BG numbers question

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PattiMcG17

Member Since 2016
So I tested my kitty's BG last night and it was 158. I didn't give any insulin. This morning it was 220. I didn't give insulin again. I don't think insulin works on her anyway.

My question: are those two numbers too high to not use insulin if it actually did work?

Thank you!!
 
Hi :) It's April from the Facebook group. :)

Whether or not you can give a shot at lower numbers really depends on the insulin you're using and how much data you have on your cat. When a cat is newly diagnosed, generally the "no-shot" limit is 200 because there's no way of knowing how your cat will react to shooting a lower number at that point. Depending on the insulin you're using, that number can be reduced over time as you get more comfortable with knowing your cat's response to insulin.

So, the 158 was definitely too low for a shot with a newly diagnosed cat. The 220 is high enough for a shot, with monitoring to see the effect the shot has on her. I know I spoke to you yesterday about food over on the Facebook page, but I can't quite remember all the details - did you say you're using Vetsulin at the moment? That does make a difference to how the "no-shot" number moves over time.
 
Vetsulin doesn't give the best results in all cats - in all honesty there isn't one single insulin that gives guaranteed good results in all cats...the best insulin is the one that works for your individual cat. So it is possible that she doesn't have the best possible response to Vetsulin. However, it's early days yet and I would give it a chance over a few more cycles before you start thinking about switching to one of the insulins that is generally thought to last longer in a cat. And remember, with a newly diagnosed kitty, these things take time - she didn't get to be diabetic overnight and it would be impossible to get her numbers consistently into the healthy range overnight while keeping her safe. This is a process rather than an instant fix. If you take a look at Rosa's SS in my signature, you can see that it took a few weeks to get her into anything even close to good numbers consistently - we were using Lantus, but no matter what insulin you use there is still the issue of keeping kitty safe while you get them back into that healthy number range. You're in the best place to find all the advice you could ever need to get your girl into those good numbers and feeling well, but we also have to remember to have patience with the process, frustrating though it can be at times.
 
It can do, depending on the cat. But if she's consistently staying above normal range, then it's probably time to look at either increasing the dose a little or changing to a different insulin. Have you been home-testing her from the start? And do you know what the lowest number she's reached has been on the dose she's currently on? Sorry, a lot of questions I know, but the response to insulin is so individual that the more information we have, the easier it is to help you.
 
Is it true that it's ok for a cat with diabetes to have higher glucose numbers than a non diabetic cat? Meaning, the range is higher for a diabetic cat?
 
Snickers was on Vetsulin for about 4 months before I finally switched her because I didn't like the vetsulin. Now she is on Lantus and has times where it's working great and then times where her numbers aren't so great.
 
The aim for a diabetic cat is the same as for a non-diabetic - to keep them in the normal BG range for a cat. However, when you're giving insulin, you keep a small safety margin at the lower end of the number range...the range for a non-diabetic is around 40-120 on a human meter. But when you're giving insulin, you take action if she goes under 50 on a human meter (68 on an Alphatrak) to prevent a hypo. Many vets will tell you that having a cat run at 250 or less is acceptable, but especially with the CKD going on as well, that number is too high for every day as, long-term, it puts extra stress on her kidneys which of course isn't a good thing.
 
OK, so to give you some more information about how to figure out whether or not Vetsulin is working for you, you'd really need to do a curve on her to figure out whether the numbers are being reduced at all at any point during a Vetsulin cycle. I don't know what your schedule is usually like so I don't know how possible this would be for you to do, but a curve involves testing every 2 hours for one 12 hour cycle - so you'd get a pre-shot test, give the insulin, and then test every 2 hours up to and including her next shot time. That way you can see what, if any, effect the insulin has on her over the course of the full 12 hours.
 
And won't her BG drop automatically being that she eats twice a day? If she's eating consistently, her BG would stay up, no? So how would I tell?
 
Food does have an effect for sure. But then many, many things affect the way insulin works for a cat - every cycle will differ at least a little because insulin is a hormone rather than a drug. So the way a cat uses it can be affected by so many different factors that there's no way of predicting 100% how any cycle will go. What you will find is that, if the insulin is working for her at all, there will definitely be some movement downwards in her numbers at some point during the cycle though the amount she moves will vary day to day.
 
What we usually do here is take the food away 2 hours before a pre-shot test so that the number you shoot isn't influenced by food. Beyond that, you let her eat as she normally would. The reason for this being that you want to know that the insulin, plus her normal routine, is getting her into the numbers she needs to be in. Actually, with a diabetic, if they go without food too long that can also raise the numbers. And if a cat's pancreas is still working even a little bit, the right food can actually help to bring the numbers down a little.
 
I guess my question really is how will I know if the insulin is doing it's job as opposed to the fact that it's because she hadn't eaten in a few hours. Does that makes sense? I'm so sorry I sound so uneducated. I'm trying! Thanks for your patience and help!!!
 
It definitely does make sense. And the honest answer is that the only way of knowing that is ongoing experience with your cat. There really are very few hard and fast rules (and even if there were, a cat wouldn't follow anyone's rules). So we do the best we can, with as much data as we can gather, and over time we start to figure out our individual cat's response to insulin, food, stress, exercise etc. The longer you do this and the more data you have, the clearer the picture gets until you can mostly predict what's likely to happen in any given situation.
 
OK, so I've tested her blood glucose daily - but I've never done a glucose curve. I'll do that tomorrow. Now, the fact that I didn't give her insulin last night or this morning, how do I know what time to give her insulin tonight?
 
And one more question - the last time I had Maddie's blood done, back in December, her creatinine was 1.8, her BUN was 21, and her phosphorus was 3.2. That's stage 2 if I'm correct?
 
The good thing is that you already know how to test successfully - that makes it much easier to do a curve. :)

For tonight, you can pick a time that you know is likely to work for you most of the time. And, of course a time when you know you'll be able to shoot 12 hours later to do her curve tomorrow. The exact time matters less than finding times that work for your schedule.

If those are US numbers, I'm not sure she's beyond stage 1 yet. The creatinine is right at the top end of normal, but not above yet. The BUN is normal and the phosphorus is in the low end of the normal range. It's good news that you've caught it that early! :)

ETA: Found the staging information I was looking for. From the creatinine number, yes, she'd fall into early stage 2.
 
Our sugarcat, Joshi, is also on Vetsulin. It's definitely a good idea to forgo giving Maddie her shot when pre-shot numbers are below 200. Last night, Joshi tested at 172 - I reduced her dosage a bit, but her blood sugar still dropped to 72 PMPS+2. The fact that we've been testing helped catch what could have turned into something more serious. I'm so glad I found this board because I was prepared. :) Not the way I wanted to learn her limits, for sure! Which means I'll be doing another glucose curve this weekend.
 
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