First home test + Glipizide

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ErinCarpenter

ErinCarpenter

Member Since 2012
Did Eddie's first BG test at home today. 3.5hrs post 5.0mg Glipizide dose and food. BG was 47. Using Relion Confirm. Last BG test was at the vet and it was 285. Any advice? Too low? Zero signs of hypo. What should I do?
 
Keep testing every 15 to 20 minutes and if he goes any lower you are going to want to get food into him to bring him back up, you aren't in terribly dangerous territory yet, but I have no idea how long Glip lasts in a cat as all 4 of my diabetics have been insulin kitties. Do you have high carb gravy type food on hand or at least something like honey or Karo syrup?

Mel, Maxwell, Autumn & The Fur Gang
 
I tried several times to get another BG but with no success. I gave him treats each time so maybe he'll start learning from that. We have karo syrup and high carb dry food in case we need it. He seems totally normal right now. Guess I'll just an eye on him. His BG was 285 at the vet last weekend with what I think is an alpha trak, what's is the readIng difference between an alpha trak and Relion confirm?
 
Hi Erin,

Well done for testing Eddie! I do hope he is OK now? Maybe a dose reduction is required....?! (Is there a good reason why you're not using insulin..? Will have a read of your other posts...)

Although 47 is an OK number for some cats my own cat had his first symptomatic hypo at that number.

And regarding the numbers, it's not just about what the number is, ie '47', but where in the cycle that occurs. So, for a cat on insulin, if that number were to appear at the peak of the cycle (lowest BG number) it might be OK, even possibly desirable for certain cats on certain insulins (though not all cats would be comfortable here..). If that number occurred before the peak of the insulin cycle - and the cat was likely to drop more - then intervention would be required to keep the cat's BG from dropping too low.

Regarding Glipizide however, I don't think there are many people on this forum who have actual experience of how that works.

I have no idea whether Glipizide has a 'cycle' of effectiveness in the way that insulin does. And I think this is something you really need to ask your vet about.

It is clear that Glipizide can sometimes cause hypoglycaemia.

And maybe this would be a good time to practice those hometesting skills. You made a great start today! And you will find lots of help here about how to make hometesting easier and manageable for you and your cat. It now seems clear that you'll need to monitor Eddie's BG's at home whether he is on insulin or Glipizide...

Edited to add: It may be that your removing dry food from your cat's diet has reduced his BG's. Therefore, another reason for dose reduction..?


PS. I don't have experience of your BG meters and so can't comment on the differences, but I'm sure there are others here who can help.
 
Erin, did you recently change the diet and get rid of the dry food and high carb prescription canned food? If so, I would discontinue the Glipizide and keep home testing daily to see what kind of range he's in without it. Glipizide only works in about 25% of cats (on a low carb, canned diet), which is about the same as the rate of spontaneous remission from diet change to a low carb, canned diet, so I would say even that success rate is questionable.

Numbers obtained at the vet are nearly always inflated by stress, so you cannot use them to judge how your cat's overall blood glucose is ranging. Bandit's blood glucose shoots up into the 200-300 range at the vet, and is perfectly normal at home. Question: was the diabetes diagnosis confirmed with a urinalysis or fructosamine? Sometimes vets will diagnosis of blood testing alone and this is NOT recommended for that very reason.

After a week of low carb canned diet only and testing, if numbers are still in a diabetic range I would start a slow acting insulin like Lantus or Levemir. However, I have a feeling your cat is likely going into remission from the diet change alone. In your other post I provided some information on why Glipizide should not be used in cats unless you're considering euthanasia. Here are a couple more articles for you to refer to your vet: http://www.ncbi.nlm.nih.gov/pubmed/9074678, and http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1885761/.
 
We took away the dry food one week ago today. I still could not get a test this morning. I think he did so well the first time because my husband was helping me by petting him and keeping him occupied when I tested him. When it's just me he keeps getting up and moving a few steps away just as I'm about to poke his ear. He has another doctors appointment this afternoon. So we'll see what his numbers are then. Hopefully it was just a little weight loss and lo carb food that he needed. His diagnosis is based on his very high BG of 430 the first visit. Neuropathy confirmed it too. His activity level is back to normal with the lower sugar levels. I could tell he felt awful before starting treatment. I will talk to our vet about a urinalysis.
 
Here's some tips to get you better with the testing. Remember, cats have very few nerve endings in their ears (less than people have in their fingertips), so it's not pain that they don't like--it's the fact that you're restraining them and doing something new while they're sensing the whole time that you're scared and nervous. Once you get the attitude that you're NOT hurting your cat and he'll be just fine, the cat calms down and is perfectly fine with being tested many times a day. You also want to get a treat after every test, successful or not. Also, set up a testing space where you're doing every test in the same place.

Once common mistake many new people make (myself included) is using too small a lancet. You want to use 26-28g lancets, not the 30-33g lancets that come with the meter. Warm the ear with something--I used to microwave a damp washcloth and put it in a plastic baggie. Here's where you're aiming: http://felinediabetes.com/images/laur_danny_famoussweetspot.jpg. Make sure the ear is backed with a cotton ball or piece of tissue, and put pressure on the spot for 20 seconds after you've gotten your test. A little neoposorin + pain relief ointment helps as well.

If he's not sitting still for you, you'll need to hold him. If he struggles, wrap him up in a blanket like a burrito. Bandit can be a difficult cat (you should see him when he thinks he's getting a bath) and was fighting me tooth and claw the first week of testing. I got a basket and lined it with fleece blankets. Every test took place there. I would wrap Bandit up in another fleece blanket and put him in the basket so that only his head was showing. Then I would get my poke, give him a treat and let him up. After a couple weeks he stopped fighting me; after a couple months he started running to his basket and purring when he heard the meter beep on. :-D
 
My lancet pen came with 30g but I bought a box of 26g to start with. I usually use a piece of cotton gauze to put behind his ear for the poke. The first few tries, I could not get any blood with the 26g. I tried the 30g just for the heck of it and... Voila, blood. It might just be that I didn't hit the right spot the first time. I'm not worried about hurting him anymore since he didn't even blink an eye at the poke last night. I'll try wrapping him up to test him. That may work.
 
Erin, are you warming the ear first? You'd be surprised how much that helps in the beginning. Once the ears "learn" to bleed (the more you test, more capillaries will be created in his ears, making it easier to get a drop) you won't need to warm them, but I had to warm them to for the first month or two. Unless I caught Bandit napping, and then his ears were already really warm.
 
Julia & Bandit said:
...Exercise helps SO much with neuropathy...
Click to expand...

The cat doesn't necessarily have to go outside to get good back leg excercise. My cat had bad neuropathy when he was diagnosed. Although he has access to outdoors his most energetic leg excercise came from his playing with catnip toys and his cat scratching pole (which I dusted with catnip): He would hold the catnip toy in his front paws, or hang onto the scratching pole with his claws, and give both a really good kicking!!! And if your cat doesn't respond to catnip then he may do to valerian.
 
I'm not sure how squirmy your kitty is, but this is how I test Buster: I call him to the "juicing room" which is just our home office, but I have a little Willy Wonka in me :lol: On the floor, I give him a few enticing LC treats and some skritches. Sometimes a little brushing. Then I kneel behind him and push his little but down so he's sitting. I'm on my knees behind/over him and he's right in the middle of my legs. At first, when he was really squirmy and unfamiliar with the testing I had to sort of squeeze him between my thighs, and keep my feet together so he couldn't back out - cats have that full reverse move goin for them, ya know? Now he just hangs out. Sometimes I can test him wherever he's napping, but we usually head to the juicing room where it's quiet. I also use a headlight - one of those ones that people often use for camping. It keeps my hands free and gives a little extra help for hitting the sweet spot.

Keep trying! You'll find your way!
 
If, after 2 tries at testing, you've been unsuccessful, and really, really need a result, you may directly poke the vein.

Be prepared - the blood often flows quite freely when you do this, the cat often shakes its head or flicks the ear, and you wind up with spatters! Also, if this is successful, apply direct pressure to the prick after testing, to reduce the formation of a bruise ... and to reduce more spattering! (These are why you don't want to do this regularly - bruises and mess)
 
can also tuck him into the corner of the couch to help keep him in one spot. also, (has happened to me) when i was first into this, I was clicking away like crazy and not getting any blood. ended up I was missing the ear entirely. I put on the clear cap and now i can see where to center the needle. I also free hand with the needle in the lancet devise for a better grip
 
BJM said:
If, after 2 tries at testing, you've been unsuccessful, and really, really need a result, you may directly poke the vein.

Be prepared - the blood often flows quite freely when you do this, the cat often shakes its head or flicks the ear, and you wind up with spatters! Also, if this is successful, apply direct pressure to the prick after testing, to reduce the formation of a bruise ... and to reduce more spattering! (These are why you don't want to do this regularly - bruises and mess)
Click to expand...

Crikey, that sounds messy! BJM, you missed out the instruction about not wearing a white T-shirt when you do this! :lol:

I've always just aimed for a few millimetres inside the edge of the ear, and sometimes it just bleeds better than at other times. Never aimed specifically for the vein - my eyesight isn't good enough! I get a 'gusher' maybe one out of 25 tests (and we've clocked up over 17,000 tests now...). Yes, always press on the test site with a little cotton wool or just with your fingers to reduce bruising and tenderness.

Erin, it looks like your cat has black ears like my cat. A teensy smear of Vaseline can help the blood to bead up and can help you to see it more clearly.
 
Great news!!! At Eddie's doc appointment today, his BG was 135 (still possibly low because of the stress factor) and down from 14lbs 3oz to 12lbs 8oz. Wow!! What a difference taking away the dry food made. They lowered his glipizide to only twice a day now too. Looks good for him. I'm still going to test him at home to monitor him but I'm really excited that he's doing so well. Maybe management/maybe remission is possible with Glipizide. We'll see. ;)
 
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