Help please - First At Home BG Curve

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4hillary

4hillary

Member Since 2023
Hi all, this is my first post but I have learned a lot from reading on these forums, so thank you!

My 12-year-old cat, Chloe (who is a boy ), was diagnosed with diabetes in June and it has been a journey to find the correct insulin dose. After several BG curves at the vet this summer, they landed on 5 units of Vetsulin, which he was on for almost two months. Then at the end of September he had a hypoglycemic event (very scary!) and they shifted his dose to 4 units. A few weeks later I noticed some unusual twitching and asked if we could go down to 3 units, which we did two weeks ago.

So today we are doing a BG curve at home for the first time using a ReliOn Platinum glucometer. The readings so far have been 8am 118, 10am 55, 12pm 40. These numbers seem soo low…dangerously low?? He is acting normal (other than concerned that we’ve blocked his usual hiding spots foe the day). Is it possible the meter is slightly off, or something else is going on? Or should I be calling the vet because it’s such a low reading right now?

Thank you in advance for any thoughts/advice!
 
Anything below 50 on a human meter is a take action number. Do you have Karo or honey and high carb food. Rub some of the Karo on his gums or mix a few drops with the high carb food. You need to test again in 20 minutes after that. You need to stop the drop and bring his numbers back up to above 50. You’re in hypo territory now and this is urgent
 
He also earned another reduction. I would go down to 2 units moving and tagging a few others here for more advice @Wendy&Neko @tiffmaxee

I would also consider switching him to a better insulin for cats like Lantus or prozinc. You may want to share the guidelines from the American Animal Hospital Assn for the treatment of diabetes in both dogs and cats with your vet. the AAHA no longer recommends Caninsulin/Vetsulin for treating feline diabetes.
 
Please post again once you’ve given the Karo and HC food and retested so we know what to do next. I wouldn’t waste time calling your vet unless you plan to take him to the er but if you can bring the bg up, it won’t be necessary.
 
Thank you all so much! Just gave him Karo and he ate some food. I’ll retest in 15 more minutes and post again.

Any advice on where to find Lantus or Prozinc for a reasonable cost? When he was first diagnosed I looked around a bit but getting it from the human pharmacy was something like $500 for a vial.
 
Ok, at 1:20 his BG was 45, so it went up a bit. When would you recommend testing again?
And should we plan to skip insulin this evening, or just go ahead and reduce to 2 units?
 
We have resources and @Diane Tyler's Mom can give you a ton of info on how to get Lantus or its generic glargine discounted. I used to get the pens from Canada and it was 1/3 the cost

you want him above 50 so I’d test again in 20 minutes and give a bit more Karo and food - don’t give a ton of food so he doesn’t get full maybe a teaspoon or 2. Keep doing that until he’s safely above 50
 
We need to see where he’ll be at this evening. If he’s under 200, you may want to skip but let’s take it a step at a time. Usually we decrease in 1/4 units but I’m suggesting a larger decrease because of how low he went and because you don’t have a spreadsheet setup so I don’t have data to review. I’m hoping others will also chime in on a new reduced dose.

do you think you can set up a spreadsheet and plug in all the numbers you have? The info on how to do that is here but we can have someone help you if needed:
  • HELP US HELP YOUhas information about the spreadsheet, signature and hypo box which you will need to be able to look after your beloved kitty properly
also, what are you currently feeding him? With Vetsulin, you need to makes sure he has food onboard at least 30 minutes before you give him the shot because it hits so hard and fast
 
I’ve not been a Vetsulin user as it generally is for dogs. Cats see harsh drops and not long enough duration. His dose is to high for sure. I’m glad you are willing to switch insulin. Can you get a RX for lantus or one of the biosimilars? I think Costco has them at a reasonable price. What are you feeding him? Do you have honey and high carb food ready?

Ale has given you good advice. You want him over 50 without needing honey or high carb food. I’m glad he was not symptomatic.
 
At 2:00 BG was 44. Gave a bit more karo and food and I’ll check again.

Yes, I can work on a spreadsheet - this is all new and also caring for my child today, so not sure if I’ll get it done this afternoon.

He’s eating 1/4 cup Iams indoor weight & hairball control and 1/4 cup Royal Canin glycobalance. We switched from fully glycobalance to try to make things more affordable. I’m open to other options, just feel like it’s been tricky to find out what’s best that fits the budget.
 
Yes, they’re both dry. Glyco is just what the vet suggested when he was diagnosed. We’ll look into slowly transitioning to one of those wet options, thanks!
 
Great, he’s out of the danger zone now and Vetsulin should be wearing off too. He may bounce due to the low bgs and you may see some higher numbers tonight or tomorrow. I’d test again in another hour or so just to make sure he continued going up.

Post here again when you take his evening preshot test so we can advise on the reduction. Have you been taking a preshot test every day? It’s important so you know if it’s safe to give the regular dose. For these tests, you want to make sure he hasn’t eaten for at least 2 hours prior so the number you get is true and not food influenced or inflated.

you want to make sure you’re testing daily if you’re going to transition him to low carb foods because it can drop the bg by as much as 100 points and you’ll be on the same boat you were in today. Take a look at this
FOOD CHART and choose foods that are under 10%.
Unfortunately most vets do not know a lot about feline diabetes….they have many animals to look after and they all have different diseases and treatments. Vets also get their information about nutrition from the big cat food manufacturers so they are biased in what they recommend. A dry high carb diet is not good for any cat, especially a diabetic cat. That’s like feeding your diabetic child a diet of chips, ice cream and sweets.

With a diabetic cat you need:
  • A low carb wet diet that is 10% carbs or under. Most of us use around 4-7% carbs
  • A suitable insulin such as Lantus or Prozinc which are long acting, more gentle insulins than the old insulins.
  • We recommend hometesting the blood glucose with a human meter…it is not necessary to use a pet meter which is expensive to run and is no better. It will keep your kitty safe and you will know how the dose is working for your kitty. Only testing every so often will not tell you what is happening in between those times and an awful lot can happen in even a day.
You will also need some higher carb foods for that hypo box..information in the help us help you link, but basically what you fed him today to bring his bg back up.

This is an excellent site for diabetic cats…it has been around for more than 25 years and has very experienced people to help you.

Keep asking lots of questions!
 
Wendy&Neko said:
It's great you starting home testing - that may have saved your kitty today. Good to see you've got the spreadsheet set uptoo. Once you've gotten some of the blood glucose data you've been getting in it, we'll be able to help you better with dosing.
Click to expand...
Any thoughts on the dose reduction for tonight given he went under 50? I know we don’t have any data…
 
Ale & Bobo & Minnie (GA) said:
We have resources and @Diane Tyler's Mom can give you a ton of info on how to get Lantus or its generic glargine discounted. I used to get the pens from Canada and it was 1/3 the cost
Click to expand...
@4hillary
Hi there Ale has asked me to give you some information on generic lantus
Rather than me type the whole thing out just tap on this blue link below
that I gave to another member about it and also some med and high carb foods for you hypo kit. Look at the post number 4 and number 5, they are to the right of each post
Tap on this link
https://felinediabetes.com/FDMB/threads/new-member-11-8-and-i-am-tired.283363/#post-3121360
 
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4hillary said:
@tiffmaxee @Ale & Bobo & Minnie (GA) @Wendy&Neko
Just took it again at 5:15pm and it’s 142. Insulin is due at 7:45pm.

Today is the first time we’ve done home testing, so not sure I have any data other than today to enter, unless I should put previous curves from the vet’s office in. I still need to read through all that info to see how it works.

I really appreciate all the help today!
Click to expand...
Great you got it setup! Go ahead and add the numbers you’ve been getting today. Are you able to get preshot tests daily at least? We like to see about 4 tests a day if you can manage so we can start to get an idea of when he’s at the lowest since we dose here by how low your cat is going, not by the preshot numbers like most vets

Thanks!
 
Ok, added today's numbers. I'm not very familiar with spreadsheets and not able to get the exact timing in the format requested...when I type +5.25, for example, it says error, so these times are slightly approximate.

Yes, I'm on eastern standard time.

I don't have half unit marked syringes at the moment.

Yes, we'll start doing preshot tests and I can try to get about 4 tests a day for the next couple of days.
 
3 units of insulin is definitely too much insulin.
What type of meter are you using? Pet or human?eta..I can see you are using a human meter!
What type of food are you feeding?
Are you feeding then waiting 30 minutes before giving the dose?
 
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Bron and Sheba (GA) said:
3 units of insulin is definitely too much insulin.
What type of meter are you using? Pet or human?
What type of food are you feeding?
Are you feeding then waiting 30 minutes before giving the dose?
Click to expand...

Human meter: ReliOn Platinum
He’s eating dry food - 1/4 cup Iams indoor weight & hairball control and 1/4 cup Royal Canin glycobalance.
I have not been waiting 30 minutes - wasn't aware that was what needed to happen.

After the info and advice given here today, I'm planning to call our vet tomorrow about switching to Lantus. I'll also be looking at wet food options.
 
4hillary said:
Human meter: ReliOn Platinum
He’s eating dry food - 1/4 cup Iams indoor weight & hairball control and 1/4 cup Royal Canin glycobalance.
I have not been waiting 30 minutes - wasn't aware that was what needed to happen.

After the info and advice given here today, I'm planning to call our vet tomorrow about switching to Lantus. I'll also be looking at wet food options.
Click to expand...
I would reduce the dose to 2 units …if the preshot BG is over 200 AND you can monitor the cycle…that means testing the BG this coming cycle.

I think it is a great idea to swap to Lantus…BUT… you need to do one thing at a time. You don’t want to be changing insulins and and changing food at the same time.
I would first find a good dose with the vetsulin so we can safely swap over to the new insulin.
You might find that with the swap to low carb food, he needs very little or no insulin, but only time will tell.
In the meantime, reduce the dose of vetsulin and monitor the cycle.
Keep in touch with us and wait 30 minutes after food before giving vetsulin.
Bron

ETA Are you giving snacks during all the cycles?
 
Bron and Sheba (GA) said:
I would reduce the dose to 2 units …if the preshot BG is over 200 AND you can monitor the cycle…that means testing the BG this coming cycle.

I think it is a great idea to swap to Lantus…BUT… you need to do one thing at a time. You don’t want to be changing insulins and and changing food at the same time.
I would first find a good dose with the vetsulin so we can safely swap over to the new insulin.
You must find that with the swap to low carb food, he needs very little or no insulin, but only time will tell.
In the meantime, reduce the dose of vetsulin and monitor the cycle.
Keep in touch with us and wait 30 minutes after food before giving vetsulin.
Bron

ETA Are you giving snacks during all the cycles?
Click to expand...

I won't be able to monitor the next cycle overnight. Does that mean I should skip and give it in the morning so I can monitor tomorrow's daytime cycle?

Ok great. We'll find a good Vetsulin dose, then switch to new insulin before changing foods.

He has food available all the time - I feed am and pm but he never eats it all at once.
 
4hillary said:
I won't be able to monitor the next cycle overnight. Does that mean I should skip and give it in the morning so I can monitor tomorrow's daytime cycle?

Ok great. We'll find a good Vetsulin dose, then switch to new insulin before changing foods.

He has food available all the time - I feed am and pm but he never eats it all at once.
Click to expand...
Let’s see what the preshot BG is before deciding what to do
How long before the preshot is due?
Would you be able to get a couple of tests in before going to bed? And if necessary get up later to check the BG?

You can still see the vet about swapping over to the new insulin and be ready to go.
 
Bron and Sheba (GA) said:
Let’s see what the preshot BG is before deciding what to do
How long before the preshot is due?
Would you be able to get a couple of tests in before going to bed? And if necessary get up later to check the BG?

You can still see the vet about swapping over to the new insulin and be ready to go.
Click to expand...
Insulin is due in 30 minutes. I could probably get a couple in before bed.
 
Thanks Bron!

@4hillary just wanted to GI over this again, are you making sure he hasn’t eaten at least 2 hours before the preshot tests. So, when you got the 175, had it been at least 2 hours since he had eaten? It’s important so you know the bg wasn’t influenced by the food in his system. It’s a steep learning curve but you’ve already made huge strides today!

You may see higher numbers later tonight and tomorrow because of what we call bouncing. Don’t be tempted to go back to the 3 units dose as it’s too much for him. If you get above 200 numbers, stay with the 2 units dose we suggested and Bron confirmed. bouncing is a kitty's self defense mechanism. Here is the description:

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).
 
4hillary said:
Ok, added today's numbers. I'm not very familiar with spreadsheets and not able to get the exact timing in the format requested...when I type +5.25, for example, it says error, so these times are slightly approximate.

Yes, I'm on eastern standard time.

I don't have half unit marked syringes at the moment.

Yes, we'll start doing preshot tests and I can try to get about 4 tests a day for the next couple of days.
Click to expand...
You can add that exact time in the cell along with the bg value but then you’ll need to add the full color manually.
 
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