Fructosamine result 513 - vet wants 2 units instead of 1 (2x daily)

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FurBabiesMama

FurBabiesMama

Member Since 2017
Mia's first follow-up visit since diagnosis (2 weeks ago) was yesterday, and I got her fructosamine results today - 513. :( They did full blood chemistry on her last visit; glucose was 481. They did a BG test yesterday, and it was in the 440s. (Let me just say that she is a scaredy cat. Scared of her own shadow. Hides when it thunders. So, going to the vet freaks her out.) The vet wants me to up her does from 1 unit twice a day to 2 units twice a day. I asked if we should try 1.5 units, but she said no, that is not a big enough difference to have the impact we need to see. I am going to be away from home the next few days from the time I give her first shot until almost time for her second shot. I told the vet I am concerned about doubling her dose then leaving and not being around to monitor her. (Technically, her first double dose could be this evening, and I would be here after that one.) She said it should not be an issue because that is still a low enough dose and her numbers are pretty high, but if I am really uncomfortable with it, I can put it off until I am going to be home with her (Monday).

I know you are all going to 'get' me for this, but I have not started home testing yet. :eek: I have read how much everyone here advocates it, and logically, I get it. How can you manage something you are not keeping close track of? BUT, I am just not ready for that. This has been a lot to deal with, much more stressful than I would have ever guessed. Over the years, I have cared for cats through many issues, but I seem to be having the roughest time with this. Lately, Mia knows when it is shot time, and she makes a half-hearted attempt to hide from me. I feel bad. I am just not sure I can stick her ear.. over and over and over. It does not help that the vet recommended against it. (Yeah, really.) She said it can 'disrupt the animal/human bond' and that she does not want me to be SO focused on 'a number'. She said it is about the 'whole cat', how Mia is feeling. She said different cats feel/behave differently at different glucose levels. I really was just hearing.. 'blah, blah, blah'. Anyway..

I would appreciate feedback on the fructosamine results and the dosing change. (Please do not beat me up too much for not home testing. I will get there.. maybe.)
 
Deep breathes. Sounds like you a bit torn right now especially when you are getting one message from us here and another from your vet. I agree with your vet that Mia is much much more than a number and you should never rely on numbers alone to determine how your cat is doing. Her general behaviour and activity levels also play an important role in assessing how Mia is feeling. I do not agree with your vet that home testing would cause a rift between you and Mia. Most of us have found the bond between us and our diabetic cats becomes even more intense. Our cats actually enjoy the extra attention and a good number of them come to get us at test/shot times.

If you are finding Mia trying to hide at shot time, use food as an incentive and give her shot while she has her head buried in her bowl.

You need to do what you are comfortable with but let me just mention a couple of things for you to think about. No one means to beat you up and I hope you will take this in the spirit it's intended.

You don't seem comfortable with the dose increase the vet is advising and I agree with you. We generally suggest increases of 0.25u and definitely no more than 0.5u because small dose changes do make a BIG difference for some cats and it's often better and faster to ease the BG down rather than trying to force it down. If you are not comfortable changing the dose by 1u, change it by 0.5u and only do so when you can be home with Mia. She's your cat and you are her best advocate and should only do what you feel safe/comfortable doing.

Your cat gets freaked out at vet visits. Mia gets upset because she doesn't understand or like what happens at the vet's.

You and Mia are both feeling out of control for very different reasons and home testing would alleviate a lot of the stress for both of you. For Mia, there would be far fewer vet visits because you'd be able to see how she is doing at home in her own comfortable environment. For you, you'd know it was safe to give insulin and how the dose was working for Mia and could make adjustments for those times when you are not available to monitor her.

We all understand that the diagnosis of diabetes in our furry friends is overwhelming and each of us has to work through it all in our own time. Whatever you decide is fine, but I hope you will give this some thought because testing is the best tool we have to keep our kitties safe and us sane while getting our kitties on the path to better health. If she is like most cats, she will adapt and might even be tracking you down at shot time! :bighug::bighug::bighug:
 
FurBabiesMama said:
Mia's first follow-up visit since diagnosis (2 weeks ago) was yesterday, and I got her fructosamine results today - 513. :( They did full blood chemistry on her last visit; glucose was 481. They did a BG test yesterday, and it was in the 440s. (Let me just say that she is a scaredy cat. Scared of her own shadow. Hides when it thunders. So, going to the vet freaks her out.) The vet wants me to up her does from 1 unit twice a day to 2 units twice a day. I asked if we should try 1.5 units, but she said no, that is not a big enough difference to have the impact we need to see. I am going to be away from home the next few days from the time I give her first shot until almost time for her second shot. I told the vet I am concerned about doubling her dose then leaving and not being around to monitor her. (Technically, her first double dose could be this evening, and I would be here after that one.) She said it should not be an issue because that is still a low enough dose and her numbers are pretty high, but if I am really uncomfortable with it, I can put it off until I am going to be home with her (Monday).

I know you are all going to 'get' me for this, but I have not started home testing yet. :eek: I have read how much everyone here advocates it, and logically, I get it. How can you manage something you are not keeping close track of? BUT, I am just not ready for that. This has been a lot to deal with, much more stressful than I would have ever guessed. Over the years, I have cared for cats through many issues, but I seem to be having the roughest time with this. Lately, Mia knows when it is shot time, and she makes a half-hearted attempt to hide from me. I feel bad. I am just not sure I can stick her ear.. over and over and over. It does not help that the vet recommended against it. (Yeah, really.) She said it can 'disrupt the animal/human bond' and that she does not want me to be SO focused on 'a number'. She said it is about the 'whole cat', how Mia is feeling. She said different cats feel/behave differently at different glucose levels. I really was just hearing.. 'blah, blah, blah'. Anyway..

I would appreciate feedback on the fructosamine results and the dosing change. (Please do not beat me up too much for not home testing. I will get there.. maybe.)
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Took me 6 weeks in before I started testing. When my vet wanted me to go from 1 to 2 is when I started. As nervous as I was too test I was more nervous I would come home and find her dead or having a seizure. Once I started I regretted not starting that first week.


I have a video in my signature showing how I test my cat CC.
 
I am a little confused about when I would have to test. It seems like a lot of people test a lot. What is the minimum testing frequency that would be effective? (If this is explained somewhere, feel free to point me in the right direction. I have just read so much and have not seen anything that spells it out at kindergarten level.)
 
It took me a couple weeks to start testing. What really got me determined to do it was when my kitty had a near hypo and the vet telling me to blindly reduce the dosage the next morning without testing him first. I just couldn't inject him without a test that morning out of fear he would drop too low again. I didn't do too well on the testing but did get a sample (along with mine too!) and he was only at 85 which would not have been good at all to add insulin. I wasn't able to test as frequently as I should have but I was getting better and quicker at it so that he wasn't so traumatized by it anymore. It was a battle at times but was much better than him going into a hypo state or being hospitalized for DKA. I hope it goes better for you. Staying relaxed and being calm helps a lot because they do pick up on the anxiety. I learned that now on just giving him meds- the calmer I stay the easier it is to get the pills in his mouth.
 
MrWorfMen's Mom said:
Our cats actually enjoy the extra attention and a good number of them come to get us at test/shot times.
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I'd have to agree here. I was terrified of the shots and what I call pokies at first. But you develop a routine. My boy now comes to get me in the AM and PM to let me know it's time for test/feed/shoot. Heaven forbid I don't get up on time :)

This is all really scary at first and I didn't start home testing seriously for almost a month. What a mistake. When I did start and had all this data it was very easy to see we were on too high of a dose. I hate to think that if I hadn't have started home testing my precious kitty would have died.

Once you get comfy with the pokies, it'll become second nature and you and Mia won't be so tense. That could be a reason she hides - she senses that your nervous.

Always test AMPS, PMPS. If you can snag a +4 +6 on random days. Try to run a curve once a week to see how she's responding to the insulin. Mine is also on prozinc and his nadir is usually +5 +6 but every cat is different. Those numbers (+5 +6 +7) are important and many times we will base dosage on them. I'm not saying you need to get them every day or every other. But the more data you have the better you can see how shes responding to the insulin. And the better our Pro's can help with dose advice.
 
FurBabiesMama said:
I am a little confused about when I would have to test. It seems like a lot of people test a lot. What is the minimum testing frequency that would be effective? (If this is explained somewhere, feel free to point me in the right direction. I have just read so much and have not seen anything that spells it out at kindergarten level.)
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Minimum prior to the shot to make sure they are high enough to get a shot. Ideally you can get at least one mid cycle readings as well to see how low it goes. ProZinc peeks around 6-7 hours after shot so testing between 5-7 hours is best.
 
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Hi Mia and her mom!
I so know how you feel. I was terrified in the beginning. It takes a little time and practice. Is Mia driven by treats/food? This is what works for my Beenie. She comes to me for testing....I know its hard to believe but it wasn't like that in the beginning. Now forget about when I open the packaging for the syringes, she screams for it because she get about a heaping tablespoon of FF naturals chicken with it!! I can't give her the injection fast enough.

Mia senses your fear and anxiety so she will react to it as my Beenie did at first. Breath :bighug:, it will get easier. Just keep trying and it will all fall into place. There's tons of information here and read one section at a time. Start with setting up your signature and spreadsheet. The first time I looked at the spreadsheet it looked all greek to me!! You have plenty of support on this forum, you are not alone, and you CAN do this. :):):)
 
By keeping close track of it, is how you manage it. Once I started it took less than 10 minutes to test, feed and shoot as we say here. You want to know how to do it, you do NOT want to learn when Mia is in crisis and possibly fighting for her life. It's how I learned, and if I knew ahead of time, it could have been prevented. Luckily we both got through it, but the stress and fear is unimaginable.
 
I agree with everything everyone has said. I'm new too and felt exactly the same way you did. It really is true that it gets easier and it only takes time. I cried and had a total breakdown the first day I had to test and give insulin. There were blood drips and test strips everywhere, didn't know if I could do it, but eventually we got it and I knew it couldn't get any worse. The first week she would run and hide from me because she was so sick of me poking and prodding her and it broke my heart. But I knew I had to do it to help her so we pushed through it. Now she jumps right up to our testing spot when I call and she's totally used to it. Even purrs while I test now. If you told me that would happen a month ago I'd never believe it. You have to do what you're comfortable with though, especially because it is so overwhelming at first. I swear it will all get easier! Sorry I can't offer any dosing advice, but sending you lots of love!!
 
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MiaNap.jpg

Sweet baby
 
Mia is an absolutely stunning little lady! That is a beautiful picture of her! She's your 'extra' Sweet Baby! :D Let us know when you get your meter and we'll help any way we can. You like all of us, will be just fine and so will Mia. Baby steps......:bighug:
 
JanetNJ said:
I have a video in my signature showing how I test my cat CC.
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@JanetNJ I thought I had watched your video before, but when I went in to re-watch it today, I realized it was not yours that I had watched previously. I liked yours much better! CC is so cute and SO good. I loved it when she acted like she was going to bite the device. :)
 
FurBabiesMama said:
@JanetNJ I thought I had watched your video before, but when I went in to re-watch it today, I realized it was not yours that I had watched previously. I liked yours much better! CC is so cute and SO good. I loved it when she acted like she was going to bite the device. :)
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Yeah she's really good about it. I hope a few of my skiddish ones never need shots!
 
Hi. This may be a stupid question, but... Is there any point in doing a mid-cycle test if I missed the pre-shot test? This morning did not go as well as yesterday evening. I did not get enough blood to test and did not want to stick her again since we are just starting this, and she was getting a bit anxious. So, should I just wait until tomorrow to do a mid-cycle test or do it today? Thank you for your help and your tolerance of my ignorance. :D
 
FurBabiesMama said:
Hi. This may be a stupid question, but... Is there any point in doing a mid-cycle test if I missed the pre-shot test? This morning did not go as well as yesterday evening. I did not get enough blood to test and did not want to stick her again since we are just starting this, and she was getting a bit anxious. So, should I just wait until tomorrow to do a mid-cycle test or do it today? Thank you for your help and your tolerance of my ignorance. :D
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Any data you get is helpful.
 
FurBabiesMama said:
Hi. This may be a stupid question, but... Is there any point in doing a mid-cycle test if I missed the pre-shot test? This morning did not go as well as yesterday evening. I did not get enough blood to test and did not want to stick her again since we are just starting this, and she was getting a bit anxious. So, should I just wait until tomorrow to do a mid-cycle test or do it today? Thank you for your help and your tolerance of my ignorance. :D
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For whatever reason I almost always have trouble getting blood from Beenie's right ear. The left ear always bleeds for me. Its kind of strange, not sure why. I do try the right because I don't want to continuously poke her left. Her right ear has to be really really warm or nada comes out.

Not sure if others have this go on but it's something to look out for if you're having trouble. You may find one ear is easier than the other. :cat:
 
Beenie said:
For whatever reason I almost always have trouble getting blood from Beenie's right ear. The left ear always bleeds for me. Its kind of strange, not sure why. I do try the right because I don't want to continuously poke her left. Her right ear has to be really really warm or nada comes out.

Not sure if others have this go on but it's something to look out for if you're having trouble. You may find one ear is easier than the other. :cat:
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Yes, Teasel's right ear is easier than his left. Sometimes I wonder if it's because I'm a leftie and get a better angle on his right ear.
 
My kitty has an easier ear too. There are a few tricks that help with bleeding. First, make sure your kitty is well hydrated. The better hydrated, the easier they bleed. Add extra water to the wet food, and try to avoid dry food as much as you can because it depletes their hydration. It's okay to leave out canned food for grazing. Adding the extra water to it helps keep it from drying out and getting all gross.

Next, make sure the ear is warm. Put some uncooked rice in a sock, warm in the microwave, use it to warm the ear and increase blood flow.

Use a larger lancet. Larger lancets have smaller numbers, so something around a 26 or 28 helps at the beginning. Once all of this is routine you can transition to the smaller lancets with the 30-33 gauge.

Hope one of those tricks helps!

And yes, any data is helpful. The nadir reading is actually the most helpful in determining dosing. If you get the pre-shot and the nadir that's ideal, but whatever you can get is helpful.
 
Beenie said:
For whatever reason I almost always have trouble getting blood from Beenie's right ear. The left ear always bleeds for me. Its kind of strange, not sure why. I do try the right because I don't want to continuously poke her left. Her right ear has to be really really warm or nada comes out.

Not sure if others have this go on but it's something to look out for if you're having trouble. You may find one ear is easier than the other. :cat:
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That happens with my cat too! Same exact thing her left always bleeds better for me. Warming definitely helps and it's true that their ears develop extra capillaries over time and "learn to bleed". Also make sure you're using the bigger lancets like 28 gauge. The higher the number the smaller the needle. If you're using the ones with that come with the alphatrak I believe they should be the right size to start with.

Definitely get the midday test if you can. All the info you can get is good to help you and your cat to see how she is reacting to the insulin. You're doing great! :)
 
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