Update on Sammy!

karizma

karizma

Member
Thank you everyone who responded to my last post! I really appreciated all the assistance given. I spoke with his veterinarian yesterday, they suggested I withhold insulin unless his BG is above 300. Today and yesterday his values were for the most part under 200. I’m going to continue monitoring. His vet said she’ll call me tomorrow to check in so I’m sure she’ll give me further advice at that point.
If anybody has any suggestions regarding Sammy’s numbers I’ll take them!
He is still lethargic not moving much but is finally eating as his mirtaz cream came in today. His UTI med also came in so he began that antibiotic earlier today.
Despite eating almost full meals his BG isn’t getting higher (which I think is good). If there’s any questions you think I should ask the vet tomorrow please drop them below! I want to make sure I’m advocating and treating him the best way possible.
Thank you again!!
 
Here is your first post for continuity https://www.felinediabetes.com/FDMB/threads/human-meter-questions.298820/#post-3250772.
karizma said:
I spoke with his veterinarian yesterday, they suggested I withhold insulin unless his BG is above 300. Today and yesterday his values were for the most part under 200. I’m going to continue monitoring. His vet said she’ll call me tomorrow to check in so I’m sure she’ll give me further advice at that point.
If anybody has any suggestions regarding Sammy’s numbers I’ll take them!
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I do not agree with what your vet has suggested at all. What was her logic in withholding insulin when Sammy has higher than normal numbers?
If he is lethargic and has a UTI, that is all the more reason he should be getting insulin.
With all that is going on, you are running the risk of Sammy developing ketones and that can lead to the much more serious DKA.
Do you have some ketostix at home you can test his urine with for ketones.? If not I would strongly recommend you go out and buy some today and test Sammy's urine. You can get them at a pharmacy

If Sammy were my cat I would be restarting the insulin. You can reduce the dose if necessary down from 1 unit to 0.75 Unit.
I would be asking the vet the reason she is stopping the insulin when the BGs are higher than normal
I would also mention the lethargy and the UTI...both reasons why a diabetic cat with higher than normal numbers should be getting insulin.
There are several doses that are lower than 1 unit so that is not an excuse to stop the insulin.
Remember you are Sammy's advocate and you don't have to follow the vets advice if you don't think it is correct or are uncomfortable with it.

Make sure Sammy is eating lots of food please.
 
Bron and Sheba (GA) said:
Here is your first post for continuity https://www.felinediabetes.com/FDMB/threads/human-meter-questions.298820/#post-3250772.

I do not agree with what your vet has suggested at all. What was her logic in withholding insulin when Sammy has higher than normal numbers?
If he is lethargic and has a UTI, that is all the more reason he should be getting insulin.
With all that is going on, you are running the risk of Sammy developing ketones and that can lead to the much more serious DKA.
Do you have some ketostix at home you can test his urine with for ketones.? If not I would strongly recommend you go out and buy some today and test Sammy's urine. You can get them at a pharmacy

If Sammy were my cat I would be restarting the insulin. You can reduce the dose if necessary down from 1 unit to 0.75 Unit.
I would be asking the vet the reason she is stopping the insulin when the BGs are higher than normal
I would also mention the lethargy and the UTI...both reasons why a diabetic cat with higher than normal numbers should be getting insulin.
There are several doses that are lower than 1 unit so that is not an excuse to stop the insulin.
Remember you are Sammy's advocate and you don't have to follow the vets advice if you don't think it is correct or are uncomfortable with it.

Make sure Sammy is eating lots of food please.
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She told me to hold off because of him stumbling after receiving insulin at a value of 158. I will definitely ask about lowering the dosage!
from what I saw online a value above 200 is high but lower is in the “ok” range. I’m assuming since he is typically lower than 200 (at home) she wants me to withhold. His values yesterday were under 200 (except one but after 20 minutes it went down). Do you think under 200 range still requires insulin?
Sammy ate his meals yesterday I really think the mirtaz is helping significantly with appetite. I’m hoping it’ll keep it up and start to give him energy back.
I will bring your concerns up during our phone call, I have to purchase the ketones test. Can you tell me more about it? What does it mean if he has ketones? Thank you!
 
Ketone information is here: https://felinediabetes.com/ketones.htm It can lead to a serious complication called diabetic ketoacidosis which requires vet treatment and possible hospitalization to treat.

I wonder if the CVS meter is the problem? 158 is a normal healthy blood glucose number. A cat should not be having hypo symptoms. Can you buy a different meter and compare it to the CVS meter with the same drop of blood? You might be able to get a free starter meter kit from AccuChek. I say might because it depends on who you talk to at AccuChek customer service. I used the live chat once to ask about a replacement for the Aviva meter and they just sent me a different meter no questions asked. https://www.accu-chek.com/contact There's a free meter voucher on the AccuChek web site but I don't know if they require additional information after you submit the online form: https://www.accu-chek.com/tools/accuracy Fill out the form with your name and information, not the cat's.
 
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squeem3 said:
Ketone information is here: https://felinediabetes.com/ketones.htm It can lead to a serious complication called diabetic ketoacidosis which requires vet treatment and possible hospitalization to treat.

I wonder if the CVS meter is the problem? 158 is a normal healthy blood glucose number. A cat should not be having hypo symptoms. Can you buy a different meter and compare it to the CVS meter with the same drop of blood? You might be able to get a free starter meter kit from AccuChek. I say might because it depends on who you talk to at AccuChek customer service. I used the live chat once to ask about a replacement for the Aviva meter and they just sent me a different meter no questions asked. https://www.accu-chek.com/contact There's a free meter voucher on the AccuChek web site but I don't know if they require additional information after you submit the online form: https://www.accu-chek.com/tools/accuracy Fill out the form with your name and information, not the cat's.
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Well that was before I gave the insulin so the thought is it brought his levels way down. I didn’t retake his BG until 2 hours later
 
Bron and Sheba (GA) said:
While the BG numbers Sammy is getting are not high, they are above the normal limits.
A diabetic cat who no longer needs insulin should have BGs in the range 50 -120, preferably 50-100.
Here is a link to a cat who has just gone into remission

https://docs.google.com/spreadsheet...-qFJT18-1RgNbteog6olv2gz6GMVwG4zxoqsj/pubhtml
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Is it typical for cats to require insulin with ranges from 120-200? I asked about lowering his dosage and the vet said to hold off keep testing and we’ll touch base in a few days. I’m wondering if it’s the diet change that has drastically changed his numbers (he tested over 400 at the vet once and then over 300 the time after)
 
Looking at your spreadsheet, PMPS was 156, gave 1 unit. How soon after the insulin was given did the stumbling start? +2 was 162 after honey was given. No additional readings were taken until the next morning AMPS which was 138.

If a hypo ever happens again, test the blood glucose level to see how low it is. Then give honey/syrup/high carb food. Keep testing every half hour or so until blood glucose levels rise to a safer level and stays there. Have these printed out:

https://www.felinediabetes.com/FDMB/threads/jojo-and-bunnys-hypo-tool-box.2354/
https://www.felinediabetes.com/FDMB/threads/how-to-treat-hypos-they-can-kill-print-this-out.15887/

Stress from the vet office results in a sky high blood glucose level.

Some cats do need insulin even if they are in the normal blood glucose range of roughly 60 to 150 mg/dl. It really depends on the cat and how much data you have on your cat's blood glucose levels. I've given a full dose of insulin to my cat when he's in the low 100s, even just under 100.
 
squeem3 said:
Looking at your spreadsheet, PMPS was 156, gave 1 unit. How soon after the insulin was given did the stumbling start? +2 was 162 after honey was given. No additional readings were taken until the next morning AMPS which was 138.

If a hypo ever happens again, test the blood glucose level to see how low it is. Then give honey/syrup/high carb food. Keep testing every half hour or so until blood glucose levels rise to a safer level and stays there. Have these printed out:

https://www.felinediabetes.com/FDMB/threads/jojo-and-bunnys-hypo-tool-box.2354/
https://www.felinediabetes.com/FDMB/threads/how-to-treat-hypos-they-can-kill-print-this-out.15887/

Stress from the vet office results in a sky high blood glucose level.

Some cats do need insulin even if they are in the normal blood glucose range of roughly 60 to 150 mg/dl. It really depends on the cat and how much data you have on your cat's blood glucose levels. I've given a full dose of insulin to my cat when he's in the low 100s, even just under 100.
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Okay thank you!! I was hesitant to stress him out more by pricking him again but in the future if (hopefully it doesn’t) happens again I’ll take the bg often! Thank you for the websites as well I’ll be sure to print!

also wanted to add I filled out for the free meter but it says I need 2 written prescriptions from my doctor to receive it at the pharmacy.
 
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karizma said:
Is it typical for cats to require insulin with ranges from 120-200? I asked about lowering his dosage and the vet said to hold off keep testing and we’ll touch base in a few days. I’m wondering if it’s the diet change that has drastically changed his numbers (he tested over 400 at the vet once and then over 300 the time after)
Click to expand...
To get a cat regulated and into remission the cat needs to be in normal numbers. The idea is to gradually reduce the dose of insulin and hopefully the cat will stay in normal numbers. If you look at the SS I sent you of a kitty that has just today gone off insulin, you will see the dose was gradually reduced and the cat was able to maintain normal numbers. That means the pancreas was working.
If you take Sammy off insulin now, apart from the risks I mentioned in post 2, he may be able to maintain numbers in the 100s for a while, but he won’t have a strong remission and sooner or later he will fall out of remission and it is much harder to get a cat back into remission the second time around.
 
Huh. Well your vet can write you a prescription and I don't think a pharmacist would bat an eye. Or just contact AccuChek Customer Service and ask. Say you were using an older model AccuChek Aviva meter and it stopped working and was wondering if the Aviva was still being made since you have tons of test strips left to use you don't want to waste, and if not, what a good replacement model is. If you do get a free started kit, give it a test try to see how well it works for you compared to the CVS meter. If you end up not liking it or test strips are too costly, that's ok :) Keep it as a back up meter.
 
Sammy has been off insulin for a few days but last night numbers were above 200 so I gave him a little under 1 unit. I purchased half unit syringes today. Morning BG was in the 150s so I passed on it, tonight’s was 170. I gave half a unit of insulin. will update on how it’s affecting him/ his BG in 2 hours!
 
Hi Karizma, ideally you want your cat a little lower than the 100-200 range. Are you working towards giving the same dose in the AM and PM? Lantus works best with consistency like this.
 
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