Help With ReliOn Prime Meter Numbers

[Jax A]

I've been doing spot tests on my cat Jax since I had blood labs done on him this last Feb. I haven't done a curve and he has not been given him any insulin ever yet, so far. I test him before eating, and then sometimes I test him 1-2 hours after eating and have kept a log on those numbers. They've always been betwen 216 and usually not above 255. This is using the ReliOn Prime. Can someone who knows this meter comment on these numbers please? I don't want to stress out his kidneys or circulatory system too much longer, and this board has been very very helpful, thank you

- Also, I've been using the food carb .pdf from dr lisa and he has gotten a range of hi protein wet foods only,..but he seems to be gtetting burned out on the wet food and waking me up more than usual wanting food when there is food or sometimes several choices. I actually broke down and gave him some Orijen, grain free dry food yesterday...just to see how it would affect his numbers. (It's %90 meat, %10 vegetavbles and %0 grain, plant, tapioca, plant protein concentrates. He has had no dry food since February, but if anyone knows this Orijen brand from Canada, it's really good quality, and he absolutely loves the freeze dried treats they make that are either, meat, poultry or fish only in them. I tried using juniper berry powder in his food and he didn't like it much, so I tried giving him tea with it, but that was stressful for him and didn't seem to affectd his nuimbers much. I've been also mixing in someting calle Sweet Eze which is a combination of herbs for diabetics thats helps absorb excess sugar in the blood. The ingredients are mostly Chromium, followed by Bitter Melon, Cinnamon, Ginseng, Gymnea, L-Aspartic Acid, Jambolan and Vanadium

 

[Jax A]

Also his weight went after taking him off dry food from 12 lbs down to 8.6 at the lowest in a few months, but he has been holding steady the last month now at 9.2 and 9.4 last time I weighed him. two days ago. Also the blood lab numbers at the vet were 466 in Feb, but he was pretty stressed out by the visit getting blood drawn and also a urine sample taken. He's shown no signs of neuropathy and except for giving him a sample of dry food yesterday, he stopped drinking as much water and making big clumps of litter mostly, but sometimes still a few. Of course, the dry food had him drinking more water again so I think I have to remove that and just go back to wet food only, but if anyone knows this Orijen and can commment about it that I'd appreciate the feedback on those who know about this brand. He's indoor, but I give him supervised outside vistits and he has lots of energy chasing birds and lizards outside and getting in a few good sprints here and there. He will be ten years old in August.

 

[Veronica & Babu-chiri]

Hi!

It would be great if we could see all the information you have collected that would help see what's going on you could use the spreasheet we use, this is the link with the instructions to set it up http://www.felinediabetes.com/FDMB/threads/fdmb-spreadsheet-instructions.130337/

Most of us use human meters like the ReliOn Prime and the normal glucose values would be 60-120, so with numbers usually over 200 I think you should consider starting him as soon as possible on insulin to help getting him regulated even if he's not yet showing any other symptoms the sooner the better chances you have

I don't know about Orijen hopefully some of the Canadian members will help with that

 

[Jax A]

Thanks Veronica,...he didn't eat very much of the dry food, so I put it away again, since he's been completely on hi protein wet food only since feb. I've only been doing spot numbers,..testing once during a day and sometimes not even multiple days in a row. All his results have been consistantly only as low as 188 and as high as 366, but in the 20-30 times I've tested him,..he's been right in the 216-266 range, which I know is too hight and he needs insulin. I was hoping and trying to get his numbers down with diet and supplements first, but think, time to stop trying and just start him on insulin. ..I'm posting on the other feline diabetes board as well, just to hopefully figure out best course as soon as possible. I see if I'm California, I don't need to go to the vet to get a prescription and syringes. At least that's what It looks like so far. I'm going to go study the links agian about dosages and shooting and testing prior. Looks like based on these numbers, he needs between 1 - 1.5 units and to use U100 3/10cc syringes. Can anyone reccomend best insulin brands? Hate to go to Walmart, but probably will to start with, but if there's a better brand say at Rite Aid ,..I'll go there too, but I've been using the Walmart brand BG tester, so I will get more strips there. I see PZI, ProZinc, Caninsulin/Vetsulin and Hypurin insulins are for 12 hour twice a day - I'm thinking Lantus, hoping this is right, ..as vet had said, looks like.. Type 2 onset

 

[Veronica & Babu-chiri]

All the insulins are to be given twice a day every 12 hours, including Lantus, if you are going to use Lantus get the pens not the vial ( that way you use each pen till the last drop as a mini vial you actually do not use the dosing mechanism )and get U-100 3/10cc syringes with half unit markings on them those are way easier to use since you will be adjusting on 0.25 unit increments or decrements, make sure you also get a lot of test strips and lancets since you will be testing more often ( at least twice a day before each shoot and if possible once mid cycle)

This is the link where you can start getting some idea as how Lantus works (http://www.felinediabetes.com/FDMB/...the-basics-new-to-the-group-start-here.18139/)

Also you should take a look at the Lantus protocols, to decide which one suits you better, there's Tight regulation (TR) (http://www.felinediabetes.com/FDMB/threads/lantus-levemir-tight-regulation-protocol-tr.1581/) and Start Low Go Slow (SLGS)(http://www.felinediabetes.com/FDMB/threads/lantus-levemir-start-low-go-slow-method-slgs.129446/)

 

[Veronica & Babu-chiri]

I'm not in the US so no idea where you can get your supplies, maybe you could post another thread with the specific question on where to buy supplies

 

[Jax A]

thanks...If I decide to use insuin specificaly for a feline...there is a vet outpost supply I've been buying him royal cainin glycobalance prescription food from,..but he's been getting other hi protein wet food as well.. appreciate your feedback so much, trying to get insulin or syringes today, but there is actually a big fire that just broke out down the road from my house, so now I don't wanna leave, as it's not under containment yet

 

[Veronica & Babu-chiri]

thanks...If I decide to use insuin specificaly for a feline...there is a vet outpost supply I've been buying him royal cainin glycobalance prescription food from,..but he's been getting other hi protein wet food as well.. appreciate your feedback so much, trying to get insulin or syringes today, but there is actually a big fire that just broke out down the road from my house, so now I don't wanna leave, as it's not under containment yet

OMG take care of yourself !!

When you decide what insulin you will be using post here to get some guidance about the starting dose and all

 

[Jax A]

thanks it's over 1000 acres, burning NE of me. Evacuated 7 miles Norrth from me,..and so far is wind is blowing opposite. Thanks,...I want to get him the insulin definitley by tomorrow...and I'm thinking I will start slow and test,..prob start with .25

 

[Veronica & Babu-chiri]

thanks it's over 1000 acres, burning NE of me. Evacuated 7 miles Norrth from me,..and so far is wind is blowing opposite. Thanks,...I want to get him the insulin definitley by tomorrow...and I'm thinking I will start slow and test,..prob start with .25

If you are going to use Lantus Start Low Go Slow (SLGS) the protocol states that the starting dose would be 0.5 and hold that dose for at least a week unless he goes under 90 at any time, but if you prefer to start a little bit more careful you can try the 0.25 and we can see how he reacts

This stiky will help you on how to measure small doses http://www.felinediabetes.com/FDMB/...insulin-info-handling-drawing-fine-doses.151/

 

[Veronica & Babu-chiri]

And I have this photo on how 0.25 looks in a BD syringe with half markings hope it helps

 

[Jax A]

Thanks Veronica,...really helpful. I got Jax into the Vet this morning and got a prescription for Lantus, since he said it had the best possibily of remission, hopefully within 2 months since it is a synthetic insulin. He said to find the syringes that held the smalles amount and reccommended 1 unit to start with. Someone in the lobby reccomended Baby syringes,..since it has the smalles increments. The vet did give me a bag of the 31 gauge 8mm (5/16" needles) that holds 3/10ml cc that doses up to 30 units. I don't know, are there different syringes for different insulins? He also said, only 1X a day. He only charged me for an office visit, but he looked at my blood labs which I brouhgt and said, i should also get ketone strips since when the blood labs and Urine anlaylysis were taken in Feb, he had ketones present. So now I am going to go hunting for place that has best price on Lantus, ..I guess, maybe Costco, they used to have a pet plan. Vet also reccommended I buy the pet BG meter, he said,,just to be sure,..but he said, based on the numbers I was giving him,..the ReliOn Prime numbers, since they are for a human,..(based on what I told him) he thought, sounds like ..add on 20 points onto the ReliOn numbers to get the proper feline Glucose level..so he approx. 280 feline. Last three days his ReliOn numbers have been between 211-270. Also, been looking at videos on best places to administer his shots...tent his skin between his shoulder blades & shoot at 45 degree angle, or near his ribs and try to rotate spots I shoot. Is is reccommended I swab every needle with rubbing alcohol, even if I use only one needle per shot, 1X only?

 

[Veronica & Babu-chiri]

He said to find the syringes that held the smallest amount and recommended 1 unit to start with. Someone in the lobby recommended Baby syringes,..since it has the smalles increments

You have to get syringes for U-100 ( those are the ones for Lantus, there are U-40 for other type of insulins but you will have to make a conversion and is a mess ), definitely get syringes with half unit markings , the one in the photo I think is the smallest available is a 1 ml 31G ( this is how thin the needle is ) with 6mm long needle ( insulin syringes are even smaller than normal baby syringes).

He also said, only 1X a day.

Your vet seems to be trying to treat Jax like they do on dogs and with other insulins but Lantus does not work well dosing only once a day ( a vet made my try it and the test lasted only 2 and a half days because Babu's numbers went all over the place) so I suggest you split that dose into 0.5 units twice a day which will be exactly how the Lantus protocol says.

said, i should also get ketone strips since when the blood labs and Urine analysis were taken in Feb, he had ketones present

That is an excelent idea you can find those in any pharmacy ( they are for humans but work just fine on cats) and that way you can monitor him and avoid a nasty surprise

he ReliOn Prime numbers, since they are for a human,..(based on what I told him) he thought, sounds like ..add on 20 points onto the ReliOn numbers to get the proper feline Glucose level..so he approx. 280 feline. Last three days his ReliOn numbers have been between 211-270.

There's no actual conversion between human and pet meters, for what I've heard the main difference is the pet meters tend to register higher than human meter but there is not an exact amount I think the differences are more notorious in high numbers than in lower numbers but I'm not sure, thing is we watch for "trends" more than individual numbers always making sure that the cat is safe so the take action number on a human meter is when they drop below 50 and on the pet meter is when they drop below 68

But one important thing to consider is all the protocols we use were written with human meters in mind, so is quite easy to follow them using a human meter and most people here are used to seeing the numbers in human meters. Actually where I live there are no pet meters so even my vet uses a human meter

Is is reccommended I swab every needle with rubbing alcohol, even if I use only one needle per shot, 1X only?

We try to never use the same syringe twice, the needle gets damaged every time you use it even if the damage is not noticeable at plain sight and it may hurt more when you shoot and give you troubles trying to get it in.
You don't need to swab a new needle if you just opened it and have not used it with anything else (they are packed sterile after all), actually is not recommended to swab it in alcohol before introducing it into the pen to get the insulin since that may contaminate the insulin.

 

[Veronica & Babu-chiri]

Here's some information about how to shoot I hope it helps

http://www.felinediabetes.com/injections.htm

 

[Veronica & Babu-chiri]

 

[Jax A]

Thank you Veronica, really appreicate your input. I also posted on the diabetic catcare forum and it has been just great the info I've gotten between both sites, so I think I'm ready to give him his first shot tomorrow morning. I do like the TR (tight regulation) they aim for on the catcare site, becuse it has to do with overlapping insulin before it totally runs out and tends to cause a big spike as a result, but we'll see howI go, I'll do lots of tests to be sure. I got the lantus and have handled and stored it properly and reviewed how best to administer. I've read everything you've wrote above also. Yes, I have the right syringes, got half unit marks, for U100 insulin..and I agree about disregarding the single dose daily. I'm gonig to pretest and test also at the onset point.. again and also mid way and start trying to see the curve. I think splitting the 1 unit to two half units is a good idea, start slow. I've only been spot BG testing him 1X during random days and he has always typically been 211 - 280. I just did a test about an hour ago and it was 273, so I think his BG being in this range 211-280 for four months 1/2 unit to start and keep testing is good to avoid a bounce. He does need his teeth cleaned as he's got some gum disease, but since he had ketones in his blood/urine when I got the labs done in Feb, I think it's safe to say becuase of the Ketones present,..his high BG numbers were diabetes related and not caused by his gum disease outright. I want to do what I can to see if his numberes can move down without trying to get him into have his teeth cleaned first, but gotta see what can happen here. Thankfully another kind person, like yourself on the diabetic catcare site,..referred me to the coupon savings for Lantus, which took $200 off the cost of the vile of insulin. It's crazy that they're $305 a vile, but it will last a long time too ..cheapest I found ,..was at Costco. Thank you I'll keep you posted, appreciate it and Jax does too!

 

[Chris & China (GA)]

It's crazy that they're $305 a vile, but it will last a long time too ..cheapest I found ,..was at Costco.

Most of us are buying our Lantus from Canada because the price is so crazy

Here's the Information on Buying from Marks Marine Pharmacy

The pens are the better buy....Most cats end up on less than 2U twice a day, so you can't use all the insulin in a vial (1000 units) before it starts to lose efficacy.

With the pens, they're good until the expiration date. You only have 1 pen "open" at a time and the others usually don't expire for at least 2 years. Since each pen is only 300 units, you can usually use every drop without losing efficacy

 

[Veronica & Babu-chiri]

Good luck, keep us posted on how everything goes,keep asking all you need.

Also try to get his teeth fixed as soon as you can, that can be affecting his numbers too

 

[Jax A]

No, I totally agree and want his teeth cleaned and get his gums healthy asap to help with the process. So I just gave Jax his first shot 12:15 Pacific Time,..near his side rib. No wet fur, so seemed like went in ok,..but couldn't leave the needle in long cuz he wanted to get up. I'm trying out two 1/2 units a day based off pre-test BG numbers. His pre shot BG was 257. Def will keep testing him for to see the curve +2-3 , +3-4 onset, and + 6-8 at nadir. I made sure to use a magnifier, since on the syringes, 1/2 unit is the very first marking & I made sure to take a full unit and then flick it upright and push up till 1/2 was left. I put his wet food away in the fridge till I can see better how the insulin is reacting, but I need to figure out the balance on feeding becuase, I'm not positive. ,..but since last night he has ate Merricks grain free pate, rabbit and also some beef, literrally like a couple tablespoons at a time or 1/3 of a big can, and when I came in after getting some supplies this morning, (I wanted to be here and get everything I needed so I could watch him.) ..I gave him a small handful of the Orijen freeze dried treats, which is his favortite thing to eat and has been getting those for a few months already. Do people base feeding off test numbers to start, since his BG at the beginning is gonna be prob moving a lot till I get the curve and dosages closer?

 

[Veronica & Babu-chiri]

No wet fur, so seemed like went in ok,..but couldn't leave the needle in long cuz he wanted to get up

Congratulations on your first shoot!! and you don't have to leave the needle for a long time is more like in, press plunger and out in a matter of seconds just try not to let go the plungger until you've taken the needle out so that it won't pull any insulin back ( this is especially important with small doses)

I made sure to use a magnifier, since on the syringes, 1/2 unit is the very first marking

I got myself one of those cheap special reading glasses to work as a magnifier lens so that I could have my hands free and still make sure I was getting the dose ok

Do people base feeding off test numbers to start, since his BG at the beginning is gonna be prob moving a lot till I get the curve and dosages closer?

The amount of food you feed is more based on his actual weight and if he´s weight is under over or normal if he's normal just give his usual amount, Babu had lost a lot of weight because of the diabetes so I just let him eat as much as he wanted even if it was more than the usual recommendation.

What you will be adjusting according with your test results is the insulin dose, but right now since you are just starting, the recommendation is that you keep the same dose for at least a week, so that you give his body time to adjust to the insulin and the depot to form (unless he goes under 90 at any time then you would lower the dose to 0.25 twice a day)

 

[Jax A]

Ok, thanks for that,..I made sure to hold the plunger, because I didn't shoot air into the vile either, I went over to 1 unit and flicked and pushed out till 1/2 a unit. Jax was 12 lbs when took him in for blood labs because i suspected something was up in February. After being off dry food since Feb he is down to 9.4 and without insulin, he was burning through and wasting also a lot of food. He has been holding at 9.4 the last month tho. Will keep checking his weight and try to get him on four or five small meals a day, but I'm thinking he can eat more until he maybe gains some more weight back. One question, you're thinking lower the dose if he goes below 90? Isn't 50-150 ideal? I'm confiused, isn't 90 right in the middle of the ideal range then? Thanks for all the great feedback and tips by the way, and thanks Chris for the tip on the pens!

 

[Veronica & Babu-chiri]

Will keep checking his weight and try to get him on four or five small meals a day, but I'm thinking he can eat more until he maybe gains some more weight back.

Yes let him have as much food as he wants just make sure to withdraw food 2 hours before his pre shoot test so that the result you get is not food influenced and you can be sure is safe to shoot

One question, you're thinking lower the dose if he goes below 90? Isn't 50-150 ideal? I'm confiused, isn't 90 right in the middle of the ideal range then?

Actually the normal range in a kitty without insulin would be more like 60 -120, but in this case remember you are giving him insulin, his body is not regulating itself and it is recommended that for newly diagnosed cats (less than a year of diagnose/starting insulin) to decrease the dose by 0.25 units of what you are giving if he goes under 90 is part of keeping him safe and still keep giving him insulin,

Actually you will probably be adjusting doses a lot after the first week, both with increases and sometimes with decreases, insulin is not like medicine that you get a fixed dose and that's it, you will establish the dose based on his nadirs (lowest test result during a 12 cycle)

 

[Jax A]

Also,..if anyone knows regarding Lantus, ..the Box it came in says, it can be kept at room temp after opening becuase injecting cold insulin can be uncomfortable,..but everything I've read has said to keep it on a shelf in a cup with papertowel cushion in the fridge, which is what I'm doing. Also, it says it expires April 2020, but to discard unused portion after 28 days? :?

 

[Chris & China (GA)]

Also, it says it expires April 2020, but to discard unused portion after 28 days? :?

The FDA only asked it to be evaluated for 28 days, so legally, they have to tell you to throw it away. The "expiration" date is how long it can sit (without ever being "opened")

Once it's punctured, they start counting the 28 days.

We keep our in the fridge because we know it WILL last longer than 28 days and who can afford to throw away that much insulin??

Another benefit of home testing is you'll see when your vial is starting to "poop out"...if the numbers start to climb with no other reason, it's time to suspect the insulin

 

[Jax A]

Thanks Chris,..since I'm trying to pickup as much as I can from those who have the experience, I've been posting my questions over at Diabetic Cat Care board too and someone there said many of the people who use Lantus found when kept in the fridge it has remained active for up to six months

 

[Chris & China (GA)]

when kept in the fridge it has remained active for up to six months

We've had people use it even longer!!