Did I mess up?!?

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Danielle Hrubiak

Danielle Hrubiak

Member Since 2015
My sweet Abilene was diagnosed a week ago. Her BG was initially 339 on Friday. On Sunday i started her on Royal Canin dry for diabetics as tbat is what was prescribed and i started timed meals twice daily--that wasn't fun. On Monday her BG was 318 at the vets. I started her on 1u of prozinc twice daily at meal times--starting on tuesday. After i had found this amazing forum i realized dry was super bad and switched her to fancy feast classics. Starting wednesday shes been on solely wet food. Her urinalysis came back Wednesday and dr said she had +1 ketones and +3 glucose but wasn't overly concerned. Abby goes in on Monday for her BG curve test. The other day I purchased a relion confirm meter to attempt to start testing her even though dr said it was pointless until she did her curve testing. She also didn't seem thrilled that I purchased a human meter vs the alphatrek. Said I may have to get the alphatrek if our numbers don't match? But anyways I fed Abby a can of FF at 645pm and gave her the 1u insulin shot. Starting at 830pm she was really begging for food. At 1230 am I couldn't hold off anymore and gave in. I gave her a scoop of leftover canned with a tsp or so of water mixed in and she inhaled it. Right after she ate I took her BG test just bc I was curious of her number and it was 184. Her lowest reading yet! Earlier today she was 284...
But did I totally mess things up by giving her that scoop of food mid cycle? Dr said only to feed at insulin times. :-/ She'll be eating breakfast at 645am and receiving her next shot then...so 6 hours after I gave her that little snack. Please tell me she'll be fine?!
 
Most of us feed multiple small meals instead of just the 2 big ones right before shots (like the vets tell us). Smaller meals are easier for the pancreas to deal with instead of big meals.

Just decide how much you want her to have in a day and divide it into mini-meals....I usually make our pre-shot meal a little bigger than the others, but then she gets a little food every 2-3 hours. Some cats do better if you get all their food in before mid-cycle so that by the time the insulin is starting to wear off, you're not adding food too, but some cats do fine being fed right up to +10

We do want the food taken up 2 hours before Pre-shot tests so you get a test that's not influenced by food, but other than that, small meals spread throughout the cycle is fine! Just keep track of when you're feeding so you can start to see if she might do better getting most of her carbs earlier in the cycle or if it matter for her.
 
She'll be fine - and I'm not just saying that. If she was that hungry then she needed to eat - cats that are running in numbers above their normal range can't get full use from the food they eat so they are hungrier than usual. The only reason you wouldn't want to feed too close to a shot time is that you'll want her to eat when you give her insulin AND because you don't want her pre-shot test to be influenced by food as that can lead to shooting a number that might otherwise have been too low to give insulin. But the cut off for that is about 2 hours before her shot - feeding her mid-cycle as you did isn't going to do any harm at all. :)
 
Thanks guys! I feel awful not allowing her to eat as she tells me she's hungry. All 4 of mine were free feeders that I've been trying to transition due to this diagnosis so this has been very hard on us. My sugarbaby Abilene eats well at her meal times (1- 3 oz can at each meal), but still wants more inbetween. I have been afraid to give her any as the dr was so adamant on only feeding twice as she said the BG would be affected mid cycle and spike the numbers. She's lost a few pounds due to the diabetes so I'm honestly not even sure how much I should be feeding her. She's currently about 7.3ish lbs. She was somewhere between 9.5-11ish lbs previously but was overweight at that point. But her back and rear area feel so boney now. I will try doing 1 can at her am shot, 1/4-1/2 around noon, 1 can at pm shot, and 1/4-1/2 at bedtime. I just didn't know if it was a bad thing to allow her to eat too much...

I'm also having trouble with 2 of my other cats. They're refusing to eat much of anything. I tried the wet, offered them their usual BB dry...they take a few nibbles and run off. I know they aren't consuming their needed daily calorie intake. That makes me worry about hepatic lipidosis. Hopefully since I'll be feeding Abby 2 small mid-meals, they will eat a bit more at those times as well. They can certainly use some weight loss themselves, but I still want to make sure they are getting ample calories for normal metabolic function.
Does anyone have any idea of how much a cat should be eating per day? I have read a lot of different recommendations and don't know what is right.
 
If you pop over to www.catinfo.org, she has a section on her website on How Much Do I Feed. If you weigh your cat regularly and she's not gaining the weight you want her to, she needs more food. Let the scale be your guide. There are also tips on that website on how to transition kitties from dry to wet food.

More smaller meals are easier on the cat's pancreas. Most of us feed small meals during the first half of the cycle.
 
Danielle Hrubiak said:
...The other day I purchased a relion confirm meter to attempt to start testing her even though dr said it was pointless until she did her curve testing. She also didn't seem thrilled that I purchased a human meter vs the alphatrek. Said I may have to get the alphatrek if our numbers don't match? ...
Click to expand...
Your vet doesn't know there are feline-specific reference numbers for human glucometers, developed by international feline diabetes expert Dr Rand of the University of Queensland.
And the numbers likely won't match as human glucometers read, on the average, 30-40% lower than pet meters or vet labs. See my signature link Glucometer Notes for more details.
Testing before you shoot will help you keep your cat safe. Testing about +5 to +7 hours post-shot, whenever you can, will let you see how low the glucose goes. You don't need your vet to do that if you can home test, which will save you money. If the glucose remains above 50 mg/dL at its lowest, that is safe. You work to get it down near that at mid-cycle, but no lower, to have the tightest control of the diabetes.
 
I will TRY to explain that to her and see what her reaction is. I feel like I really want to follow the lead of so many on this board, but I'm scared to step on the toes of the vet and have a bad relationship with her. This is a new vet that we've started using since the diagnosis, so I really don't have much experience dealing with her and fully trusting her--although I don't have a specific reason not to either. I'm hoping she is on board with me utilizing suggestions and experiences from this forum. When I told her about how I've been reading up on this feline diabetes forum I found online and how the feline diabetes pet-parent community uses the human meters, she said well in MY community, we suggest the alphatrek...yikes.
The only thing that I'm now questioning in relation to the differing test results is...Abby was diagnosed with a BG of 339. A few days later her BG was 318 at the vets. I then started randomly testing with my meter and I've had high 300s a few times. So if my numbers are actually lower than the more calibrated pet meters, that means her BG was even higher than what my meter read!! That scares me! I even have her on a fully wet diet now. Why wouldn't her BG start to lower even without taking insulin into account? I know the numbers wouldn't be normal, but I was hoping for a nice reduction on her own from diet change.
Anyhow, a bit of a gear change--this morning I screwed up and was late an hour giving Abby her 1u of prozinc. Her BG was around 367 pre shot. I just checked her at +2 and she is now 346. Is a reduction of 21 normal over 2 hrs post shot? Or should we be seeing a much more rapid decline?

And--I've noticed a huge reduction of water consumption from all of my cats since starting wet (and since Abby started insulin). They used to live at the faucets and drink constantly (and waste a lot of water too). But now I rarely notice any of them drinking, especially my sugarbaby. She would drink A LOT and pee huge clumps before...I haven't noticed her drink much of anything or really pee much lately. Is this bad? She did have +1 (or 1+) ketones in her urine the other day...which I hear is really bad... Any insight on this?
 
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Share this research article with your vet; page 2 provides the reference numbers.

And unless your vet is going to pay for the AlphaTrak and the very pricey test strips, you can thank her for her input and tell her your budget doesn't allow for the most expensive option. At $2.00 or more per day, that'd be at least $60.00 and it just isn't in most folks budget.

Don't get too freaked out by high numbers; you're just at the starting point of working on control. In the 300s and up, you do want to test for urine ketones, which are an indicator of fat breakdown for calories and may mean that there is a risk of diabetic ketoacidosis. See my signature link Secondary Monitoring Tools for some details on that, plus other assessments you can make to evaluate her health.
 

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She already tested positive for ketones. :-(. Vet wasn't too concerned though? And I've been waiting to catch her pottying so I can slide a test stick under her but if she goes at all, it must be during the night? She's in my sight throughout the day and I've yet to see her go pee or poop.
 
Some folks scrunch up some plastic wrap and place it in the litter box around the edges to catch urine.
Many cats eliminate about 15-20 minutes after eating.
 
Here are some other Urine Testing Tips for you. Hopefully you'll find one that works!

On the reduction of water....that's what should happen!! When you switch to a canned food, you greatly increase the amount of water they get in their food (which is how cats are "programmed" to get the majority of their water). Cats are desert creatures, so the majority of their water comes from the prey they catch and eat.

Kibble has hardly any moisture in it at all, so to get water, our cats have to drink, but even then, they can't get enough water to really keep them as healthy as possible.

A lot of us even add more water to the canned to get as much water into our sugarcats as possible. The more water, the better!
 
I've been taking her BG every 2 hours as best as I can today, just for reference even though vet is going to curve her Monday. I haven't gotten to the point of making a spreadsheet that I keep reading about on here... This evening, can I post her numbers and get some interpretations of them from you guys? Even though I only took a few tests yesterday, I feel like she had better numbers and the drop in BG was much greater than I'm seeing thus far today. But I'll post them later and then hopefully you all can tell me what you think...
 
Sure thing!

This should help a bit instructions are here.

Understanding the spreadsheet/grid:

The colored headings at the top are the ranges of glucose values. They are color-coded to clue you in as to meaning.

Each day is 1 row. Each column stores different data for the day.

From left to right, you enter
the Date in the first column
the AMPS (morning pre-shot test) in the 2nd column
the Units given (turquoise column)

Then, there are 11 columns labeled +1 through +11
If you test at +5 (5 hours after the shot), you enter the test number in the +5 column
If you test at +7 (7 hours after the shot), you enter the test number in the +7 column
and so on.

Halfway across the page is the column for PMPS (evening pre-shot)
To the right is another turquoise column for Units given at the evening shot.

There is second set of columns labeled +1 through +11
If you snag a before bed test at +3, you enter the test number in the +3 column.

We separate day and night numbers like that because many cats go lower at night.

It is merely a grid for storing the info; no math required.
 
Thank you for that. I will get the data into the spreadsheet tonight.

So Abilene just finished her 1st cycle of the day... But first let me share the few results I have from yesterday...

4/10 @ 7 am she received her first shot
+5.5 (12:30 pm) BG-341
@ 6:45 pm she received second injection
+2.25 (9 pm) BG- 245
(I did not do pre shot testing that day as vet said wasn't necessary just yet, but from then on I will do it anyway...)

That evening Abilene was very pesty for food. I wasn't sure if I should give it to her as dr said only twice at insulin times.
Well at 12:46 am on 4/11 I couldn't hold off any longer and gave in. I tested her BG prior (so at +6 her evening dose) and her BG was at 182 (her lowest reading since diagnosis). I gave her a small scoop of canned food with some water mixed in around 1 am. She inhaled it. Then it was bed time. And I hate to admit, I overslept an hour and was late on her AM shot.

4/11 @ 7:45 am- AMPS- 367
She ate 1/2 can of food and received 1u injection @ 8 am.
+2- 346
+4- 317
(Ate 1/2 can of food)
+6.5- 277
+8- 262
(430 pm- 2-3 small pieces of freeze dried duck treat)
+10- 234 (6 pm)

6:55- ate 1 can
7:15- 2nd 1u injection
(I did not retest her before this injection because I thought since I had tested an hour prior it would be fine. I'm probably wrong for assuming such :-/ )

Does the decline in BG seem too minimal today?
If she requests such, I was planning to allow her a small snack this evening as well. But I dont want it to affect her BG from dropping. I know I need to be consistent and either do 2 meals with shots or allow the smaller meals maybe 4 times instead. How do I know which will be best for her?
 
(PS-on 4/10 she only received her two meals of 1 can at each injection time) Today was the first day I allowed any minimal snacking throughout the day...
 
It takes 5-7 days of consistent dosing before you're really know how she's doing on the 1 unit dose, but so far she's looking pretty good. It's just too soon to say though.

Most of us will test/feed/shoot all within about 5-10 minutes....You test to make sure they're high enough to give insulin, feed to see if she's eating "normally" and shoot (I usually shoot while China's head is buried in the food bowl)

You don't want to feed for the 2 hours right before the Pre-shot tests. You want those tests to be without the influence of food, so take the food up after +10

It is always important to get that Pre-shot so you have a "starting point" for each cycle
 
So am I waiting too long to shoot after she starts eating? I've been waiting until she's done eating (she eats slow) so I don't upset her and cause her to run off without finishing her food. She's very boney so I want to make sure she gets in enough calories. And she's been on the insulin now for 5 days. She started it on Tuesday morning. Although, I don't have testing numbers since then bc I only started randomly testing her on Wednesday night when I purchased the meter. I will certainly make sure I get the pre shot test done from now on. Definitely makes sense.

Food would definitely be up long before 10+ hours if I stray from the two meals a day like the vet recommends. Unfortunately I can't leave it down and can only go as far as offering it at different times because I have an overeater that would inhale everyone's food.

I am going to tell the vet on Monday that I caved in and gave her food outside of the 2 meals and feel out her reaction about it. If she's not pleased about it, what do you suggest? What if she released us as a patient for not following instructions? Lol.

Should I continue testing her every 2 hrs for the rest of the night? Or do you normally only do 12 hrs?
 
As far as your vet goes...there's no real reason you have to tell her anything. Most of us here don't even see our vets anymore except for routine vaccinations, new problems and to get our scripts when we need them.

Some vets will give you that "do what I tell you to do or find another vet" ultimatum.....if you get that, you're better off knowing now instead of later anyway. You can find another vet that's willing to work WITH you instead of dictate TO you! Just tell her you'd like a copy of her test results. You paid for them...they are YOURS

As for testing, there's really no such thing as too much data!! Since she's still coming down, I'd probably get a +5 or so and see how she's doing. You don't have to do tests every 2 hours all the time, but the Pre-shots and at least 1 midcycle during the AM cycle and at least a "before bed" test at night are the most important ones. After that, if you look at your spreadsheet and see big open spaces, get a test in at those times. Think of the spreadsheet as a puzzle. If the only pieces you have are along the edges, it's really hard to see what the picture is, but if there are pieces sprinkled all over, that makes it much easier
 
At bedtime (1245 am) she was 132. This morning at 645 pre shot 398!!! What in the world would make her jump like that? I can't imagine that being acceptable? 398 is the highest reading she's ever had. This is depressing!

(Side note: I had made a lemon olive oil that I had in a small bowl with plastic wrap over it on the counter over night. This morning it was tipped over and had seeped out onto the counter. I can't imagine Abby lapping up olive oil, but if she really did, could that have caused the rapid spike? My one kitty is notorious for knocking anything and everything over so it could have been her, but I can't rule out Abby either. I guess I can't leave anything out unattended anymore.) :-(
 
it's probably what we call a "bounce", so while it can be un-nerving, it's normal. When our kitties are first diagnosed, they've usually been diabetic for quite some time and their body has gotten used to living at those higher BG numbers, so when we start insulin and start bringing down the BG, the liver thinks there's something wrong and releases stored sugar and hormones to bring the numbers back up to where it's been used to living. Bounces happen for several reasons, the most common 3 are:
1. the blood glucose dropping too low into unsafe numbers
2. BG dropping FAST....like from 400-250 in 2 hours....even though 250 is still too high, dropping 150 points in 2 hours is too fast of a drop so can trigger a bounce
3. BG dropping into numbers lower than the body is used to...so if your cat has become accustomed to living at 350, and then the insulin "kicks in" and brings them down to 200, it may have been a long time since they'd been even that low (even though 200 isn't low) It's lower than they are used to, so the liver does it's thing and you have a bounce.

Bounces can last up to 3 days, but as your cat spends more and more time in those "better" numbers, her body will gradually adjust and she won't bounce as high, and the bounces will clear faster.

I know we keep harping on this spreadsheet, but it really is important so people can quickly go back and see your test results....and it's important that we see them in the format we're used to .....it just makes it easier on us to use what we're familiar with which means we can give you better feedback, faster
 
I promise I will get the spreadsheet done today. Have been so busy and stressed dealing with this diagnosis and trying to finish wedding planning. I'm going nuts.

But just wanted to say... Abby was 215 at +6.5 and at +9.5 she's jumped to 385. What the heck?!?!
 
A bounce can take up to 3 days to clear; that can cause high numbers during that period.
And if she ate between the 6.5 and 9.5, that could raise the numbers.
And some cats may break down the insulin faster than others.
Its hard to say.
 
Welcome Danielle,
Try to take a deep breath and relax a little bit. You're doing everything you should be doing. It's great that you're testing at home! I didn't start doing that for several months but now I can't image not doing it. It all gets easier as you and your kitty get used to the new routine. Like everyone else has said, you do not need the AlphaTrak. I've been using one for about a year but am switching to a human meter because the AT test strips are over $1.00 each. I can get 200 of the human strips for less than the cost of 50 AlphaTrak strips. I also think it's worth the effort to find a vet that you're comfortable with and who will work with you, not against you.
 
Okay guys... I got all of Abby's numbers, thus far, input into the spreadsheet. Forgive me, they are a bit all over the place. I know the first few days I wasn't taking pre-shot tests as I didn't know I was supposed to be (vet didn't tell me to). The days to come will be much more accurate. Tomorrow she goes in for her first curve test at the vet. I am going to see if they can also test with my meter so I can get the same reference numbers to put into the spreadsheet. This evenings preshot test nearly floored me. Highest reading yet, and what makes me feel even worse is--my 432 reading from the ReliOn Confirm is actually lower than what the vet would have gotten. So she must have actually been in 500s or close to it! This is scary stuff...
So the spreadsheet is just numbers. It doesn't allow for any comments such as if I had given food in between, which would affect the numbers. So how do you all interpret the spreadsheet numbers without seeing the whole picture and why the increase/decrease may or may not have occurred?
 
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