Glucose curve

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Georgia

Georgia

Member Since 2014
I took Rocky to the vet yesterday for an all day glucose curve testing. He was in remission, but as of Feb.21, he is back on insulin (now 2 units twice a day of Pro-Zinc). I didn't get a copy of his bg levels, but plan to have the vet e-mail me these.
He hates going (the car ride, staying in the cage all day and strangers). I know his stress levels make his numbers worse. Therefore, I am considering doing his next curve myself. The vet wants him to come back in a week. This is not what my last vet required, so I wonder if she is being overly cautious or if this is normal. I just can't bring myself to put him through this again so soon.
What do I need to know and do in order to do this curve myself? It will have to be on a weekend, because I work and this would be the only time I could be home all day.
Need all the help I can get!!!
Thank you
 
Welcome Rocky' s Mom and Rocky,

No, you do not need to take Rocky back to the vet for the curve. Especially if he is upset there, his numbers will be elevated and not as accurate as your tests at home. We test our cats daily, before every shot, and at midcycle whenever possible. That way we know how the insulin is working. Here is a shopping list for home testing:

A human glucometer. Any one that sips and takes a tiny sample is fine. Some members stay away from any meter with True in the name and the Freestyle meters. Some people think they are unreliable and read lower than other meters. The meters are often free at drug stores; it’s the strips that are expensive. You can, however, buy them on ebay at less than half the price of stores. Lots of people here also like the ReliOn from Walmart. It is an inexpensive meter and its strips are the cheapest around. Try the meter out on yourself or someone else before you try it on your cat. You want to be familiar with it before you poke the cat.

Lancets and a lancet device. Usually, until the ears “learn” to bleed, a 26-28 gauge is good. Any brand will work as long as the lancets match your device.

Ketone strips. (Ketostix) Just like human diabetics use. You will sometimes need to test urine if the numbers are high.

Rice sack. Make this out of thinnish sock, filled with raw rice or oatmeal and then knotted. You heat this in the microwave until very warm but not hot. Then heat the ears before poking. You can also use a prescription bottle filled with very warm water. It provides a good surface to poke against.

Also nice to have. Flashlight: so you can look at the ears and find the little capillaries that come off the vein running down the ear. Vaseline: Put a tiny smear where you want to poke. It will help the blood bead up.

And some lo carb treats to give your kitty, successful test or not Lo carb treats

And here is how to get Rocky ready for testing:
First pick a place where you want to test. Some people use the kitchen counter, a blanket on the floor, between your legs while sitting – whatever works for you. Take the kitty there and give him/her lots of praise while you play with his/her ears. Give a treat and release. Next time, add the rice sack (thin sock filled with raw rice, heated in the microwave until very warm but not hot) or a prescription pill bottle filled with very warm water. Lots of praise, treat and release. Finally add the lancet so he/she will get used to the noise. The hope is that when you finally poke, they will be used to the process and know a treat is coming!

We have a protocol for ProZinc that may be helpful:

PZI Protocol

Please let us know we can help.
 
Oh...I've been testing for awhile, since Rocky was diagnosed last April. However, the vet I was seeing no longer works where I take him and the new one seems a little "green" about all this.
I already have the ReliOn Confirm meter from WalMart and the 26g lancets.

I guess what I needed to know was in order to do a "curve", how many times should I test him that day and how do I know the results. The vet said something about the time he "peaks".
 
Sorry, I misunderstood. To do a curve, you test at preshot, then every 2-3 hours during the cycle until the evening preshot. This should give you an idea of how low the dose takes him, when the lowest point (nadir) is, when he starts back up and how fast he goes back up.

Your curve is much more accurate than the one at the vet, as there won't be all the strange noises, animals and people around to stress him out and raise his levels. Then you can fax your results to the vet.
 
If the new vet is 'green', he may not understand that using a human glucometer is OK. It is like reading temperature in Celsius vs Fahrenheit.

You may have to explain that a human glucometer will read roughly 30-40% lower than a pet-specific one, or lab results. We don't convert; we just use reference values for cats.
 
:RAHCAT Thanks so much for your help. I will be letting my vet know that I intend to do this over next weekend instead of bringing him back to the clinic. Hopefully she will accept this, but if not...oh well! I just can't put him through the ordeal of going there weekly for three weeks which is what she suggested.

Wish me luck!
 
I usually recommend 3-4 tests a day instead of a curve because one day curve doesn't give a good enough picture of whats going on. If you do regular retesting you will be able to check for bounces etc

- always before the shot - this is mandatory as you don't want to shoot when too low. As a newbie this too low number is 200 but is reduced over time once you have the data to know if its safe.
- mid cycle - 5-7 hours after morning shot depending on your schedule. This is to see how low the cat’s blood sugar is going. The low point "nadir" is what you base dose changes on since you don't want the cat dropping too low (under 50).
- before bed (2-3hours after Pm shot) to get an idea of what the cat's overnight plans are. If this number is less than the pre shot test number you may want to set the alarm for a test a few hours later as this implies an active cycle

Also I don't think a second remission is out of the question but you will need to be more vigilant on food, get him checked for infection, and be more aggressive on dosing - if a dose isn't working, change it. that will give him the best chance.

Wendy
 
Since you're an old hand at the home testing, doing a curve at home should be easy for you to do. The new vet may not be aware of your proficiency with home testing, so that could be one reason the vet suggested bringing the cat in for a curve.

With the daily testing we do here, before every shot and mid-cycle when possible, it's not necessary to do a curve.

I found this some time ago, and made note of it. Some good info from Jill and Alex and Hillary & Maui on the usefulness of curves.
Curves, valuable yes or no
Jill and Alex : Hillary & Maui wrote:regarding the curve - don't focus or think about it. it honestly isn't necessary. If you can get tests in during each cycle you don't have to do a curve. really there is no rule that says you have. Look at Maui's chart, I never did one.
Doing a curve with a long-acting insulin is highly overrated. A curve with the long-acting insulins such as Lantus or Levemir will only give you a single snapshot in time.... on that day. One can actually get a better idea of what a particular dose is doing by getting random spot checks throughout the week.

For example: If you happen to do a curve on a day kitty is bouncing from a low number... you'll probably see high numbers. If you increase the dose based on that single curve you could easily over dose kitty and inadvertently cause a hypoglycemic episode.

When obtaining random spot checks you want to look for:
• Onset - the length of time before insulin reaches the bloodstream & begins lowering blood glucose
• Peak/Nadir - the lowest point in the cycle
• Duration - the length of time insulin continues to lower blood glucose
Like Hillary, I've never intentionally set out to do a curve. Random spot checks at different times will yield much more information with the long-acting insulins.
Click to expand...
 
Interesting thread. Lots of great info in these posts. :smile:

Regarding glucose curves, I actually found it quite helpful to do one initially (and when changing to a different insulin), to work out the times of onset, peak (BG nadir), and duration. But after that I've found, like others here, that spot checks on a daily basis provide much more useful data about how well the insulin is working for the cat. A cat's response to insulin can change a lot from day to day, and a curve done on any one day may well not show a 'typical' response...

Eliz
 
I am mainly doing this at home curve to satisfy my new vet. She was adamant about me bringing Rocky in for testing several weeks in a row. This is way to stressful for him and my wallet! Therefore, today I am attempting to so my first "at home" curve. So far so good. Rocky is on Pro-Zinc 2 units twice a day. I guess she wants to be sure this is the correct dosage or if it needs to be changed. Something I do trust her to tell me.
My only other concern is, he has never been a good eater. The kind of food he eats best is, of course, the kind he can no longer have. I feed him Fancy Feast Classics and Friskies Pate.

Thanks for all the useful information. I have made a note of it and will keep it for future reference. :roll:
 
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