Glucose Curve

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BuddyisMyCat

BuddyisMyCat

Member Since 2021
I am doing my first glucose curve on my kitty. I forget if you start the time, every 2 hours when you checked glucose numbers before first meal or after the insulin administration. My cat takes 20 minutes to eat so I know it would make a difference.
 
I did the curve but hoping my vet can use it because, my kitty was feeling a little better and jumped up on the counter and ate some kitty food that one of my other cats didn't eat that I had in a bowl in the sink. Since he had not been feeling good, I didn't think he would do this.
 
Cassy have you looked at the dosing methods for Lantus
Can you choose which one you want to go with


You need to be testing during each 12 hour cycle (just not the pre shots ) also to see how the insulin is working for Buddy and how low he's dropping
At least 2 or 3 more tests after giving insulin that includes the night cycle also
Like a test @+3, then @+6 both cycles if possible
Mix the test times up each day, like filling in the pieces of a puzzle
I asked @Sienne and Gabby (GA) to look at you SS I think you are
holding that does too long, we'll see what Sienne says


I can also tag
@Wendy&Neko

@Chris & China (GA)

@tiffmaxee

Casey here are the dosing methods
https://www.felinediabetes.com/FDMB...-low-go-slow-slgs-tight-regulation-tr.210110/
 
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Diane is correct. Lantus dosing is based on the lowest number in the cycle (i.e., the nadir) and not the pre-shot numbers. You need to be getting at least 4 tests daily -- your two pre-shot tests and at least one additional test during both the AM and PM cycles. I'd strongly encourage you to get into the habit of getting a test before you go to sleep every night so you know that Buddy is in safe numbers.

I wouldn't worry that Buddy ate during the curve. Most cats do. Is your other cat eating high carb food? If so, consider feeding them the same low carb diet. It's healthier for your other cat, as well.

One quick question. Are you using syringes or dispensing insulin directly from the pen? If the latter, you need to get syringes. Buddy needs a dose increase. Depending on which dosing method you want to use, the dose would be increased to 1.5u with Tight Regulation or 1.25u with Start Low Go Slow.
 
If you are not using syringes with half unit markings here are some you can buy
Using syringes with a pen, cartridge, or vial: with these it makes it easier when having to adjust the doses
  • U-100 3/10cc syringes with half unit markings are the best to use for drawing Lantus, Basaglar, or Levemir from vials, cartridges, and pens.
  • BD Ultra-Fine, CarePoint Vet, Monoject, GNP, UltiCare Vet Rx, Sure Comfort, and ReliOn are just some of the brands available with half unit markings.
  • Syringes come in ½ inch or 5/16 inch needle lengths. Needle gauges are 29, 30 or 31 (31 being the thinnest)
  • Full and half-unit syringe scales:
49823063143_3437e9e997_o.jpg
 
What do you guys mean by holding the dose too long? I will try and get some night readings, right now he is a bit scared of me. Also I first started with the needles that go on the pen and then I noticed that sometimes nothing was coming out. So I switched to syringes. However I only had a pack of ten and have ordered more and they don't get to me until Tuesday. So I am a little nervous because I had some u-100's that I use to give b12 shots for but their marking are only at the 2 unit mark, so I had to eye 1 unit tonight, I am hoping I gave the right amount but it was very hard to eye that. Buddy's vet is looking at that curve tomorrow and I am thinking she will have me up it to 1.5 units....So I guess I will try the tight regulation method. A lot of it does not make any sense to me. And I have been very nervous, at the emergency vet he had slight ketones in his urine but I was able to test it today at home and it showed none so I am thankful for that. But right now he is very sick and I would like to get him to feeling better because it is breaking my heart.
 
BuddyisMyCat said:
What do you guys mean by holding the dose too long? I will try and get some night readings, right now he is a bit scared of me. Also I first started with the needles that go on the pen and then I noticed that sometimes nothing was coming out. So I switched to syringes. However I only had a pack of ten and have ordered more and they don't get to me until Tuesday. So I am a little nervous because I had some u-100's that I use to give b12 shots for but their marking are only at the 2 unit mark, so I had to eye 1 unit tonight, I am hoping I gave the right amount but it was very hard to eye that. Buddy's vet is looking at that curve tomorrow and I am thinking she will have me up it to 1.5 units....So I guess I will try the tight regulation method. A lot of it does not make any sense to me. And I have been very nervous, at the emergency vet he had slight ketones in his urine but I was able to test it today at home and it showed none so I am thankful for that. But right now he is very sick and I would like to get him to feeling better because it is breaking my heart.
Click to expand...


I'm going to tag
@Sienne and Gabby (GA) for you
I just popped on for a minute, I've got a really bad headache or I would reply
Sienne should be on tomorrow
 
My vet got back to me and she wants me to up the insulin to 2 units. Is this something that I should do, or should I only up it to 1.5 units?
 
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I see you have to wait for syringes until Tues, did you order the ones with half unit markings
You can also get them at Walmart if you want to until you receive the other ones
You definitely need to get note tests in during each 12 hour cycle
Day and night time


upload_2021-9-5_23-18-9-jpeg.62508
 
BuddyisMyCat said:
What do you guys mean by holding the dose too long?
Click to expand...

We need to know what dosing method you want to follow using Lantus
With TR, you evaluate the dose every 6 cycles/3 days. If the majority of the nadirs are not in normal range, you increase the dose

. By holding the dose as long as you are, you may be running into glucose toxicity developing. Buddy's system may be getting used to the higher numbers and treating them as the new "normal."


SLGS: You hold a dose for 7 days (unless a reduction is earned). You decrease the dose when the BG falls below 90. The aim of this protocol is to keep the cat in the 90-150 range. This is more suited for caregivers who can't test as much as TR requires. You do a weekly curve with SLGS.

TR is a more aggressive protocol with increases as often as every 3-5 days. Reductions are earned when the BG falls below 50. The aim is to keep the cat in the range of 50-100 (which is the normal BG range for cats). To follow TR, you would need to get at least one more test per cycle in addition to the pre-shot one i.e. 2 tests per cycle or 4 tests per day. You would also need to be feeding only LC canned food and no dry food.

Please read the dosing methods
https://www.felinediabetes.com/FDMB...-low-go-slow-slgs-tight-regulation-tr.210110/
 
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She said she will follow TR. so 1.5 is what Sienne suggested. It might be easier to measure with your syringes too and you won’t need to wait for your order.
BuddyisMyCat said:
My vet got back to me and she wants me to up the insulin to 2 units. Is this something that I should do, or should I only up it to 1.5 units?
Click to expand...

We would not increase by a full unit. We would give 1.5. You could miss a good dose with that big an increase.
 
BuddyisMyCat said:
So I guess I will try the tight regulation method. A lot of it does not make any sense to me. And I have been very nervous, at the emergency vet he had slight ketones in his urine but I was able to test it today at home and it showed none so I am thankful for that. But right now he is very sick and I would like to get him to feeling better because it is breaking my heart.
Click to expand...
Cassy can you please put TR in your signature now since that what you said you will follow, also can you add it to your spreadsheet up top


When was Buddy in the ER just recently?
Did the vet test for keytones with the dip stick or meter
What was it a trace, small ?
I'm glad you tested today, . What do you mean he is very sick right now, what's wrong

please be sure to do that at least once a day while he's running this high or if he starts to act like he doesn't feel good in any way (not eating hiding, lethargic, etc.)
 
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Yes was at the vet on the 17th. They found trace ketones at that point. He is just very lethargic, pretty much the last 2 weeks. I tested today because he was seeming a little extra lethargic and his number was 484 so definitely not hypoglycemic. I have an appointment for him on October 22nd to see an internist because his lab values have some things like high bilirubin, so hoping its diabetes and not pancreatic cancer that is causing the diabetes. They also think his high BP is strange because there is no cause that they can find and primary hypertension in cats is pretty rare, from what I am told. He has lost a pound in just one weeks time, so I have been very concerned.
One thing about the TR that makes me nervous in only doing reductions when BG is less than 50, that seems dangerous and I am a little nervous about doing that. I will change my spreadsheet to TR but I definitely don't like that.
Also, has there been any data that shows if TR or SLGS is more successful? I am curious if one has shown to be a little better.
 
Actually primary hypertension is more common than they once thought. Max had it. Vets just don’t test for it very often unless they have ckd. I asked for a baseline as I had a cat with high bp in the past. My vet and I were shocked when we found Max had primary hypertension. He did not develop ckd for years after.

Our anecdotal records show that way more cats go into remission on TR. The faster a cat gets controlled the better chance of remission so it makes sense.
 
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Yes my baby's kidney levels are not high enough to be the culprit of his HTN. Well I had a good number this morning, which makes me happy. First number under 300 since he was diagnosed!
 
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