Good news and a Question about BG monitoring

[SassyCat04]

So Wednesday was 7th day for Makari on his insulin. He was diagnosed with diabetes on October 31st. It's be a rough seven days for those of you who did not see me introduction post. Another big thanks to those of you that did and helped me out and gave me encouragement and offered advice.

So yesterday I called in his BG curve numbers and talked to his vet. Well, I suppose his temporary vet. His usual vet in the practice couldn't see him through all this so a bit of added stress was we were working with a new addition to the practice. We go to a very large hospital with eight doctors and the one we were seeing is new and I've never worked with her before. Though I did like her - I'll be getting back to his normal doctor at his next checks.

Anyway!! His doctor said she couldn't have been more happy with his numbers. For reference his pulls over a 12 hour period were 169 155 182 211 174 starting at pre breakfast and ending at pre dinner and no food eaten through the day even though I offered a mid day snack and he declined. He is on 1 unit of Lantus twice a day. We tested every 3 hours from 9am to 9 pm.

So here is my question. She told me to repeat a curve in 3 months. I thought that was a long time for a new diabetic. She told me if it made me feel better I could do it in 6 weeks but it really wasn't necessary.

She also told me I absolutely did not have to check his BG at all like ever between now and then unless he showed signs of not feeling well or his drinking/peeing symptoms reoccurred. I'm just not comfortable with that. Does that sound odd to anyone? Having a cat on insulin, especially an NEW diabetic with ZERO BG checks??

She rationalized he's doing really well extremely quickly and he's stable. She said it's fantastic and such an improvement only happens occasionally, this usually takes much longer. I think she's a little surprised that in 7 says his numbers are so good and his symptoms were gone in like 3 days. I'm shocked too to be honest. But the not checking his BG at all is freaking me out. What say you all about this??

 

[Hendrick Cuddleclaw]

Makari is gorgeous!! Those numbers aren't bad at all for so early in the process. Do you have a spreadsheet set up?

Many, many vets tell people that there is no need to check kitty's BG at home. At all. My vet said the same thing.

The consensus among the experts (and non-experts) here at the FDMB is that is pure lunacy. The BG should be checked every time you are going to shoot insulin to ensure it is safe to do so, and then on top of that, a few spot checks throughout the day so if the current dose of insulin suddenly becomes too high for some reason you catch it and prevent serious injury or death due to a hypoglycemic episode. It is far too often that we get a new member posting about a cat nearly dying due to a hypo condition, and how they are kicking themselves for not doing home BG testing regularly. People just sick to their stomachs over their lack of monitoring and letting their cat almost die.

Put another way, if a person has a diabetic child, they wouldn't dream of injecting insulin without checking the BG to make sure it is safe to do so! So why not do the same with a pet?

Regarding curves, if you're home testing the BG here and there, a different times over the course of a few days or a week -- that is actually much better than a single curve on a single day, especially if that curve is done at the vet where BG levels are typically elevated due to stress.

 

[SassyCat04]

Thanks for your input. This was kind of my first thought. She was perfectly happy not having a single BG check between now and the next curve in 3 months. I was like, yeah that's not going to happen. So Makari does not do car rides so I'm doing his curves at home. I was also questioning not doing a curve for 3 months?

Her advice was doing too much and stressing him out was also bad. Point taken. But not checking his BG at all? That just sounds stupid and negligent. So I've got to figure out what I feel comfortable with. In her opinion checking it once a day pre meal / pre insulin was overkill for a stable cat. My thought is how do I know he's a stable cat with out BG checks. Assumption is very dangerous and laziness is very dangerous. I also don't want to be neurotic about all this and I know that's my tendency. So finding a happy medium is going to be hard.

I don't have the spread sheet done yet. I stink at those. I'm logging everything in a book which helps me but not people on here I get. I may work on it this weekend? I hate spreadsheets LOL They confuse the crap out of me.

 

[Bron and Sheba (GA)]

It never fails to amaze me how many vets are happy to check the BGs every few months. I think all vets need to be in charge of a diabetic cat and give the insulin and check the BGs for at least a week or two. I think they would then see how much the BGs can fluctuate in a day…let alone a month!
Checking daily is not overkill… where do vets get these ideas from?. Would they do this to a child? Leave it for 3 months?. You are not being neurotic at all. You are being a good responsible cat mom!

My suggestion would be to set up a spreadsheet (we can help if you can’t do it) and start monitoring Maraki before every dose and again during each cycle … this way you can keep him safe and know how the dose is affecting the BG and adjust accordingly as per one of our dosing methods. Checking before every dose tells you it is safe to give the dose. If the BG is too low and you haven’t checked and give the dose, Maraki could be in danger of dropping too low and you would have no idea this is happening.
Post here daily for help and when you are completely set up we can move you over to the Lantus forum.

 

[Hendrick Cuddleclaw]

Her advice was doing too much and stressing him out was also bad

if done right, home BG testing does not stress the cat at all and in fact, can be a happy time the cat looks forward to.

a lot of vets are not aware of this. They only know to poke the marginal vein and yes that is painful and causes bruising. That is how they did it at the vet where I took Hendrick.

But later, when we got into a routine at home where I was not poking the marginal vein, Hendrick would run to the "pokey spot" and sit there and meow at me to say c'mon, let's get the BG test on so I can get a yummy treat please! Those freeze dried treats worked wonders for me.

 

[Sienne and Gabby (GA)]

My knee jerk reaction to the vet's advice was the same at Kyle's. If this was the vet's diabetic infant, would she follow her own advice? I suspect not. Further, and this it the leverage I keep in my back pocket and would ask about. Essentially, if you follow the vet's advice and your cat has a symptomatic hypoglycemic episode and suffers brain damage or dies, is the vet's malpractice insurance paid up because I'd sue her into the ground and work to make sure she/he loses her license.

The guidelines for treating diabetes from the American Animal Hospital Assn recommend home testing (see p. 10 of the linked guidelines). This information is from a very reputable veterinary association. I would hope that your vet actually pays attention to what one of their professional associations recommends.