BG 190

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terri1962

terri1962

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Lilly is at 190 so I guess she will be going back on the insulin this evening. I guess I will start her back at 1 unit tonight and back to 1 in the morning?
Need help please
Terri
 
No she did not get into anything with carbs in it, they have nothing but FF classic out ever. Maybe I should have listened to the vet?
What will happen if I give her the shot after three days with no insulin? She has been eating all day long she is a grazer she does not eat at any specific time.
 
Before going back on insulin, take another test and see where she is at. You don't want to base a decision on just one number. Yes, this number is above "normal", but it could be a result of almost anything and she may bring herself down on her own and won't need insulin.

Get in a few more tests and then let's see. you can always start insulin again if needed.
 
All it means is you start over. Nothing bad will happen to her if you have to start over.

I personally would feed and wait and check again in 3 hours. Past that I don't know what to tell you, someone else will come along with more experience than me.

She's on lantus right? I'd recommend going over to the lantus board viewforum.php?f=9 and asking them there. Make sure you tell them what her BG has been when you checked her the last 3 days and see what they recommend.
 
How long ago did she eat? Her blood sugar will go up if she ate not that long ago. That's why I was told if Raja's number was high, feed and wait 3 hours and check her again.
 
She just ate a bit. If I go over to the Lantus board they are going to ask me about curves and such which I am not able to do on her she is difficult to test to begin with let alone to test her multiple six times a day, its not going to happen. Its all I can to to test her twice a day and give her a shot.
 
Her blood sugar went up because she ate. If you can't test her again in 3 hours then I would wait until tomorrow and test her in the morning. I wouldn't give her insulin tonight. What I would be afraid of is that her blood sugar is high because she ate and would naturally go down on it's own, if you give her insulin there is a good chance her blood sugar will go down too low and you'll be in the same position you were in a few days ago when her numbers got too low
 
Thank You Heather, I am not going to give her a shot tonight, she is in there eating again. I am going to have to find a new vet that can better explain this to me and give some help.
I am so frustrated. I will check again in the morning, I may try to check her again later if she will be cooperative. Thats why I could not believe you poked Raja`s paw. Lilly would probably tear me up if I tried that.
I will remove 911
Terri
 
It is confusing and I remember questions and doubting every thing in the beginning with Raja but as time goes on you get better at it and it's not quite as scary

Keep in mind you want to wait 3 hours after she last ate before testing her, otherwise you'll get an inflated number

Raja fought be bad in the beginning. I had more scratches than I could count but eventually she settled down and I bet Lilly will eventually. Just keep giving her treats after you test her blood and she will learn to tolerate it much better because she knows she gets a treat afterwards.
 
agree with everything Heather and Hillary have said. :-)

something else to consider is that most of our cats were diagnosed with numbers in the 300's, 400's and higher. a higher number for a little while won't do as much damage as fast as a low number will. just keep doing what you are doing and asking for input. no one here will steer you wrong believe me.

one little bit specifically i will address is the dose. if, and that's a capital IF, she does need insulin again, you can shoot less than 1 unit and given that her pancreas is clearly trying to get going again, it would be safer in my own opinion to do less than 1 unit. there are syringes with half unit markings or you can eyeball halfway between 0 and 1 unit to do 1/2 a unit for instance if the need arises.

once insulin's in a kitty, you can't take it back out so you always always want to make sure you are not shooting too much.
 
My cat never had numbers higher than 300`s they were not even sure she was really diabetic or if something else was going on is what they told me. She had pancreatitis about three years ago and was very sick. She has never been in the 400 or 500 range. So I guess there could be something else going on. She has been on insulin for baout a month and half maybe, lantus.
She hides all the time, now in my bedroom, something she never did before, So I don`t know maybe she feels really bad, may be its time to let her go. I think she is miserable.She rarely comes out of the bedroom except to go the litterbox.

Terri
 
If you decide to do insulin tomorrow, I would not go over 1/2 unit. She has gone pretty low on 1 unit and stayed there for more than 24 hours - I don't think it is safe to do 1 unit.
 
Dear Ms. Terri,
Please dont get frustrated! It will get easier and she may not take to pokie poke as fast as others, but just be nice to yourself. Everyone here is also here for you too. I myself, got out the pokie poke basket for my Sugar Bean last nite. When I looked on the meter, it has been since 8/30 when I tested last! eeeeeks - bad mommy. WE tried to do pokie poke and Bean was not having it. We are out of practice. I tried 2 times and did not get blood, she was not happy either. I do have the advantage of her being in remission, so I just took out the lancet and we practiced AGAIN, like in the beginning, without the lancet and just holding the pen to her ear, clicking it and giving love, treats and praise. After about 4 times, she actually settled back down and we did the process about 7 more times (without the lancet). Mommy should not have waited so long between pokie times. I will try again tonite with the lancet and see if she will act better and I can get a reading of her numbers.

She is also acting out a bit. We have a new member (since 7/19) to our furry family and I am not for sure if that is it or not, but she is hissing more and going to the back room or just avoiding the rest of us????? Dont know why either. GGGRRRR.

Hang in there, I promise this does get easier!! PAW HUGS YOUR WAY
 
She is at 155 this morning. So I ma not sure what to do at this point. Last night we were at 190.

Terri
 
terri1962 said:
She is at 155 this morning. So I ma not sure what to do at this point. Last night we were at 190.
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155 is fine, if jsut slightly over normal :smile: I would not give any insulin this morning. Can you do a few bg tests today?

It doesn't seem like your cat is truly diabetic, maybe just barely borderline. In your first FDMB post http://felinediabetes.com/FDMB/viewtopic.php?f=28&t=45474 you said "I took my Siamese mix to the vet, noticed she was losing weight and her coat seemed unkempt. They did urine test and blood test on her. Oh also Fructosamine level test. None of the levels were high enough to determine that she is quite yet a diabetic cat and in a reply "Her blood sugar was almost 300 and she had sugar in her urine". Do you remember if the 300 bg level was from a simple blood glucose test? If so, then you have to factor in stress for that number. Some cats get so stressed out at the vet's office that their blood glucose levels just skyrocket which can lead to a false diabetes conclusion. If the initial fructosamine was normal, then it's unlikely that your cat is diabetic. The fructosamine give an anverage of the what the blood glucose levels have been for the past few weeks. Was your cat at the time of the vet visit showing classic signs of diabetes such as flooding the litter box with sticky sugary smelling urine, eating tons of food but losing weight at the same time? Weight loss and unkempt fur can indicate other health issues besides diabetes.

If your cat is hiding and not acting like herself, there could be other things going on. I suggest a vet visit, maybe with a different vet to get a fresh set of eyes and opinion. Some cats will hide if they don't need insulin. Strange but it's true :smile:

Just my thoughts :smile:
 
seems to me her little system is trying to do this on its own! gooood girl. I am sure more exper. folks will chime in shortley. I still say no shot
 
I agree about a second opinion from a different vet. I have a feeling that diabetes might not be the main problem, especially since she's hiding and not acting like herself when her blood sugar isn't super high. Perhaps she has a dental issue (Siamese cats are prone to tooth resorption) or possibly a respiratory infection? I thought I recalled you mentioning she was coughing and wheezing a few days ago.
 
Just took her to a different vet and had x rays done, blood tests, urinalysis, fructosamine which I will find out tomorrow. X rays looked good listened to her heart and did not hear any murmurs. Only thing is this vet said she does not have any diabetic cats right now as patients so she had to call my old vet to get information form her. WTH? So now the old vet is probably pissed at me. When I talked to the receptionist/vet tech she let on liked they knew all about diabetic cats and so on. I actually went in there before I made the appoinment.
They did ask me what I was feeding her and wanted her on FF or something similiar, no dry which suprised me. So I am supposed to try and do a curve on her Sunday. We will see how that goes.
While she was at the vets office she threw up and pooped on the table. She has never done that before. Oh and they used a human glucometer and it was 40 points off from mine. Should I start new test strips?

Terri
 
I wouln't care what the old vet thinks about you. The vet I fired cussed at me, called me a bi*** and I gave it right back to him. I'm sure he hates me and I couldn't care less, don't worry about the old vet. Yall were not a good fit, plain and simple.

If you get a chance read my post I started about 2 different meters, same drop of blood 2 different numbers. Basically there is a margin of error with all monitors so the key is to be consistent with the one you use, meaning don't use meter A today and meter B tomorrow. Stick with 1.

Did you bring your meter to the new vet and use the same drop of blood? If not you'll get different numbers just like a human would. If you were to check your blood right now on your meter and then check it again 10 min later with a different drop of blood on a different meter you wouldn't get the same results. It's the same with our kittys and nothing to be too worried about and I wouldn't go out and buy new test strips until you run out

That's good news that the new vet said no dry! That's a step in the right direction, and it's good the xrays look normal. Hopefully the other tests come back normal too

What was her BG at the vet? Keep in mind if kitty is nervous or scared their BG is higher. What did they say when you told them her BG numbers for the last few days?
 
We did use the same drop of blood for both of the meters at the vet. My old vet practice has 3 vets, 2 of them are husband and wife and they just bought the place not so long ago. The third vet is the one I had been using for 8 years for my cats I like and respect her. Anyhow when these people bought the place they cut her hour from full time 5 days a week down to 2 days a week. I do not think the husband and wife vets know what the hell they are doing and they are the ones who staff the place the majority of the time.
Had my old vet been able to stay on full time I would never had a problem.
Lilly`s BG was 241 at the vet today on my meter. It was 197 on theirs and they used a human meter as well. Like I said she was VERY upset though. Pooped and threw up.
 
Did they tell you to start her back on insulin and how much?

Have you checked her BG since then? What is it?

If you like your original vet I'd just make sure to schedule Lilly (and all of your kittys) visits when your original vet can see them

I got two way off numbers every time I checked Raja's when I tried two meters, I just decided to stick with the relion meter and forget the other one.
 
They did not want me to start he back on insulin until I can try to do a curve on Sunday. The vet said to do the curve start checking her at 8 in the morning and check every two hours seven times up until 8 that evening is that right? I have never done a curve. That would be seven times of checking BG.
I tried using my regular vet just when she was the two days a week. That did not work because she would say oh if I am not here the other vets can take care of you or will call you or what ever and then I would end up hearing from the vet tech. It just got messed up. I guess because the now that they own the place she maybe had to respect them and seem like she was keeping them in the loop.
The vets that own the place are nice enough people but I don`t think they know a thing about cats.
 
Reminder: pick up the neosporin ointment with pain relief to put on her ear. It may help.

Vet stress often raises the glucose 100 points.
241 -> could normally be about 141 at home
197 -> could normally be about 97 at home

Also remember the + or - 20% range the FDA allows in meter readings
241 could be between 192.8 to 289.2
197 could be between 157.5 to 236.4
Notice how the low end of the top range (192.8) is below the high end of the bottom range (236.4) ie, they overlap, so essentially, they were the 'same' reading.
 
Honestly, if you can't get a curve in, just try to get a preshot test and one or two inbetween and then another preshot test in the evening. Whatever you get is what you get ok?

Jen
 
She needs to be put back on her insulin, she has not had a shot since Sunday. I took her off it and I should not of. I should have listened to the vet but was freaking out because her numbers were so low. Now they are starting to creep up again, she was at 193 this morning and 155 last night. I guess I am thinking in terms of human diabetes and should not be.
So now I guess we will have start over with the insulin.
I have to do the curve or try to so I can email it to the vet.

Terri
 
When you restart, because of how she responded to 1 unit, I would not go any higher than 0.5 (1/2) unit. and if you think you can measure it consistently, make it a skinny half unit by lining up the plunger to the bottom of the line (nearest the needle) and not the top of the line where you'd normally measure.
 
I took Squeak off of insulin a bit premature, he relapsed a little bit, we started up, started hometesting (we hadn't been) and we never looked back. he didn't need it for long, just a little longer than what he'd gotten. Have some faith :)
 
terri1962 said:
She needs to be put back on her insulin, she has not had a shot since Sunday. I took her off it and I should not of. I should have listened to the vet but was freaking out because her numbers were so low. Now they are starting to creep up again, she was at 193 this morning and 155 last night. I guess I am thinking in terms of human diabetes and should not be.
So now I guess we will have start over with the insulin.
I have to do the curve or try to so I can email it to the vet.

Terri
Click to expand...

Hi Terry,
Hey, listen, you need to stop blaming yourself, okay? You didn't mess up by not shooting. Also, here you say that maybe you should have listened to the vet, but a couple posts earlier, you say that you don't think they know anything about cats.
Please remember, she is your kitty. If you think she needs insulin at 193, and you feel confident in giving her some, it is your decision (no matter what your vets or anyone else thinks). Just because they tell you NOT to give her any until you do a curve doesn't mean you can't do it. I might advise you not to shoot if she's under 120, but that's only my opinion. Other people here shoot insulin under 100.
All you can do is ask for advice, read what people have to say, and then you have to decide what's right for you and for Lilly.

Here's something you said early in this thread, when someone suggested you go to the lantus forum and post there:

She just ate a bit. If I go over to the Lantus board they are going to ask me about curves and such which I am not able to do on her she is difficult to test to begin with let alone to test her multiple six times a day, its not going to happen. Its all I can to to test her twice a day and give her a shot.
Click to expand...

Terri, if you can't do a curve, for whatever reason (time and schedule won't allow it, kitty won't cooperate, etc.) then that's just reality. There are a lot of people there who are really experts with Lantus. I know that sometimes, they can be insistent about testing and curves and stuff, but I also know that you aren't the only person using Lantus who has trouble with the testing schedules. You just make do, and do what you can. I know for sure that there are people over in Lantus who understand that and will help you. Everybody just wants what is best for our sugarcats. They want what's best for Lilly, and they'll help you no matter what you can and can't do in terms of testing.

I'm pretty sure that they would advise that if you do start Lilly back on insulin after this weekend, that you start her back on a low dose. Please, if you do a curve, and send the data to your vet, and your vet comes back and says "you should start her back on 2 units BID", please ask for lantus advise before doing that. I would hate to have you start back, using too much insulin, and make the situation even more difficult for you and for Lilly.

You'll both get through this Terri. Even if she needs a little more insulin. But please don't beat yourself up about it. We all know you want to do what is best for her, and we're all with you on that.

If you do a curve, it would be a total of 7 tests from 8 am till 8 pm, every two hours. But if you can only do it every 3 hours, or 4, then that's all you can do. Whatever you get done will help in trying to figure out exactly how she is doing.

Carl
 
Jen,
I'm guessing they want the curve to determine her "new" dose. But waiting make the odds better that the numbers will be higher, which is why I am concerned they will recommend a dose that is higher.

Carl
 
Yeah, but curves without insulin aren't curves...there will be some changes in bg due to food, etc. but it won't be a curve. Curving to determine a dose without insulin makes no sense.
 
The most you would see is a rise from food, maybe some evidence that the pancreas is pushing it down, and then a flatness when the food wears off? I don't know what the logic is either.
But I would think her numbers will continue to creep up until something pushes them down.

Carl
 
She is still not on insulin. I did not check her this morning. I did check her last night and she was at 193. This was a different vet that told me to do a curve on her.
So I should start her back on insulin before I do a curve? Maybe I need to make an appoinment with the old vet and go in and sit down with her and see what I should do. I will test her tonight and see where we are.
So what is the point of doing the curve is that what I am understanding if she is not on insulin? I am not going to put her through that for no reason.

Terri
 
Terri
Yes that was the point. If she is not on insulin, then the curve wouldn't really be useful. A curve shows you how the bg goes up from food, and down from insulin. With no insulin, there's nothing pushing the bg down. Not unless her pancreas produces insulin on its own to push it down. The only value in a curve would be to see how or if her pancreas is doing that.
That MIGHT be what the new vet is trying to find out. I would call the new vet and ask them to explain the point of a curve with no insulin.
Carl
 
I swear to god, this is why I am so frustrated. This was a new vet I tried. She told me she did not have any diabetic cats as patients. I should have known better.
Well I am not putting her through that for no reason. They did a fructosamine test that the vet insisted on that cost 75.00 and I have been keeping her morning and night BG since last Sunday. The new vet can email all the stuff to old vet I used so I don`t have to pay another 300.00
WTH, why do vets not know a thing about feline diabetes? It seems fairly commom.
 
Ithink it seems common to us because,well,we're here! Before Bob was dxd, I had never heard of it. My vet gets about three new cases a year. I don't know anyone beyond this board who has or ever had a sugarcat.
I agree, I wish all vets knew more about it.
Carl
 
I would give the new vet another try.

Let's look at what you've said about the new vet and the old vet

Old vet: You said they don't want you to home test. You also said when you called them to tell them Lilly's BG was in the normal range they told you to give her 1 unit anyway. Two very dangerous things in my eyes, two things that could end up either killing Lilly or causing her to go into hypo and possibly requiring a vet visit and overnight care and more expensive tests and bills

New Vet: Wants you to home test and then told you to do a curve on Sunday before giving her insulin. Ok, I'll even admit I was wrong about the curve without insulin but in my eyes something minor, something forgivable because even if you had done what the new vet said there is no real harm to Lilly. She couldn't get sick from testing her on Sunday.

Vets are similar to human doctors in that they don't always know everything. Most vets don't get any real training when it comes to diabetic cats in school, they learn in the real world and you've got an opportunity here to teach the new vet.

The vet I see now is the vet I used to take Raja to as a kitten but then I moved away for 10 yrs and recently moved back to the area. Instead of driving an hour to an hour and a half to the great vet I found and helped me treat her diabetes I decided to give our original vet a try. My best friend's cat was diabetic and they diagnosed and treated him. They did not tell her about home testing and they had her cat on a prescription wet food. I knew all of this but still decided to give them a chance. I emailed the vet and explained that Raja's BG was elevated several times when I checked her (and gave them the numbers), plus they had her records from the emergency vet that also showed that. I explained that I thought she needed insulin again and that I wanted to use lantus because that's what I had used in the past with her. The vet herself called me back and agreed Raja needed insulin again. She stated she had never used lantus before and she read up on it and it told her to start her Raja on 2 units twice a day but that she didn't feel comfortable starting Raja that high and wanted to start her on 1 unit. I agreed with her on that. She then said she wanted me to bring her in for testing every few days and I told her that I home test and that Raja hates car rides and if I did bring her in her BG would be artificially elevated and wouldn't do us any good. She said ok but then stated she wanted me to bring her back in 3-4 weeks for a fructosomine test. I agreed then simply because I hadn't read up on the test and after reading up on it and seeing other comments and asking on here I decided it was a waste of money because I am home testing, because if the vet wants to see Raja's overall BG I could print off the SS and show her. And in fact I did just that, after about a week of testing Raja and giving her insulin and making sure her SS was up to date I emailed the vet and gave them a link to the ss. The vet was very impressed and in fact said that and told me to keep it up.

I gave her a chance and I think it's working, and I think Raja's case and the fact that she just might be OTJ will make her think twice the next time she gets a diabetic cat in her office and she may change how she treats them. You have that opportunity with your new vet. You have the chance to teach them and they seem receptive, in my eyes they seem much more competent that your old vet.

You also never have to have a test done, the frutosomine test they insisted on you could have said no. You don't ever have to agree to a test. I would imagine though that the test was not done in vain because you admitted that you didn't check Lilly very often before she had the hypo incident a little while ago. If you don't have the numbers then a test like that gives them the average BG over a few weeks. I would say now that you've got the testing down, even though Lilly doesn't like it and it's still hard at times, that as long as you are consistent then you won't need the frutosimine test again. I'd highly suggest you set up an online SS though because it's keeps everything together, makes it easier for us here to help you and also you could do what I did and email the link to the vet so that she can keep an eye on Lilly's progress.

What did the other tests say they ran?

Also keep in mind that if Lilly's BG is high it very well could be because she ate before you tested. If you get a high BG then I'd take the food up for 3 hours so she can't get back into it and then test her again to see what her BG is. Raja grazes all day and there have been a couple of times I've gotten a high number and when that happens I take the food away and after 3 hours test her and put the food back down.
 
Terri, As far as the new vet is concerned I think I can understand why she wanted additional data with no insulin on Sunday.

When you were at the new vets the first time her blood sugar was 197 and kitty was extremely upset at being there
( pooping on table, etc) .

Check out BJM's post above about the vet's 197 BG number possibly meaning a much lower number (as low as 97). Had she said give insulin and based the dose on a 197 BG on a very upset cat while in the office I believe she would have been criticized here for that. Perhaps a full curve would not have been necessary but 3 times or so done in your own home seems reasonable.

I know you want a vet to guide you and I can understand that but the questions prior to finding a new vet would not be how many diabetic cats they treat but do they know about TIght Regulation and the studies by Rand ,German group. and Hodgkins. Then the info you are getting from them would jive with what you are getting here on this site.

Your new vet said wet food while mine sold me DM Dry. My vet doesn't have any clients home testing that I know of. My vet was very surprised I wanted to hometest and probably thought I wanted to save money which didn't even enter into the equation. Your new vet encouraged you to home test. Mine prescribed Humulin N -- I had to ask for different insulins.

Check out this link that I posted on another thread :
http://partnersah.vet.cornell.edu/Carin ... /Treatment

Videos explain conventional type treatment information that many vets go by . It is not that they don't know about diabetes but they are coming from a whole different perspective where clients don't test and vets want to avoid hypos which could occur if shooting blind. Their old studies in school haven't caught up with some of the research advocating wet low carb food and home testing that have a goal of remission if possible.

I really don't see my vet about diabetes info now --to be honest I don't really care that he isn't up on TIght Regulation Protocol treatments (wish he were but he's not). I don't ask him questions about BG numbers and what to dose as 'normal' or regulated to many vets for a diabetic cat is 100 to 300. He's there for other problems and emergencies As Heather pointed out --he will probably learn alot from my cat and what I am doing . Lets hope it works out well as it could influence what he does with other patients. This could be true with your new vet as well.

Now you could say it sure would be easy to forget hometesting and just go with 2 shots based on testing done at infrequent vet visits. But to me with your cat's numbers remission would be my goal. May not be possible but worth the extra time, money, effort to try. Are you following one of stickies on the Lantus board about dosing? Follow one of those and hoepfully your cat could go into remssion like Heathers.

Good luck. Elaine
 
Hi, Terri - Didn't see your post, because I spend so much time in the Lantus group.

The fructosamine may come in handy as a benchmark in coming weeks.

So sorry for your frustration -- which I have shared. I did find a young woman vet at one point. Recent grad, so she didn't have much feline diabetes experience, but she was really open to learning, to reading the Queensland protocol, and to working WITH me.

But I'm with Elaine. I ended up using the vet for general health issues more than diabetes guidance.

Kathy
 
I think your new vet sounds miles ahead of other vets even if they don't have any current diabetic patients.
1) they are having you do a home curve, instead of insisting on doing it themselves
2) they want you feeding fancy feast, no hard food
3) they not only understand a human meter is fine, they use one themselves and compared meters to yours to understand your readings to their meter

Those 3 things are usually HUGE fights with vets who want to stay steeped in old school practices. It tells me that even if they aren't treating a diabetic right now they are researching and learning and staying current in the industry practice of treating the disease.

The start of treating and testing at home can be very frustrating. My first test I almost passed out and there was blood all over my kitchen cupboards. It took 2-3 weeks of Smokey hiding under the bed and me laying beside it crying before she got used to the testing. After that she would run to her testing spot purring and still rubs her check against the lancet device and her motor just revs when we get out the testing supplies. Take a deep breath. One thing my husband kept pointing out to me is that if I go into the testing stressed and worried, she'd sense that and would react. Make sure to make the testing time snuggling and loving time, with a little poke and treat added in.
 
She is now at 209 tonight and need to go back on the insulin. I have no idea how to dose her nor do I want to try. I am not comfortable with that right yet.
I will have to at least try to make an appointment and talk to the vet about getting her back on the insulin. I am sick and may end up in the ER myself either tonight or in the morning but I need to get her taken care of soon.

Terri
 
Terri, I know you have so much going on. Sending good thoughts that YOU will feel better. Must have healthy humans to get the kitties healthy!

When you're ready to start her on insulin again, just start low, be consistent and test. From there, the Queensland protocol (and this FDMB community) will help you.

Feel better!
 
Terri I hope you're feeling better today :YMHUG: It's hard enough to deal with a sick cat but when you're sick too it just makes it harder.

I would personally start her at half a unit and see how she does, and you don't need to make an appointment to go in. If you feel more comfortable getting advice from the vet about how much insulin to give then you can do it over the phone and hopefully save you a vet visit.
 
Went in today to the doctor, I feel like I have been pounded around the rib area from coughing so much. I have bronchitis. Steroids and antibiotics. Hopefully soon enough I can get Lilly taken care of.

Terri
 
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