.

Is that what members here have done? Every two hours for a full cycle?

Yes that is correct, you can feed during the 12 hour cycle also.
Let's say you test ,feed then shoot at 9 AM you will then test at 11:AM, then 1Pm , then 3PM, then 5PM, then 7 PM then 9 PM which will be your PMPS

Always aim for the sweet spot warm the ears up first, you can put rice in a sock and put it in the microwave, test it on the inside of your wrist to be sure it's not to hot, like you would test a babies bottle. You can fill a pill bottle with warm water and roll it on the ears also.Just keep rubbing the ears with your fingers to warm them up

6. As the ears get used to bleeding and grow more capilares, it gets easier to get the amount of blood you need on the first try. If he won’t stand still, you can get the blood onto a clean finger nail and test from there.
When you do get some blood you can try milking the ear.
Get you finger and gently push up toward the blood , more will appear
You will put the cotton round behind his ear in case you poke your finger, after you are done testing you will fold the cotton round over his ear tostop the bleeding , press gently for about 20 seconds until it stops
Get 26 or 28 gauge lancets
You can also use a little Vaseline on the ear if you want to so the droplet of blood will bead up
Here is a video that one of our members made testing her kitty
VIDEO: How to test your cat's blood sugar

 

[Hendrick Cuddleclaw]

Ok I plugged in the numbers from the vet. Ugh, looks so bad. Have to remember that he was probably running high from being at the vet. Once we get our hometesting act together, we'll see how it looks. Also he is now on 1.25u 2x/day

I had them redo bloodwork though and his liver enzymes are almost completely normal and while they did detect ketones it was a very very small amount, so they said not a concern:

Chemistry: CHOL 285 (H), ALT 136 (H), CHLO 110 (L), ALB 3.9 (H)
Serum Ketones: Small 1+ A

 

[Suzanne & Darcy]

We have not yet successfully performed a hometest so I let the vet go ahead and do a curve.

He got his 1u Lantus at 6:30a, dropped off to vet at 7:30. His BG ran high most of the day and they called it at about 2pm when he was just staying high (400-500 i think she said).

They are recommending a half-unit increase. They are also going to try and help us learn how to do home BG test, we are told to bring our meter (AT2) and pick him up in about an hour. I plan to ask them for his specific numbers they got throughout the day when they tested.

They also said per their records he went DOWN from 10.5 pounds at discharge on 1/10 to 10.23 pounds today. I thought he had gone up, could have sworn they told me 9.8 lbs at discharge. So annoying that I didn't get any half-unit syringes yet, the huge box our vet had us order at dx does not have half-unit markings. What do I do, just eyeball it? I ordered some from Chewy but of course don't have them yet.

If you get a blood drop, work fast and scrape it onto the back of your thumbnail and test it from there. This will work until things get better.

 

[Hendrick Cuddleclaw]

Yes that is correct, you can feed during the 12 hour cycle also.
Let's say you test ,feed then shoot at 9 AM you will then test at 11:AM, then 1Pm , then 3PM, then 5PM, then 7 PM then 9 PM which will be your PMPS

Always aim for the sweet spot warm the ears up first, you can put rice in a sock and put it in the microwave, test it on the inside of your wrist to be sure it's not to hot, like you would test a babies bottle. You can fill a pill bottle with warm water and roll it on the ears also.Just keep rubbing the ears with your fingers to warm them up

6. As the ears get used to bleeding and grow more capilares, it gets easier to get the amount of blood you need on the first try. If he won’t stand still, you can get the blood onto a clean finger nail and test from there.
When you do get some blood you can try milking the ear.
Get you finger and gently push up toward the blood , more will appear
You will put the cotton round behind his ear in case you poke your finger, after you are done testing you will fold the cotton round over his ear tostop the bleeding , press gently for about 20 seconds until it stops
Get 26 or 28 gauge lancets
You can also use a little Vaseline on the ear if you want to so the droplet of blood will bead up
Here is a video that one of our members made testing her kitty
VIDEO: How to test your cat's blood sugar

OMG!!! PMPS success!! Used vaseline (don't need much do you!) and instead of trying to lance him with one of the short-ass lancets that came with the alpha trak, we used a longer one that the vet gave us a few of. both changes helped, also I had in my mind everything everyone here has mentioned as tips and tricks thank you all so much!!

unfortunately Hen's BG was a very high 458

He also seems to have little to no appetite at dinner which is very unusual, he has been eating really, really well since discharge last week. He did eat some though and we gave him his 1.25u Lantus just now.

{edit} he went and took huge dump in the litter box and then ate some more food so...considering yesterday he ate more than I've seen him eat in one day since discharge, that might have something to do with him not wanting much dinner

 

[Suzanne & Darcy]

If he was constipated then that could explain his inappetence. I hate it when they don’t eat well. It’s such a worry.

 

[Hendrick Cuddleclaw]

If he was constipated then that could explain his inappetence. I hate it when they don’t eat well. It’s such a worry.

Exactly, and yesterday he ate SO well, my heart was so lifted by it...and he has been seeming to improve each day since discharge, appetite getting better every day. Then he goes to the vet for a curve, we change his does to 1.25 and today for the first time since before going to the hospital he did not seem quite right. Hopefully just a little constipated and tomorrow he'll be back to how well he was coming along.

Hard to not be suspicious of the dosing change having a negative impact.... but it isnt much of a change, we are just eyeballing a dose that is just a hair over 1u since we don't have half-unit syringes just yet (on order from chewy). I doubt we are even giving him a full 1.25, as we are erring on the cautious side with the increase.

 

[Suzanne & Darcy]

Exactly, and yesterday he ate SO well, my heart was so lifted by it...and he has been seeming to improve each day since discharge, appetite getting better every day. Then he goes to the vet for a curve, we change his does to 1.25 and today for the first time since before going to the hospital he did not seem quite right. Hopefully just a little constipated and tomorrow he'll be back to how well he was coming along.

Hard to not be suspicious of the dosing change having a negative impact.... but it isnt much of a change, we are just eyeballing a dose that is just a hair over 1u since we don't have half-unit syringes just yet (on order from chewy). I doubt we are even giving him a full 1.25, as we are erring on the cautious side with the increase.

And going to the vet is a big deal, especially after being in the hospital. It all takes time to settle down. There are just so many factors in play.

 

[Katherine&Ruby]

When my cat was diagnosed, I went to the local pharmacy with the vet prescription and got half unit syringes called BD Ultrafine U100 3/10 cc 31 gauge. You may be able to get them at your local pharmacy without waiting for a shipment. Lots of people here get syringes from Walmart. I dunno where you are located tho.

 

[Hendrick Cuddleclaw]

And going to the vet is a big deal, especially after being in the hospital. It all takes time to settle down. There are just so many factors in play.

mmmm good point too. Well in a way, it was a good thing he was off his feed so suddenly, he ate so little at meal time I told my wife "well, this is it. We HAVE to get a BG test -- he didn't eat much at all and we need to know if it's even safe to shoot"

unsuccessful up to that point, we were. But we tried again, not using those little short-ass lancets from the ALphaTrak box, but longer ones the vet gave us (16mm). Much longer than you need but for me, it helps me get the right 45 degree angle having a longer needle.

They are also 25 gauge which is a little big but maybe helped me since I'm so new to it. We have some 27s ordered. So his BG was 458, we dosed him and then lo and behold about 2 hours later, he wanted a snack. And pats. And was just himself as he can be

Its like you can see the insulin working its magic yknow. I am starting to suspect we are going to end up increasing dosage quite a bit, if he was 458 at 6:30p when he had not eaten since 12:30p.

 

[Diane Tyler's Mom GA]

OMG!!! PMPS success!! Used vaseline (don't need much do you!) and instead of trying to lance him with one of the short-ass lancets that came with the alpha trak, we used a longer one that the vet gave us a few of. both changes helped, also I had in my mind everything everyone here has mentioned as tips and tricks thank you all so much!!

unfortunately Hen's BG was a very high 458

He also seems to have little to no appetite at dinner which is very unusual, he has been eating really, really well since discharge last week. He did eat some though and we gave him his 1.25u Lantus just now.

{edit} he went and took huge dump in the litter box and then ate some more food so...considering yesterday he ate more than I've seen him eat in one day since discharge, that might have something to do with him not wanting much dinner

Congrats on getting a test! ,favor can you add TR to your signature also and you can get rid of lantus .25 since the dose will change

 

[Hendrick Cuddleclaw]

Congrats on getting a test! ,favor can you add TR to your signature also and you can get rid of lantus .25 since the dose will change

Thanks!!! Isn't it funny how easy it *can* be? This successful hometest was a breeze. Everything went just perfectly. And it seemed nigh impossible just the other day.

whoops, that was supposed to 1.25u but yeah, seeing as we are just starting out and haven't yet landed on the right dose (far as we can tell anyway)....makes sense to remove it all together. Done and done

 

[Hendrick Cuddleclaw]

When my cat was diagnosed, I went to the local pharmacy with the vet prescription and got half unit syringes called BD Ultrafine U100 3/10 cc 31 gauge. You may be able to get them at your local pharmacy without waiting for a shipment. Lots of people here get syringes from Walmart. I dunno where you are located tho.

ty for the suggestion, I tried my local walmart and they did not seem to have the right ones. Ones from Chewy should arrive today i think so, no problem

....and yes...I am up early most days lol.

 

[Hendrick Cuddleclaw]

woohoo! 2nd successful hometest! On consecutive days even! First time we've gotten an evening number at +3

It was 118 (1.25u Lantus). He just had a snack

never would have been possible without the help from people here...we're getting there. Gotta get that spreadsheet populated. Told my wife we need to get AMPS data next, I think

 

[JaxBenji]

118 (1.25u Lantus)

what a nice blue number - looks like it was at +3 (so 3 hours after you shot insulin?) And it's on an AT....without a Preshot test (I get that you are working on testing), we don't know if he's going up or down but I'd try to test again in an hour (so +4 after you shot insulin). I can't stay online but I'll tag a couple of people to help keep an eye out for the next test... @Bron and Sheba (GA) or @tiffmaxee or @Bandit's Mom

And, hang in there it's clear how much you all care about Hendrick

 

[Hendrick Cuddleclaw]

shoot, my wife already went to bed. I need a helper, at this point anyway. thanks though

 

[tiffmaxee]

It’s definitely good you didn’t take him up to 1.5. I hope you will be able to get the +4. My vet taught me to test using a needle and that’s what I did. I bought the super sharp terumo ones though. Successfully prick every time. Walmart does carry syringes with half unit markings. The people working there don’t always know that.

 

[tiffmaxee]

shoot, my wife already went to bed. I need a helper, at this point anyway. thanks though

Make sure he eats a little since you can’t test. Your signature says TR BUT in order to follow TR you need a minimum of two tests every cycle. Until comfortable testing you might want to follow SLGS.

 

[Hendrick Cuddleclaw]

what a nice blue number - looks like it was at +3 (so 3 hours after you shot insulin?) And it's on an AT....without a Preshot test (I get that you are working on testing), we don't know if he's going up or down but I'd try to test again in an hour (so +4 after you shot insulin). I can't stay online but I'll tag a couple of people to help keep an eye out for the next test... @Bron and Sheba (GA) or @tiffmaxee or @Bandit's Mom

And, hang in there it's clear how much you all care about Hendrick

omg I think we just MIGHT be getting the hang of this. 3rd straight successful hometest!!! PMPS was 507 though

PMPS was 458 two days ago when we were *just* starting 1.25u Lantus and I had hoped to see it trending down esp since last night's PM +3 was a nice blue 118.

 

[tiffmaxee]

Yesterday’s +3 bg was low blue so you need to hold 1.25 for 10 cycles which is 5 days from the first blue. He might have even gone lower. He’s now bouncing from being in lower numbers than his body has been seeing. A bounce can take 6 or more cycles to clear.

 

[Hendrick Cuddleclaw]

Yesterday’s +3 bg was low blue so you need to hold 1.25 for 10 cycles which is 5 days from the first blue. He might have even gone lower. He’s now bouncing from being in lower numbers than his body has been seeing. A bounce can take 6 or more cycles to clear.

that was my thought as well, although he did register a 458 the other day. Basically we need more data points, a lot more. Working on that, and ketone testing -- ketone strips arrive Monday.

 

[JaxBenji]

Here's some info on bouncing (i.e. one of the most frustrating parts of FD ) -

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).

Just for reference (for anyone reading), this is from this sticky - The Basics: New to the Group? Start here!

Congrats on getting another test Yes, more data points will help and will help you understand what's happening (i.e. to actually see he's not staying high all the time )

 

[Hendrick Cuddleclaw]

PMPS of 322 woohoo

 

[Diane Tyler's Mom GA]

PMPS of 322 woohoo

I think you put your PMPS in the wrong spot, you put it for the 24th
Congrats on another test

 

[Hendrick Cuddleclaw]

142 @ +3

nice

 

[Hendrick Cuddleclaw]

I think you put your PMPS in the wrong spot, you put it for the 24th
Congrats on another test

whooops, thanks

 

[FrostD]

142 @ +3

nice

That is awesome to see!

 

[FrostD]

I would start posting over in the Lantus forum now. First order of business is to change your feeding schedule to help prevent those steep dives.

What's current feeding schedule?

 

[Diane Tyler's Mom GA]

To start posting over in the Lantus Forum ( There are more eyes over in that forum)
We do a new post everyday
Here is an EXAMPLE
1-24 Hendricks AMPS- 320/ 220+3/174+6 and so on PMPS - 198/ 174+4 and so on

Then you need to link the previous days post to this so members can go back and look if needed

Link the previous post and then you can write what you want to

I see you decided to follow TR just remember
In order to follow TR you need a minimum of two tests every cycle
More would be better so you can find his nadir and know when to increase or decrease

Do the tests at different times each cycle , like filling in pieces of a puzzle

 

[Hendrick Cuddleclaw]

first successful AMPS today....highest BG we've seen yet though. 543. After yesterdays PMPS of 322 I didn't expect that but if he is bouncing, that would make sense I suppose.

 

[Hendrick Cuddleclaw]

I would start posting over in the Lantus forum now. First order of business is to change your feeding schedule to help prevent those steep dives.

What's current feeding schedule?

main meal 6-630pm and 6-630am with shot. Small meals/snacks offered every 2 hours for first 6 hours of cycle

 

[Hendrick Cuddleclaw]

To start posting over in the Lantus Forum ( There are more eyes over in that forum)
We do a new post everyday
Here is an EXAMPLE
1-24 Hendricks AMPS- 320/ 220+3/174+6 and so on PMPS - 198/ 174+4 and so on

Then you need to link the previous days post to this so members can go back and look if needed

Link the previous post and then you can write what you want to

I see you decided to follow TR just remember
In order to follow TR you need a minimum of two tests every cycle
More would be better so you can find his nadir and know when to increase or decrease

Do the tests at different times each cycle , like filling in pieces of a puzzle

thanks, yeah my wife was so happy that we actually got a few successful tests, on consecutive days and I was like...don't celebrate just yet. We actually need to get to where we are doing multiple tests every single day, at least two. I thought it was good to get a routine on the PMPS shot so was doing that every day at pretty much the same time instead of random different times scattered throughout the cycle but what you say makes perfect sense, gotta fill in that picture of what is going on in his little feline body

yesterday was the first time we got two BG's in a cycle (PMPS and +3). And today was the first AMPS ever so...we are getting there

 

[Hendrick Cuddleclaw]

@FrostD dammit dammit dammit I am 99% sure my am shot did not get in him, he jerked away JUST as I was pushing the plunger. with an AMPS of 543 and a good meal, he needs his insulin

this sucks but I know I can't reshoot. Not really sure what to do though, wife is leaving for work so I am not going to be able to test him. Well I could try, never done it without her. If I get a test at +2 or +3 and he is still through the roof 5-600 or higher...should I give insulin? I guess that is the question

 

[FrostD]

He'll be ok, we've all done it. I would not give another dose even if you get high numbers.

Let's change those meals. Snacks are good, but the PS meal - let's split that in half. Half at PS, half at +1. And see if that helps those dives (and make a note in SS that you're trying that - any time you change a "variable" always good to note - changes to food, timing, meds, etc)