Curve for Fluffy Today

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robind21283

robind21283

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I'm taking Fluffy 's first curve today! Vet said his urine sample had a ton of glucose and likely we will have to increase his insulin after she sees the results of the curve. Can't wait to get my boy regulated. I use the tidy cat breeze litter system (which btw, is amazing) and I've been having to change the pee pad 2-3 times per week rather than once a week which was normal pre dx. Think I'm going to switch him to wet food soon too.
 
The wet food can make all the difference! Feeding dry food and giving insulin is like a human diabetic eating donuts and increasing their insulin to compensate. :D Just be sure to be monitoring carefully as you switch. My Oliver went down 100 points overnight when I switched him from dry to wet; if we hadn't been testing and gave the usual amount, he would have hypoed.

After the curve, you might consider slowly increasing the wet and decreasing the dry before you up the dose?
 
Switching to low carb wet food may drop the glucose from 100 - 200 mg/dL and may drop any insulin dose by up to 2 units. Switching gradually will let you adjust any insulin gradually too, with less risk of hypoglycemia. When you start changing it, make sure you have available some Karo or other syrup, plus some high carb gravied food, just in case you need to steer the numbers to keep them safe.
 
OMG - Fluffy's blood sugar was 102 this morning. Vet said to always shoot the last I talked to her, but I couldn't in good conscience shoot him this morning with a great number like that. Maybe he's honeymooning already? He had wet food last night and again this morning. We'll see what the evening brings.
 
Actually, wait 30 minutes without feeding and re-test.
If rising, a token dose may be helpful if over 150 mg/dL by + 0.5 or + 1.0
 
What a useless vet. He said don't shoot him. I asked, do I resume this evening - he said send the BGC and for a nominal fee of $104 I'll interpret it. Well, it's useless cause it was on dry food and now he's on wet. I just want to know if I should give him a token dose this morning and resume the scheduled dose later.

Hrmph.
 
Well, now you know more than your vet about Fluffy and Feline diabetes both. :D You're right, the curve on dry food is irrelevant now so no expensive "interpretation" necessary.

Tonight he may be high, after 24 hours since his last shot, but I would still lower the dose. Clearly the 2.5 is too much for wet food. Maybe 2 units if you can get a nadir overnight, maybe 1.5 if you can't? But I would try for a before bed test, regardless.

Looks like wet food is going to be good for him!
 
Nadir can be from +5 to +7 hours post shot. In my experience, it tends towards the +5 with ProZinc, though cats can and do vary ... daily ... on this.
 
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Someplace 5-7 hours after the shot. Lots of people get the test when they wake up at night (people of a certain age, you understand). Or you can set the alarm clock, wake up, test and go back to sleep.

What I am thinking is that he looks like he will really be reacting well to the food switch. And if his numbers are in a pattern of lowering, you want to stay on top of the numbers so you don't overdose. Another thing to do, especially during this time, is to get a retest. Any time he is near 200 and below, wait 20 minutes without feeding and test again. You want to be sure he is rising, not still falling, when you give insulin.
 
And after all that the vet never called me back. Time to start looking for a better vet! Gave mr. Fluff the normal dose and will check his nadir later.
 
Darn. I was hoping you'd go with 1.5 or 2 units. Definitely a reduction for the next shot - no matter how high the preshot.

You need 3 rising numbers before you can fully relax. Give him a small amount of the gravy off high carb and retest in 20 minutes or so.
 
Woah!!! That +4 is low! On the bright side, it's clear that the wet food is working! But I agree with Sue. You definitely need a reduction. Did you get more numbers last night? Are you going to be home today to monitor?

I wouldn't go with any higher than 1.5 units today unless you are there to monitor. Naturally, depending on his AMPS, you might go lower or even have to skip that shot.

Sue, you cracked me up with your people of a certain age comment!!! That age must have already arrived for me, because I constantly wake up at LEAST once during the night...used to be a great time to get tests for Gypsy though!! :D
 
Haha - if only Mom was willing to test Fluffy - I'm not sure she ever sleeps! Thanks so much guys for the advice. Mr. Fluffy almost convinced my dad yesterday (who leaves the house 2 hours after mom and me) that he hadn't been fed - thank goodness he asked me! And boy, Fluffy thought it was time for food at 4AM - this is why I never meal fed him before - guess he's a little spoiled :)
 
Ok guys, need your brains. I reduced fluffy's dose by 1u to 1.5u because his blood sugar is hanging so close to 100 when I test. Definitely need to do a new curve a asap. Other than being cranky that I have him meal feeding (4am wake up calls), he is otherwise acting his usual self.
 
I'm clueless ...now he was 110 AMPS so I gave a token 1u. When I tested 8 hours later he was at 100. Doubt he'll make it up to 200 prior to dinner time. I'm going to do a curve again tomorrow to see how low he's dropping for nadir. Think I should stick with 1u? With the U40 syringes it's hard to give just .5u. Not sure if I can get syringes in CT without an RX assuming the pharmacy had U100s. I think I shoul be happy the is BS is way better, but I'm so nervous about hypo.
 
You can use a stiff ruler with millimeter markings as a reference gauge for your syringes. Line up the bottom of the barrel with the bottom of the ruler, then determine how many of the markings yield 1 unit. Slide down the lines as needed to reduce. You're still eyeballing it, but it'll likely be more consistent.
 
I can get the half units consistently as long as it's greater than 1, but 0.5 is impossible to draw. Definitely not sure about the dose though.
 
You might want to do drop dosing.
Use a colored liquid to practice as it will help you see.
Pull up 1 unit.
Carefully squeeze out equal-sized drops, until you can do so with consistent size and the same number per unit.
Now, you can draw up more than the amount you need, and squeeze out drops to the dose you want.
You discharge the excess into the sink.
 
Maybe call around to see if syringes require an prescription in your state or nearby? If lower doses are in your future, it really is so much easier.
 
I just did another curve now that he's on wet food. What do you guys think? I would say that if I wasnt a newbie, it would be pretty good, but definitely on the low side.
 
Blues and greens are nice, but I think shooting 123 is really chancy. I wouldn't shoot under 170. He didn't go into hypo numbers but he was close. What would you think about reducing to .5?
 
Can't draw it with the U40s - I tried tonight. I'll try to pick some up tomorrow, if I can't get them in the AM I will probably not shoot since I'll be at work. I'm almost wondering if he needs the insulin. Maybe I'll do a new curve Saturday with no shot. I really wish the vet would be more of a partner in this.
 
To get him off inaulin, you will most likely have to dose some tiny amounts to gradually get him gradually lower.

One way to possibly use the U40 syringes is to put a line on your syringe where you think .5 would be. You could use a permanent marker or tape. Then use it as your sample each time you draw up insulin. If you can get U100s, it would be much easier.
 
If you're concerned he might go too low when you're away, you might skinny the dose by squeezing out a drop or two.
Otherwise, that is a great curve.
 
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