I need help with testing BG

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Yvonne & Freddie

Member Since 2014
I posted but now I see my post in the announcements and did not get any replies. I have a hard time with computers...and posting.
My Freddie was diagnosed with Diabetes and has been on Lantus, 2 units twice a day for 2 weeks Yesterday the vet put him on 2.5 unites. Could someone plaese help me with him. He just does feel good.
He now has diabetes, chronic pancreatitis, chronic asthma. I got him on pred 2.5 every other day for the asthma and he is on flovent 4 puffs a day
My husband went in to get the confirm Relion meter with strips and lancets but now I have not a clue how or when or what do it. . He is fed at 5:45 am in the morning and given insulin between 6 and 6:15 am. Evening fed at 5:45 and insulin at 6 or so. Is this what I need to be doing???He only eats the w/d hard kibbles food will not eat the wet W/D he is over weight 17lbs and needs to loose more weight down from 23 lbs in Aug.
I am totally frustrated because I called my vet and he did not call back first time ever. Vet does not want him off the W/D kibbles which I know is not good for him...don't know what to do because I have done so much reading and it says to test and feed soft food. Fred is a hard food junkie. If anyone can help steer me in the right direction I would love it..
Yvonne and Freddie
 
Hello and welcome to the board - you are in the right place

Here are some testing tips for you now that you have the relion confirm: https://docs.google.com/document/d/13c_CPZVKz27fD_6aVbsguadJKvjSrSAkD7flgPPhEag/pub

Also I usually recommend 3-4 tests a day

- always before the shot - this is mandatory as you don't want to shoot when too low. As a newbie this too low number is 200 but is reduced over time once you have the data to know if its safe.
- mid cycle - 5-7 hours after morning shot depending on your schedule. This is to see how low the cat’s blood sugar is going. The low point "nadir" is what you base dose changes on since you don't want the cat dropping too low (under 50).
- before bed (2-3hours after Pm shot) to get an idea of what the cat's overnight plans are. If this number is less than the pre shot test number you may want to set the alarm for a test a few hours later as this implies an active cycle.

Once you are testing I would recommend you move him to a low carb wet food - dry food spikes blood sugar. However a low carb wet like Friskies pates or fancy feast classic pates can reduce his blood sugar and even send him into remission. We have tips to get him onto wet - but as I said, lets start with testing first!

Wendy
 
I tried to pick Freddie's ear 3 times still can not get any blood what can I be doing wrong. This will be my first time doing it. He doesn't have any hair on his ears because of the steroids he is on flovent and pred.
Am I suppose to test before his morning meal and not have him eat until after the testing.
 
If you have to, aim for the vein. Just be prepared to blot quickly after getting a drop to test.

Test, feed, and shoot within about 15 minutes for Lantus, Levemir, Prozinc, and PZI.
 
Give him a treat and try later.

Meanwhile let's look at your technique,

1. What are you warming the ear with?
2. What size lancets are you using?
3. Are you freehanding the lancets or using a tool?

Wendy
 
Are you warming the ear before-hand? Take some rice or beans or lentils, stick them in a sock and knot the end, microwave for 15-20 seconds, and test on your forearm first to make sure it's not too hot. Hold it against the ear for a few seconds, feel if ear is warmer, repeat as necessary. Then try testing. You can also use an old pill bottle filled up with warm water. When first starting out, warming the ear is highly crucial to the success of getting blood.
 
Also try massaging the ear both before and while you are trying to get blood. That will help to get the blood flowing and most cats enjoy it. You want to test before you feed him since food will affect the glucose levels. If you hold a flashlight next to his ear, you will see a vein running around the edge of it. If possible, aim for the area between the vein and edge of the ear. However, if you hit the vein, don't worry. You should keep a paper towel or cotton ball handy since hitting the vein will cause a much larger drop of blood to flow. Otherwise, your cat will probably shake his head and your walls will look like a scene from CSI. :lol:

Are you using the lancet device that came with the meter? Many of us found it easier to use the lancets freehand instead of using the device. I feel like I have more control with it and can poke exactly where I am aiming for.
 
Where are you located? There may be a member nearby who can come over and help you.

Here are some more tips:

Remember to poke in the area between the ear edge and vein (AKA the sweet spot)



You can poke from the inside of ear to back OR from the outside of ear to front. It really doesn't matter, whichever is easier for you to see and do.

If you are using the lancet device, be sure to remove the cap, keep it on the deepest setting as that may help. You can also try it without the device and just freehand the poke (I personally find that easier).

If you free hand, you want to poke in an upward 45 degree angle - don't go straight in, like putting in an earring. It should look more like this:



You can also poke several times in one area and collect the blood that pooled in that way.

If you warm the ear as others suggested, it will help with blood flow. Plus you can put some petroleum jelly on the ear prior to poking - any blood will bead and pool on top the goo and make it easier to collect.

Hope these tips and tricks help.
 
I am in MI, Kalkaska area.
I warm the ear with a rice bag.
I am using a 30 G lancet with free handling.
I tested before his evening meal and insulin shot and we did get some blood after 4 tries and the reading was 456. He did eat some fancy feast salmon with some Wysong rabbit on top. I know fish is not good for him but it is a start to switch him from kibbles. Then he had some kibbles. Now it is 9:25 and I tried to retest again and just could not get any blood after picking him 4 times again...so I am going to test before his morning meal and insulin. I also upped his insulin to 2.5 units like my vet wanted me to and he seemed pretty good with that. He is still walking funny..
I don't know what I will do when I have to do a curve how will I get blood every 2 hours. My Vet said he wanted me to do a 24 hour curve and that Freddie would have to be in an over night clinic. I will do it from home, he would go nuts in a over night clinic. What is the purpose to do a 24 hour curve. I think Freddies BG is extremely high yet..at 456. I will try again in the morning.

Yvonne
 
some more suggestions:

30 gauge lancets are thin lancets. I suggest you purchase 28 gauge lancets - they are a bit thicker and may be easier to use. Keep in mind the higher the number the thinner the needle part.

secondly - you DON"T have to do a curve. I really wish that people would stop pushing the need to do a curve. It honestly it not necessary and not something you need to stress over.

I never did a curve with Maui (yes I was home so I tested frequently) but never did a real curve.

The important factor is to get comfortable with testing, teaching the ear to bleed and then testing when you can in order to get the information needed to make decisions.

So please stop focusing on doing a curve and just get comfortable with testing. I bet if you get a lower gauge lancet, it will be easier.
 
OK yes those lancets are a bit too thin to start - try and find thicker ones 28g. What do you put behind the ear to press against? Something hard like a pill bottle lid is best.

I usually recommend 3-4 tests a day

- always before the shot - this is mandatory as you don't want to shoot when too low. As a newbie this too low number is 200 but is reduced over time once you have the data to know if its safe.
- mid cycle - 5-7 hours after morning shot depending on your schedule. This is to see how low the cat’s blood sugar is going. The low point "nadir" is what you base dose changes on since you don't want the cat dropping too low (under 50).
- before bed (2-3hours after Pm shot) to get an idea of what the cat's overnight plans are. If this number is less than the pre shot test number you may want to set the alarm for a test a few hours later as this implies an active cycle.


Any kibble can spike his BG for up to 24 hours. I would gradually wean him off that once you have the testing sorted out.

Wendy
 
Hi Yvonne,

It's Barbara from the asthma group. You have gotten some good starting advice here. Let's concentrate on the basics first. It appears you have started trying to transition to wet food so that's good. I think in another post BJ mentioned the EVO lower carb dry, while not great it would help to get him on that instead of the other dry while you are trying to transition to wet. Don't let your vet tell you he has to be on prescription food. I can't remember what all health issues Freddy has so it might be helpful to list those out again. As far as testing until you get a spread sheet set up you could post his numbers something like this:

3/8
AMPS - 123 (means the morning test BEFORE food or insulin) the time really doesn't matter since everyone is on a different schedule. I think you are already giving insulin 12 hrs apart? If you can get more test in you would post them as following
+1 - 123 (means 1 hr after his insulin shot) or if it's 2 hrs later it would be +2 & so on

PMPS - 123 (means the evening test BEFORE food or insulin)

typically we test - feed - shoot that is so we are sure the cat is eating before he gets insulin. If something is off with him & you shoot the insulin then he starts vomiting or won't eat you could get in trouble since he would have insulin on board & no food in his tummy. We don't give insulin typically to a cat that is not eating normally, especially since you are new at this & Freddie already has many health issues. Better a cycle too high than one minute of being too low & having a hypo on your hands. BTW, if you have not already look for the sticky that says "Hypos can kill" or something like that, at the top of the board, & print that info out just in case he ever goes too low. You don't want to be hunting for that info when you are in a panic.

Your concern about him continuing the oral pred due to his asthma....I don't see where anyone told you to stop that? I might be missing it? Ladies, she got the impression she needed to stop his pred. Freddie has asthma & is on Flovent but if I understand correctly he also needs the pred. I believe he starts coughing on the Flovent alone? Is that correct Yvonne? If he needs the pred so be it, you just have to deal with it by giving a higher insulin dose than you might have to without the pred.

Keep posting & take some deep breaths. Freddie is a little more complicated but the ladies here have lots of experience to help you. Try to list your concerns in order of importance so it won't be so confusing to you & come back often to get answers. Start a new thread daily so it won't get so long. It appears you have gotten the hang somewhat with testing which is a great start. You are also working on getting him on a lower carb food....one thing at a time! Now try to keep a log of all his tests & post them here so you can get help with the dose of insulin. List all the meds he is on so everyone knows what might be effecting his blood sugar. When trying to transition him to lower carb by all means keep him eating.....whatever that may be...he has to eat & you just deal with the numbers. Hang in there...I know it's tough & confusing when you have one with multiple health issues.

Ladies, I don't post on a regular basis anymore since diabetes is the least of Thumper's worries these days. :sad: I have my hands full with multiple cats with multiple health issues & working way too much! I met Yvonne on the Feline Asthma group when my 4 yr old was DX with asthma. I have become a little rusty on helping someone get started with diabetes & for sure don't know how to help her start a SS. I sent her here cause I know this is the best place for the best advice! This board saved my Thumper's life a few years ago! The feline asthma group is very different (I think harder) and Yvonne is having a hard time figuring this board out. I'm leaving her in good hands & I know you can help her figure Freddie out! Thanks!

Yvonne, keep posting on a regular basis!

Barbara & Thumper
 
You shoot around the treatment for other medical conditions. if he needs oral steroids, so be it. If he's on alternate day dosing, discuss daily dosing at a lower level to keep that effect more stable, Otherwise you will get higher glucose on the steroid days. Another option is to use a small dose of a supplemental shorter acting insulin on days he runs high from the pred.
 
We have a diabetic asthmatic kitty who is also on prednisolone daily in addition to the Flovent. You may have to go to a higher dose of insulin to compensate but it can be balanced. The most important thing is to stick to the protocol of increasing the insulin by .25 U every 8 cycles until the BGs are in a manageable number. Let me know if I can help you with anything at all!
 
Re: Freddie diabetes and asthma..

I just wrote a note and have not seen it come in so am trying to write a different way. If and when I see this come through I will write more. Thanks Barbara for writing in for me...I am so sorry that I just can't figure this board out on how to post.
Yvonne and Freddie
 
Re: Freddie diabetes and asthma..

3-9 AMPS 288 +6 344 so far today on 1.5 units of Lantus




Freddie started out on 2 units of Lantus on Feb 10th twice a day when he was diagnosed with diabetes. Then he was tested for the fructosamine 2-25 was 465 still high and was put on 2.5. I felt he was off on Wed.

3-5- so I learned to test that day and his BG was 64 tested again 1/2 hour later after food and was 80. Called vet he said not to give insulin and to give insulin in the morning after testing if BG was above 200. AMPS was 295 gave 1 unit.

+9 242 talked to my vet and he wanted me to start Fred back on 1.5 lantus for 2 or 3 days and then if BG above 300 go to 2 units 3-5 PMPS 339 1.5 units
His BG is going higher again. I am planning to start him back on the 2 units tonight and test before.
He has chronic asthma so he does have to have pred. He is on 2.5 every day and I tried to take him down to every other day and he is having wheezing problems. So will continue to give him 2.5 pred daily. Will that keep his number stable again.
His BG has been all over the place this week. I am also getting him on Cats in the kitchen wet cat food. He will not touch the Fancy Feast or Wiskas. I bought some Evo and mix into his W?D that he was on.
Fred's BG last night was 479 PMPS.
I will keep him on the pred. and will have to adjust the insulin if I have to . Am I trying to fast to get him on soft food after being on hard so long. Fred just does not feel well. His hind legs are very weak. I have him on zobaline and cosequin.
He is drinking a lot of water yet and peeing 4 to 6 big clumps a day. I have him on miralax 1/4 teas twice a day and more when he can't go. He does get constipated real easy.

What is every 8 cycles.?
I hope I will finally figured this out and I am learning so much.. Thank you all so much. I just am so unsure as to what to do for him and what to be looking for.
I am keeping a daily log from a sheet I ran off on the group.
Yvonne and Freddie
I
 
8 cycles means 8 shots and their 12 hour periods.

Hang in there and take it 1 step at a time

What's another question you'd like answered?
 
Yvonne, when you want to continue with a post you just hit "reply" at the bottom then type out your message & hit "submit".

It looks like maybe you need dosing advice at this point? Try starting a new thread with something like "Lantus dosing advice - new member" Use the ? icon.

Could someone help her set up a SS? I have no idea how to do that anymore.

Barbara
 
Re:Lantus dosing advice

3-10- AMPS 322 Freddie uped to 2 units

This morning i went from 1.5 to 2 units per my vet.
Should I be testing Fred real often today?

At the start of his diagnose he was put on 2 units then 2.5 and that was when I started to test and his BG was all over.

Also I am getting him to eat Cats in the Kitchen canned food Goldie Lox 66 P 35 F 4 Carbs Funk In the Trunk 63 29 8 are these a good foods for diabetes and pancreatitis? I also have to put a little EVO and W/D on top for him to eat ...he ate really well this morning.
I got him back on 2.5 prednisolone last night and his breathing is better for his asthma ...he also takes 2 puffs of Flovent 250 2 times a day.
Tested his urine this am No ketones but glucose was I would say more 2 --2000.

Yvonne and Freddie (how do I change for the new topic and for the board to see that I have a question....) Sorry to send this again to see if it show a ? flashing
 
Hi Yvonne. I'm sorry you are having technical difficulties but as you can see you have lots if responses. I wrote you back privately in response to your post so hopefully you will be reading this here. Start a new post each day and write your new topic. Put the date and Freddy. If you want the question mark, click in the space before the question mark at the top. The nine is always there unless you change that. All the wonderful people that have been helping me have written to you.

Elise
 
I usually recommend 3-4 tests a day

- always before the shot - this is mandatory as you don't want to shoot when too low. As a newbie this too low number is 200 but is reduced over time once you have the data to know if its safe.
- mid cycle - 5-7 hours after morning shot depending on your schedule. This is to see how low the cat’s blood sugar is going. The low point "nadir" is what you base dose changes on since you don't want the cat dropping too low (under 50).
- before bed (2-3hours after Pm shot) to get an idea of what the cat's overnight plans are. If this number is less than the pre shot test number you may want to set the alarm for a test a few hours later as this implies an active cycle.

Wendy
 
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