Blood Glucose Hometesting Question

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smandermetz

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My fuzzy buddy, Maverick, is 16 and was diagnosed diabetic at the beginning of this year. Started on 1/2 unit and since that time it has increased with every visit. This past Friday I took him to the vet again because I knew his levels were off and was told to increase the dose which is now 5 units. This seemed like a lot to me so I started doing some research and here I am. I've learned a great deal and decided to start home testing. After visiting several websites, I immediately took up his dry food and have been feeding him wet. He normally got both, but preferred dry.

Today was my first home test, results:
0530 he was at 169
1300 (1 pm) he was at 170

Both tests were done before he ate. Should I test, feed, and then give insulin? That is what I did and only gave 1/2 unit based on information I printed from a different site. The chart said to administer insulin accordingly:
151-170, .5 units
171-185, 1 unit
186-200, 1.5 units
201-220, 2.5 units
221-250, 2.5 units; etc.

Is this accurate? Where should he be? He is on Protamine Zinc, is that okay?

Tonight it doesn't seem like he wants to eat, is this normal? Urination has decreased, is that normal? I don't want to harm him and feel like I might be.

I've read so much information and think I'm getting confused. Any help would be greatly appreciated.

Thanks! Stacy
 
We usually tell newbies not to shoot under 200. It is usually safe, but since you don't know yet how Maverick will react, it is better to be conservative. You test, feed and shoot. You want to know what his number is before you give the shot. You can shoot while his nose is deep in his dinner dish, if you like. It looks like you have a while before the evening shot? Let's get a test then and you can decide about the dose.

The chart is good general information. Our motto here is "Every cat is different". That's why we test before every shot and keep the data so we know if the kitty reacts stronger to the insulin than average or not.

Your info can look like this:

amps 169 .5 units PZI (amps means morning preshot, 169 is his blood glucose level and then your dose
+8 170 (+8 is our universal way of telling time - it means 8 hours after the shot

amps 169 .5 units PZI
+8 170
 
That makes sense. Thanks!

His reading at 8:12 pm was 171 and this morning at 4:10 am was 158.

He nibbled a little last night but doesn't want to eat this morning. He is drinking. Is this normal?

I will test again in 8 hours to see where he is and go from there.

Appreciate your help.
 
It looks to me like you will need to keep on top of his numbers. He is higher than a cat would be who is not diabetic, but those numbers are not safe for a new diabetic (without any testing data) to get insulin. You need to be more vigilant about testing. Are you around to do that? After you have some data and have an idea of what the insulin is doing, you can shoot tiny doses. Any chance you could do a curve and see what is really happening? A curve is a test every 2 hours or so.

I am guessing the diet has lowered his numbers. But he does need to eat or you could have a very sick kitty. Here are some ideas to tempt him to eat: Getting your cat to eat. How long has it been? Has he eaten anything?

I hope you will come back on the board and give us more information and get more advice. Your kitty is in a dangerous situation, needing some insulin but not getting any yet and not eating well.
 
Hi there! welcome and congratulations on your home testing! There are lots of more experienced people who can give you dosing advice, but I would say using that chart is dangerous when you don't have a record of your cat's reactions to those dosages. My cat responds very strongly to the littlest bit of insulin and giving her more that 1.2u even when her numbers are in the 400,s had caused precipitous (and potentially dangerous) drops. You really need to know your cat.
Why not join us on the ProZinc forum? (look for ISG PZI on the board index) Very friendly and helpful people.
 
Welcome,

Good work on getting the home testing going!

My first reaction is that many who PZI use U100 syringes. You should go over to the PZI Insulin Support Group and read the PZI sticky in there about using u100 syringes. At the doses you are giving they will really help you be more consistent.

My second reaction is that your "scale":
151-170, .5 units
171-185, 1 unit
Seems perhaps a little "aggressive" for me. The difference between .5u and 1u is very large especially at numbers below 200. And again the U100 syringes would help you get finer gradients between the .5 and 1u. And they would help you shoot less than .5u too if you needed to do that. But please read the PZI sticky about this and the warnings. The reaction to .5u seems generally OK. As far as "accurate" there really isn't any hard and set rules with PZI so accuracy is not the word I would use. "Best for your cat" is more the terms I would think of it in.

If you are going to work from a hard scale like that I would just make sure to have the latest version. The sites that advocate this type of scale have revised their scales somewhat more recently to be a little less aggressive. And there is even a splinter group that I heard has a revised beginner scale. Unfortunately I do not know what those groups are. ohmygod_smile

My third reaction is that it would really help us if you could get your data in a spread sheet and most it in your signature like many folks here do. It would help us better see the full picture of what's going on. Instructions for this can be found in the Tech Support Forum. Also while you are doing this set up a profile and instructions can be found again in stickies at the top of the Tech Support forum.

The not eating thing is a concern. Maybe your kitty is just eating less now that it is regulated? Urination will decrease as they become regulated.
 
Wow, thanks to all.

I just tested again and he is still at 158. I did not administer insulin. I would not be able to do testing every two hours until Sunday. My schedule is very tough, even for me, full & part-time jobs and school.

He is eating, he actaully ate shortly after I posted he wasn't eating, just like a cat!

I will get a spreadsheet set up with the data I've collected thus far, get to the PZI support group site and try the tips to get him to eat a little more.

Should he be getting insulin? That is the most confusing part for me.

Using the chart is not set in stone for me and if that is not a good idea then it's out the window. Just trying to learn what is best.

Trust me, I'll be on here a lot to get help! I really appreciate all of you taking the time to help.
 
Glad to see you back. I am so glad he is eating. There just isn't a set formula for this because every cat reacts so differently. A cat at 158 is not in remission, but you have to be careful giving insulin with a low number like that.

There are a couple possibilities. Take his blood sugar before he eats and then 30 minutes or so after he eats. If his numbers go back, it means the pancreas is working at least a little. At least then you will have that information.

If you are going to be home and can monitor and test (perhaps in the evening?) you could try a tiny dose - like .25 - to see what happens. You would want to be ready with some high carb food in case he drops into the 40s. Here is the info on the syringes Gator was talking about: http://www.felinediabetes.com/insulin-conversions.htm

This period in the sugar dance is sometimes more stressful than the first day when you were overwhelmed with the diagnosis. You want to get him off insulin, but you need to be able to do it safely. It's why we call it a dance :mrgreen:
 
Just to clarify, I'm not that big on completely skipping doses above a PS [pre-shot] of 100 [unless you are checking for remission]. But that is just me and hardly everyone's idea here. BUT I do think that one needs to be careful at numbers below 200 and VERY careful at numbers below 150. What that "careful" translates into is making sure you are reducing the dose appropriately. This is kind of the general idea "scale" dosing is based on. If you can get away with a microdose of .25 or lower at 150 or below then IMHO that is preferable to completely skipping a dose. But this is complicated right now by the fact that you don't have the ability to really measure reliably the very small doses. So probably save what I'm saying until you can upgrade your syringe situation. BTW the syringes can be found at Wal-Mart - Reli-On brand [if you are in a state that allows one to buy insulin syringes w/o Rx]. But I really do prefer the GNP or Monoject brand.

But for like in today's scenario and you are scared/worried to shoot the .5 at 150 or so then try to shoot .25u. as sue points out. I want you to remain safe but I also do not want you to lose too much of the excellent ground you are in. As I was pointing out earlier the difference between .5 and 1u is large - 50%. So is the difference between .25u and .5u which again is the same % difference. I've found this to be especially true with the ProZinc insulin. Small changes with it seem to have relatively larger effects.

Getting that SS up will help us see just how aggressive you can be and we can be in our recommendations to you.

If you cannot get every two hours, try to get a +3 and a +6 or even just a +6.

There's also a recent topic in PZI that tries to gather some of the best thoughts for ProZinc usage. This link goes directly to my input and you might read the whole topic too:
viewtopic.php?p=300553#p300553
 
Is there a number he is supposed to be at?

I just tested again and he is now at 166 which is up from earlier today.

I've got a lot of work to do and much more research.

Thanks again for all the info.
 
Here are general guidelines:


Treated but not regulated [often above 300 (16.7) and rarely near 100 (5.6), poor clinical signs]
Regulated [generally below 300 (16.7) with glucose nadir near 100 (5.6), good clinical signs, no hypoglycemia]
Well regulated [generally below 200-250 (11.1-13.9) and often near 100 (5.6), no hypoglycemia]
Tightly regulated [generally below 150 (8.3) and usually in the 60-120 (3.3-6.7) range, no hypoglycemia, still receiving insulin]
Normalized [60-120 (3.3-6.7) except perhaps directly after meals -- usually not receiving insulin]

Off insulin, it would be nice to see numbers in the double digits the majority of the time; lots of cats in remission here run from 40 - 70. Some are closer to 100. You are not quite there yet, which is why we would like you to give a little insulin, but not so much that it will throw your kitty into hypoglycemia.
 
Maverick is on U-40 and I have U-40 syringes.

He seems to be staying between 170 and 158 so for now what is your recommendation for insulin if that trend continues?

I will get that spreadsheet done hopefully tomorrow.
 
Can you give the rundown on what this BGs were today and what doses if any you gave at the PSs like the sample below:
AMPS .5u - 156
+3 - 110
+6 - 101
PMPS .5u - 168

You are testing before every shot right? The testings before every shot are the pre-shot [or PS] levels. The + numbers are the hours after that PS.
 
To give the small doses like .25units, you could buy the syringes in the URL from my previous post. That same URL explains the conversion from U40 that you would have to use. You can try to eyeball with your syringes, but it is harder.
 
If you are going to be home and can monitor and test for at least the next six hours, if I were you, I would give .25 units. Maybe you can try to pull in half a unit and then squirt out half. That will leave you .25 to shoot.

Understand we are not vets and can only give you our best guess. It is your job to monitor.
 
Understood.

I will do that and you are right, it is hard to eye it. I printed the syringe conversion chart and I'll get the needles tomorrow to make it easier, I'm just about out of the U-40's anyway.
 
You should be fine. Keep an eye on him. Get a test about +3 and +6. The data will be helpful and you can be sure he is not going too low.
 
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