HELP-- Confused about insulin levels

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LoriD

Member Since 2014
Hi, I am really new to this and I'm sure it shows. Forgive me for posting this as a 911, but I am heading out of town tomorrow afternoon and I'm am afraid that I will not have the correct levels prior to leaving town and leaving my baby with someone who has said she is not comfortable checking his BG.
He has been on 4 units of insulin for the past 3 years. Last week, we switched him to a EVO food, found this site and bought a meter. I spoke with a vet (we just moved to a new state) who said the ideal was to keep his blood sugar above 50 but below 200.
When we switched food we began testing. Below are the results.
Monday 9pm, bg 110, 1 unit insulin given
Tuesday 8am, bg 184, 2 units insulin given
Tuesday 2:45pm, bg 46, handful of IAMS kibble given
Tuesday 8:29pm, bg 129, 1.5 units of insulin given
Wednesday 8:45am, bg 84, 1.5 units of insulin given --- 1 hour later, handful of IAMS kibble given and 2 treats
Wednesday 8:45pm, bg 143, 1.5 units of insulin given
Thursday 6:45am, unable to get enough blood for reading, 1.5 units of insulin given
Thursday 11:46 am, BG 24, no symptoms, but a handful of IAMS Kibble was given
Thursday 7:45 pm, BG 111, 1 unit of insulin given
I feel like this is all over the place and it's been torture on both of us trying to learn how to test (although we are both committed). I have to leave on a business trip tomorrow and my kitty sitter has said she doesn't think she can test after watching me poke him 6 times.
I'm not sure if I should just go back to the blue naturals food and put him back on his normal 4 unit insulin dose or keep feeding him the new EVO food and if so, what would be a safe unit of insulin, if he can't be tested for a 10 days?
ANY RECOMMENDATIONS WOULD BE APPRECIATED. I have called his vet, but he could not see him until the 25th.
 
Hi Lori,

I'm only a novice sugar kitty parent so I can't comment on dosing. However, there are experienced forum members here whom I am sure will be able to help you.

In the meantime, it would be helpful if you could post again with the type of insulin that your cat (name?) is being given because different insulins work in different ways. Also, can you post details of the meter you are using (human or veterinary?).

It might also be helpful if you could take some additional test readings during the current cycle to indicate how low your kitty's BG lowers today.

If I understand your post correctly it sounds like you might need some additional information on testing technique. I'll try to find the testing guide for you and post a link.
 
You data shows that 1 1/2 unit is too much. Maybe even 1 unit is too much but you do not have enough data for one unit.
ALso give insulin and when you give a BG between shows just use the nomenclature XX BG@ + Y where Y is the hours after the shot. There way every uses will not have to do the calculation to determine the time after shot.
 
Hi Lori,

Here's the link to your other post where you provided a bit more information about your kitty, Tiny: http://www.felinediabetes.com/FDMB/viewtopic.php?f=28&t=124941&p=1294403#p1294403

You had mentioned in the post that you were considering an insulin switch. Are you still using Humulin-N? That will be important for those giving advice to know since Humulin works differently than the other insulins.

Here, we consider normal numbers for a kitty to be between 50 and 120. (Your vet has said between 50 and 200 because under 200, we avoid damage to the organs). Anything below 50 is hypoglycemia territory, and low numbers can be fatal. If an insulin dose takes a kitty's numbers below 50, then we know that dose is too much.

Larry and Kitties said:
ALso give insulin and when you give a BG between shows just use the nomenclature XX BG@ + Y where Y is the hours after the shot. There way every uses will not have to do the calculation to determine the time after shot.
Click to expand...

We all speak a common "language" here that was super confusing for me when I first got started, and I know no one has explained it to you since you joined. Here's an overview of it: AMPS is the morning (AM) reading we get before the shot (Pre-Shot) If we get any blood sugar checks, we talk about them in terms of time since the shot. For instance, if we get a test three hours after the shot, we refer to it as AM+3. We do the same thing for the evening: PMPS is the blood sugar level before we give insulin in the evening. If we get a test 6 hours after that PM shot, we would note it as PM+6, for example. So, when we change your numbers into the "common language," it will look something like this:

9/8 PMPS - 110, 1 unit
9/9 AMPS - 184, 2 units
AM+6.75 - 46
9/10 AMPS - 84, 1.5 units
PMPS - 143, 1.5 units
9/11 AMPS - No reading, 1.5 units
AM+5 - 24
PMPS - 111, 1 unit

I know our language can be confusing, especially when you're already overwhelmed with managing everything else. If you have any questions about it, let us know so we can help.

You've been doing a good job with testing. I know that can be hard, too, when first starting out. One suggestion I would have would be to not give any insulin if you can't get that pre-shot reading. (Others may disagree with me on this. Let's see what they have to say.) The pre-shot readings tell us if it is safe to give insulin. For example, one morning, I got a pre-shot reading of 38. :shock: If I would've given Jersey insulin that morning when she was already that low, she could have gone even lower and had a fatal hypoglycemic episode. That's why those pre-shot tests are super important. We don't know where Tiny was to start with on 9/11 but we do know that he went way too low that day - all the way down to 24. Can you get a few more tests (at least one) in between each shot? That will tell us more about whether the 1 unit is too much.

Assuming that you are still on Humulin and you don't have anyone who can test Tiny while you're gone........If I were in that situation, I would probably skip the insulin completely while you were gone. Tiny's numbers right now are all below renal threshold (where organ damage occurs), and we don't know how low some of these doses are actually taking Tiny. I would rather err on the side of caution and keep Tiny safe while you're gone. Again, that's just my 2 cents'. Hopefully others will be along soon to give you their thoughts on what to do. I would also be hesitant about giving Tiny any insulin even today since most of the pre-shot numbers have been in the normal range. Again, this is based on the assumption that you're still using Humulin.

Hang in there - I know this is hard. :YMHUG:
Shelly
 
Thank you so very much for the support and the guidance. Having an explanation of the numbers has helped me to understand a lot more about the forum and what I am doing.
Yes, Tiny is on Humlin N (for now) and I have been using a Relion meter. I will check him this morning and if he is still fairly low with just 1 unit given last night, I will wait and not dose him unless he starts climbing. My concern is that I will leave him with the house sitter around 1pm today and I won't be back for 12 days. He's been insulin dependent since I got him from the shelter, so the idea of not giving him insulin for 12 days sounds very scary to me, especially if someone can not check his BG. I will make a couple of calls this morning and see if I can find a vet that would be willing to check his BG for me a few times while I am gone.
 
Thanks for confirming that you're using Humulin. That helps us better understand the numbers. Usually, Humulin brings the numbers down to their lowest point around 3 to 4 hours after the shot (although it can range from about 2 to 6 hours). If you can get some tests especially around those "low point" times, that might really help when it comes time to figuring out a dose.

Some people have called their local colleges to see if there is a pre-med/pre-vet student who could test and give insulin while they were gone. I don't know if that is an option where you live, but I wanted to throw it out there just in case.

I only used Humulin (sporadically) for a very short time before switching to Lantus. I'm just not experienced enough to help you figure out a safe dose to give while you're gone. I'll try to flag someone down who might be able to help you with that.
 
Just an update... we tested again at 7am and his bg was 120, so I did not dose him. I will check again about 9, 11 and 1 and see where he is. The testing links really helped. I'd never warmed his ear. This time I did and the first time I stuck him, I went through 3 test strips because the first 2 error-ed out because of too much blood.
 
Thanks for the update. As promised, I did ask a more experienced member to pop in and share some thoughts on what to do while you're gone. I don't think she's signed on yet this morning. In the meantime, hopefully some other individuals will stop by and offer their advice, too. I know it's a difficult position that you're in right now. :YMHUG:

Just a thought - are you hitting the main (big) vein on the ear? That can result in a lot of blood. From what I've read, you should aim for the edge of the ear and not the main vein. Regardless, you're doing much better with the ear testing than I ever did. :thumbup I couldn't get enough blood without hitting the main vein, and even then, we struggled. :cry: We ended up moving to paw testing - not the ideal situation, but it's what worked for us.
 
LoriD said:
The testing links really helped.
Click to expand...

I'm delighted to hear that, Lori. After all the help I've received from other FDMB members its great to do even a small thing to help someone else.

Hopefully the testing will go much smoother now for you and your kitty. :smile:
 
N is a very harsh insulin for cats it drops then fast and wears off in about 6-8 hours. Personally I wouldn't be comfortable leaving my insulin dependent girl with anyone who isn't testing especially on N.

Would your vet do a medical board for you while you're away? Or perhaps have a vet tech that would like to pick up some extra cash by pet sitting? With a diet switch just happening its really risky to have anyone giving insulin without testing first.

Mel and The Fur Gang
 
At most, 0.25 - 0.5 units, given about 30 minutes after eating might be safe. If the sitter can eyeball 0.25 units, that would be better. Just a teeny bit, given after the sitter is sure the food is stayiing down. Stress from your absence could cause the glucose to rise.

If you can find a vet tech who needed some pocket change, or someone willing to learn how and do it, that would be ideal. You might point out that learning to test widens her pool of employers.

Also, would your sitter be willing to do non-needle assessments? There are a number of measures in my signature link Secondary Monitoring Tools which she could do. Maybe print them out an discuss them with her.
The most useful ones would be
water drunk
urine volume/frequency (based on number of clumps and clump size)
food consumption/hunger
skin check for dehydration ( a warning clue for problems)
weight, if you have a digital scale
breath odor -a fruity or nail polish remover odor
 
Seems like he is going low when you give more than 1 unit. You could have your pet-sitter only give 1 unit at a time. Of course, ideally you should call your vet and run the numbers by him/her to check. If they aren't open Saturday, you could just have the petsitter dose the insulin on the low side for a couple of days (better to be a little high than life threatening low IMO) and call the vet Monday and then get in touch with the petsitter after the convo.

1. Make sure the petsitter only gives insulin knowing that he has been eating his food. If he stops eating his food, she should hold his insulin if she is not checking his blood sugar or uncomfortable with force feeding.
2. Make sure the petsitter is familiar with symptoms of low blood sugar. Give her instructions in case this happens.
3. Keep an emergency vet number close-by.

If I lived nearby I'd be that available vet tech :) Good luck!

And, just to be clear, is your vet not willing to take phone calls to discuss his regimen??? This is a big deal! That would not fly at my practice.
 
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