Blood glucose meter reads "high" insulin adjustment?

Discussion in 'Feline Health - (Welcome & Main Forum)' started by Holtfam6, Apr 24, 2022.

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  1. Holtfam6

    Holtfam6 Member

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    So I just checked Chance's blood sugar with relion meter and it reads high. He's on 3.5 units prozinc twice a day. Do I need to do an insulin adjustment? @FrostD @Suzanne & Darcy

    I should also say he is asymptomatic.
     
    Last edited: Apr 24, 2022
  2. Diane Tyler's Mom

    Diane Tyler's Mom Well-Known Member

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    Last edited: Apr 24, 2022
  3. Holtfam6

    Holtfam6 Member

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    yes. the libre 2 sensor malfunctioned yesterday and he missed a day dose of insulin. Chance is a stinker. My daughter keeps the dry in a cabinet above the desk and he broke in and ate some hills science diabetic dry that we don't use today. This happened around 2:00 pm Vet recommended when first diagnosed. she saves it as emergency carbs. He prefers dry. He gets about 1/2 cup Dr Elsey's at night to tide over. needless to say, the dry has been moved out of her room to a more secure location.
     
    Last edited: Apr 24, 2022
  4. Diane Tyler's Mom

    Diane Tyler's Mom Well-Known Member

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    Can you add that to your signature ,members need to know that ,
    Tap on your name ,a drop down will appear then tap on signature and add Dr Elsey's Dry
    That's really not that high of carbs in case he drops really low to bring his BG up or do you mean for emergency carbs you would give the Hills Science Diabetic Dry
    What is the low carb wet you're feeding

    I see you are feeding Fancy Feast Pates
     
    Last edited: Apr 24, 2022
  5. Holtfam6

    Holtfam6 Member

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    The low carb wet is stella and chewy's turkey pate which has a carb count of 1.39%
     
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  6. Holtfam6

    Holtfam6 Member

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    We do do some fancy feast pates but also bought some more higher protein as he lost a lot of weight when diagnosed. I'm going to recheck him about 10 pm and see where we are.
     
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  7. Diane Tyler's Mom

    Diane Tyler's Mom Well-Known Member

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    Thanks for adding the Dr Elsey's but you need to say it's the dry
    You'll want a hypo kit going. You'll want a mix of wet foods - medium carb 10-15%, high carb 16-20%, and I like to have a few small cans of something like 23% on hand as well
     
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  8. Diane Tyler's Mom

    Diane Tyler's Mom Well-Known Member

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    Such as
    For your hypo kit you want some
    Med and High Carb food and some honey



    Fancy Feast Gravy Lovers Gourmet Beef Feast in Gravy 20% High Carbs

    Fancy Feast Gravy Lovers Gourmet Chicken Feast in Gravy 15% Med Carbs

    Fancy Feast Gravy Lovers Turkey Feast in Gravy 15% Med Carbs

    Fancy Feast Gravy Lovers Chicken and Beef in Gravy 15% Med Carbs

    Good idea to mark the cans with magic marker how many carbs

    Or any on the food chart.
    https://felinediabetes.com/FDMB/threads/dr-pierson-new-food-chart.174147/

    dry is not a good option when trying to bring very low numbers up because it takes too long to work.
     
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  9. FrostD

    FrostD Well-Known Member

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    When did he get ibto the food, today?

    Did you by chance double check that 456 last night? If that was legit that's a heck of a bounce, likely from all that time in nice blue. Given AMPS I'd say the 456 was close to legitimate.

    If those ketones really are 4.2 please double check. That is DKA-level high
     
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  10. Holtfam6

    Holtfam6 Member

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    yes I did . two separate sites- right and left ear. 484 reading now. ketones per blood 0.4 now. I think the blue was false read from the defective libre 2 sensor. He got into the dry hills science around 2 pm today. I was gone and walked into the room and saw him eating. Hubby was cat sitting.
     
  11. FrostD

    FrostD Well-Known Member

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    Ok, phew. Scared me.

    The dry food obviously won't help, and it may affect things for a few cycles.

    Technically per guidelines you'd hold the dose for at least a week. The skipped shot does mess things up a little bit, but you had enough data before it happened (even if it may have been inaccurately low). Even if the Libre readings were good, you still have room for a 0.25U increase.

    Can you do me a favor and insert a row (merge columns) above the the 22nd and say something like "Data for 4/22 and 4/23 believed to be inaccurately low and Libre malfunction". That way it's just more obvious to anyone reading, in case they happen to miss it or misunderstand the remarks column.
     
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  12. Diane Tyler's Mom

    Diane Tyler's Mom Well-Known Member

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  13. Bron and Sheba (GA)

    Bron and Sheba (GA) Well-Known Member

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    If you got a reading of 4.2 ketones after a skip of insulin, I would be very careful not to skip again but post and ask for assistance.
    Also make sure Chance is eating well.
    Is there a history of ketones?
     
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  14. Diane Tyler's Mom

    Diane Tyler's Mom Well-Known Member

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  15. Holtfam6

    Holtfam6 Member

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    How do I merge columns?
     
  16. Suzanne & Darcy

    Suzanne & Darcy Well-Known Member

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    What did you shoot this morning? I don’t see it on the spreadsheet.
     
  17. Suzanne & Darcy

    Suzanne & Darcy Well-Known Member

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    Also, where are we thinking that the Libre malfunctioned? What date/cycle? The blues?
     
    Last edited: Apr 25, 2022
  18. FrostD

    FrostD Well-Known Member

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    Are you on your phone or a computer?
     
  19. Suzanne & Darcy

    Suzanne & Darcy Well-Known Member

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    I still don't see an update. I'll check in later. I hope Chance and everybody are okay.
     
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  20. Holtfam6

    Holtfam6 Member

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    The morning read high per relion blood meter. I think it started malfunctioning the night of the 22nd. He started turning blue for too long of a period for him. I use my mac computer to update but do have phone access. Just did a plus 6 check and he is 354. Still doing good. Sorry for not updating sooner. It's been a busy monday.
     
  21. Suzanne & Darcy

    Suzanne & Darcy Well-Known Member

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    No worries. I figured you were working!
     
  22. Suzanne & Darcy

    Suzanne & Darcy Well-Known Member

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    Well, he's doing better in pink, anyway. Tonight will be cycle five after the skipped dose.
     
  23. Holtfam6

    Holtfam6 Member

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    just did the 8pm check 552 so I think were heading in the right direction. did go up to 3.75 units prozinc.
     
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  24. FrostD

    FrostD Well-Known Member

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    Did he have the same Libre on on 4/11?
     
  25. Holtfam6

    Holtfam6 Member

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    no it was the old sensor. That one did well and lasted 14 days. This one not so much.
     
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  26. FrostD

    FrostD Well-Known Member

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    Ok just trying to see if those blues were real either. Let's see how he does for a few days but if he doesn't see blues we probably need a larger increase.
     
  27. Suzanne & Darcy

    Suzanne & Darcy Well-Known Member

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    Thank goodness you increased. Paws crossed for better numbers! Could you update your spreadsheet when you get a chance, please?
     
  28. Holtfam6

    Holtfam6 Member

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    I did update the spreadsheet? Is it not showing up? 335 right now +5. Better but still have some work to do.
     
  29. Suzanne & Darcy

    Suzanne & Darcy Well-Known Member

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    Yes. I see it! It's a bit better, but we want even better! Soon!
     
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  30. Holtfam6

    Holtfam6 Member

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    Going to do an experiment since we got a new sensor today. First, we applied the new sensor and tried to get the reader to work with it. It kept saying sensor is incompatible with the reader. called technical support. They tried to tell my daughter that the pharmacy sold her an expired sensor. I took the phone and said it was well within expiration date. We debated a little and I voiced my concerns. Didn't tell them it was a cat and they didn't ask. Anyhow, they are sending me another free sensor and now a new free reader. My daughter was able to connect it to her phone so we decided to leave it in. She gets nervous at night with him. anyhow, 8pm blood sugar check with the relion was 332 and the libre 413. Quite a difference. I'm going to post updates comparing the two as I find it interesting.
     
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  31. FrostD

    FrostD Well-Known Member

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    Glad they helped you at least.

    So I'm not too surprised by that, they each have 20% variance. So the ReliOn could technically be as high as 398, and the Libre as low as 330. Of course the opposite is true as well lol the Libre also does read interstitial glucose, one of them lags the other by 15 minutes but for the life of me I can't remember which. I believe interstitial lags the blood.
     
  32. Holtfam6

    Holtfam6 Member

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    yes I believe you are right interstitial would lag blood. I was surprised as a nurse. Haven't had a lot of experience with libre. If I get bored I'll have to google more on this subject. It's real interesting.
     
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  33. FrostD

    FrostD Well-Known Member

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    When I get a chance I'll dig for some old threads, there were a few recently (last 6 months ish) that had same problem
     
  34. Holtfam6

    Holtfam6 Member

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    Wondering if any of you wonderful people when you have a moment can look at Chance's blood sugars and provide your great feedback? He's still running in the high numbers. We have had no further dry food break ins. I just checked his blood sugar by blood and it's reading high on the meter. wondering if i should go up to 4 units twice a day or ride out a little more? It makes me nervous with the high by blood. Thoughts?
     
  35. FrostD

    FrostD Well-Known Member

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    The trouble is I'm not sure what he did on the nights without tests. It's possible he's going lower at night but bouncing daytime, so I'm not comfortable giving the green light.

    I would give it another day or two and just be sure to get some night tests in case he's bouncing. Ketone test as well.

    Can you add in Remarks section when he got the new libre?

    He still won't let you ditch the Dr Elsey's? Reason I ask is he would benefit from following the full MPM, but can't have any dry in the picture for that
     
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  36. Holtfam6

    Holtfam6 Member

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    He's very dry driven. When we rescued him, he had a feeding tube. We couldn't get him to eat anything to get rid of the tube. It took months to get him to eat. He finally ate frisks gravy twirlers dry only. We did eventually broaden his taste to some can but he never really ate much can. We have managed to get him to can only during the day. We have left only can out at night, but he refuses to eat it. Were going to keep working on it though.
     
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  37. Holtfam6

    Holtfam6 Member

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    @FrostD When you have a chance, can you please review Chance's blood sugars? He's still up there and were currently doing blood testing. Thank you so much!
     
  38. FrostD

    FrostD Well-Known Member

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    Yeppp up to 4U you go!

    If those ketones creep up consider a 0.5U increase.
     
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  39. Suzanne & Darcy

    Suzanne & Darcy Well-Known Member

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    Hi there. I see you guys are trucking along. It looks like Chance is approaching time for an increase. How is he acting and feeling? Any better than before? I guess his Libre malfunctioned?
     
  40. Holtfam6

    Holtfam6 Member

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    Ha! more feisty than ever! He's been climbing on top of the fridge, trying to open closet doors. Looking all over for his dry food. I think he is doing much better. More active and talkative. It's like the old chance. I just wish his blood sugar would come under better control. really praying for a remission. I called libre technical support and they are sending a new reader and sensor as the last two malfunctioned. It should be here later this week or next week. I think we are still going to utilize blood more as the libre reads high at above 400 if I remember correctly but it will make life easier to get a good curve reading in. Do you think it's time to bump him up? I was trying to post a picture of chance on the prowl for his friskies and had to post it as a profile picture.
     
    Last edited: May 11, 2022
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  41. Suzanne & Darcy

    Suzanne & Darcy Well-Known Member

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    I do think it is time for an increase. You have been on this 4 units long enough. I do wish there were more night time tests. I hope you can get a functional Libre sensor.
     
  42. Suzanne & Darcy

    Suzanne & Darcy Well-Known Member

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    Oh, I love that new picture of Chance. He looks very good!
     
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  43. Holtfam6

    Holtfam6 Member

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    He's quite feisty. I put the new libre in tonight. He didn't like the cobain wrap and I think that was why he was pulling out fur. I Tried a new tape method so we shall see how it works and how long it works. Fingers and paws crossed.
     
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  44. Suzanne & Darcy

    Suzanne & Darcy Well-Known Member

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    It really looks like Chance’s doses are being held for too long. He is not getting nadirs that are low at all - only two yellows so far on four units. Also, can anyone scan the Libre a little more frequently- especially during the p.m. cycle? This would be really beneficial information. There are no nighttime numbers on his ss for almost 2 weeks. Is that because of Libre problems? Are you doing backup spot checks with a human meter/ear testing? I’m just trying to get a good picture as to what’s going on. I hate seeing all those black numbers on his spreadsheet.
     
  45. Holtfam6

    Holtfam6 Member

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    We were taking a break from the libre. Just installed a new one yesterday. Will try to scan more frequently. The other readings were from relion blood. will do back up blood ear checks also as needed and will try to document in comments times with ear checks.
     
    Last edited: May 15, 2022
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  46. Suzanne & Darcy

    Suzanne & Darcy Well-Known Member

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    Oh that’s right. You put it on yourself! I hope he won’t mind the dressing.
     
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  47. Holtfam6

    Holtfam6 Member

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    Any thoughts on if I should increase to 4.5 units twice a day? Chance is still running pretty high. Libre 2 reads high so we have been doing blood draws to get a number. Thanks!
     
  48. Suzanne & Darcy

    Suzanne & Darcy Well-Known Member

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    He’s very high. Are you following TR? I don’t see any dosing method on your spreadsheet so I wasn’t sure. But if you are then you can increase after six cycles (as long as he stays high like this.)
     
  49. Suzanne & Darcy

    Suzanne & Darcy Well-Known Member

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    So tomorrow morning …
     
  50. Holtfam6

    Holtfam6 Member

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    4.5. I'm assuming since he's 4.25 now. I can't figure out why he's looking so high lately. Nothings changed that I can put my finger on.
     
  51. Suzanne & Darcy

    Suzanne & Darcy Well-Known Member

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    Keep testing those ketones. Is he still feeling well?
     
  52. Suzanne & Darcy

    Suzanne & Darcy Well-Known Member

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    Sorry, I meant if you were following the Modified ProZinc Method …. but it will be the same, increase by .25 units. I think you should increase to 4.5 units tomorrow if he continues along so high. Melissa @FrostD do you think Chance’s dose should increase by .25 tomorrow. There are lots of tests on the SS.
     
  53. Holtfam6

    Holtfam6 Member

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    Yes. The other day ketone 0.7 blood
     
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  54. Suzanne & Darcy

    Suzanne & Darcy Well-Known Member

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    Did y'all increase. I don't see any updated info on Chance's spreadsheet. How's he doing?
     
  55. Roxana & Henry

    Roxana & Henry Member

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  56. FrostD

    FrostD Well-Known Member

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    Sorry I didn't get the tag for some reason. With MPM you can actually increase by 0.5U if nadirs aren't below 200....trick is you have to be sure you're not missing anything lower. But if he's still getting the Dr Elsey's at night by default you have to go with SLGS and hold each dose a week, increase by 0.25U at a time.

    If your vet is typically booked pretty far out, I would consider scheduling an appointment 1-2 months from now for some bloodwork to look for acromegaly and IAA. In the meantime I would stay on top of increases. once they get to 6U we recommend testing for those conditions (Cushing's too if he has symptoms but you haven't mentioned any). You can always cancel the appointment if he hits a breakthrough dose, but he's getting up there now
     
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  57. Holtfam6

    Holtfam6 Member

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    Sorry! At the Er with my mom and a dead laptop. Did a blood sugar curve today with the relion. He received 4.5 units prizinc today. His BS were as follows: 08 365 1000 300. 1200 122 2pm 94 4pm 145 8pm 365. Will try to update the spreadsheet tomorrow if I can’t access by iPhone.
     
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  58. Holtfam6

    Holtfam6 Member

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    Ok. Spreadsheet updated. That’s a good idea about testing—hopefully it’s not needed. I’m questioning if the Libre is accurate or a good fit for him. His sensor started testing high yesterday. I put High on his spreadsheet if tested by blood. Hi is if with libre. I documented this on the spreadsheet too. We did one draw and he was 365 I believe so I thought the 20% difference. Then late last night the reader started acting up. It was reading unavailable and recheck. Then this morning I tried to scan and it said time to change scanner and we were on day 3 or 4 of the sensor. So we decided to draw every two hours by blood to try to get a better picture and it looks much better. I do have one more sensor and a new reader but think we are going to do blood for a few days to get a better picture.
     
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  59. Suzanne & Darcy

    Suzanne & Darcy Well-Known Member

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    Oh my. I hope your mother will be well!
     
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  60. FrostD

    FrostD Well-Known Member

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    Hope your mom is ok!

    Definitely hold this dose now
     
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  61. Suzanne & Darcy

    Suzanne & Darcy Well-Known Member

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    Yes. Look at those blues and green! That looks good. Don't bounce, Chance.
     
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