Finished First BG Curve, Need Help with Interpretation

[Liz&Gus]

Hello!

I just finished Gus' first BG curve. The link is in my signature.

To give background:
- Gus has been on Lantus at 1 unit bid for 3 weeks.
- He has been transitioned to Purina MD and Fancy Feast classics.
- Treats are EVO cat and kitten (dried food, but lowest carb dried food that I could find)
- Gus is about 1 pound underweight (14 lb currently)
- Testing via ear failed miserably, so I paw-test.
- He has glucose in urine but no ketones.

His BG was high at all time points, so I think he needs a dose increase. How much should I increase it by? 0.25 units or 0.5 units?
- I'm not very good yet at testing, so each BG value actually took 4 or 5 sticks. He was frustrated and angry with me, which might raise the BG levels. I also gave him treats after each test, which might raise the BG level.
- He did not eat anything between +8 and PMPS, how did his BG rise so much?

Also, when I paw-test I put neosporin on after the test. Do I need to take any other precaution to prevent infection, as his paws will come in contact with many dirty surfaces (litter box, etc)?

Thank you in advance for any guidance!

Liz

 

[Chris & China (GA)]

Hi Liz and extra sweet Gus!!

It's really important for you to try to get some more tests in before we can really advise you on dosage. The reason is that we don't know where Gus has been during the cycles, especially overnight. Most cats go lower at night, so without those tests, we can't know if he's bouncing, or needs more insulin. Changes are made in .25 increments, but it's really hard to know if he needs a higher dose, or just more time on this one without more testing.

It's also important to hold the same dose for at least 3-5 days..I know when you see those higher Pre-shot numbers (like you did on 12/12's PMPS) it's tempting to give more, but that's just not how Lantus works. It really requires consistent doses.

Can you try to get some more tests in? We can help you with testing too. It's important to try to get a mid-cycle during the AM cycle (if possible..I know you said you aren't available for 12 straight hours except on weekends) and at least a "before bed" test during the PM cycle. If you can at least get a +2 at night, it's a great little test to do. If the +2 number is a lot different than the pre-shot number, you can expect an "active" cycle..and would want to set an alarm if necessary to get up and get some more testing in.

Gus is still very new to all this, so I wouldn't give up on the ear testing. As long as you're able to get blood from his pawpad, let's try just getting him used to having his ears fooled with for awhile. Just decide where you'd like to do your testing, and as many times a day as possible, take him there and just give his ears a little rub..even for a split second, and then give him a yummy treat. I like to buy chicken when it's on sale, and boil 1 piece (freeze the rest) and chop it into bite size pieces to use as testing treats. China was one of those cats that hated having her ears touched too, so it took a little time, but now she comes when she's called because she knows she's going to get her treat!

About all you can do is what you're already doing regarding the pawpad..after testing putting some neosporin on it should keep him from having any problems, but I've always been worried about the same things you are...litter boxes aren't the most sanitary thing in the world, so if you can get him to let you test his ears, that would be the best choice.

I don't remember for sure, but I think the M/D is a little higher carb...if Gus will eat the Fancy Feast classics, you might want to try just feeding those for awhile.

I know there's a lot to learn, and the learning curve is steep here, but we'll be here to help you any time you need us!

 

[Wendy&Tiggy(GA)]

Hard to tell from one days worth of data because cats vary day to day which is why I usually recommend 3-4 tests a day to see how a dose is working.

- always before the shot - this is mandatory as you don't want to shoot when too low. As a newbie this too low number is 200 but is reduced over time once you have the data to know if its safe.
- mid cycle - 5-7 hours after morning shot depending on your schedule. This is to see how low he is going. The low point "nadir" is what you base dose changes on since you don't want him dropping too low (under 50).
- before bed (2-3hours after Pm shot) to get an idea of what his overnight plans are. If this number is less than the pre shot test number you may want to set the alarm for a test a few hours later as this implies an active cycle.

Paw pad resting is fine - the neosporin will be enough. I would make sure you get the paw pads a bit warm first and give him a treat after even if unsuccessful. Should make the process easier. and you will get better over time. What size lancets are you using? And what kind of treats did you give him?

I doubt the BG was influenced by his temper. But You do need to be more consistent with dose. As China said, each dose should be held 3- 5 days to build up to the correct level in the cats system . Maybe read this protocol: http://www.felinediabetes.com/FDMB/viewtopic.php?f=9&t=1581

Wendy