Bibo's numbers are better! But they're going too low!

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Taline & Bibo

Taline & Bibo

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Good Morning my friends,

I got up early to check Bibo's bg and at +22 from the last shot, it was 220!!! I thought that was a good number. So I fed him his morning meal and gave him .25u. I decided to stay home one more day, to check on him and just to be here for him. His ears bleed a little after the shot, and he doesn't let me put a pressure on them after the poke, should I be concerned that he's loosing any blood?

I want to thank all our friends on FDMB forum, for guiding me through this. Good Day!
 
Re: Bibo's numbers are better!

Fantastic news, Taline. You are learning this stuff fast. He looks like he won't be on insulin for too long. :-D
 
Re: Bibo's numbers are better!

Great!
It is a good idea to gently squeeze where you poked -- very brief is better than none. I pet my diabetic kitties heads before, during and after pokies, and just kind of blend in the little squeeze with the pets, rubs, scritches
 
Re: Bibo's numbers are better!

Bibo's bg is 49 at +4. I think, eyeballing on U40 for a .25u is not working. What if it was a little more than I thought. I'm scared now that it will go even lower in the 6th hour. I'm feeding him!!!! Cananyone give me some advice please?
 
Re: Bibo's numbers are better!

Do you have some High carb food?

Feed some of that - preferably canned, then test in an hour.

Definitely time to get some U100 syringes so it will be easier to do tiny doses.
 
Re: Bibo's numbers are better!

I will today. Bibo's very sensitive to the tiniest dose of insulin, it seems like. Thank God, I didn't leave home today. This is so scary for me. I just opened another can of ff gravy good for him to eat.
 
Re: Bibo's numbers are better!

I'm wondering if it's time to start giving a fat zero.

With Misty(GA) she would go way too low and too long on PZI and Levemir. Her dose on Lev by the end was so tiny I bought reading glasses and filled the syringe just enough so the needle had insulin in it, but barely anything in the barrel.

Still wondering if there is an underlying infection causing the BGs to rise. What do you think about checking the teeth, urine and maybe bloodwork to rule out dental, urinary tract infection or other infection.

However, all that said, could be the diet change, once you switch away from higher carb foods, BGs come down naturally and Bibo could just be a cat who will be diet controlled and in remission quickly.
 
Re: Bibo's numbers are better!

I hope so Jen, but I switched his food almost a month ago to a wet food diet. Does it take that long to show the change in blood glucose? Perhaps yes. I wish my vet did some blood work on him last week when we were there. I don't know what to say about my vet, I always liked him, as I take all my family's 5 cats there, and he's good, but the fact that he wanted to start with 2u and then settled for 1u is still bothering me so much! He also never mentioned any infection idea. Bibo urinates fine, and never cries while urinating. Are there any signs of UTI for cats?
 
I think usually with UTI, you would see signs that it hurts to go

Teeth on the other hand could be bad without any warning signs that you would see unless you pry open their mouth and look (e.g. red gums, tartar on teeth)
 
Ditto what Phoebe said re: UTI and teeth.

Regarding food, I'm no expert, Bean went off insulin within 3 days of food change BUT.. she was a steroid induced FD and her steroids were also probably out of her system.

Mr. Darcy's food, I believe his food was changed 2-3 weeks prior to being transported up to me, however his previous care person was not hometesting him, he needed no insulin at all since arriving with me. No idea if he needed none before that.

Overall, how is Bibo? Drinking or peeing less? What was the reason that he was originally brought to the vet and dx with FD? I don't recall that. Was there excessive water intake and urine output, weight loss? Anything like that?
 
Re: Bibo's numbers are better!

Taline & Bibo said:
Are there any signs of UTI for cats?
Click to expand...

This may be so obvious it doesn't bear worth mentioning, but blood in urine can also be an indication of a UTI. Rufus once left us a bloody spot on a piece of paper during a UTI episode - it was probably caught by his "pantaloons" when he was in his litter box and it transferred onto the paper when he sat.

Is Bibo a long-haired cat? I was told that UTIs are more common in long-haired male cats than others, due to an inability to "clean up" back there as well as short-haired cats can.

(I wish I could help you with Bibo's Diabetic concerns, but I'm a newbie, too!)
 
Well, a month ago, I noticed Bibo was drinking and using the litter box a lot. He never lost any weight, nor never peed outside his litter box. So I read on line about the symptoms and since I had a glucose monitor, I learned how to poke his ear from YOUTUBE and checked his bg, which was 361. So I immediately called the vet and since he knew that Bibo was a difficult cat , he asked me to take him his urine sample and I did, and that evening, the vet called me saying that Bibo was indeed diabetic. I checked Bibo's mouth last night, didn't see any red areas but saw some tartar build up,(not much of it though). He had all kinds of blood work done 6 months ago, and he had anemia which we thought with blood transfusion got solved, and his gums and tongue are nice pink.
 
Re: Bibo's numbers are better!

Good catch Taline! He may be one of those kitties that likes to drop fast early in the cycle. What food are you feeding Bibo? I'm wondering if maybe a slightly higher carb food at shot time might work better for him...not much, just a little higher to cushion his drop? Along with a tiny dose of insulin, that might be the answer. He does seem to be super sensitive to insulin!

Another thought...it seems like his pancreas is working somewhat. Maybe when you get that next preshot, try no shot, feed and then test an hour later to see if the food triggers his pancreas to bring him down without insulin? Does anyone have any thoughts about either of those ideas?

Infection is always something to think about! My experience with URI with Tinkles was that his overall response to insulin was lowered with infection, he needed more insulin to get some response, and he never went low when fighting infection. That was just our experience, not saying there can't be an infection with low BG.
 
Re: Bibo's numbers are better!

Laurie and Mr Tinkles said:
Another thought...it seems like his pancreas is working somewhat. Maybe when you get that next preshot, try no shot, feed and then test an hour later to see if the food triggers his pancreas to bring him down without insulin? Does anyone have any thoughts about either of those ideas?
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I like that. I did this with Bean, I wanted to see if she could bring her numbers down herself and she did, but I think she was in the 150-160 range, I have to look at my spreadsheet.

Just be sure to be ready if Bibo does prove to need a shot. I do believe we have a working pancreas here, but I'd like to make sure numbers don't go high and stay high for too long causing other issues.
 
Usually before AMPS or PMPS, I don't feed him for 3 hours so I can get a better result. Laurie, what you said in your post "try no shot,feed and then test an hour later to see if the food triggers his pancreas to bring him down without insulin", is so new for me. I thought the food will increase the blood glucose and therefore the diabetic needs more insulin, but as I told you guys, I'm so new and absorbing more information everyday. I wish someone has an insight about that idea that Laurie thought of.
 
I'm trying so hard to get hold of him,to get another rreading but the minute he sees me, he runs and hides under the bed, which makes it impossible for me to catch him. He ate little more and looks active but I wanna get a little higher number from him. What a difficult boy he is!
 
Taline & Bibo said:
Usually before AMPS or PMPS, I don't feed him for 3 hours so I can get a better result. Laurie, what you said in your post "try no shot,feed and then test an hour later to see if the food triggers his pancreas to bring him down without insulin", is so new for me. I thought the food will increase the blood glucose and therefore the diabetic needs more insulin, but as I told you guys, I'm so new and absorbing more information everyday. I wish someone has an insight about that idea that Laurie thought of.
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I know it's confusing! In a non-diabetic cat, food triggers the pancreas to produce insulin. In a diabetic cat, the pancreas is not producing insulin. When a diabetic cat is treated with insulin, and the BG #s are kept down, the pancreas sometimes will heal, and will start to produce insulin again. That's what I suspect may be happening with Bibo. One way to see if that's the case is to feed him and see if his BG goes down without a shot. If it does, then you will know that his pancreas is producing insulin at least some of the time. His inconsistent response to the insulin doses makes me think that he is producing some insulin. If he is, you probably will still need to give very small amounts of insulin for some time because he isn't able to keep his BG down to normal levels yet. It is important to try to keep his BG #s down in normal range as much as possible to allow the pancreas to continue to heal. So, if you try the no shot, test in an hour idea and his BG goes down, but then rises after that, you will want to be prepared to give the shot...a very tiny amount though, ok? It's a balancing act.

This is GOOD news, even though the wild swings are scary, I'm sure. It looks to me like Bibo is trying really hard to go into remission.

Can you lure him out with some food? He's a smart boy, he knows you want to poke him again, huh? :lol:
 
I've tried everything you can think of. He's out now, but he knows my moves, I have to close the door of the bedroom and chase him around the house. Wish me luck! !lol
 
He bit me so hard that i'm bleeding now. How am I ever gonna test this guy, even, with burrito (towel) he started biting me. He hates it!! Couldn't get a blood out of him. I wish he knew hoow much I want to make him better....
 
Try not to be anxious when you go to test him, he will also be anxious if you are. Take a deep breath, and be calm. Talk soothingly, or sing to him, scritches and petting before you try to poke. Above all, stay calm. Make it pleasant for him. Then when he's calm, try to poke.

The big jump is from so much HC food. When he gets low next time, you can use your regular LC food, just put a few spoons on gravy from the HC on top of it. Most of the carbs are in the gravy, and you only need a little bit to bring him up. It's ok, 124 is a nice number! Good job!
 
ok, so let's figure out how you're measuring the dose.
are you drawing up insulin and eyeballing it?

for a fat zero, which could end up being somewhere between 0.1u and 0.25u, here's how you figure it out.
take a used syringe and draw up some water with it. push the water out but not hard.
now take a look at the syringe and depress the plunger harder. a drop of water should be showing on the outside of the syringe. that is your fat zero dose.
obviously you don't push the syringe hard into bibo himself, you just squeeze the two parts of the syringe harder into each other (the syringe's body and its plunger).

now that you're familiar with the process by using water, try it with some insulin. once you're pretty sure the little drop is consistently about the same size, that's gonna be what you put into bibo.

(compare that size of drop against the 0.25u you've been giving. it should be smaller.)

hope this helps.

(i wouldn't worry there's too much blood from testing, but. you don't have to apply heavy pressure, just apply very light pressure for a few seconds. what are you doing this with? i find it easier to use a cotton ball. (so i put the cotton ball on back of the ear, to poke into so i don't poke my fingers, then i use part of the cotton ball on the other side of the ear --so it's on both sides of the ear--to apply a little pressure.)
 
Hi Chris, I'm glad you're here now! I'm leaving now to go to Walmart and get the U100. So maybe in the afternoon, you can help me through figuring it out, once I have the syringe in my hand. No more eyeballing. I'm not good at it! I'm taking the measurement you gave me with me. Thank you so much.
 
Chris - the good news is that Taline is using U40 PZI with U40 syringes.

Taline is going to buy U100 syringes and will need to use the conversion chart -- but it will be easier to get 0.1u and 0.2u doses using the U100 syringes.

(0.2u will be 0.5 mark on U100 syringe)
 
right. not positive, but i believe a fat zero on a U40 syringe with U40 insulin is closer to 0.25u (thinking the amount you get left over when pushing the insulin out is still less than what you'd get when eyeballing the 0.25u while drawing up the insulin, but wanted her to check the two procedures and see whether that's true for her).
i believe a fat zero on a U100 syringe with U40 insulin will be closer to 0.1u.

we don't have anything more sophisticated at home to measure, but eyeballing the size of the drop may show this.
 
Hi Taline, looks like you have everything under control & are getting great advice!

I agree a fat 0 is the way to go, and I also like the idea of trying feeding if you get a # that is a little higher (say 130 - 200ish), but not super-high. Feeding a small amount stimulates their pancreas to produce insulin. His looks to be working - you may find that if you let him eat when he wants, rather than taking food up at the end of the cycle, that the PSs are lower and no shot even needed.

I wouldn't go too hard on your vet - Bibo is the exception rather than the rule in getting such an amazing response so fast on low doses. The majority of cats that I have seen need over 1u, so that is usually a safe baseline starting point, and many cats need as much as 2u or more. It's not a great idea IMO to start at 2u, especially if you have already switched to a LC food, but I've seen a lot of vets do much worse than that.

My vet didn't think the food change from dry (lower carb) to wet would make any difference in the #s - it's just unfortunate that many vets don't seem to have the in-depth knowledge to make the best recommendations. But if you think about it, they are trained to deal with 100 different kinds of illness that might come in to their office, rather than really specializing in diabetes. So to me, if you like your vet, I would just share your data and what you have learned and hope that helps shape his decision-making for the next cat that comes in with diabetes.

As far as Bibo's BGs not coming down too much over the past month, a lot of times a food switch helps but they still need a short course of insulin to get in good #s. It's like their pancreases go to sleep and need a nudge to get back on track and do the job themselves. Clearly he's getting his nudge now & running with it, yay!!! I'm sure it is really scary for you to be hitting all these green #s so fast when you are still getting used to things, but I think it's a really good sign that his pancreas is trying to take over, yay!
 
p.s. just had a thought - if you have been taking up food in the last couple hours before a shot and then feeding at shot time, I'm wondering if maybe that's leading to the drama-drop after the shot - i.e. his pancreas is getting in gear at the same time the PZI is kicking in? just speculating here...

I would probably experiment with it some - I'd try testing, and giving him a small meal (but no insulin) at his normal shot time, or maybe 1 hour before. Then test in an hour 1/2 or two after eating. If his BG is above 150 and the meal didn't help him bring the #s down on his own, then give the fat 0. Just a thought :)
 
I got the U100s and looking at it. It starts with 5, 10, 15...and in between there are 9 little lines or measurements. I tried the fat zero on U40 and it's so tiny little drop that hardly comes out of the needle. my eyeballing of the .25u is definitely 4 drops of that. My goodness, how could I give him just one drop, it's so difficult to collect, and I reallythink he needs just a little more. Well, now that I got the U100, I see so many little marks. How can I measure a 1u on U100? to have an idea where the .25u will be. I'm gonna need help with this. I'm not a technical person, and sometimes I don't get technical concepts very well, so please bare with me on this. Thanks.
 
File:3-10.JPG


hopefully this works to show the syringe

edited to add nope, it doesn't look like it worked. If you have 9 markings that means you have half unit syringes. I've heard people describe it as giving just a few drops so you aren't imagining things...
 
Taline & Bibo said:
I got the U100s and looking at it. It starts with 5, 10, 15...and in between there are 9 little lines or measurements. I tried the fat zero on U40 and it's so tiny little drop that hardly comes out of the needle. my eyeballing of the .25u is definitely 4 drops of that. My goodness, how could I give him just one drop, it's so difficult to collect, and I reallythink he needs just a little more. Well, now that I got the U100, I see so many little marks. How can I measure a 1u on U100? to have an idea where the .25u will be. I'm gonna need help with this. I'm not a technical person, and sometimes I don't get technical concepts very well, so please bare with me on this. Thanks.
Click to expand...


hello Taline,

Do your syringes' markings more resemble the syringe on the left, or on the right in this picture?

http://t2.gstatic.com/images?q=tbn:ANd9 ... 7Et1SwkR0=

If they more closely resemble the syringe on the left - then you got syringes with 1/2 unit markings. EXCELLENT!
The left most marks are each denoting .5 unit. The uppermost left-side mark would be the equivalent to .2 units of your U40 insulin,
which is a wee bit less than you are currently giving him at .25 units. HALF of that amount, (back to eyeballing the dose here),
would be .10 units of your U40 insulin.

HTH,
~M
 
very first little mark is 0.2u. so you might want to try slightly less than that.
if you want to sacrifice one syringe out of that box of 100, you can test it out with water.
 
Yes Mary, it's the left syringe with half measurements. And Chris, I think I got it. The first little mark is .2 and the following would be .4 and so forth. The 5th mark would be the 1u on U40? So you want me to give him a little less than .2u and your reasoning behind it that he went too low with .25 this morning. But now that I saw and I checked the fat zero, I think I gave him perhaps.35u. Well, learning process...I'll be checking his bg in couple of hours at +12 and see where Mr. Bibo is heading! Thank you all.
 
Taline & Bibo said:
Yes Mary, it's the left syringe with half measurements. And Chris, I think I got it. The first little mark is .2 and the following would be .4 and so forth. The 5th mark would be the 1u on U40? So you want me to give him a little less than .2u and your reasoning behind it that he went too low with .25 this morning. But now that I saw and I checked the fat zero, I think I gave him perhaps.35u. Well, learning process...I'll be checking his bg in couple of hours at +12 and see where Mr. Bibo is heading! Thank you all.
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Link below is to the insulin conversion chart. Please study it for converting your doses so that you are certain of how much insulin your baby is getting.

http://www.felinediabetes.com/insulin-conversions.htm

~M
 
Mary, that was helpful, thank you. I studies it very well, and I know that eachmarking on U100 is .2u of U40. So it's easier this way to go .2u or .4u. Anyway, I just tested Bibo at +11.20 and the reading was 137. So, again, I can't give him a shot right now, so I have to skip and wait for tomorrow morning. If anyone out there saw this, and has any advice, I'll be so happy to hear it. BTW, I gave him 1/4 of a ff pate an hour ago.
 
Taline & Bibo said:
Mary, that was helpful, thank you. I studies it very well, and I know that eachmarking on U100 is .2u of U40. So it's easier this way to go .2u or .4u. Anyway, I just tested Bibo at +11.20 and the reading was 137. So, again, I can't give him a shot right now, so I have to skip and wait for tomorrow morning. If anyone out there saw this, and has any advice, I'll be so happy to hear it. BTW, I gave him 1/4 of a ff pate an hour ago.
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Taline,

My baby, Stormy Blue, is off of insulin now and is diet controlled. Thank God!
However, his half-sister, Samantha, (my mother's cat), has developed diabetes now *sigh* and is, at 2.5 weeks of treatment so far, insulin dependent.
I use Lantus on Samantha and I am VERY hopeful that she will, like Stormy Blue, be off of insulin before too much time passes. *anit-jinx*

Anyway..... my Mother is not capable of doing the shots for Samantha because she is VERY fractious and runs like her tail is on fire when it is "time", (my Mother has to use a walker to get around), so I go over there twice a day to get the pre-shot tests, give insulin, and run fluids, (she has CRD, too - just like her brother). If Samantha is under 150 at the pre-shot test, I go ahead and feed her, and then retest in an hour. If she is then OVER 150, (and generally, she is), she gets her insulin.

Perhaps you could try the same? Test, feed, re-test in an hour and go from there...

~M
 
just saw your note. this would be a perfect time to test again and see if you can shoot 0.2u. (nice with the U100s, huh?!! :) )
he may just be biting you because he knows he's doing ok and doesn't think he needs anything. but he could just be acting like a cat and tired of getting poked.

next time rather than just skipping the shot it would be good to check a half-hour or hour later to see if he brought himself down further after eating or his numbers went up as the insulin wore off (asked you to skip yesterday because you saw a big response to overlap from shooting a larger dose early, but tonight you didn't have that problem). but, as the 134 was after eating and may even be a partial spike upward in blood glucose from eating, it definitely would help to check again to see what's up with his numbers. don't really want to shoot a food-related spike.
 
Nice PS!!! I agree although I may be too late to the party :) I would go ahead and feed him and then retest in a couple hours like you have the past couple nights. If it's over 150 I would give basically the smallest amount you can get in the syringe - definitely less than the first mark - a 1/2u mark, so over on the left side of the column - on my syringes there's actually a line that is 0 that is the 1st line, then the 1st 1/2u mark is after that. I'm not sure if all syringes are like that. Regardless, I would go with the teeniest-tinyest amount you can.

I agree too that it's worth sacrificing a syringe to test with water beforehand - that way you can see how much actually comes out of the needle vs. where you measured to (since I presume with any syringe you basically are pulling more insulin into it than actually comes out, since the needle will still be full of insulin once you have shot). Does that make sense? I would try drawing up water to the point that you think is a fat 0, then shoot it slowly over the sink or something so you can see if it's literally one drop coming out of the syringe, or if it's a lot more, and then you might want to experiment further.

Does he normally eat several small meals, or just one big one at shot time? If it's just one big one, I'm thinking that feeding him more smaller meals might help things along, if that's something you can manage. If he's not eating anything overnight that could contribute to a higher PS in the AM. A little mid-night snack and maybe an early morning snack may help his pancreas do it's thing.

Regardless though, he is doing really awesome, and you are doing a great job managing his #s. Congrats!!!
 
I just got another reading at +13.5 the bg is 155 and he ate 45 min ago, 1/4 ff wet food. He has the habit of eating small meals every 3 to 4 hours. So with the U100 syringe, I can always give him half of the first mark, which is .1u. What do you guys think? maybe in an hour but without testing. I'm the one who's being scratched and bitten all the time!!!! :? And as far as eating at night, I give him 3/4 can of ff at 9:00 pm and he eats that in 3 hours, and then by 4:00am he wakes me up for a little snack too of a 1/4 ff.
 
I would test in a hour if you can. Right now it could be a food spike, and if the # has gone down in an hour.... yippee! If it has risen, then I would go ahead with the 0.1u. Chris has been following more closely than I have, as well as having more experience than I do, so if she says something different though, I would go with what she says...

I am probably off for tonight ... I'll try to check in in the morning just in case you have another crisis (hopefully not!!!). To some extent I am hoping the lower #s mean his pancreas is helping out & getting him in perfect #s, rather than really the insulin being too much on its own. I'm not sure, that's just my hope. :-D
 
never shoot without testing. many of us here have been surprised by a sudden low number at shot time.
yep, 0.1u sounds good to me.
U100s are so much nicer for U40 insulin, huh? :)

bibo is a very smart cat. his eating habits are extremely good for babying the pancreas along (small meals every 3-4 hrs).
 
Chris, a quick question. I prepared the syringe with 1 drop in it. I practiced it 20 times perhaps, but Bibo went under the bed, and I can't reach him. Can i keep the syringe in the fridge and when he comes out, give him the shot? or get a new syringe and another insulin? Sorry for all these questions!!!
 
yes, you can keep it in the fridge.
it's so little insulin, tho, you might want to prepare a new syringe. whichever makes you feel more comfortable. pzi is one of those insulins that can be loaded in the syringe early.
any special treats you can tempt bibo with? or do you have a toy like a fishing pole with a toy dangling on a string that you can tease him with to get him to come out from under the bed?
 
I gave the shot Chris. Used the same same syringe that I stored it in the fridge for 25 min. This is a trial, it's probably 2 drops of insulin he got. we'll see tomorrow morning. I can't thank you enough for always checking on us. God bless you for helping the needy newbies like me. Bibo is even more cautious than ever now. He looks depressed to me. I don't see the sparkle in his eyes, and I know that it's all these pokings, he's so tired of. Nothing makes him come out of under the bed. I always have to wait and close the doors and trap him to catch him, except at night, when I sleep, he comes around and sleeps next to us for a brief time. Well Chris, have a good night.
 
Trust me, his attitude/behaviour will change and improve. Soon he'll link the shots and the testing to feeling better. Some cats even start to remind their owners that it is time for testing and shots!
 
very true. he'll get better (if you even have to do this for long!).
always give a cuddle, a lot of praise, and a yummy treat every time you test (no matter what the number is). eventually most of our cats come get us at test time. in my case, ALL my cats come get me at test time coz they all get a little snack out of it. :)
 
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