First BG test at home

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FelineFriend said:
Smokey's PMPS with NO food prior is 17.1/308
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What did you end up doing? I would have suggested 2.
MrWorfMen's Mom said:
Here we are at the conundrum of dealing with feline diabetes. My view of this is that yesterday Smokey was still in a bounce in the morning and then it "broke" which is exactly what we wanted to happen. Today she followed a more expected course with Caninsulin in that she reached a low at +3 instead of at +6. Nadirs (lowest reading) can move a bit but with Caninsulin, they are more often around +3 or +4 than at +6. If I were you, I would think about dropping her to 1.25u tonight just to be safe. It's obvious the dose the vet had her on was way too high and she now has other ideas but things are definitely moving in the right direction. :D

Food wise do you mean Taste of the Wild. If so it's about 22% carbs which while too high is not the worst you can get. I was feeding that to my girl for a time while I tried to find something with less carbs available in Canada that she would eat. You are definitely lucky to be near the border and able to get Young Again (she says as her green eyes get greener ;)). When you do get the Young Again, it's likely you are going to see Smokey's need for insulin drop considerably so I'd make the switch slowly over a few days to a week and monitor Smokey closely.
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My cats nadir was always between 5-6 on vetsulin.
 
I admit to being very conservative with dosing especially when there is only 5 days of data and kitty started out on a dose that has proven to be too high setting off a bounce because that muddies the waters when it comes to knowing how fast and when kitty will nadir and what dose is most appropriate. I've seen cats on Caninsulin drop swiftly at +1.5 hours post shot and some that ideally drop later and more smoothly. Every cat metabolizes insulin at a different rate so until bouncing stops, it's hard to know what kitty's norm is. Ideally a curve with Caninsulin would look like this.
Ideal curve with Caninsulin_Vetsulin.PNG

I suggested the 1.25u last night for a couple of reasons. It's harder and sometimes not possible to monitor late into night cycles (up to or even past +6) and with Smokey going down to 4.4 (79 US) on the 25th and 4.1 (74 US) on the 26th, both being numbers Smokey has become unaccustomed to, I expected her to bounce again last night which it appears she did given the PMPS of 308. I think sliding scales work well once one has a good handle on how different doses work for the individual cat, but this early with so little data, giving higher doses on high pre-shots when ideal numbers have been reached in previous cycles would in my opinion just set off more bouncing or possibly send Smokey dropping too low. Given I would have reduced Smokey's dose based on her going down to 4.1 (74 US) yesterday anyway, I'd rather see Smokey running a bit high than too low overnight because that 17.1 (308) looks to me like another bounce.
 
last night i gave Smokey 1.5u then tested her at +2 and BG was 10.7/193. this morning her AMPS with NO food was 14.9/268.
BTW i finally figured out that i have to use the site's emojis not mine. sorry if some of my previous posts were taken the wrong way, not the same without a bit of emotion :) thanks again!
 
I don't think any of your posts have been taken the wrong way so no worries.

Good to know you gave 1.5u last night. With that 14.9 (268 US) this morning and that drop of over 100 points in the first 2 hours last night, I'm still thinking a dose of 1.25u might be in order. I could be wrong but the trick is to slowly get kitty's body used to lower numbers rather than trying to force it. Forcing it, sends them into a bounce of ups and downs and makes it impossible for them to become used to lower numbers and hard to see what dose is best. It's easier to up the dose a bit if needed than to deal with a kitty that has gone too low.

I wouldn't be as concerned about being precise with dosing as I would be with consistency. You could fill a couple of syringes with coloured water to a dose of 1.5u and 1.25u so that you can use them as a comparison when drawing up those doses. That way you will know your dose is consistent if not precise. Some folks count the drops in a full unit and guestimate from there by letting out one drop at a time.

You can get syringes delivered from this site. http://www.thepetpharmacist.ca/endocrine/caninsulin-0-5ml-injection_100-syringes. I think these ones have the 1/2u markings but I'd suggest you call them to be sure. The other option is ordering from the US if you are going to go over there for the Young Again food anyway. This is but one option at ADW in the US. https://www.adwdiabetes.com/product/bd-pet-syringes-u40-29g-3-10cc-1-2in-half-unit_18570_112.htm
 
MrWorfMen's Mom said:
I don't think any of your posts have been taken the wrong way so no worries.

Good to know you gave 1.5u last night. With that 14.9 (268 US) this morning and that drop of over 100 points in the first 2 hours last night, I'm still thinking a dose of 1.25u might be in order. I could be wrong but the trick is to slowly get kitty's body used to lower numbers rather than trying to force it. Forcing it, sends them into a bounce of ups and downs and makes it impossible for them to become used to lower numbers and hard to see what dose is best. It's easier to up the dose a bit if needed than to deal with a kitty that has gone too low.

I wouldn't be as concerned about being precise with dosing as I would be with consistency. You could fill a couple of syringes with coloured water to a dose of 1.5u and 1.25u so that you can use them as a comparison when drawing up those doses. That way you will know your dose is consistent if not precise. Some folks count the drops in a full unit and guestimate from there by letting out one drop at a time.
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good idea @MrWorfMen's Mom, i like the idea of comparing for a consistent dose. Smokey doesn't seem to be dropping as quickly this morning which, i think, is good. at +2 her BG was 10.3/185.
 
That 10.3 (185 US) is still a big drop for 2 hours post shot. If you can get another reading at +4 and at +6 today, you should get a good idea of when her lowest point is today.
 
ok, the +4 dropped to 6.8/122 US and as suggested, will do a +6. if the BG stays above 5 should i go with the same 1.5 units tonight? if it drops below 5 then i think i will drop the insulin to 1.25ish units. several people have suggested that it's good to keep same amount for several cycles before changing the dosage.
 
I think your plan is fine as long as the PMPS is high enough and nadir is not below 5. It's a combination of pre-shot and nadir readings that have to be considered when making dosing decisions. It is definitely ideal to stick with one dose for several cycles to see how that dose is working but that of course has to be determined with the pre-shot and nadirs in any given cycle and whether extra monitoring is possible should it be necessary. Once you have more data and Smokey becomes a little more predictable, it does get easier. The first couple of weeks are when you gradually get enough puzzle pieces to start seeing what is going on. If you make a diet change Young Again, that will make the puzzle change again and you'll again have to monitor a bit more intensely and watch dosing because the dose of insulin required is almost certainly going to go down.
 
MrWorfMen's Mom said:
I think your plan is fine as long as the PMPS is high enough and nadir is not below 5. It's a combination of pre-shot and nadir readings that have to be considered when making dosing decisions. It is definitely ideal to stick with one dose for several cycles to see how that dose is working but that of course has to be determined with the pre-shot and nadirs in any given cycle and whether extra monitoring is possible should it be necessary. Once you have more data and Smokey becomes a little more predictable, it does get easier. The first couple of weeks are when you gradually get enough puzzle pieces to start seeing what is going on. If you make a diet change Young Again, that will make the puzzle change again and you'll again have to monitor a bit more intensely and watch dosing because the dose of insulin required is almost certainly going to go down.
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thanks! i may have missed her nadir today, tested at +2 (10.3/185) +4 (6.8/122) +6.5 (10.4/187) and BG on the rise for last one so tomorrow will test on the odd hours. would it be better to test at +4 +5 +6 tomorrow or at +3 +5 +7? i'm wondering if it's more important to determine the nadir or to test periodically in cycle. i'm afraid her ears are getting sore...
 
Don't think of this as missing the nadir. You now know her nadir was somewhere around +4 to +5 today. All data adds another piece to the puzzle. You never know when you hit the nadir dead on but you get a reasonable idea of when it has occurred and how low Smokey has gone. None of us know precisely when our cat reaches nadir. The nadir can and does move. It may shift very slightly or by an hour or more n any given day. Some cats are more consistent, some more erratic. Much of this sugar dance is learning how to read your own cat's dance steps and then you can act accordingly.

If you think Smokey's ears are getting sore, you could try some Polysporin (Neosporin) ointment with pain relief to make the blood bead up better and help heal her ears. If you want to give Smokey's ears a rest tomorrow, I like your suggestion to test at +3 and +5 tomorrow and then if Smokey's BG is on it's way back up or holding relatively steady, you could give her a rest until PMPS. I know this seems like you are flying by the seat of your pants right now, but you are definitely getting a lot of good data that will make this easier in the days to come. And you are learning to read what Smokey is doing and make decisions about how to proceed. :D
 
MrWorfMen's Mom said:
Don't think of this as missing the nadir. You now know her nadir was somewhere around +4 to +5 today. All data adds another piece to the puzzle. You never know when you hit the nadir dead on but you get a reasonable idea of when it has occurred and how low Smokey has gone. None of us know precisely when our cat reaches nadir. The nadir can and does move. It may shift very slightly or by an hour or more n any given day. Some cats are more consistent, some more erratic. Much of this sugar dance is learning how to read your own cat's dance steps and then you can act accordingly.

If you think Smokey's ears are getting sore, you could try some Polysporin (Neosporin) ointment with pain relief to make the blood bead up better and help heal her ears. If you want to give Smokey's ears a rest tomorrow, I like your suggestion to test at +3 and +5 tomorrow and then if Smokey's BG is on it's way back up or holding relatively steady, you could give her a rest until PMPS. I know this seems like you are flying by the seat of your pants right now, but you are definitely getting a lot of good data that will make this easier in the days to come. And you are learning to read what Smokey is doing and make decisions about how to proceed. :D
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thanks for the pep talk :). i have been using arnica in olive oil for pain relief and bruising control. i was using the polysporin but my husband said it makes his skin sore if use more than a few days. since the arnica i'm getting much less bruising, but could also be due to better aim ;)
i'm dreading the one week vet visit because he didn't want me to home test...between testing i've been reading as much research and online info as possible. depending on the visit i may be looking for a new vet :nailbiting:
 
FelineFriend said:
thanks for the pep talk :). i have been using arnica in olive oil for pain relief and bruising control. i was using the polysporin but my husband said it makes his skin sore if use more than a few days. since the arnica i'm getting much less bruising, but could also be due to better aim ;)
i'm dreading the one week vet visit because he didn't want me to home test...between testing i've been reading as much research and online info as possible. depending on the visit i may be looking for a new vet :nailbiting:
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Any vet who would think testing at home is bad is either money hungry wanting you to only go to them for tests, or an ego maniac control freak.
 
Oh Dhana, you need to learn the techinique many folks here employ with their vet. Just smile and nod! I can't see how your vet can possibly argue with the fact that the 3u he/she prescribed was too high and that testing saved Smokey from what could have been a scary or worse situation. I still say the best way to handle a close minded vet is to ask them if they would give insulin to a baby without first testing to make sure it was safe to do so and to make sure their BG wasn't going too low. Any vet who doesn't think twice about their no testing stance with that question does indeed deserve to be fired! Smokey is the furry equivalent of a baby!

What you do at home is entirely up to you. Diabetes is a 24/7 proposition for the CG. The vet can't possibly adequately prescribe or monitor with a quick visit given most cats end up with an elevated BG at the vet's office and for any vet who thinks they can, is nothing short of delusional. Ok I'll get off
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now! I know I'm preaching to the choir! :rolleyes: I just don't see how any CG who goes to the trouble of monitoring their pet at home and taking so much interest in the well being of their pet should have to worry about being berated by their vet when they should be praised!
 
thanks for the support! i made some calls and i found a vet who believes in home testing and will work with me :)
after chasing Smokey around the house in a casual way, i finally got the AMPS. her BG is 14.7/265 and i thought i'd stay with 1.5u this morning then try to find her nadir in +3 to +5
i like the strategy of Smile, Nod, Ignore ;) but i think i will tell him that i'm going to a vet who "specializes" in FD and provide some of the information i've found because i'd hate for someone else to have a life threatening situation with their fur baby because of him.
 
Wonderful news about finding a new vet! I think it's important to have a vet who will work with you as a partner rather than someone who thinks they can bark out orders and expect you to blindly follow. Treatment of a diabetic cat is very much a hands on situation and you know Smokey better than anyone else ever will so your input and comfort with how treatment is handled is of paramount importance.

Good call on the 1.5u this morning! I agree with Janet.....I think Smokey may be in a bit of a bounce again right now and a reduction soon is a good possibility.
 
MrWorfMen's Mom said:
Wonderful news about finding a new vet! I think it's important to have a vet who will work with you as a partner rather than someone who thinks they can bark out orders and expect you to blindly follow.
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so very true! i'm very pleased to have someone knowledgable about FD. the vet tech is also well informed about it and we chatted for half an hour about Smokey's numbers (i just walked in and visited).
 
my friend brought some Wellness Core dry and wet food yesterday, i have been feeding Wellness cans not realizing there was a difference, so when i tested Smokey's BG last night (PMPS 15.8/284, 1.5u insulin) at +2 i was shocked to see it had dropped to 6.4/115 then at +4.5 BG was 5.1/92. this morning AMPS is 14.8/266 which has been the same for the last three mornings. i will give 1.5u again and will test mid cycle because i added a bowl of the dry for free feeding and Smokey really liked it.
 
Smokey is looking good and you are doing a wonderful job. I'm sure your new vet is going to be very impressed with your progress!

Do monitor Smokey today because the Wellness Core is lower in carbs than the Taste of the Wild. I believe Wellness Core is in the neighbourhood of 15% vs 22% for TOTW so a decent difference. That alone could lead to the need for a dose reduction in the not too distant future. :D
 
MrWorfMen's Mom said:
Smokey is looking good and you are doing a wonderful job. I'm sure your new vet is going to be very impressed with your progress!

Do monitor Smokey today because the Wellness Core is lower in carbs than the Taste of the Wild. I believe Wellness Core is in the neighbourhood of 15% vs 22% for TOTW so a decent difference. That alone could lead to the need for a dose reduction in the not too distant future. :D
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Wanted to give an update on Smokey. did a BG curve then took her to new vet the next day who said her numbers looked good and wants another BG curve one week after she is on the YA for a week. she also will test fructosamine levels at that time. she also suggested i get an alphatrak for doing the curves. until i get the YA i will just be doing PS tests, i used the SNI routine when she said that testing wasn't necessary unless changing diet ;)
the vet and her nurse were very impressed with the spreadsheet so i told them about this forum!
 
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