How often & what numbers to look for when testing?

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bufford

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Hello,
I'm new to this forum and the whole diabetic cat thing. We've decided to do 'home testing' of the blood glucose levels of Whiskers as the weekly visit to the vet's was more than the payments on the Buick! Can someone tell me how often I should be testing the cat and what numbers I should expect to see? Is it necessary to test at the same time relative to the clock or feeding? I've done a few tests and had results all over the map. I've maintained the recommended dose of insulin that the vet told us, his' weight has gone back up since initially being diagnosed and switched to wet food, his thirst has returned back down to what I would say is normal and other then still walking a little funny ( vet said this condition may be permanent) he's back to his old self, should I take it that we are in the right area?
 
Hi and welcome to FDMB. Home testing is definitely the way to go. And we have lots of info to save money even on that, strips can be expensive and our members have checked most of the meters out. Do you have a meter yet?

What insulin are you using? Different insulins may need different timing. Generally we always test before the shots to be sure the cat isn't too low to shoot and then some testing in between to find out how low the insulin is taking them. We have a nifty on spread sheet, to help keep track of everything too.
 
Welcome, yes you've come to the right place!

It is really great you've decided to do home-testing. That is the one thing above all others that will help you and most importantly, you new sugarcat.
Before being able to answer your questions effectively, it would be terrific if you could give us a little more info.

1 - what type of insulin are you using? You say you've stuck with the same dose so far. How many units, and how many times per day?

2 - you said that you are feeding an all canned diet? Any specific brand? How often do you feed?

3 - How long ago was kitty diagnosed? How long have you been testing and dosing?

4 - were there any other conditions found at the time of the diagnosis for diabetes?

5 - How old is your kitty, and how much did/does he weigh?

6 - how is his general condition today vs how he was when first diagnosed? It sounds like he's improved generally?

General answers to some of your questions -
You need to always check his BG level BEFORE dosing with insulin. Most of us test,then feed, then shoot in that order. That process can be done in a 15-30 period. Usually a cat is given a 2x per day (we call it BID) dose schedule, so most people would do the test/feed/dose routine in the morning and at dinnertime. That will depend on your answers to some of the questions above.

Let us know the basics, and then we can be a lot more helpful.

Again welcome!

My name is Carl, and my sugarcat is Bob
 
Thanks for the responses. In answering the questions:
The vet prescribed "Lantus" insulin and after many weeks of visits and testing is currently @ 1.5 units twice a day after feeding.
The vet recommended Purina DM and given her knowledge far exceeds mine in this area we've followed that advice, giving Whiskers 1/2 can in the morning and the rest 12hrs later in the evening.
I believe it was about 3-4 months ago when we initially noticed Whiskers enormous appetite, eating his and the dogs food but yet dwindling to skin and bones, gulping back both his and the dog's water and the final straw was a funny walk he'd taken on.
He is a 10yr old tabby and weighs about 12lbs or so which was more or less his weight prior to becoming diabetic.
I bought a tester and strips and lancer @ Walmart and so far we've tested him 3 times with readings ranging from 14.1 ((255) to 1.8 (30) to 5.7 (103). I posted my questions because I need to have an idea of what to expect to see and how often I should be testing. These tests were taken randomly as he and time allowed so they don't really provide much information.
Common sense has told me based on his weight regaining, normal water consumption that we are in the right area. We did note that when he was still @ 3 units of insulin he had bad reactions twice, meowing to tell us something was wrong, loss of balance etc. Based on that and a discussion we'd previously had with our vet we dropped him back to 1.5 units and all has been well since.
 
bufford said:
Hello,
I'm new to this forum and the whole diabetic cat thing. We've decided to do 'home testing' of the blood glucose levels of Whiskers as the weekly visit to the vet's was more than the payments on the Buick!

Good for you for deciding on home testing :thumbup It's a lot less and more accurate than having the vet do it.

Can someone tell me how often I should be testing the cat and what numbers I should expect to see?

Before every injection so that you will know if the blood glucose level is at a safe enough leve for insulin or not. So that's twice a day testing at the very minimum.

Random testing can be done whenever. One or two tmes a day is plenty and you don't even need to do random testing every day. Some people do, others don't.

Since your cat is newly diabetic, don't be surprised to see diabetic numbers, generally anything over 200 mg/dl (11 mmol if you live outside the US). Some diabetic cats are even way up in the 400s in the beginning.

Non-diabetic numbers are generally 6o md/gl to 150 mg/dl.

Under 6o mg/dl or so results in a condition called hypoglycemia (low blood glucose level). It can be mild or it can be very serious. Here is a list of common symptoms and how to reat: http://felinediabetes.com/FDMB/viewtopic.php?f=14&t=1122 And a list of items to keep on hand to use if your cat ever has a hypo: http://felinediabetes.com/FDMB/viewtopic.php?f=14&t=2354

Newbies are often advised not to give any insulin if the blood glucose level is under 200 mg/dl. This is to prevent a possible hypo.


bufford said:
Thanks for the responses. In answering the questions:
The vet prescribed "Lantus" insulin and after many weeks of visits and testing is currently @ 1.5 units twice a day after feeding.


Lantus is good :smile: There's a board here specifically for Lantus users. There's good info there about how Lantus works for cats and other stuff. http://felinediabetes.com/FDMB/viewforum.php?f=9 Check it out when you get a chance.


The vet recommended Purina DM and given her knowledge far exceeds mine in this area we've followed that advice, giving Whiskers 1/2 can in the morning and the rest 12hrs later in the evening.

Bad advice on the food. Purina DM does nothing for a diabetic cat. I think the DM stands for "dietic management" now instead of "diabetic management". The ingredients in Purina DM is pure junk :-Q And expensive to buy, too. At least the vet recommended the canned DM which is slightly better than the dry junk.

Most people here feed commercial canned foods such as Fancy Feast, Wellness, Friskies, and Merrick. These are all easy on the wallet (some more than others) and available in pet stores and supermarkets and other places. Not all brands and varieties are good for diabetics, though. You want to feed low carb canned. Use the handy cnaned food charts: http://binkyspage.tripod.com/canfood.html Just choose foods that have a number 10 or less in the carbs column. There is no "best" brand so just choose whatever your cat likes to eat and you can find in the local stores. Limit seafood based foods to occasional treats/meals. They tend to be too high in phosphorus and some cats get addicted to eating it. http://www.catinfo.org has more info about proper diet.

There are members from all over the world. Someone will be able to suggest a good brand if you can't find any of the big US brands where you live.

Also, newly diagosed diabetics are always hungry. Half a can twice a day often isn't enough. I suggest splitting the 5 oz can into smaller meals and feed more frequently. You can used a programmable timed feeder tp provide the meals during the day.

I bought a tester and strips and lancer @ Walmart and so far we've tested him 3 times with readings ranging from 14.1 ((255) to 1.8 (30) to 5.7 (103). I posted my questions because I need to have an idea of what to expect to see and how often I should be testing. These tests were taken randomly as he and time allowed so they don't really provide much information.

You're right. A few random numbers don't tell much. A blood glucose curve will tell much more. That is testing appriximately every 2 hours for 12 hours. You can plot the numbers on a line graph and see what it looks like. A gentle U-shape is ideal but sometimes you get a pretty much flat line or even an inverted U-shape.

Many people here keep track of their cat's blood glucose numbers on a spreadsheet. There's info about that on the Tech board.

We did note that when he was still @ 3 units of insulin he had bad reactions twice, meowing to tell us something was wrong, loss of balance etc.

Sounds like hypoglycemia to me. Were you testing your cat's blood glucose levels at the time? Did you do anything to treat the hypo?

Based on that and a discussion we'd previously had with our vet we dropped him back to 1.5 units and all has been well since.

That's good :smile: Once you start testing blood glucose levels at least twice daily, you'll start to see how the 1.5 units is working and what adjustments are needed.
 
Hi Bufford, and, of course, you too, sweet Whiskers,

Let's deal with twice bad reactions first, okay? Can you tell us what happened with Whiskers during those two bad reactions?

Here's the deal, Bufford. Whiskers will always love you for home testing! That will tell you how to avoid more bad reactions -- and will cost you far less than payments on the Buick. You don't want bad reactions, okay? I'm guessing in Whiskers' case, it was a hypo or possibly two... The 1.8 (30) was a tip... I'm so very glad you backed down to 1.5 units. We're a start low, go slow kind of community...

Whiskers is young, by most standards, here! Giz was diagnosed shortly after her 14th birthday, and we danced for four more years. Although you may not understand it now, there is something magical about dancing with a sugar cat. The gift arrives in a furry package, I don't know morning or evening, when you steel yourself to test PS (pre-shot) once again. And, you sigh... And, then, you just smile one morning or evening when your Whiskers nuzzles you and you remember he's still your cat, he's just extra-sweet is all...

As far as feeding? I was taught by Giz, who ate DM and that was the only cat food she'd actually eat. I fried two George Foreman grills for Giz... Nikki came to grace my heart actually eating cat food. Color me lucky! Okay, she arrived at around (guessing) age 8, with a bag and a half of DM, which I donated to a local feral shelter, because I didn't want to go there again... She's a Fancy Feast girl for three years and change. And, it's always available. Whatever feeding schedule Whiskers is used to eating, my humble suggestion is to continue it. If he's a grazer, let him graze. You can always adjust things later when you, your schedule, and he's a bit more stable... Or not. He might always be a grazer. You never know, it's a dance...



The funny walking might be something called diabetic neuropathy -- which is reversible, despite what your vet said. And, I'm not a vet basher. Is Whiskers walking on his hocks? Think kind of like long ankles on his back legs. Giz did that for a while at the beginning; but, went back on her toes within a month or so of being on insulin. She'd do that sad gait, rest a minute, do it again, rest another minute. Eventually, she'd get to where she was going. She was a very determined cat! I'm telling you this, Bufford, because one day or night, she just suddenly decided to go in a crazy mood around the apartment -- all of it on her toes! And, any sadness I had about her diabetes or second guessing myself about treating her instantly vanished! She was, indeed, still my cat. Look for posts from Karen and Rambo here. Rambo will always be the FDMB's furry poster boy for neuropathy. She has a link under her signature which will show pictures of Rambo before and after going on insulin. I don't have the link, because those pictures are forever embedded in my heart...

Here's a link for Jasper's story:
http://www.laurieulrich.com/jasper/
The funny walking is reversible, Bufford. Trust Rambo. Trust Jasper. Trust Giz.



Do test PS (pre-shot). The order would be test, feed, shoot. It's summer where I am (northern NJ), so I've learned to make sure there will be no hairball surprises before shooting... Think of it as a magical dance, Bufford. You'll learn the steps. Trust me.

Welcome to the place you never wanted to be; but, will be blessed for having found.

Love and encouraging hugs,
Deb and Nikki -- and, Giz, forever dancing in my heart...

PS: The spread sheet thing would be great. Check out the Tech Forum here to figure it all out. In the meantime, start a log book.

PPS: Where do you live? No specifics are necessary, just a general location. This Board is global. Maybe one of us lives near you and can lend a hand, or paw...
 
We had been on 3units of insulin down from the previously prescribed 5 units, he had been impressing the vet and we were set for a good report meaning we wouldn't have to return for testing for 6 months instead of weekly. However, the vet felt Whiskers numbers went from extreme to favorable and wanted to continue weekly testing. We just couldn't do it financially anymore and I'd been creeping this web site and decided to take a shot at things ourselves, after all, he had made improvements and was pretty much back to himself. He does walk on his hocks but has learned to deal with it.

His bad reactions came early the next week when right after eating we gave him his injection as we'd been doing for months. Not too long thereafter he meowed in a strange way and was loosing his balance and being clumsy. My daughter (who aspires to be a vet) went on line and read a bit and then gave him some maple syrup. I was at work and got a text from her that Whiskers was ok now and sleeping with her. He was clearly worn out from the experience she said but by the time I got home he looked normal so we fed him, and gave him his shot that evening and all was normal. The following morning was a repeat of the episode and my wife recalled the vet saying she may want to back him down to 1.5 units, so we tried that and have kept him there now incident free for two, almost 3 full weeks now.

That same week we went to Walmart and asked the pharmacist for a quick lesson on testing, testers and all that. At first he was a little hesitant but I convinced him that I was not looking to hold anyone liable, simply looking for some help and with or without his, I was going to be testing the cat at home, the difference was whether or not he got to sell a vial of test strips and a tester or not.

As far as Whisker's eating habits he had been somewhat of a grazer but of course when his bowl was perpetually empty we knew something was wrong. Since his diabetes diagnosis we've followed the vet's advice and fed him 1/2 a can of food twice daily followed by his insulin shot. IF he whines a lot we were told we could supplement that with no more than 1/4er cup of dry Purina DM.
The only thing I hate about that is weekends because it means getting up between 5:30am and 6:00 or the meowing will not stop! I'm an early riser but I have my limits too! We started that schedule for consistency as it allowed for the same feeding time each morning and someone is always home that time in the evening and the vet stressed his eating habits & insulin schedule had to be pretty strictly followed.

I am hoping he will take to another brand of food as $42/case is steep, however prior to this whole diabetes thing he ate nothing but Whiskas brand dry food and wouldn't consider anything else so we'll see how this goes.

As far as his numbers being so variable for the vet I wonder if stress didn't play a part in it since the morning routine on test day presented such a change. Instead of eating when I got up he had to hang around, go for a ride to the vet (he is not a fan of car rides), get left there and after a test finally get fed while hanging around in a cage for the day. The vet tech commented that he'd hiss at them as they neared him (something he rarely does at home) but his good nature prevented him from biting or taking a swipe at them.

So if I understand correctly, most of you do the blood test, then feed, then insulin?

We live in southern Ontario, so are also enjoying summer and despite what the vet said, I allow whiskers to go outside if he wants, he doesn't stray and therefore hasn't found another food source, I think he just likes the outdoors. He was an awesome 'mouser' despite having no front claws but he's either lost his zest for this type of entertainment or the odd walk makes it too hard to be stealthy.

Thanks for all of your suggestions and help.
 
Sorry, one other question:
If you are testing multiple times/day are you working all along one ear then switching? I have no problem doing the testing but don't want to have his ears looking like pin cushions either!
 
Lantus is a great insulin to be on, but you need to be very consistent w/ the dose and the timing of the shots for best results. Here is a sample of what an ideal curve would be on Lantus.
Example of a typical curve:
+0 - PreShot number.
+1 - Usually higher than PreShot number because of the last shot wearing off. May see a food spike in this number.
+2 - Often similar to the PreShot number.
+3 - Lower than the PreShot number, onset has started.
+4 - Lower.
+5 - Lower.
+6 - Nadir/Peak (the lowest number of cycle).
+7 - Surf (hang around the nadir number).
+8 - Slight rise.
+9 - Slight rise.
+10 - Rising.
+11 - Rising (may dip around +10 or +11).
+12 - PreShot number.

This is from the New to the Group stickey on the lantus board. Just click the link and you will find all the info you want and then some.

Other than testing at the preshot, when you test is up to you and what is going on in the cycle. I get a +11 test (an hour before shot time) so that i can see if the preshot test is rising or falling. Some cats have a tendency to drop early in the cycle and others have a late nadir, it varies a lot. In the beginning try to find out when the onset and nadir are and get periodic curves w/ tests every 2 hours.

Besides being much more economical, home testing give a much better reading. Many cats get extremely stressed at the vet and their BG numbers sky rocket. Many here use the Walmart meter.

The neuropathy can go away on it's own, but many give a supplement called methelcobalamin or methyl-B12. The methyl part is important. One brand fomulated specifically for cats is Zobaline. Fortunately I haven't had to use it, but it gets good reviews from others. Read up on it before you try anything.

Oh yeah, test, feed shoot. Many of us shoot while the cat is eating and they don't even notice. :twisted: :lol: Welcome again.
 
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