Home testing 3 months after DX, total newbie!

[Harukyo]

Hello everyone in the ProZinc forum!

Kyo has been on ProZinc since 4/5/2019 and I was completely under vet care until recently coming to this forum a few days ago. I had a long and extremely eye opening conversation with another FDMB member who works with DCIN and I learned that I NEEED to home test. Not only does it cut down on my vet costs, but its imperative to the health of my cat. I immediately went and picked up a meter, I am using the ReliOn Prime, and after testing it out on my self and running through all the great advice that was given to me from DCIN, I managed to (almost) test my cat! We are working on positive associations and all of that. But I am left with some really pressing questions.

1. What levels am I looking for?
2. When do you decide to lower the dose of insulin, or increase the insulin?
3. She is currently on Purina DM dry (big mistake I know), and I want to work toward FF classics wet strictly for a LC diet. How slowly should I be transitioning this food and how do I make sure my cat isn't going into remission while I'm still giving insulin? (Wanting to avoid hypo at all costs)
4. Should I stop giving insulin and just home test before every meal to determine what her base levels are without the insulin and then bring back the insulin gradually? Shes currently on 1.5u/2x a day (10AM/10PM)

I apologize if these questions have been answered elsewhere, please feel free to link me to what I should know! I am totally new to this home testing stuff, and while I've figured out how to get the results, I'm having trouble what to do WITH them and how to interpret them. Thank you so much for reading.

PS- Can someone explain "bouncing" to me?

 

[Idjit's mom]

Hi and welcome to the sugar dance! I am not a Prozinc user, but I can refer you to the Beginner's Guide to Prozinc at the top of this forum.
1. from the Beginner's Guide:

• FDMB has general BG references for use with human meters: A cat is considered regulated if BG is in the mid-200s mg/dL {mid-11s mmol/L} for pre-shot and in low 100s mg/dL {low 5.6s mmol/L} or double digits (U.S. mg/dL) for nadir. (BUT notbelow 50 mg/dL {2.8 mmol/L} which is approaching hypoglycemia range, which is too-low blood glucose - we commonly call this “hypo.”) If you are using an Alpha Trak2 (pet meter) your hypo range starts at 69 mg/dL {3.8 mmol/L} and below. Again: You may want to consider raising your No-Shoot number to as much as 250 mg/dL {14 mmol/L} in the beginning of this sugar dance when using a pet-specific meter. That’s your and your vet’s decision.

2. Also from the Beginner's Guide:

• The proper sequence for dosing insulin is: Test/Feed/Shoot. In the beginning, if your cat’s BG is not up to at least 200 mg/dL {11 mmol/L}, if your schedule allows, you can stall (without feeding) for 20+minutes, then retest the BG. You are looking for a number that is rising, not falling and up to 200 mg/dL {11 mmol/L}. If you stall once, but can’t do another round of stalling and your cat hasn’t reached a BG of 200 mg/dL {11 mmol/L}, you’ll need to skip the dose and wait until the next cycle. NOTE: Because pet-specific meters (such as the AlphaTrak2) often read higher than human meters, you may want to adjust the NO-SHOOT number to 225 mg/dL {12.5 mmol/L} or even 250 mg/dL {14 mmol/L} This gives you an added margin of safety when using an AlphaTrak2 or other pet-specific meter.

• IMPORTANT NOTE: Do not feed your cat within the two-hour window right before the scheduled dose time; doing this can raise your cat’s blood significantly, giving you a higher BG number based on food. This could result in your giving insulin when you should not, or giving more insulin than you should.

3. From the FAQS forum
http://www.felinediabetes.com/FDMB/threads/transitioning-your-cat-from-dry-to-wet-food.956/

4. I don't think anyone would advise you to stop giving insulin. Read that guide and test accordingly. Before each and every injection to be sure it's safe to do so, and during the 12 hour cycle between injections. Enter the data on the spreadsheet and you will see if Kyo's blood sugar is going high, low or staying level. I can't advice on dosing, but Djamila or Rachel or someone will. Always test, it's the best way to keep Kyo safe from hypo and if she approaches that, you can intervene.

• How to treat HYPOS - THEY CAN KILL! Print this Out!!
• jojo and bunny's HYPO TOOL BOX

Bouncing, this is what I have in my little info file:
Here's an explanation of what we call "bouncing". It explains why a kitty's BG can go from low to sky high: (possibly contributing to your kitty's high BG at the high dose he's on)
BG goes low OR lower than usual OR drops too quickly.
Kitty's body panics and thinks there's danger (OMG! My BG is too low!).
Complex physiologic processes take glycogen stored in the liver (I think of it as "bounce fuel"), convert it to glucose and dump it into the bloodstream to counteract the perceived dangerously low BG.
These processes go into overdrive in kitties who are bounce prone and keep the BG propped up varying lengths of time (AKA bouncing).
Bounce prone kitty repeats this until his body learns that healthy low numbers are safe. Some kitties are slow learners.
Too high a dose of insulin can keep them bouncing over and over until the " bounce fuel" runs out and they crash - ie., have a hypo episode. That's why we worry so much about kitties that have had too high a starting dose prescribed by the vet and the owner isn't home testing.

 

[Yong & Maury GA]

Welcome Kyo and her mum!
Great job getting started so far and we'll try our best to help you and your fur baby! There's lots of experience here and we all have or have had a sugar kitty. Always glad to share our experiences .
And Lou has done a lovely job answering your initial questions , So the only thing I'll chime in on is the dose. Since your just starting the testing, I'm gonna suggest you not raise it yet since it seems to be helping her. One tip, try not to get caught up too much on a single number, we tend to look at the big picture and trends.

Oh and if you ever feel wet at the shot area, NEVER re-shoot because we don't know how much of the insulin actually got into them. Just mark a FS one your dose for that cycle, which means Fur Shot. We've all done it at least once . Also, because I was seeing the occurrence more, do NOT rub the injection site as this can effect the absorption rate of the insulin. Just give some head or butt scratches/pets after administering shot .

Feel free to keep asking questions, we'll try to help as much as possible! I check in on weekends cos of work but will try to peek in the middle of the week too.

P.S. Just saw your notes (love them!) How much was the Purina DM bag and what size? There is a better alternative if Kyo must have crunchy. My boy must have some crunchy lol.

 

[Harukyo]

Welcome Kyo and her mum!
Great job getting started so far and we'll try our best to help you and your fur baby! There's lots of experience here and we all have or have had a sugar kitty. Always glad to share our experiences .
And Lou has done a lovely job answering your initial questions , So the only thing I'll chime in on is the dose. Since your just starting the testing, I'm gonna suggest you not raise it yet since it seems to be helping her. One tip, try not to get caught up too much on a single number, we tend to look at the big picture and trends.

Oh and if you ever feel wet at the shot area, NEVER re-shoot because we don't know how much of the insulin actually got into them. Just mark a FS one your dose for that cycle, which means Fur Shot. We've all done it at least once . Also, because I was seeing the occurrence more, do NOT rub the injection site as this can effect the absorption rate of the insulin. Just give some head or butt scratches/pets after administering shot .

Feel free to keep asking questions, we'll try to help as much as possible! I check in on weekends cos of work but will try to peek in the middle of the week too.

P.S. Just saw your notes (love them!) How much was the Purina DM bag and what size? There is a better alternative if Kyo must have crunchy. My boy must have some crunchy lol.

Thank you for letting me know about the rubbing!! I will avoid pets in that area (I usually do a full body stroke with praise). The Purina DM was about $41 and I only bought the 6 pound bag because I wasn't sure if she'd like it. Turns out she loves it and I have to take it away from her already I'm sorry kitty, it's for the best I promise .

My new concern is that I've read about transitioning her to wet food from Dr. Lisa's info on it, and if I'm switching to a LC wet food diet from the DM dry (which I see has a pretty high carb content so I've been less worried about a hypo incident in conjunction with shooting insulin). So when I start her on the wet food (FF classic seafood varieties) I'm wondering if I should not shoot insulin even if she does read in the 200s because the carbs won't be running her BG levels up as high? I believe that's right please correct me if I'm wrong. And I know the motto here is better to be too high than a minute too low. I don't know how to make the wet food transition and adjusting the insulin at the same time pretty much. I think I need more data on her nadir times and that might help the process. I've only been continuing to feed the dry food because of this concern. Trying not to move too quickly and all. I hope this makes sense, it's 5 in the morning here for me so I'm a little sleep deprived also thank you for the compliment on my notes in the spreadsheet! I have tried so hard to relay as much info as possible!

 

[JanetNJ]

Thank you for letting me know about the rubbing!! I will avoid pets in that area (I usually do a full body stroke with praise). The Purina DM was about $41 and I only bought the 6 pound bag because I wasn't sure if she'd like it. Turns out she loves it and I have to take it away from her already I'm sorry kitty, it's for the best I promise .

My new concern is that I've read about transitioning her to wet food from Dr. Lisa's info on it, and if I'm switching to a LC wet food diet from the DM dry (which I see has a pretty high carb content so I've been less worried about a hypo incident in conjunction with shooting insulin). So when I start her on the wet food (FF classic seafood varieties) I'm wondering if I should not shoot insulin even if she does read in the 200s because the carbs won't be running her BG levels up as high? I believe that's right please correct me if I'm wrong. And I know the motto here is better to be too high than a minute too low. I don't know how to make the wet food transition and adjusting the insulin at the same time pretty much. I think I need more data on her nadir times and that might help the process. I've only been continuing to feed the dry food because of this concern. Trying not to move too quickly and all. I hope this makes sense, it's 5 in the morning here for me so I'm a little sleep deprived also thank you for the compliment on my notes in the spreadsheet! I have tried so hard to relay as much info as possible!

I have a video in my signature showing how I test my cat CC at home and

 

[Djamila]

I think as soon as you are comfortable and confident that you'll be able to get 4-5 tests each day for a few days, you can start the transition off the dry food. For some cats the change in BG is quite dramatic, for others it lowers, but not dramatically so. I would definitely not stop the insulin, just increase the testing.

Yesterdays two tests were pretty flat which means that either Kyo isn't getting enough insulin yet, or that she was in a bounce cycle, so give another day or so of testing so we can see what's going on, and then start the transition off. You don't have to pull all the kibble immediately. You can just start reducing the kibble until it's all gone (maybe a week or two of transition time - less and less kibble, more and more wet food).

 

[Harukyo]

I think as soon as you are comfortable and confident that you'll be able to get 4-5 tests each day for a few days, you can start the transition off the dry food. For some cats the change in BG is quite dramatic, for others it lowers, but not dramatically so. I would definitely not stop the insulin, just increase the testing.

Yesterdays two tests were pretty flat which means that either Kyo isn't getting enough insulin yet, or that she was in a bounce cycle, so give another day or so of testing so we can see what's going on, and then start the transition off. You don't have to pull all the kibble immediately. You can just start reducing the kibble until it's all gone (maybe a week or two of transition time - less and less kibble, more and more wet food).

Thank you so much! This is great information! Exactly what I need to be able to move forward! When you say flat, does that mean I'm looking for a drop in BG after she's eaten? Around the +3-+6 mark?

 

[Harukyo]

Also omg it must have took me like 30 minutes and Soo many pokes to FINALLY get blood from her ears. God she is so patient with me I'm thanking my lucky stars that I don't have a more stubborn can because I already feel awful having to do this to her and I'm so bad at it. Pretty sure I've pierced her ears a couple of times. I know her ears are learning to bleed now and I shouldn't be too hard on myself, but I hate this right now and im dreading the fact that I have to do it again in a couple of hours...

 

[Jenna Josie]

Don't worry -- we've all accidentally pierced our cats' ears from time to time. It happens.

The good news is that it does get easier and easier as new capillaries form and the ears start to "bleed easier." You'll be a pro in no time!

In case you haven't seen it, here's a nice image of the "sweet spot" which you'll want to be aiming for. It's *between* the vein that runs all the way around the ear and the edge of the ear. http://www.felinediabetes.com/FDMB/threads/hometesting-links-and-tips.287/

 

[Harukyo]

Don't worry -- we've all accidentally pierced our cats' ears from time to time. It happens.

The good news is that it does get easier and easier as new capillaries form and the ears start to "bleed easier." You'll be a pro in no time!

In case you haven't seen it, here's a nice image of the "sweet spot" which you'll want to be aiming for. It's *between* the vein that runs all the way around the ear and the edge of the ear. http://www.felinediabetes.com/FDMB/threads/hometesting-links-and-tips.287/

Thank you @Jenna Josie ! I've watched all the videos and images that have been provided here and on youtube. It looked easy enough until I had to actually do it lol, but I know I should be giving it some time and patience. Things went better for our +6 BG test!~ but I am noticing that her levels are staying flat at around the 200-299 mark. I've only done 2 cycles of testing so I will be doing another cycle and then if shes still flat, I'm going to start transitioning her over to LC wet food and see if that helps. @Yong I know you said your cat loves the crunchy texture! In the event I can't get her to eat just her FF classics wet food, do you sprinkle freeze dried treats on it? Or do you put in a couple pieces of the dry food? Tell me your secrets!

 

[Yong & Maury GA]

Thank you @Jenna Josie ! I've watched all the videos and images that have been provided here and on youtube. It looked easy enough until I had to actually do it lol, but I know I should be giving it some time and patience. Things went better for our +6 BG test!~ but I am noticing that her levels are staying flat at around the 200-299 mark. I've only done 2 cycles of testing so I will be doing another cycle and then if shes still flat, I'm going to start transitioning her over to LC wet food and see if that helps. @Yong I know you said your cat loves the crunchy texture! In the event I can't get her to eat just her FF classics wet food, do you sprinkle freeze dried treats on it? Or do you put in a couple pieces of the dry food? Tell me your secrets!

Hi Lauren and Kyo!
Sorry I got a little busy the past couple weekends! My boy loves his crunchies and the freeze dried treats didn't cut it in his wet food lol. Janet was the one who told me about Young Again ZERO carb dry food and that's what I've been using for a while now. When I tried to completely remove dry food he protested and just let his wet food sit at meal time and looked at me like "Umm aren't you forgetting something?" . I guess for him it's like people who need toast/bread with meals lol. I also use their treats along with freeze dried one's (got the bigger one's for dogs with one ingredient by Stewart's and cut them to cat size pieces). The 8lb bag is $49 but it lasts him about 6 months. Before I learned about his diabetes he was on Purina Indoor dry (very high carbs ) and a 28lb bag lasted about the half the time .

But just looked at your SS !!! Maybe the switch to LC diet for Kyo will be enough! (antijinxing!) Great job!

 

[Harukyo]

No problem and welcome back @Yong ! Wow I have learned and gained so much experience from the last time I update this thread, it's crazy! This community has done so much to educate me on how to help Kyo. That's funny how your sugar kitty has his preferences, gotta love their personality in the choices they make and how we have to work around them. I know I'd be an awful diabetic because I LOVE bread lol. Thanks for checking up on us ! Give some pets to handsome Maury for me!

 

[Yong & Maury GA]

I know I'd be an awful diabetic because I LOVE bread lol.

OMG I know! I love rice too! lol