B/G Curve

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JennyBankers

Member Since 2014
Is the vet going to want b/g curve before he determines the amount of insulin my cat needs or is the b/g curve only needed once she starts insulin? Just trying to get a head start if a b/g curve will be needed to determine how much insulin she needs (since the only days I will be able to do it is on the weekends since I work FT and will do it Sunday if needed prior to insulin) I expect results of blood work & a treatment plan to be discussed Monday. Thanks!
 
Hello,

Usually a curve is only done when Insulin is given. It is the way that you determine how well the Insulin is bringing the numbers down.

You may have heard the term nadir (lowest BG level for the cycle). That is what we here rely on for dosage adjustment.

Usually the initial dosage is based upon ideal body weight (.25u per kg (2.2 lbs))

Marbles numbers look fairly good and you have readings at various times so this gives a better picture that just one test at the Vet (which usually raises the BG due to stress). I will bet that even my BG goes up when I take my kitties to the Vet! :oops:

My Jack was dx @ 634 and Samantha had readings averaging 350 prior to starting her on Insulin (not on spreadsheet).

The Vet only prescribed .5u for Samantha, even though she was 15 lbs.

I started out @ 1u because I am following the Tight Regulation Protocol. You can see by her SS that it took only 3 cycles to bring the numbers into the green. I then backed off.

I figure that your vet will start Marbles at .5u and adjust with a curve in a week or so.

Since you are home testing you have the ability to monitor Marbles closely. Once you find the nadir, (if using Lantus it is between +4 and +6) but varies from kitty to kitty, you will use the nadir number to determine if any adjustments to the dose is warranted.

All the best!
 
What insulin is he wanting to use? If it's a depot insulin (Lantus or Levemir), it takes 5 to 7 days before you see the full effect of the insulin dose on the numbers. ProZinc/PZI can also take a couple of days before seeing how the dose works on bringing down the numbers. Any other insulin, you don't really want to use since they don't work well in cats because cats have a much faster metabolism than those insulins are suited for (they work better in dogs).

Usually, the starting dose for most cats is around 1u (depending on size) because it's always easier to increase the dose as needed if numbers still remain high than it is to chase lower numbers and try figuring out how much to decrease by if you start on too high a dose.
 
Thank you for the information on the b/g. Talked to the vet today and they are going to put her on Prozinc. I have an appointment at 8am for them to show me how to inject her with the insulin and receive all the instructions about how much, etc.
 
Please be cautious in starting if the vet wants you to use more than 1 unit twice a day (BID).

Regardless of dose, be prepared for possible hypoglycemia (too low glucose) by having on hand high carb gravied food, oral syringe, Karo syrup, and directions to nearest 24 hour emergency vet.

Read over and print this post on managing hypos
 
Thank you! I printed this out and will hang on my refrigerator for reference. I'm not sure what the dosing will be, but I will make sure not to give more than 1 unit twice a day.

I'm nervous about starting her on insulin especially since I work full time, so I plan to get up at 530am to give her the shot so that I can test her again before I leave home at 830am. My poor kitty will probably be pricked way too many times in the next few days due to her nervous owner making sure she isn't going too low.
 
Marbles is officially starting on ProZinc 1 unit 2x's a day. I plan to give her the first shot around 6pm tonight as I think 6am/6pm will be the best shot times for me.

Also, the vet will let me use the human glucometer for spot checking and pre-shot testing, but said she will only let me use the AlphaTrak for b/g curve or Marbles has to go into the vet for that test (which is $200). So, I'm going to buy an AlphaTrak to only use for b/g curves that the vet wants to have. I think that is kind of ridiculous but she doesn't trust the human glucometer yet - I'm hoping to convert her in time.
 
but said she will only let me use the AlphaTrak for b/g curve or Marbles has to go into the vet for that test (which is $200).
Click to expand...

Just a quick note since I'm at work. I would personally tell your vet that unless she is going to pay for the AT and test strips, you will be using the human meter. ;-) Yes - human meters read differently than pet meters, but we factor that difference in when we are looking at the numbers. I've seen many, many cats go into remission in my brief time on the board, and almost all of them were being tested with human meters.

Sorry to be so grouchy about the vet. I'm just tired of vets who won't work with their clients and cause them to needlessly waste their money, especially since the majority of people on this board - who live and breathe feline diabetes every day - use human meters without a problem. :YMSIGH:

Shelly
 
Please see my signature link Glucometer Notes. Maybe print it out for your vet to share.
 
BJM said:
Please see my signature link Glucometer Notes. Maybe print it out for your vet to share.
Click to expand...

I did print this out for her. I brought my Relion into the office and it read 345 compared to her AlphaTrak that read 367. She said that according to the notes in that document Anything 280+ should read 400+ on her AlphaTrak so that made her say that she wasn't sure about using the human meter. At this point, it will be cheaper for me to buy an AlphaTrak for any curves the vet wants versus taking her in for a curve in the office which was quoted at $200.

I still plan to use my Relion for anything other than vet requested information on her. I am so overwhelmed and I am hoping the vet will come around eventually to the human glucometer testing after seeing how well it works. I'm almost tempted to just use the human glucometer for my curves and increase the numbers slightly so they "appear" to be AlphaTrak for the vet.

Any other suggestions on how to get my vet to agree?
 
Shelly & Jersey said:
Sorry to be so grouchy about the vet. I'm just tired of vets who won't work with their clients and cause them to needlessly waste their money, especially since the majority of people on this board - who live and breathe feline diabetes every day - use human meters without a problem. :YMSIGH:

Shelly
Click to expand...

I completely agree, but I'm afraid to get grouchy with the vet because I am so worried she will just say that she won't treat Marbles. Maybe I need to grow a little back bone. I tried to push back on her but didn't flat out say no.
 
JennyBankers said:
I think that is kind of ridiculous but she doesn't trust the human glucometer yet - I'm hoping to convert her in time.
Click to expand...
They didn't even have pet meters until just a few years ago so everyone (including vets) used human meters. So, for her to say she doesn't trust them "yet" is absurd and ill-informed.

JennyBankers said:
I'm almost tempted to just use the human glucometer for my curves and increase the numbers slightly so they "appear" to be AlphaTrak for the vet.
Click to expand...

Yeah, that is probably what I would do. :lol: It's similar to turning down (or returning) the prescription foods and telling the vet that their over-priced junk is just not appealing to the kitties instead of telling them the truth. :roll:
 
[Grump]

Put your foot down and say that it just isn't in your budget and she'll have to get used to human glucometer readings. You're the customer and its your cat.

[/Grump]
 
My vet is driving me crazy. She called today to check on my cat and kept telling me that my human glucometer readings are not accurate and the AlphaTrak will give her precise numbers! I told her I don't have the budget for the AlphaTrak right now and she said that I would have to bring in my cat for a b/g curve. If I don't have the $80 for an AlphaTrak, does she think I have the $200 for a b/g curve in her office? Has anyone had a vet just harp on them about the AlphaTrak, and you were able to convince them to use the human glucometer? Also, I'm wondering if I can find a vet that advocates the use of a human glucometer and have them talk to each other?

I'm pretty frustrated with vets in general because they are so expensive, and I feel like I've received better advice about insulin, needles, dosage, and testing from this forum than anything else but I need a vet in order to get the insulin.
 
You're the customer; you have the right to go elsewhere.

Pet and human glucometers sold in the USA both have the +/- 20% allowable range around what a lab would get. She can check it out at the FDA.
 
Hi Jenny,

Sorry to hear that you are having a hard time with your vet. My vet supported at home testing, but not to the extent that I have and I am so glad I followed what I learned here. Jack is in remission.

I have both the AlphaTrak and the ReliOn Confirm.

Jack was my first to be diagnosed and I not knowing what, where, when or how to do anything, I just went with the AlphaTrak. After finding FDMB, I got educated in the ways of Diabetes.

I had tested Samantha with Jacks meter prior to her DX and knew she was diabetic as well. I realized the AlphaTrak was going to cost a lot more than the ReliOn but that really had nothing to do with it. I wanted to use a meter whereby the people here have more experience with and having a backup meter I thought, was a good idea. I still have purchased AlphaTrak Strips for Jack.

I have kept each patients numbers on their own meter. I have snuck a reading or 2 with each, on the others meter, just to confirm what I have seen here and I am comfortable with results.

At the low end, I did a test and found that the AlphaTrak read 136, the ReliOn 88. Based upon the information that BJM provided it was spot on. 136 X .65 =88.4. Close enough for me. BJM did say that one test does not confirm everything and I understand and agree but in this instance it was valid in my book.

I also realize that based upon BJM's information, the 280 ReliOn should read 430 on the AlphaTrak, that is where this gets a little hairy and for that I have no answer.

What I have read here and believe is, that whatever meter you use, the important information are the readings over time and their relation to each other. Have they gone up, gone down or stayed the same. This is important when giving insulin. I think that the 50 -130 Human Meter and the 76 - 180 for AlphaTrak are your targets. They are mine.

My suggestion, Use the ReliOn, do your own curve with unabashed numbers. I have put my faith in the people here that they know what they are talking about and that they will be the ones to help you through. They have been there for me and I have no doubt they (and myself) will be there for you.

All the best,
Kevin
 
Kevin - thank you so much for the kind words and encouragement. I've had a difficult day with Marbles and sometimes question if I'm making the right decision to try treating her. She wouldn't eat at all for me today until I got home at 530pm (she was hiding from me for the first time since I started testing her) and she was reading 73 at that point because she didn't eat. She ate about 2/3 can and is now up to 195 (and acting normal again), but I think I'm going to hold off on any insulin until tomorrow morning. This board and the people on it are so much more knowledgeable than the vet. I'm surprised more cats don't die of hypo with all the people out there shooting blindly. I can't imagine the results if I would have shot blindly tonight with her reading at 73.

It's nice to know that someone with the AlphaTrak has tested out the .65 theory. My threshold is also 50-130 (although since I'm a beginner I would be worried about shooting under 200 right now). I'm trying to figure out a dosage that works for her but it's hard to do with her not eating today - kind of threw everything off. I guess I'm starting "fresh" tomorrow with her dosage and I'm going to start low with .20 (I got the U 100 needles today and printed out the conversion chart). I'm too worried to do anything higher with her refusing to eat today.
 
Thebudster77 said:
....
At the low end, I did a test and found that the AlphaTrak read 136, the ReliOn 88. Based upon the information that BJM provided it was spot on. 136 X .65 =88.4. Close enough for me. BJM did say that one test does not confirm everything and I understand and agree but in this instance it was valid in my book.

I also realize that based upon BJM's information, the 280 ReliOn should read 430 on the AlphaTrak, that is where this gets a little hairy and for that I have no answer. ...
Click to expand...

Not a "should read", a "could read".
1) All meters can read within +/- 20%.
2) The human meter estimate is 0.6 to 0.7 times the pet meter value; the human meter/0.6 or 0.7 estimates the pet meter.

Thus, that 280 is likely somewhere between 224 to 336. (The +/- 20%)
A midpoint estimate of the AlphaTrak could be between 400 to 467
The lowest possible estimate: 224/.7 = 324
The highest possible estimate: 336/.6 = 560
 
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