Can’t understand the numbers - hypo?

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Catsmom

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Peter Pan had a seizure on Friday. We think it was a hypo episode, but I just don’t understand the numbers. I thought hypoglycemia is when the level is very low. If that’s the case, why was his number after the episode higher than what is usual for him? I asked the vet and was told, “that’s just the way it was” – Huh?

When Peter Pan’s glucose was tested on Thursday, it was at 71. Previously, it had been in the “normal” range on his Fructosamine test, but the vet kept him on insulin anyway. After the episode, the vet tested his level at 109. When they checked it on Saturday, and showed me how to test it myself, the level was at 80. The vet tech told me a reading in the 80s, when I test each day, would be good. Last night, I tested for the first time myself and the number was 102. I don’t know if I should worry.

I had no idea I should be regularly testing his glucose level myself. When Peter Pan was diagnosed, the vet said we’d only need to test if he seemed to be having a reaction. As a result, I have no idea what numbers are good/bad for him. I’m scared and confused. I’ve read everything over and over, but I’m just getting myself more stressed trying to understand.

Can anyone tell me, in simple terms, what numbers are good/bad? And, does it vary from one cat to another? If anyone can help me understand, I’d really appreciate it.

Rose
 
This may be helpful:

Comparing a human glucometer to a pet-specific glucometer is like reading temperature in Celsius vs Fahrenheit. Both are correct. You just need to know the reference ranges to interpret what the numbers mean.

[Glucose reference ranges are unsubstantiated and have been removed by Moderator]


* * * * * * * * * * * * * * *​
Examples of using the chart:

Ex. You are a new insulin user and you test your cat before giving insulin. The test is 300. It probably is safe to give insulin.

Ex. You are an established user of Lantus, following the Tight Regulation protocol. You've tested around +5 to +7 to spot the nadir. It is 200 mg/dL. You probably need to increase the dose, following the instructions for the protocol.

Ex. Your cat is acting funny. The eyes are a bit dilated. You are concerned and test the glucose. The number is 35 mg/dL. ACK! The cat may be in a hypoglycemic state. You quickly follow the HYPO protocol linked in the glucose reference values chart. (which we really, really, suggest you print out and post on your refrigerator.)
 
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What insulin are you using?

We advocate testing before you give insulin, plus when possible, testing around the likely nadir (lowest glucose) between shots for safety. You want it to remain above 50 mg/dL when using a human glucometer.
 
Hi Rose,

All of those blood glucose readings you've mentioned in your post above are normal blood glucose numbers. That is to say, they are the numbers that are seen by cats who aren't diabetic.
'Normal numbers' are approximately (depending on which source the info comes from) 49 to 130. (But some cats naturally have levels a tad higher or lower than that).

Were all those tests done at the vets? If so, then, because of stress, the results may have been higher than you may see at home in more relaxed circumstances.

Given those numbers it is entirely possible that your kitty had a hypo. He may have dropped a bit below the normal range.

Well done for learning to test.
At what point in the cycle (ie how long after insulin) did you get that 102..?

May I ask a couple more questions:
What insulin are you giving, and what dose?

I strongly recommend that you test Peter Pan immediately before giving any more insulin, to make sure his blood glucose is high enough for him to have that shot.

We suggest that, for folks new to diabetes, no insulin is given if the blood glucose is below 200.

Oh, welcome to FDMB! :smile:

Eliz
 
Peter Pan has, most recently, been on 0.5 units on Humulin N twice each day.

But it's complicated more complicated than that. We went to a specialist for tests last Thursday. Because he was sedated for the ultrasound, he did not have his second shot on Thursday evening (at the specialist's direction). I gave him his regular shot after breakfast on Friday. He had the seizure about three hours after that shot. He has not had insulin again since then and, I think, that's why the vet has me checking his levels every day until he goes back for a re-check. All the numbers, except for the 102, were taken by the vet. I got the 102 on Sunday (my first time taking it alone). Last night I got 86 when I took it.

Peter Pan did okay without insulin on Sunday and Monday. I continue to only feed twice each day with Purina DM canned. I will test again tonight before I feed him. He has lost 20 pounds since he was first diagnosed with diabetes, and I think that is why his needs are changing. As far as I know, his glucose numbers have been in the "normal" range since January 2014.

I'm sitting on pins and needles every day, while I'm at work, because I can't be home with him.

Rose
 
Hi Rose,

If Peter Pan has had no insulin since Friday then it may well be that he is going into remission. ('Remission' means that the diabetes can be controlled by diet alone.)

Keeping fingers and paws crossed for you here...
 
Thanks, Elizabeth. We've been hoping he'd be off insulin since he had good numbers on his test in January. But when the vet said he had to stay on, we were disappointed. I sure hope you're right about the remission. Peter Pan has been through so many health problems, but he is just the sweetest guy and it would be such a blessing for him to be well again.

Rose
 
No typo. Peter Pan did lose 20 pounds. I'm embarrassed to say that, when he was diagnosed, he weighed 37 pounds. :oops: He now weighs 17 and we're working to get him down to 15, which should be a good weight for him because he's a big guy -- his paws look more like a dog than a cat! After that, it will just be working to maintain his weight at that level.

The BG readings I've taken for the last two days have been in the 80s. I'm hoping and praying that things stay good and we get a favorable report when we go back to the vet on Saturday.

Rose
 
Well then, you've done a fantastic job taking the pounds off Peter Pan. Since a cat being overweight is one of the main causes of insulin resistance, taking those pounds off has really helped out your boy.

Would you put those BG readings into context for us? When do you test? We call the test before you give the insulin, the pre-shot tests AMPS for morning pre-shot, PMPS for evening pre-shot. Then subsequent tests are expressed in a + hour format. So, 2 hours after the shot would be +2, 4 hours after the shot would be +4, etc.
 
A big cat, huh? Some extra large cats may have a condition called acromegaly which then causes diabetes. Typically, those cats require humongous doses of insulin. It is possible, however, for that kind of tumor to function sporadically. Keep that in on the reserve list for things to check should his insulin needs start climbing. If you want to read more about it, pop into our acromegaly / IAA/ Cushings/high dose group and look at the sticky posts.
 
Deb, All the BG results I've posted have been since the hypo episode (reading that day at the vet was 109), and all readings are since I stopped insulin. I do the test in the evening before I give Peter Pan his supper. Because of my work schedule, I feed him at 5am and again at 5pm.

Rose
 
So Pweter Pan is not getting any insulin right now? And has not had any insulin for several days? How many cycles/days have you skipped the insulin?

Are you trying to do an OTJ Trial?

OTJ Trial instructions

Here are the instructions for an OTJ trial:
  • Test at your normal AMPS and PMPS times. Feed multiple small meals throughout the day as much as possible (small meals are less likely to overwhelm a newly functioning pancreas). The morning test is now called the AMBG. The evening test is now called the PMBG.
  • If your cat is green (0-99 mg/L human meter, 0-130 mg/L pet meter, 0-5.5 mmoL) at your normal test times, no need to test further until the next "PS" time, just feed small meals and go about your day. If the numbers are blue (100-199 human meter, 130-230 pet meter, 5.5-11 mmoL), feed a small meal and test again after about 3 hours. Food raises BG's. So if the number is lower 3-4 hours after a meal, then the pancreas is working!
  • After 2 weeks, if everything is looking good, we have a party! And boy, do we party hearty. :cool:

Sometimes, the trial doesn't work the first time and we have to give a little more support by starting the cat with a tiny dose of insulin again. I had to do that with Wink. We simply start the cat back on a tiny dose of insulin to support the pancreas with healing for a bit longer. Our goal is a strong remission and it's better to be safe now then sorry later that you rushed it. With just a little more time we will probably get that strong remission we are looking for.

You might want to try testing in the morning also, not just in the evenings.
 
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