first glucose curve: home or vet?

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Pussina2001

Member Since 2012
Tomororow will be a week since I'd started giving Pussina her insulin shots, so vet said it is time to do the first glucose test.
She is not opposed to me doing it at home...but she said she did research and some of it advised to do the first test at the vet and also have the vet do a "parallel" one with the home glucometer to see what the correlation of readings is.

Is there a concensus on this? I am sure the vet and glucometer readings will differ, so is that curve even helpful at the vet? I am not sure.
 
I would skip the vet and do the curve at home. Your cat will be stressed at the vet and this cause their numbers to go up. Plus testing at home is much cheaper
 
Have you been doing spot checks at home?

I was advised to do the curve after about 2 weeks to allow the depot to stabilize.
It also allows you to get really good at testing.
And, don't both with the vet - the bg readings there are likely to be off.
 
No, I haven't been doing any testing myself - haven't gotten the glucometer yet, but will get ReliOn Micro tonight.

Are there are instructions on this forum somewhere about performing home glucose test and how to adjust the insulin dosage accordingly.

I think the reason my vet wanted to do the test after a week is because Pussina's glucose was really high, in the 500s. Also she keeps mewing after her food and insulin shots and sporadically going to the food bowl throughout the day like she's still hungry, so the vet was saying that possibly she needs a higher dosage.

But again, I have no idea how her curve would even be helpful if my home readings are almost guaranteed to be very different...
 
there is lots of information in the FDMB faq which is linked above your post. in it you'll find some info on hometesting.
Further, there are some good links on the internet to videos that show how to do it

dosing is tricky. you don't change a dose every time depending on the test result, rather,, you gather information on trends and then decide whether to go up or down, and then hold that change for awhile as it can take time for a dose change to take effect. the only time this rule doesn't apply is if you get a lower than usual number and then have to decide whether to keep the same dose, lower or skip altogether.

bg testing at your vet's may or may not be valid depending on whether conditions (food, rest, water, exercise etc) are the same as at home, and whether stress from being there affects your cat's blood glucose levels or not. Honestly, there is really little need to do it there and every need to start testing at home.
 
Do home testing. Save on the vet glucose curves & buy a good human meter & lots of strips instead with that money. Get on a sliding scale tight regulation regimen & test 3 or 4 times per day (as your schedule allows). You can find protocols for that either on this board or yourdiabeticcat (for PZI NOT Lantus).

You'll have infinitely more detailed information than you can get in any finite number of glucose curves at the vet and at lower cost.

Eventually, when you get your cat controlled, or hopefully in remission, you won't need to test or shoot as often.

But a lot of effort early on will be much better for your cat & will pay dividends in safety & less heartache later.

My humble opinion.
 
just a caveat here

one option for treatment is learning about tight regulation and sliding scales. Some people use this method very successfully. But most people start off with a conservative dose and stick with it while they get the hang of injecting and testing and get their cat stabilized. Then, some people want to be more aggressive and they learn about the various methods of tight regulation.

meanwhile, please know that everyone works with the the goal of remission but it isn't always achievable, so first and foremost is a happy and healthy cat :)

Jen
 
And a competing caveat.

Hyperglycemia at least keeps the pancreas from functioning normally short term ("puts it to sleep" with respect to its endocrine function). Some feel hyperglycemia is directly toxic to pancreatic beta cells in a cat and over time those cells will die and be replaced by amyloid. At that point, you'll have a cat on insulin for life.

This may explain why it is almost always possible to get a newly diagnosed diabetic cat into remission, very quickly, sometimes with diet alone, and much more difficult to get a chronically diabetic cat there.

Maintaining your cat above a BG of 150 for an extended period of time, as some vets recommend may render a remission impossible in a cat where it might have been possible if tightly regulated earlier. That's tragic, IMHO.
 
guess it comes down to what the new person is up for. If I had met you I likely would have been scared off. Luckily my cat went into remission without tight regulation.

Sandman, what I am trying to suggest is that when you give info that you do it with the reader in mind and considering their position and not just yours. There have been lots of discussions about this over the years. There are other websites that are adamant in having one single approach but that has never been the way for the FDMB. Please consider.
 
Do it at home. No reason at all you can't do what your vet can do but better--and with less stress to your cat and no cost to you.

There have been various posts with meter comparisons. I did one a long time ago comparing the One Touch Ultra with the Freestyle Flash. The Flash was a bit lower but ultimatively the EXACT numbers are not the issue, it probably more the overall range that you are in. IN general you are not going to get meters that are 50 or 100 off, they might be 10-30 off, which is really normal variation and standard error so not biggie...

I usually will do a home BG on my cat at home before vet visit or while at the vet visit if I know they are going to do a blood test so that they I can get the results and compare. Usually it's about the same. Again no need to get super nitpicky about these numbers there is variation and error ranges, but it's the overall picture you want...

My biggest lesson was realizing that if I use slow acting insulin--Lantus--which takes a few hours to kick in--if given at a low dose--then if the preshot reading is HIGH I WAIT to feed him for a couple of hours so that the insulin can start kicking in before I jack up his BG with some food. Normally the standard protocol is to feed with the shot, or just before...however if the number is high I think that this can kepp the overall slope/range in the higher range and then this encourages you to increase the dose. When in fact if you just held off on the food a bit, you can stay with a lower dose and still keep a nice even and lower-range BG curve over the day.
 
Thank you everyone for replying...
We did a home glucose test and got some bizarre numbers....also our cat is driving us nuts with mewing and scratching all night & we haven't gotten a good night's sleep in a week. I'm delirious, can't get a hold of the vet yet for her to analyze the curve.
I'll post as a separate post when I get a hold of my log.
At first it was the shock of the diagnosis and the financial burden, then learning the blood taking and shots, now I just want to be able to sleep through the night, she wakes us up at 2, 3, 4, 5 am jumps on the bed, scratches etc... but she seems to be ravenous when being fed 3 oz of Fancy Feast at 6 am and 6 pm, followed by 2 units of Lantus. Vet said ok to leave out dry food, but I can't after all the reading I've done...My vet personally doesn't think no-dry food is key to diabetes management, so....I just don't argue with her.
 
One of the symptoms of FD is that kitty will be very hungry and thirsty. The cat isn't able to metabolize and use its food correctly, so it is always HONGRY. It's best if you can find a way to feed small meals throughout the day - it's easier on the pancreas and kitty gets snax in the process! Many people use auto feeders if they are away most of the day. You can also add some water to the canned food and freeze it so you can leave some out to thaw when you leave. You may also want to add water to the fresh canned food to help kitty stay nicely hydrated.

Hang in there! Believe it or not, this will get easier!
 
Pussina2001 said:
Thank you everyone for replying...
We did a home glucose test and got some bizarre numbers....also our cat is driving us nuts with mewing and scratching all night & we haven't gotten a good night's sleep in a week. I'm delirious, can't get a hold of the vet yet for her to analyze the curve.
I'll post as a separate post when I get a hold of my log.
At first it was the shock of the diagnosis and the financial burden, then learning the blood taking and shots, now I just want to be able to sleep through the night, she wakes us up at 2, 3, 4, 5 am jumps on the bed, scratches etc... but she seems to be ravenous when being fed 3 oz of Fancy Feast at 6 am and 6 pm, followed by 2 units of Lantus. Vet said ok to leave out dry food, but I can't after all the reading I've done...My vet personally doesn't think no-dry food is key to diabetes management, so....I just don't argue with her.
Click to expand...

2u is a higher dose of Lantus. Most cats on a low carb, canned diet (no dry) do not need more than 1u of insulin. Please make sure if you remove the dry food that you are also testing mid-cycle and lowering the dose as needed, or you might see a dangerous hypoglycemic incident.

It is very rare to find a vet that gets every aspect of feline diabetes management right. Some are better than others, but I cannot think of a single person on these boards that has not had to disagree with their vet at some point.
 
It seems likely she is hungry and that is why she is waking you.

Until she is regulated, she will be hungry because she can't use the glucose in her body.

Also, if the insulin is too high (and 2 units twice a day may be), and the food too low, you are set up for a hypoglycemic episode, which can kill. This would also explain why she pesters you - mom, feed me, I'm going too low. You won't know how low she is unless you test.

It is OK to feed her a bit more - maybe try 1 1/2 cans of the Fancy Feast per meal - and leave it out. It will hold for the 12 hours.
 
Thank you. I just posted our crazy first curve at home....as well as notes. We want to have one restful night for all of us :)
 
replied on other post...cat is getting way too much insulin and hitting 20s & 30s

Mel, Maxwell, Autumn & The Fur Gang
 
it might help you to know that my cat, Sneakers, was eating 15-18 OUNCES of food a day- so that is 5 to 6 CANS of FF in a 24 hour period. She ate every hour, almost one the hour, except for when I took it up two hours before testing the AMPS and the PMPS. And, yes- she woke me up all night long. I just used that as a chance to get a BG test in through the night. In fact, that is when I normally test as I work all through the day cycle.

Once your cat gets better numbers, closer to regulation, closer to being and FEELING better she will be hungry. That will be one of the first indicators for you on how she is feeling- when she stops being the food vacuum and leaves food on the plate. Yes, she will go back to it later so leave it out for her to eat- free feeding is what we call it.

Currently Sneakers eats between 6-8 ounces- a HUGE drop in food intake, but she got there in stages.
 
My vet personally doesn't think no-dry food is key to diabetes management, so....I just don't argue with her.
Click to expand...

The key is low carb. Cats are carnivores with absolutely no need for carbs, and these can only cause problems in a diabetic cat (or even a non-diabetic one in the long term). There are bad moist canned foods and good kibbles. But it's nearly impossible to find a good kibble at the petsmart and alot easier to find an acceptable moist canned variety. At best you can find a so-so kibble, but there are plenty of good choices for low carb canned at your local retail outlet.

Even some of the fancy feasts are disasters where carbs are concened. Stick to the "classic".

Consider yourself lucky your cat has a ravenous appetite. Mine has been anorexic since his diagnosis & though his blood sugars are well controlled off insulin continues finicky. He's better, but still marginal as far as holding his weight.

As a result it's tough to find something he'll eat consistently & he needs to remain on mirtazapine. Tried going off it & he stopped eating again... Was still mouthing the young again kibble & chewing on it, but I think he wasn't swallowing. Losing an oz or two a day. Got to wrap him in a towel & shoot mirtazapine in the side of his mouth as no other way to get it in him. Loads of fun.

If your cat is ravenous, it's likely it will be much easier to find a low carb food he likes, so count your blessings. I wish my cat had that problem. And while it can cause problems free feeding a high carb food (most but not all kibbles fall in that category), you can safely do that with a low carb one. Range feeding such a food may actually be a bit safer, since the cat has an out if he starts going hypo. With a moist food, you can put water in it & mix it up to keep it from drying out on you. And you'd get some sleep!!!

Something to think about...
 
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