Glucose monitoring (fog)

Djamila said:
Meh. Human meters work just fine. Your vet may not be able to help with dosing, but I'm keeping my fingers crossed that Storm isn't going to need insulin much longer anyways. :D Oh, and here's a study that uses human meters (although it does say AT2 is good when possible) www.felinediabetes.com/FDMB/attachments/management-of-diabetic-cats-pdf.11641/

I'd hold off on the fructosamine until we figure out if he's going to go off insulin or not. If he does, your vet will want to verify that with another fructosamine anyway. Might as well save the money and just do it once.

The back legs could be arthritis. He's in pretty low numbers to be showing severe neuropathy to be honest. Although my kitty shows it in pretty low ranges too, so it's not impossible.
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** He is not showing severe neuropathy- his stance is a bit off. I would think that with arthritis in the legs/leg joints, Storm would show some pain while walking. He shows none. Very informative study....sent it to the vet (I think that put him off). Just called Banfield (national vet)- they only use AlphaTrak2. I'm in the process of getting that meter, because 2/2 on this area will only use pet meter. BUT- if the vet 'may not be able to help with dosing....'. What can they do then?!
 
MLT said:
BUT- if the vet 'may not be able to help with dosing....'. What can they do then?!
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Lol...great question! They can help with lab work, charging money, and writing prescriptions :D

As far as the dosing help -- we can do that part. And right now, Storm is skimming a little too low during the cycle, which means it's likely he's dipping below that at night since most cats (though not all) run lower at night. I would lower the dose to 0.25u and see how that goes.
 
Storm is down to .25 syringe measure (as eye-balled). Ironically, when I started, vet recommended 1U, but because of the incorrect way I was dosing, Storm got air and @ .1U insulin. (No records in 1st two weeks, as vet said to do curve only...) His excess urination stopped within 2 days. Pre insulin, Storm was usually fed soft food in the morning and at dinner time, with kibble down for free grazing; this past year, I worked remotely, and shifted him to my 3x/day meal schedule (not good, soft food returned to 2x/day), plus kibble.

He now gets soft, DM food 2x/day, no kibble. He is still ravenous at mean/insulin times (because of the insulin or because the little dude is used to grazing?!) 1) Can I introduce a high protein kibble and reduce soft food a tad, making sure that the bg measurements stay within the same range?

2) in general, if a cat gets other food during a 12 hour period, does that reduce the efficacy of the insulin/create the need for more insulin, or?

I thought that a nadir occurred after each dose; however, I've been rereading- 3) the nadir occurs about 7-8 hours after 1st dose, and lasts for @ 8 hours...so there is one 'nadir period' per 24 hours, yes? So logically, rather then schedule additional tests during the day, I should try to do them starting a few hours after his PMPS?
 
And his higher, blue numbers seem to be related to days when he got treats (and ergo my question about food in addition to 2ce/day soft food.
 
Can you share the article where you read that? I'm curious... Typically cats will nadir twice - once each cycle. However, when they are close to regulation, or close to going off insulin, the cycle will usually be fairly flat.

I absolutely would not introduce hard food. Storm looks very close to possibly going into remission. And kibble, no matter how low carb, would likely mess that up as it's very unhealthy for them aside from the carb count.

There is no reason not to let Storm graze on wet food. Most of us leave wet food out all day for them to eat as they wish. As long as you control the total amount so that Storm doesn't start gaining weight (unless he needs to gain weight?), then it's fine to let him eat whenever he wants.

Add some extra water to the wet food - I usually add about 3 Tablespoons to a can of fancy feast - and that helps keep it from drying out when it's left out. You can also mix the food with the water, freeze into a patty, and leave that out - then he can eat as it thaws and avoid scarfing it all down at once.

In truth, only feeding twice/day can be a little hard on them, so spreading the food out more during the cycle can help him not be ravenous at meal times.

I'm still concerned about how low he might be going overnight. Nighttime cycles are often lower than daytime cycles, and giving a dose on a green number is not quite safe for a newly diagnosed cat. I would really encourage you to get a before-bed test at night to make sure he's staying in safe numbers.
 
Tried back tracking to the reference. Today, all I can find says nadir starts within 3-4 hours of insulin shot, all point to 2 phases. (I will keep looking) In theory, if a cat is getting too much insulin, BG readings decrease (worst case scenario is hypo);therefore, since Storm's BG readings are so low, is it logical that he should be getting even less insulin in order to raise the levels?
 
No worries about the article -- I've definitely had that happen too where I read something really interesting and then can't find it again. I've got to get better at bookmarking! Onset for Prozinc is typically somewhere between +2 and +4, with the 3-4 range you cited being reasonable. Nadir is the lowest point in the cycle - so it can happen at any time, though typical is somewhere in the +4 to +7 range. So if you tested all the way through the whole cycle, whatever number was lowest would be nadir for that cycle. And when the nadir occurs can change from cat to cat and from cycle to cycle. Most cats will have a "typical" time, but can still vary. We use the term a little loosely around here since we don't test every hour -- sometimes we are making our best guess based on patterns, trends, and what we've learned from studying hundreds of spreadsheets. We should probably be more careful about being precise with that term. ;)

As for Storm's dose -- Based on the data we can see, it's not that you need to raise his BG levels - everything you've caught so far has been safe. However it's possible that he's dipped lower during the night - there are a couple of daytime cycles that hinted at that, so that's why I suggested lowering to 0.25. And now the question is if he could stay mostly in that 50-80 range on his own, without insulin. Your one test last night - the 56 - is making me think you could try dropping down to a 0.1u dose and see if he still hangs out in the greens. You would just pull in a teeny tiny bit of insulin - just to that first line - the line for zero. When you inject, it won't feel like you gave anything at all, but even that tiny bit can make a difference. Give that a try and let's see how he does. And I'll keep my fingers crossed that he might be just about ready to go off of insulin altogether.
 
(I am more nervous than Storm...) Eye-balling it, I gave him a smidge under .25/on top of initial line this AM- after eating, I got him playing with his pop toy, which he continued to swat and chase around for @ 20 minutes. Now sleeping. (Had meant to measure BG him @ 4 hours before his AMPS, but I overslept.) I setup and practiced with the AlphaTrak yesterday, and will do a curve on Sunday.
 

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He's looking good on his first day with the 0.1u. Keeping my fingers crossed he'll be ready to go on his own soon...
 
So much for a "curve" (results are in the AlphaTrak SS). Storm's numbers were fairly consistent, with the exception of one nose dive. Yesterday, I still gave him the PM insulin. No insulin today. I have introduced one more feeding of DM (soft food).
 
What does the curve indicate? (vet not responding) Dosing?! Not sure what to do....will return Storm to .1U with morning feeding.
 
Well, my hunch is that the 39 was a bad reading. While I suppose anything is possible, having such a flat curve, and one steep diving hour like that, seems unlikely. If you ever get a number that seems out of place, it's a good idea to run a second test to double check. All it takes is a little too much or too little blood and you can get a false reading like that.

And as for what it says, it's saying that he's not ready to be off of insulin yet. His numbers are still just a little too high to be where you'd want to see them when he goes off insulin altogether. The vet may say differently since they tend to tolerate higher numbers than we do. But if it was my cat, I'd keep up with insulin support until his numbers start looking a little bit lower than what you saw yesterday. He's close though!
 
Hi MLT!
I've not been following the entire thread but just the most recent comments. I'd have to agree the 39 was probably a bad reading and agree with Djamila in doing a retest whenever you get wonky numbers like that o_O. I also agree he isn't quite ready to stop insulin but his pancreas is showing some good signs :woot:!

Such an adorable face, he has :cat:
 
Am doing another curve today with AlphaTrak meter. Two days ago, Storm got out and hid under porch. Until he came toward my daughter/was brought in house, he 'munched on grass'. The 1st day, loose stool and what looked like vomit in litter box (to be expected). This morning, dangerously low AMPS- gave food and raw topper treats. Gave Zobaline in AM 3x/day, did not give this morning. I have a food question, will ask the nutrition group. AND, it takes me on average 3-4 pricks to get blood. Is there any way to estimate the impact of increased 'stress' ?! (I might have asked before, but that could be skewing all his numbers....)
 
Warming with a rice sock worked a few times, then he saw it as aggravation, started biting again...I massage the ear gently, but that can aggravate him as he has ear polyps/growths, which causes him to start scratching his ears with paws. I started with 26, have been using 33's , and started using 28 this afternoon. I am back to stroking him for @ 20 mins and post treat. I am aiming for up to 2 pricks. Bigger question (I had started to post on Main this morning, but was booted off the site)- 2ce/day feeding is NOT normal for Storm. Everything I read says that one should maintain eating pattern...that would be soft food for breakfast and dinner, with grazing during the day. I have been giving him soft food in small portions, to make the total with the PMPS timing. (I have the luxury of being home now, but that will end, so I have ordered Young Again Mature Zero kibble). I have frozen some DM in ice cube tray- he bit at the stuff when it was still icy.... Kibble should arrive this week, so I will return his regimen to AM soft food meal (kibble down during day) PM soft food mean.
 
The 28's should help, and you can go back to the 26s if needed. Rachel used to do two pokes right in a row to help with the bleeding. Since it's just bam-bam, it doesn't cause any more stress than just one poke, and might help until his ears start bleeding better.

YAZ can be really hard on their digestive system - often causes stinky poo and diarrhea. And it can vary from one bag to the next - one bag might be fine, and then the next bag can cause liquipoo. In some cats, it can also raise BG quite a bit, and again, varies by bag. Just some things to be aware of as you try that.

It's also fine to just leave out wet food - frozen or not. When I freeze chunks of it, mine will sometimes bite into it early too. It doesm't hurt them any, and they abandon it quickly and come back later. I honestly think Sam prefers it a little bit frozen.

And cats who tend to scarf it all down at once will often settle down after a few days when they learn to trust that there will always be food available and they don't need to panic and eat it all at once.
 
(FYI- this past week, keep getting database errors, unable to access) Missed 2 PM curve measure yesterday...Storm more lethargic last week (than he has been);back to sitting at his food bowl. This AM, stopped eating his 'usual' amount, so I added additional water (2X) Second time, he nibbled but left some, which I have left down. The shot that I gave him was exactly on the 1st line (ie none). Will put out a frozen soft food cube for mid morning-early afternoon. Is there value to doing curves more often than 2 weeks?
 
Hi there! It looks like Storm would like you to stop giving him insulin. See those lime green numbers? Those shouldn't be there. They tell you that he's going too low to be getting injected insulin.

Also, if you are giving insulin, it's really dangerous to do so without testing, so all of those skipped tests have me a bit worried.

I would suggest doing an OTJ trial (off the juice). So don't give a shot, but do test twice/day. Any two times is fine - keeping the AMPS and PMPS is easiest for most people, but there is some flexiblity when not injecting insulin. If you start to see the numbers creep into the blues (human meter), or over 150 (AT), post and ask for someone to take a look at it - you might need to restart insulin. But let's give it a try without and see if Storm can keep his numbers down all on his own.
 
Without insulin, looks like there is a consistent drop in bg. If anything, I had expected to see numbers rise (??) This morning feed was an hour late. He has not touched DM. Added more kibble to his other bowl- he ate one or two pieces, then just sits by eating area. (Too much protein?!)
 
(I restart full time work out of house on 6/17). A dish had fallen and cracked, which had startled him as he started to eat. I left kitchen (thinking he would eat if there was no movement around him). He followed me upstairs, did a turn around the room, then left. He jumped on toilet in the bathroom (to then jump on sink, for water in the sink?). I went downstairs. He returned to the kitchen, looked at food bowls, pawed a few times at water dish, then started taking sips. Hovered around food mat, then came into room where I was sitting, stayed on floor, jumped on sofa. I just gave him three Blue Wilderness cat treats, which he ate. He has settled down, but not in sleep position. Also notice this AM- he is using front and back legs as little as possible. EX: when I picked him and put him on sofa in order to take AM bg, he just lay in the same position (vs adjust himself). Why are numbers decreasing, when increase would have been logical?
 
I'm afraid I'm not understanding what you're asking right now. BG only goes up in diabetic cats because they don't make enough insulin to counter-balance carbs. Storm's pancreas ismaking insulin, so is able to keep the numbers down. However, taxing his system with all of those carbs can bring him right back out of remission, so I would really encourage you to stop the kibble and BW treats and just keep him on the canned low carb food and freeze dried treats. Once a diabetic, they will always have a rather fragile pancreas so you don't want to overwork it.
 
I stopped insulin as of 5/27, and have been monitoring Storm 2x/week. His AMPS this morning is 'in the blue'. Because he hangs at his food bowl, I would 'remound' it for him; @ half a week ago, I also started moistening the DM with water- he eats @ half, waits for it to be moistened again, and finishes most (the level of his soft food intake has not changed). Should I monitor bg more than 2x/day?
 
It makes me giggle how many of us stir and revive the food for our kitties. They are soooo spoiled! :rolleyes: (I do it too when I'm home)

I wouldn't be too worried about that blue since it's still under 120. We say they are OTJ after 14 days without insulin. You're really close right now! I would keep testing twice/day to finish out your 14 days, and let's see if any more blues pop up. Sometimes they just have an off day. It looks like most of his numbers have been 80's and below.
 
O K. What also concerned me is he eats less, waits for more water to be added to the food (at which point he starts up again). His legs are really not the same. Since his numbers are back to 'normal' does that point to arthritis? (I bought Zobaline, but is neuropathy now ruled out?)
 
It can take awhile to heal from neuropathy, so I would go ahead with the zobaline. However, he's old enough that arthritis is certainly possible. :(
 
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