? 02/06/2022, New Member, Mumu, AMPS 439

Status
Not open for further replies.
Ok its done now, sorry I am very worried. I knew something was going on :(

It should work now?

Should I give him his AM insulin injection or hold off?

His BG at +3 is at 317.1 from 313 at +1.5 but I did feed him 2 tblsp of Tiki wet food.
 
Last edited:
It should work now?

Nope, permissions are still wrong. Click on the "share" and you should see a box like this come up. Down at the bottom hit "change" and then it'll say "anyone with the link can view". Then click "Done"

upload_2022-5-22_23-48-38.png
 

Attachments

  • upload_2022-5-22_23-48-38.png
    upload_2022-5-22_23-48-38.png
    48.9 KB · Views: 563
Ok now it should work
Yes it's good now, if you want to go back and put the 313 @+1.5 like you had before go ahead, the 317 @+3 doesn't need the .1 after it

Nothing to be sorry about, that's ok it was 317 ,it's because he got a food bump from the food. I see no reason to not give him his insulin in the AM, do you work from home ? Only asking because if you work and aren't home to test I would tell you to leave some food out for him .
You can continue on this post and change your title to
New Member the Date , then Mumu, then his AMPS#
 
Do you think that 5.8 mmol/L drop in 1.5 hours is too much? I am concerned that this is whats causing his daytime highs. He isn't reacting to the insulin in the daytime like this.
 
Do you think that 5.8 mmol/L drop in 1.5 hours is too much? I am concerned that this is whats causing his daytime highs. He isn't reacting to the insulin in the daytime like this.
I don't think it was too much, cats usually drop lower at night, you have to give it time , he just started on the insulin , are you home during the day
 
Yes i am. Maybe i will stay up a bit longer and check again at +4.5?
So you're home during the day ,that's good, you can test again at +4.5 if you want to , to give you piece of mind, but I think he'll be ok
Just go back and add the @1.5 to the 313 on your spreadsheet, don't forget to color it in manually again :cat: you're doing fine
I'll watch out for your next test
 
When i use the lancet i am pricking him with the slanted part pointing upwards or downwards? Upwards right? Nobody told me about that before, didn't even see it on any of the videos online.
 
Don't know if you saw this I added on above
Just go back and add the @1.5 to the 313 on your spreadsheet, don't forget to color it in manually again :cat: you're doing fine
I'll watch out for your next test
 
Just in case you want to see this
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
c2b8079a-b471-4fa6-ac36-9ac1c8d6dcca-jpeg.57072
fec17d29-5ab4-44a8-912b-3a91944c3954-jpeg.57073

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 to stop the bleeding , press gently for about 20 seconds until it stops
Get 26 or 28 gauge lancets
A lot of us use the lancets to test freehand
I find it better to see where I'm aiming
You can also put a thin layer of vaseline on the ear ,to help the blood bead up
A video one of our members posted
VIDEO: How to test your cat's blood sugar
 
Yes i am aiming for that area free hand and with a flashlight/papertowel, thank you so much for the help. I have a good feeling I can get him into remission if I can grasp what is happening.
 
Yes i am aiming for that area free hand and with a flashlight/papertowel, thank you so much for the help. I have a good feeling I can get him into remission if I can grasp what is happening.
You're doing fine, not to be a stickler:cat: the 313 @+1.5 isn't showing up all the way on your SS you need to put a space after the 313 then put @+1.5 take a peek
 
I actually just got back from shoppers here and the pharmicist said they wouldnt have anything like that, i will stop by the other shoppers to double check.
You want the BD Ultrafine II syringes, purple and yellow on the box. I have seen them at Shoppers on the west coast. But any other pharmacy should also have them.
 
His curve is coming along, the +4 is the lowest I have seen since the hypo incident.
 
Good job so far on the curve. :) Any luck sourcing 1/2 unit marked syringes, specifically the BD's? You'll need those before changing his dose.
 
Mumu had an asthma attack at +10.85 and I gave Albuterol and Flovent and checked PMPS was at 509 :(.

He will be back on the Flovent at 12 hour intervals from now on.

He has had his 1 unit along with his food and I will try to check his BG at +4.5 if that is the best time?
 
He has had his 1 unit along with his food and I will try to check his BG at +4.5 if that is the best time?

There's no set "best time". We usually suggest getting a +2 because it can sometimes act a little like a crystal ball in predicting where kitty might be later in the cycle. For some cats, the +3 is a better predictor.

If the +2 is about the same as the PS, it's usually a pretty normal cycle...gradually down to nadir and gradually back up to the next PS.

If the +2 is a lot higher than the PS, that's usually a sign that a bounce is starting and it may be OK to take a break in testing (and catch up on sleep if it's the PM cycle!)

If the +2 is lower than the PS, that's your early warning that he might be dropping a lot lower later in the cycle. Those cycles it's important to plan on getting more tests and either stay up or set alarms until you're sure he's going to be safe.
 
Thank you so much Chris & China that is very good to know.

Mumu had another asthma attack right before his AMPS, he got himself all worked up because it was feeding time meowing a lot and i think it caused it. No attack is better but this one wasn't as severe as yesterdays.

I am bringing my BG curve to the vet today, I will not agree with 2 units per cycle, does anyone have any thoughts into dosing? If I was to suggest a 0.25 increase ( it might be hard for me to measure it exactly as the ticks are very small on the needle ) that would be the way to go? Any tips for measuring a 1.25 dose? I am assuming just try your best.

@Margaret (and Pearl)
 
Thank you so much Chris & China that is very good to know.

Mumu had another asthma attack right before his AMPS, he got himself all worked up because it was feeding time meowing a lot and i think it caused it. No attack is better but this one wasn't as severe as yesterdays.

I am bringing my BG curve to the vet today, I will not agree with 2 units per cycle, does anyone have any thoughts into dosing? If I was to suggest a 0.25 increase ( it might be hard for me to measure it exactly as the ticks are very small on the needle ) that would be the way to go? Any tips for measuring a 1.25 dose? I am assuming just try your best.

@Margaret (and Pearl)
I think you meant to tag
@Chris & China (GA)
Instead of the person you tagged
 
No i meant to tag Margaret because i contacted her for advice on FD coupled with asthma and she wanted me to tag her here so everyone can see. :)
 
Thank you! And yes I had to go to another Pharmacy to get them. For some reason I do not have permission to upload a picture.

https://www.bd.com/en-us/products-and-solutions/products/product-page.328440
These were the only ones they had that matched the description, I showed them the picture of the product Diane had referenced.

His BG is climbing back up now, but the +4 is promising as I haven't seen that happen yet with 1 unit.
The upload isn't working, but you can copy and paste the pic of the ones you got
Don't forget to fill in the units for today on your spreadsheet
These would be the ones you want
51gQdEYUPbL._AC_SX425_.jpg



BD Ultra-Fine BD Ultrafine U-100 Insulin Syringe 31 Gauge 3/10cc 5/16 inch Short Needle-1/2 Unit Markings 100/box (328440), 100 Count (Pack of 1)

49823063143_3437e9e997_o.jpg
 
Last edited:
Hi @Sisu I’m glad Chris and Diane have been here today! They are great to help work the dose!

re: the asthma. Breathing is the most primary thing, so don’t worry about how the asthma meds may or may not affect BG at this point. As someone told me when I was starting out, we can always adjust insulin dose. Most basic thing here is that kitty has got to breathe. My best advice is to get on the Flovent twice daily. Every 12 hours every single day. asthma is a chronic condition so this is how you will keep the lung inflammation down over time. I am glad you’ve got the Albuterol for attacks and are using it! If you find out this combo is not working well, what may be happening is that your cats lung inflammation load is too high for these maintenance meds alone, and you may need to add in Pred for a time to get the inflammation to come down. Goal is for best management whatever that means. For a long time Pearl had to use the Pred to assist. Best case scenario is if your cat can use only the inhaler steroids but not matter what, the situation is workable!

and yes those high BG numbers you see after an attack are because of the attack. Imagine you can’t breathe and your insides start freaking out. That’s what is happening with your cat. It would take Pearl up to 12 hours for her BG to calm down after an attack.

as you’re new to FD, honestly I would suggest two things. First do whatever you need to do for the asthma and don’t worry about that in relation to the FD right now. Second, become an expert at keeping your spreadsheet of BG numbers, post daily on FDMB for advice on learning how to interpret the patterns you see. This ia super important to find out where you need to be with dosing the insulin and how to make adjustments.

Once your cat is more regulated on the insulin, that’s when we can start to see more clearly about how the asthma attacks throw off the BG. You won’t be able to tell that now because the diabetes is not controlled yet.

It is a good practice for an asthmatic is to write in the notes or boxes on your spreadsheet when an attack happens. This will help over time - you can take a peek at Pearls ss for 2021 and see where I put the attacks in the boxes if it will help you with the visual.

I know you said your vet may be reticent about the asthma meds thinking it affects diabetes. It likely will not. However you don’t have the data to show your vet yet to support that. You can definitely use the logic that breathing is the most primary, so you have to do those treatments. The great news is that this FDMB will help you become excellent on diabetes dosing and you WILL be able to manage both conditions simultaneously!! Pearl got to remission and she still takes her asthma meds daily!

Does this help to start?
 
I have no idea whats going on, I gave Mumu his food and 1 unit with PMPS @ 454 then @ +3 524???

My glucose test strips were suppose to be in yesterday as well and didn't arrive, I am down to 3 left and about to have a meltdown.

Anyone have any idea what is causing this and what I should do in the meanwhile?
 
@Sisu your cat is just bouncing from the yellow you saw earlier in the day. That’s when the body freaks out a little as it is learning that lower numbers are good - your cat just isn’t used to yellow yet.

no worries this is just part of the journey. If you check out some other members spreadsheets you’ll see the same things when we all first started and before our cats were regulated.

I’ll tag Wendy and Elise who I believe are closer to your time zone. It’s important to start a new thread every day and report there the numbers you get.

@Wendy&Neko @tiffmaxee
 
My glucose test strips were suppose to be in yesterday as well and didn't arrive, I am down to 3 left and about to have a meltdown.
That's why many of us use human meters. Test strips refill are as easy as a visit to your local pharmacy, and a whole lot cheaper. The Freestyle human meter needs the same size blood drop as the AT and is one that many Canadians use. I would go to your pharmacy (maybe compare on line prices first) and get a Freestyle meter, if nothing else, to use as a backup for your AT. We'd want you to have more test strips before increasing. Which he does need that increase to 1.25 units.

As for your questions about shooting, maybe some tips in here will help: Testing and Shooting Tips (includes videos). You might want to read all the Sticky Notes on the top of the
Lantus / Levemir / Biosimilars
forum. The one on insulin and syringes shows you pictures of how to draw 0.25 units. A good light, white background, and readers or a magnifying glass can help.
 
@Sisu - waving from the Kawarthas. This forum is a veritable fountain of knowledge populated by people who are willing to help you every step of the way.

(I apologize for not waving at you sooner. We got our hydro back last night, and internet today. That was some storm.)
 
Thank you everyone for the support. Mumu has been uped to 1.5 units twice per day. I just checked his PMPS and its the lowest ive ever seen it and am unsure of what to do. Its read 300 mg/dl or 16.7 mmol/L. He is currently eating and i will check his BG again but is 300 a safe level to give 1.5 Units I didnt ask that question to my vet.
 
I must also say to give some dialog that he has been on 1.5 for the last week and his PMPS were always in the 400's. The reason i have not been updating the SS is private as I have been going through a lot. Thank you for your understanding.
 
I must also say to give some dialog that he has been on 1.5 for the last week and his PMPS were always in the 400's. The reason i have not been updating the SS is private as I have been going through a lot. Thank you for your understanding.
I am pretty new myself and don't want to give you wrong info. However, I would post in the Lantus forum when you have urgent questions on dosing. The thread would be Today's Date, Cat's Name PMPS = 300 number Dosing Help urgent You will get more eyes and you will get a quicker answer.

Tagging some experienced people that may be available to help you.
@tiffmaxee
@Wendy&Neko
@Suzanne & Darcy
@Bandit's Mom
@Chris & China (GA)
@Diane Tyler's Mom
 
We cannot giving dosing help without seeing spreadsheet data. Numbers for preshots don't mean much. Have you gotten any other data points besides preshots?
 
I must also say to give some dialog that he has been on 1.5 for the last week and his PMPS were always in the 400's. The reason i have not been updating the SS is private as I have been going through a lot. Thank you for your understanding.
Not sure if your vet mentioned the Free Libre sensor. I have it on my kitty and you scan the sensor and as long as you scan once in 8 hours you can download data to your computer and see his BG every 15 min. I am a new member myself and find it soo helpful especially as I am learning to do ear pokes. You can probably do it yourself there is a Facebook group for cats and dogs for the Libre and if you search on this forum you will see many of us use it. Not sure if in Canada you need a prescription; here in the US you do need one from vet. Hope your kitty is doing well.
 
We cannot giving dosing help without seeing spreadsheet data. Numbers for preshots don't mean much. Have you gotten any other data points besides preshots?

I have updated all the values I have on Mumus spreadsheet. I don't understand whats going on, does this look normal to you?

Not sure if your vet mentioned the Free Libre sensor. I have it on my kitty and you scan the sensor and as long as you scan once in 8 hours you can download data to your computer and see his BG every 15 min. I am a new member myself and find it soo helpful especially as I am learning to do ear pokes. You can probably do it yourself there is a Facebook group for cats and dogs for the Libre and if you search on this forum you will see many of us use it. Not sure if in Canada you need a prescription; here in the US you do need one from vet. Hope your kitty is doing well.

Yes they did, I have no problem anymore reading his BG the manual way. The Libre is just over 200$ here and I honestly doubt it will stay on him as hes a bigger guy and will get it off one way or another.
@Sisu - waving from the Kawarthas. This forum is a veritable fountain of knowledge populated by people who are willing to help you every step of the way.

(I apologize for not waving at you sooner. We got our hydro back last night, and internet today. That was some storm.)

Hello! Yes I am just trying to get him regulated, but I don't understand whats going on, I am feeding him a strict diet/ schedule and have not missed any shots, always at the same time each day.
That's why many of us use human meters. Test strips refill are as easy as a visit to your local pharmacy, and a whole lot cheaper. The Freestyle human meter needs the same size blood drop as the AT and is one that many Canadians use. I would go to your pharmacy (maybe compare on line prices first) and get a Freestyle meter, if nothing else, to use as a backup for your AT. We'd want you to have more test strips before increasing. Which he does need that increase to 1.25 units.


Do the Human metres read an accurate reading for cats? I have enough AT strips for now but they are very expensive.
 
Thanks for spending the time updating the spreadsheet, it really helps us to help you.
I have updated all the values I have on Mumus spreadsheet. I don't understand whats going on, does this look normal to you?
Yes, this looks completely like what I'd expect for a recently diagnosed cat. He is seeing the odd mid blue number (mid 100's), then bouncing. Bouncing is pretty much the norm for all newly diabetic cats, and even some not so new at it. I think I'd give him another day at this dose, then increase to 1.75 units to see if you can get rid of some of those higher numbers, provided you don't see anything below 150 the next day/night.
Do the Human metres read an accurate reading for cats? I have enough AT strips for now but they are very expensive.
You get slightly different readings, but our dosing methods were developed using human meters, back before the AT meters were developed and marketed so heavily to vets. So even though the numbers are different, somewhat higher for the AT for the most part, our methods take that into consideration. The two meters are actually a lot closer in lower numbers where it counts.
 
Thank you so much Wendy.

Yes, this looks completely like what I'd expect for a recently diagnosed cat. He is seeing the odd mid blue number (mid 100's), then bouncing. Bouncing is pretty much the norm for all newly diabetic cats, and even some not so new at it. I think I'd give him another day at this dose, then increase to 1.75 units to see if you can get rid of some of those higher numbers, provided you don't see anything below 150 the next day/night.

My Vet has discussed switching insulin if this dose doesn't do well, I will try to show her the method of measuring .25 unit and see what she thinks, I would rather stick with the Lantus as he has responded to it but not latley it seems?

I must say I have rolled the bottle gently and tipped it also gently and i have just seen on another post that you are not suppose to do that with Lantus but it was what I was told by the technician. Do you think i damaged the insulin in anyway? I do smell insulin on his back but everytime i make sure the needle is all the way in before pressing the plunger in and i also feel for wetness and havent felt any wet spots.

His BG has actually risen tonight slightly from his PMPS.

One other question I had is he always seems sleepy after his insulin. Is this normal? I have been worrying a lot that maybe he needs less of a dose but I am unsure if i am just thinking too much?


You get slightly different readings, but our dosing methods were developed using human meters, back before the AT meters were developed and marketed so heavily to vets. So even though the numbers are different, somewhat higher for the AT for the most part, our methods take that into consideration. The two meters are actually a lot closer in lower numbers where it counts.[/QUOTE]

So if i bought a meter I should buy the freestyle? I will buy one tomorrow and test against the AT just unsure what model i should use.

Thank you again.
 
It's is waaaaay to soon to think about switching insulin types.
I must say I have rolled the bottle gently and tipped it also gently and i have just seen on another post that you are not suppose to do that with Lantus but it was what I was told by the technician. Do you think i damaged the insulin in anyway? I do smell insulin on his back but everytime i make sure the needle is all the way in before pressing the plunger in and i also feel for wetness and havent felt any wet spots.
There are some Sticky Notes on the top of the Lantus/Levemir/Biosimilar forum that you might want to read if you haven't already, including this one:
Insulin Care & Syringe Info: Proper Handling, Drawing, Fine Dosing
If you've been quite gentle with the insulin, it should be OK. We'll notice over time. As for the smell, sometimes you can get a drop on the needle when you are preparing the shot and squeezing out the extra. Then that drop transfers to the fur. Another post that might be of interest: Testing and Shooting Tips

One other question I had is he always seems sleepy after his insulin. Is this normal?
Cats do sleep a lot. :) Seriously though, the Lantus doesn't start taking effect for a couple hours after the shot. I think he needs a larger dose, not a smaller one. You've been doing a pretty good job testing, and we'd see some drops into dangerous numbers (below 68 on that AT) if the dose was too high.
 
Thank you so much Wendy,

I am going to do a full curve Monday and talk to my vet Tuesday. I really want to increase his insulin now by .25 but there is an inner complex in me with talking to the vet first ( part of me wants to just do it part of me says i should wait ).

I should also say the reason for switching insulin was for the variability of the .25 increase. Do you think I could do it consistently or is it very difficult to be precise? I will practice tomorrow nonetheless.

It's is waaaaay to soon to think about switching insulin types.

There are some Sticky Notes on the top of the Lantus/Levemir/Biosimilar forum that you might want to read if you haven't already, including this one:
Insulin Care & Syringe Info: Proper Handling, Drawing, Fine Dosing
If you've been quite gentle with the insulin, it should be OK. We'll notice over time. As for the smell, sometimes you can get a drop on the needle when you are preparing the shot and squeezing out the extra. Then that drop transfers to the fur. Another post that might be of interest: Testing and Shooting Tips


Cats do sleep a lot. :) Seriously though, the Lantus doesn't start taking effect for a couple hours after the shot. I think he needs a larger dose, not a smaller one. You've been doing a pretty good job testing, and we'd see some drops into dangerous numbers (below 68 on that AT) if the dose was too high.
 
I should also say the reason for switching insulin was for the variability of the .25 increase. Do you think I could do it consistently or is it very difficult to be precise? I will practice tomorrow nonetheless.
Doesn't matter which type of insulin people use here, increases are by 0.25 units at a time for all of them. The Sticky Note I linked has pictures of what 0.25 units looks like. It's basically eyeballing the difference. Which type of syringes are you using?
 
Doesn't matter which type of insulin people use here, increases are by 0.25 units at a time for all of them. The Sticky Note I linked has pictures of what 0.25 units looks like. It's basically eyeballing the difference. Which type of syringes are you using?

I am using the BD ultra with half unit markings.

With regards to the Human metre, would you reccommend one? And will it read accurate but higher or lower? Ive looked online and it is saying that human metres are inaccurate for pets so I am a bit confused.
 
Relion from Walmart is very popular here, test strips are the cheapest as well. Here is a post I stole from @Diane Tyler's Mom
I see you are from

THe Relion is a human meter, so it's going to read lower then an alphatrak. the numbers are closer together at lower ranges, and far apart at higher numbers. The scale for normal on a human meter is 50-120 and on an alphatrack it's 68-150

When the AlphaTrak first came out in 2006 one of the members here, Hope, did a comparison with several meters, including the AT. Her conclusion was that the AT was no better than a human meter and not worth the price. You can read about it here: http://www.felinediabetes.com/glucometer.htm
You can also use the search function to find other meter comparison discussions. Here's one: https://felinediabetes.com/FDMB/threads/accuracy-of-human-meters-on-cats.36558/#post-384346


All human glucometers are allowed to have 15-20% variance: For glucose meters used by people with diabetes at home (“over-the-counter”), the FDA guidance specifies the following accuracy standards: 95% of all measured blood glucose meter values must be within 15% of the true value (a lab measurement); and 99% of meter values must be within 20% of the true value.

I use the Free Libre Sensor and when numbers seem funny I perform a check with Alpha Track or another human monitor if the AT acts up or user error lol.

Here are some other glucometers I have noted people use here :

Free Style Lite - small - uses 0.3 units - this looks like the AT but Dr
Contour Next
Aviva Accuchek
Nova Max (can be used to test ketones and glucose)
CareSens N

Now after writing this long post I realized you are from Canada so not sure which will be available to you. Hopefully other members can jump in and help.
 
I used the BD Ultrafine II syringes, likely the same ones.
With regards to the Human metre, would you reccommend one? And will it read accurate but higher or lower?
For the most part, human meters will read lower than the AT meter, with larger variances in higher numbers than the normal numbers. Frankly if numbers are above 200, it really doesn't matter when one meter reads 320 and the other reads 400 (just a made up example), both are "too high". What matters is when numbers get into the normal range and that's when the meters read closer. We do know we don't want cats getting below 50 on a human meter or 68 on pet meter. We also know what is the range of "normal BG numbers" for both types of meters. We also know that depending what country you are in, there can be a 15-20 % allowable difference between meters. So what we are looking at is more trends. And our dosing methods are designed for use with human meters. Human meters were around way before the AT started getting heavily marketed to vets. My vet used a Onetouch and found it reasonably close to the lab values she's get. Funnily enough, a lot of vets are now pushing the Freestyle Libre, which coincidentally is a human meter.

For a human meter, you want one that uses a small blood drop. The Freestyle Lite is one option. I've seen use quite a few other types of meters in Canada. You can buy test strips on eBay for cheaper cost. You cannot buy the Relion in Canada. I am close to the border so cross border shopped, back in the day when it was more convenient.
Ive looked online and it is saying that human metres are inaccurate for pets so I am a bit confused.
Where are you looking? You can find almost anything on line. Most of the diabetic cat forums started out back before the AT was a thing and use human meters.
 
Status
Not open for further replies.
Back
Top