Consistently low preshot numbers

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atajev

atajev

Member Since 2014
Argh! It happened again for the 4th day in a row. Her BG is 189 (on an Alphatrak) and I need to leave in a half hour for work.

What should I do? Shoot .75 instead of 1?
 
Re: 189 and need to leave!

I gave her .75 and headed out. Stalling every day is really not feasible, so I'm not sure what to do here as a general rule since she's been between 180-230 (on an Alphatrak) at every preshot test since switching to wet food.

Any advice that doesn't include stalling since I am not able to do that consistently with my work schedule? I'm happy to stall on days when I can, but half the time I can't. :(
 
Re: 189 and need to leave!

hi, it's such a worry isn't it?

Is it worth having a word with the vet and showing him/her Mona's spreadsheet? I know the advice here is not to give a shot if bg is under 200, and I think that's on a human meter that reads lower than an alphatrak.

I hope someone more experienced can advise you.
x
 
Cassandra - my vet is totally unresponsive and I'm in the process of looking for a new one. I'm still waiting on a response about switching to wet food that I asked 4 weeks ago now, despite me calling in with numbers regularly. I just went ahead and did it using information from this site and others and she didn't ever call to talk to me about that, even though I told the tech. So, at this point I'm acting on my own or the advice from this gang. Whom I am so grateful to have access to through this board!
 
oh, I know the feeling, the emergency vets I saw were so incompetant.
Is there a site you can go to where you can find reviews of local vets?

Good luck x
 
I've been doing searches to see if any of the local places have been reviewed by people with diabetic cats specifically, but no dice so far. I live in a small city where there are plenty of vets, but not enough pets for vets or clinics to specifically specialize in anything as a general rule.

I'm sure I'll find someone, but it's frustrating and I don't want to just test people out. My vet even "passed" the test of the suggested questions on here, but I now know she gave me some really scary advice (like to shoot anything over an 80), along with good advice like getting good at home testing (which I'm grateful for at least)! But, the non-responsiveness is really the critical problem, so I guess anyone that's willing to call me back is a step up, eh? We'll see.
 
With a couple of weeks of testing mid-cycle under your belt, you are ready to gradually lower the no shot limit. Looking at your recent week, I think you could lower it to 200-215 for the AlphaTrak you're using.

If you've got your spreadsheet up and running, have the diet on low carb, and are able to get mid-cycle tests, especially when making dose adjustments, you're ready to move into one of the Lantus forums.

Lantus Tight Regulation - intensive glucose monitoring, at leats 3-4 times a day, to optimize glucose control and possibilities for remission/diet-controlled status

Relaxed Lantus - often a slower protocol, generally due to testing obstacles.

(There are some Vet Interview Topics in my signature link. Sometimes you go for basic competence and trainability)
 
Woo hoo! I feel like I've graduated getting the suggestion to moving into a Lantus-specific forum. Thanks! :)

And "trainability" sounds like an excellent thing to seek in a vet at this point.
 
Thanks for that link. There are two vets listed on there - neither of whom I've looked into yet. That's really helpful!
 
hope it helps. I've no idea how up to date it is, plus I did the search from uk, so maybe you would get more results.
I just typed 'vet specialising in feline diabetes u.s.a.' (only you wouldn't need the u.s.a link). I've forwarded the link I sent you to one of the moderators to see if she thinks it's worth posting in resources.
x
 
If you do decide to go over to one of the insulin specific forums, be sure to give some of your background that folks here over in the Feline Health forum know about, like those 2 young children of yours and your work schedule that does not allow you to get mid-cycle tests during the week.

We know that people's lives get very busy and complicated, so anything you can do to help us understand that better is useful information.
 
I am relatively new to providing care for a diabetic cat. In researching information on all areas relating to care, I have found that there are any number of reasons why you might be experiencing consistently low blood sugar readings. Many of the glucometer strips are not coded or approved for use in animals. This can translate into low blood sugar results. It can relate to the insulin dose or not enough caloric intake. One thing my vet did share with me is that I am to give the insulin dose (after eating). Lantus insulin will begin to have an effect within about an hour, but is a sustained insulin with out a peak effect. My cat was running consistently low sugars and I would hold the insulin dose. She would then rebound to some seriously high levels. Since giving the insulin consistently, despite the low sugar reading, she has really done well. I have seen not side effects relating to hypoglycemia. Although her numbers are on the low side, they stay within a consistent range. Her overall condition seems to be stable. Good luck, Jane and Stewey
 
jane and stewey said:
..Many of the glucometer strips are not coded or approved for use in animals. This can translate into low blood sugar results. ...
Click to expand...
This is why we use pet specific reference ranges with the human glucometers. We know they were normed on humans. Research (Roomp & Rand) is the basis for most of our reference numbers, in addition to experience here with human meters, and the Merck Veterinary Manual.
 
One thing my vet did share with me is that I am to give the insulin dose (after eating). Lantus insulin will begin to have an effect within about an hour, but is a sustained insulin with out a peak effect.
Click to expand...
Since Lantus insulin has a later, gentler onset and does not cause such a steep drop in the BG levels as do some of the other short acting insulins such as Humulin N and Novolin N, it's not as critical that your cat eat before the Lantus dose is given. With the short acting, steep quick drop insulins, it was much more important to be sure your cat had eaten first before giving them the insulin. Yes, you do want your cat to eat before the insulin has it's peak effect, but that can be many hours after the dose is given.

Jane and Stewey are incorrect in stating that Lantus does not have a peak effect. Lantus does have a peak effect or nadir. That is usually around the +5 to +7 hour timeframe after the shot. Some cats are early int he +3 to +4 hour timeframe, and some cats nadir( or peak) later. You need to test to find out when your cat has their nadir.

Lantus also starts to have an effect in most cats usually around +2 hours after the shot, not at +1. ECID so again, you need to test to see when your cat starts to onset with the Lantus insulin.
 
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