Glucose curve - 1st time doing it

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Patti A

Patti A

Member Since 2021
This may be a dumb question and I have tried to search the threads for an answer but can't find it. Buffy does not always receive insulin. My specialist has said if she is under 15 not to give the .5 units. I want to do my first curve to get more information and was planning it for tomorrow. Can I still do a curve if her BG is at a number that does not require insulin? Should I only plan to do a curve on a day when she actually receives insulin?

Thanks,
Patti
 
@Diane Tyler's Mom , yes to only lantus once a day. My specialist feels that Buffy has not fully decided if she is going to be diabetic or not. She also said at 15 or over as she was concerned more about her going hypo.
I am to take her back in about 3 weeks to have joint taps redone for her legs and will be consulting with the vet more then although I can email her if something comes up. That is why I wanted to get a curve done and then let her see
all the numbers including some of these higher ones that are recent.
 
Hi Patti and Buffy.
Thank you for setting up the SS and signature. That is very helpful.

Looking at the SS it looks as if you are only giving the insulin only once a day. Is that correct?
Lantus needs to be given twice a day to a cat as cats have a faster metabolism than humans. Only giving it once a day is leaving the other 2 hours with no coverage at all.

Are you testing for ketones in the urine..
****This is early important as diabetic cats are prone to ketones and if they are not getting insulin, they are more at risk. That is why testing daily is so important, especially if you are not giving insulin.

Are you feeding an all wet diet or some dry food?

In the beginning we suggest not got giving insulin if the BG is under 200 on main health page, until you get more data and then we can start reducing the threshold.
My suggestion would be to start giving insulin twice a day and giving it if the BG is over 200. As you gather data we can lower the BG for giving the dose.
Would you be happy to do this?

It wouldn’t hurt to do a curve anytime. But if you are not giving insulin, it will just tell us how Buffy is managing without the doses.
Bron



 
Patti A said:
My specialist feels that Buffy has not fully decided if she is going to be diabetic or not. She also said at 15 or over as she was concerned more about her going hyp
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Was a fructosamine test done at diagnosis? That will tell if the cat is a diabetic or not.
Looking at the SS all those BGs are well above normal. “Normal” on an alphatrak meter are approximately 68 to 150.
If you are hometesting you will be able to see if the numbers are dropping and feed Buffy to bring the numbers back up.
We have many many cats 15 and older and they are no more prone to a hypo than any other cat in my experience.
 
@Bron and Sheba (GA) , I am giving Lantus only once a day and I asked the vet about it. Normally I have paper to right down all the answers but I can't exactly remember her explanation. It seemed reasonable at the time. I am concerned about giving it twice without the vet's approval. Nothing with Buffy is ever straight forward and she has unusual issues and I am freaking myself out some. I like the advice here and it makes sense but I have been with this specialist for 9 years and I have actually willed Buffy to her if anything happens to me. Sorry to babble.

I haven't been doing ketone testing but I have ordered the strips to try and start.
Buffy only gets a wet diet and has for years.

I know a fructosamine test was done at diagnosis but I am not sure I was told what the results were other than she had become diabetic
 
Patti A said:
I know a fructosamine test was done at diagnosis but I am not sure I was told what the results were other than she had become diabetic
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That should have given the specialist a definitive answer as to whether Buffy was a diabetic or not.
What are her specialities? She may be very qualified in other areas but not know much about diabetes in cats.

Patti A said:
I haven't been doing ketone testing but I have ordered the strips to try and start.
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I’m glad you have ordered them. Ketones is serious and if not treated, they can lead to DKA which is very serious.


Patti A said:
I am giving Lantus only once a day and I asked the vet about it.
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It doesn’t make any sense to give insulin once a day in a newly diagnosed cat.
Getting the BGs back into normal numbers as soon as possible using a dosing method gives the best chance of regulation and remission.

I can understand you not wanting to go against your specialist advice. You need to weigh up all the information and ask the hard questions of the specialist.
You are Buffy’s advocate.

I would suggest you get some tests in during the cycles because dosing is based on the nadir or lowest point in the cycle.
I would also suggest getting a PMBG test done every day (that’s when the second dose would be due) and another one late in the cycle before you go to bed to see what the BGs are doing throughout the day and night.
At the moment we don’t really know how well the 0.5 units is working and what is happening in the other half of the day when no insulin is being given.
 
Bron and Sheba (GA) said:
That should have given the specialist a definitive answer as to whether Buffy was a diabetic or not.
What are her specialities? She may be very qualified in other areas but not know much about diabetes in cats.

@Bron and Sheba (GA) , she is an internal specialist.

From what I understand, you are saying I should do some interim tests to see what Buffy is doing throughout the day when she does not get insulin as well as what she does when she gets insulin. Maybe not a full curve on days of no insulin?
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I do not see any replies after your last question. I do believe members are suggesting more testing at home. Will you be able to do that?
BTW, my new vet, whom I adore and believe is really competent, also told me to shoot Sister Lantus once a day.
The members suggested twice a day, splitting the dose between the two.
I went with FDMB's advice because vets just can't know everything about diabetes. And especially about specific insulins.
I did keep her in the loop and told her I would continue twice a day. Then waited to see if she would balk. She didn't.
 
@Ann & Sister, I can test more often. Because this morning she was at 6.3 I was concerned that she may dip more so I have tested 4.5 hours later (couldn't do earlier as I had to go to an appointment). She was up to 10.4 so I let her eat the rest of her breakfast that she hadn't finished. She seems to be getting ill on her Atopeca liquid so I am arranging to get pills instead. She was on this in pill form before and tolerated it well so am going to try that again.
I still feel wary about the two shots a day against my vet's advice. I also found a medical study which indicated that Lantus for cats was better on a once a day basis. It was from 2006 with a small sample. I guess I am just going to have to wrap my head around this and figure out what I can feel comfortable with and what is best for Buffy.
 
Patti A said:
@Ann & Sister
I still feel wary about the two shots a day against my vet's advice. I also found a medical study which indicated that Lantus for cats was better on a once a day basis. It was from 2006 with a small sample. I guess I am just going to have to wrap my head around this and figure out what I can feel comfortable with and what is best for Buffy.
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Absolutely. You are your cat's best advocate, the one holding the syringe. All decisions are up to you. The members here can only give you their very best advice, and I have to say, they do this selflessly for the benefit of your cat and mine. It will take time for you to trust. And that is o.k.

You do realize that the suggestion is to give half the recommended dose every 12 hours?
That is the equivalent of what your vet has prescribed, just given half each time. It is not doubling the dose.
 
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Patti A said:
@Ann & Sister, I can test more often. Because this morning she was at 6.3 I was concerned that she may dip more so I have tested 4.5 hours later (couldn't do earlier as I had to go to an appointment). She was up to 10.4 so I let her eat the rest of her breakfast that she hadn't finished. She seems to be getting ill on her Atopeca liquid so I am arranging to get pills instead. She was on this in pill form before and tolerated it well so am going to try that again.
I still feel wary about the two shots a day against my vet's advice. I also found a medical study which indicated that Lantus for cats was better on a once a day basis. It was from 2006 with a small sample. I guess I am just going to have to wrap my head around this and figure out what I can feel comfortable with and what is best for Buffy.
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What did you decide about dosing? I have read that Lantus needs to be replenished every 12 hours, even though it is longer lasting than some others, and that just one dose will not last 24 hours, leaving your kitty without insulin in her system when needed.
 
Ann & Sister said:
What did you decide about dosing? I have read that Lantus needs to be replenished every 12 hours, even though it is longer lasting than some others, and that just one dose will not last 24 hours, leaving your kitty without insulin in her system when needed.
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We started twice a day on the 13th. Her numbers kept going up and now we are pushing her move into the diabetic state because her autoimmune disorder requires that we greatly increase her steroids.
 
Patti A said:
We started twice a day on the 13th. Her numbers kept going up and now we are pushing her move into the diabetic state because her autoimmune disorder requires that we greatly increase her steroids.
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I am so sorry to hear about her BG numbers going up and requiring increased steroids. Somehow Buffy's autoimmune disease and her diabetes treatments need to find a balance. I personally think the twice-a-day insulin will help to regulate Buffy better.

It is good you have every confidence in your vet's role in this. I hope you have found a way to prevent Buffy from getting into Rutherford's food. In my home, the kibble bowls are on a high credenza now. The other 4 cats can access, but Sister cannot due to neuropathy.
 
Ann & Sister said:
I am so sorry to hear about her BG numbers going up and requiring increased steroids. Somehow Buffy's autoimmune disease and her diabetes treatments need to find a balance. I personally think the twice-a-day insulin will help to regulate Buffy better.

It is good you have every confidence in your vet's role in this. I hope you have found a way to prevent Buffy from getting into Rutherford's food. In my home, the kibble bowls are on a high credenza now. The other 4 cats can access, but Sister cannot due to neuropathy.
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Rutherford has a chip reader bowl but Buffy has a way to knock him aside and get in. I have rigged it so I think that has stopped now. I am doing another curve tomorrow on which my vet will look at adjusting her insulin intake. I am completely freaked out tonight as it was 27.9 on world scale and 502 on the US. Numbers are sky rocketing but will have an answer about the insulin amount in about 24 hours. Hope she does okay until then. Fingers crossed
 
Patti A said:
Rutherford has a chip reader bowl but Buffy has a way to knock him aside and get in. I have rigged it so I think that has stopped now. I am doing another curve tomorrow on which my vet will look at adjusting her insulin intake. I am completely freaked out tonight as it was 27.9 on world scale and 502 on the US. Numbers are sky rocketing but will have an answer about the insulin amount in about 24 hours. Hope she does okay until then. Fingers crossed
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Sending Big Hugs to you and Buffy. My fingers and toes are crossed for the best outcome. :bighug:
 
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