Ketosis testing - am i collecting sample correctly?

Status
Not open for further replies.
TheBowHuntress said:
BJM said:
You can use some of the secondary monitoring tools in my signature link.

What size are the pee puddles?
How are the 5 Ps?
How much water is being consumed? Include how much is being added to his food.
How's his appetitite? Any food left after eating?

Once you get to WalMart, pick up more urine ketone strips, as well as the glucose test strips. And by the way, our shopping partner ADW carries the strips for the Confirm under the brand Arkray Glucocard 01, as its the same meter, just labeled for WalMart.

I suspect you may safely drop your 'no shoot' number to 190 with the ReliOn meter. As you get the test data accumulated, the no shoot number can be lowered so long as the nadir is always above 50 and so far, it has been, even with the other meter, which tends to read lowish.

As far as increasing, jumping an entire unit is too much. At most, a dose increase or decrease would be of 0.25 units, and only if the nadirs stay between 50 and 150.
Click to expand...
I gave him 1-2 drops more of his insulin AM
Click to expand...
Purring - is the cat exhibiting customary signs of contentment or happiness?

Playing - will the cat play and interact with others? Plays a little as is his norm but in the past basically usually looks at me like "yeah, right", he stretches his self up the cupboard where his food is and makes sure he leaves some claw marks (I did cap him in the past, but he hates it so my husband told him to take them off and leave him be)

Preening - is the cat maintaining its fur and cleanliness? He does clean himself (as well as my Nigel grooms him--who has a grooming disorder...LOL)

Peeing - occurs, and is a normal volume? Peed this morning before AMPS exceedingly--about a 6" clump and peed this PM at 1:00 pm (+4 insulin injection) a very normal amount. Dranks a lot of water this AM.

Poohing - fecal material is formed and passable? Yes

I always add water to his food...on the average, I would say 15% of his can of FF is water. Also, as is his norm, he usually doesn't purr HOWEVER as his norm he licks my face to wake me up and gets toilet paper off the roll for me when I sit on toilet!!!
 
Wendy&Tiggy said:
Hi Wendy...thanks for the speedy response! I can get to WallyWorld tomorrow because I believe that's where they sell the Reli-On strips (my cuz gave me that meter)...Yes, you really should get some lottery tickets or else a crystal ball :) I had just reported to my Vet last week his false low numbers...he wants to increase the Lantus if he goes over 300 at +4...but I think that 300 any time of the day is just terrible and dangerous for him, correct (be honest, I can take it) I wasn't going to test him tomorrow AM, but perhaps I should?
Click to expand...

;) Don't increase yet. Lets get the relion strips and do a few days of proper testing to see where he really is first. Lets get AMPS, PMPS and +6 or nadir for the next few days and then we can make a dose decision. For the short term 300 isn't going to hurt but we don't want it long term. (I thought relion strips were in Walmart only? Not got Wally world in Canada so not sure what it is)

I would test tomorrow morning even with the true meter just to make sure he isn't too low. Personally I never shoot without a test first. And you know the true meter is at least ok at low numbers.
Click to expand...
Went all the way to Walmart and I think I must of got the wrong strips. I have the Ultra model and the strips are for the "Prime". I tried 6x to get BG at +4.5 and it wouldn't work and I was using a lot of blood. So then I grabbed the TrueResult and was so flustered I couldn't get it....8 jabs...poor little guy--he is actually moping. The Reli-On strips I got are shorter than the ones I had that I ran out of.
 
Ok hello! here are my thoughts, sorry for delay as I am in the office today with limited access.

1. See if you can get a ketone test. And/or can you smell acetone on his breath? If the answer is YES to either of these go to the vet immediately!
Even if you cant grab his pee as it comes out you can cheat a little to get a rough idea if he has ketones.
a) dig a tablespoon of clean litter out the box. Mix it well with a tablespoon of water. test for ketones. Should be negative - if its not this wont work and dont bother with step b.
b) if the clean sample is negative ... repeat the test with 1 tablespoon of peed on litter and 1 tablespoon water. test for ketones. If you see any go to vet! Note that if this is clear he could still have ketones, this way of doing it isnt accurate. But if you see ketones then its vet time.

2. 274 on the true meter means Gobbles BG is probably 300+. That explains the drinking as he tries to flush the sugar out his system, and the peeing is due to the drinking. Adding more water to his food is a good idea. Maybe give him kitty milk or mix water into his wet food to help support his system. Dont panic though! -Assuming no ketones above, his body can handle this for a short while but lets try and get him regulated asap. Some peoples cats on here are much higher for much longer.

3. When will you get the strips? By tonite please? ;) As soon as you get them please mark his SS with the new meter - and you might as well update yesterdays numbers to the new relion numbers instead.

4. Since you gave him a few more drops, we call that "fattening the dose" so in the SS put "1.00f" in the dose column. Thats an increase. As BJM says, you need to hold that for three days to see how he does. No more increases unless we tell you lol ;) It might seem counterintuitive but he could be getting too much insulin and thats causing his high bounces and hig BG symptoms. Until we can do some good measuring for a few days under a steady dose, we wont know for sure what is going on.. so no more dose changes for now! The key to lantus is consistency and slow dose changes. Lets keep him on 1.00f for three days (6 cycles) unless he tells us otherwise ie he drops below 50.

5. I would like to see you weigh him once a week and mark it on your sheet.

Get the new strips!

Wendy
 
Poor boy! Give him lots of treats, and get yourself some while you are back at Walmart ;)

his 5Ps dont sound too bad. Cleaning and playing a little is good.

When we got Bailey he had been diabetic and untreated for 6+ months. He was so thin and all bones. He wasnt cleaning properly and was dirty - you could feel it when you touched him, his face and nose had food stuck to it. He smelled. He would literally crawl from his food bowl (he ate tons) to stand with his head in the water fountain and drink and drink. he peed like crazy and would hunch near the water bowl to sleep for maybe 10 minutes and repeat. he wouldnt play. he could barely walk. His eyes were cloudy (glucose damage). he was a mess. he wouldnt have lasted much longer we dont think which is why we adopted him from my husbands sister.

A year on, he is heavier (although not as much as I would like), clean shiny fur, clearer eyes, playful running up and down and fighting with Tiggy, energetic, small pees mostly. Doesnt eat as much or drink as much. And all for less than 0.25Iu of insulin twice a day. Its amazing really.
 
Wendy&Tiggy said:
Ok hello! here are my thoughts, sorry for delay as I am in the office today with limited access.

1. See if you can get a ketone test. And/or can you smell acetone on his breath? If the answer is YES to either of these go to the vet immediately!
Even if you cant grab his pee as it comes out you can cheat a little to get a rough idea if he has ketones.
a) dig a tablespoon of clean litter out the box. Mix it well with a tablespoon of water. test for ketones. Should be negative - if its not this wont work and dont bother with step b.
b) if the clean sample is negative ... repeat the test with 1 tablespoon of peed on litter and 1 tablespoon water. test for ketones. If you see any go to vet! Note that if this is clear he could still have ketones, this way of doing it isnt accurate. But if you see ketones then its vet time.

2. 274 on the true meter means Gobbles BG is probably 300+. That explains the drinking as he tries to flush the sugar out his system, and the peeing is due to the drinking. Adding more water to his food is a good idea. Maybe give him kitty milk or mix water into his wet food to help support his system. Dont panic though! -Assuming no ketones above, his body can handle this for a short while but lets try and get him regulated asap. Some peoples cats on here are much higher for much longer.

3. When will you get the strips? By tonite please? ;) As soon as you get them please mark his SS with the new meter - and you might as well update yesterdays numbers to the new relion numbers instead.

4. Since you gave him a few more drops, we call that "fattening the dose" so in the SS put "1.00f" in the dose column. Thats an increase. As BJM says, you need to hold that for three days to see how he does. No more increases unless we tell you lol ;) It might seem counterintuitive but he could be getting too much insulin and thats causing his high bounces and hig BG symptoms. Until we can do some good measuring for a few days under a steady dose, we wont know for sure what is going on.. so no more dose changes for now! The key to lantus is consistency and slow dose changes. Lets keep him on 1.00f for three days (6 cycles) unless he tells us otherwise ie he drops below 50.

5. I would like to see you weigh him once a week and mark it on your sheet.

Get the new strips!

Wendy
Click to expand...
AMPS +6 = 184 (truetest) Oh gosh, no need to be sorry...though I can't work, I use to work in an attorney's office and it was always deadlines, chaos, etc. OK: 1. I did a keytone test this afternoon directly into stream of urine = negative. No, I smell no acetone on his breath. 2. Is Kitty Milk the milk sold for kittens? He used to like milk, but I took it away from him as soon as he was diagnosed. I always mix water in his food and warm it slightly--he really likes it that way. 3. I will most likely get the strips tomorrow-I can't go back today as I don't/can't drive (husband drives though), unless it would be an emergency. I WILL get them tomorrow though because I have a doctor's appointment and will be near the Walmart. BTW, I can't return them as I used 3 of them. Any idea what to do with them? Do the strips HAVE to be labeled as Reli-On "Ultra" because the Walmart I went to today did not have any of those (only 2 others) though I will go to a different Walmart tomorrow. 4. So I will give him the few extra drops for the next 5 shots...BTW, my vet told me that if he was over 300 AMPS +4 he was INCREASING HIM TO 2 U. (Lantus every 12 hours). After being informed by ya'll here, that seems a bit excessive to me.... Although I know next to nothing re: everything, I don't think a few extra drops would make him hypo low. 5. I will have to buy a scale with ounces...he was weighed at the vet, the time before that (at the local shelter -- Angels For Animals), then vet before that. I decided I am NOT going to take him to the shelter for weight as it may be risky that he'll be exposed to some type of disease. Please note the weights that I do have (they are on his SS). His SS has been updated...
 
Wendy&Tiggy said:
Poor boy! Give him lots of treats, and get yourself some while you are back at Walmart ;)

his 5Ps dont sound too bad. Cleaning and playing a little is good.

When we got Bailey he had been diabetic and untreated for 6+ months. He was so thin and all bones. He wasnt cleaning properly and was dirty - you could feel it when you touched him, his face and nose had food stuck to it. He smelled. He would literally crawl from his food bowl (he ate tons) to stand with his head in the water fountain and drink and drink. he peed like crazy and would hunch near the water bowl to sleep for maybe 10 minutes and repeat. he wouldnt play. he could barely walk. His eyes were cloudy (glucose damage). he was a mess. he wouldnt have lasted much longer we dont think which is why we adopted him from my husbands sister.

A year on, he is heavier (although not as much as I would like), clean shiny fur, clearer eyes, playful running up and down and fighting with Tiggy, energetic, small pees mostly. Doesnt eat as much or drink as much. And all for less than 0.25Iu of insulin twice a day. Its amazing really.
Click to expand...
I have given him very minute nibs of turkey for treats (I know, I know...it was a from our family turkey dinner on this past Sunday)...I figured it was better than the whisker lickins' but then had the grand idea to give him ground venison (just a dab)--very lean- fresh from the field to the grinder (very small amount of suet added to keep it together due to super-leanness, and most certainly pure and healthy! I think the venison is a better treat than the turkey (which I'm aware that it probably has some sort of sugar in it as it was purchased whole from the freezer of the local grocery store).

How wonderful that you saved the little guys life--I am so happy Bailey is getting better and .25!!! Wow, God is good :)
 
So do either or you think that his 184 BG +6 (from TrueResult) is fairly accurate, since the TrueResult is generally close under 200?
 
I also have a True2Go gluconometer that was sent to me by Webmaster Rebecca (from this website--the free kit)...I thought maybe that would be more accurate than the TrueResult since it was sent to me....I am going to use both the True2Go and the TrueResult when I test him PMPS and post the results here...I forgot I had it! Anyone know about how accurate the True2Go is (vs. the TrueResult)?
 
Also, The Reli-On Prime test strips I bought cost me $9/50...the cost of a Reli-On Prime meter is $16.24... The cost of the Ultima strips are $19.98/50 ... Therefore, I plan on just buying a Prime meter and using the Prime strips I can't return.... Make Sense? What are your "reviews" re: the Prime?
 
Sounds like a good idea, it's cheaper and it looks like a number of people use it on the forum and are happy once they get the hang of it. You might want to look online to see if you can get a coupon as some meters come free when you buy xx strips. And you'll probably use them!
 
Check this out https://docs.google.com/spreadsheet/lv?key=0AjcBiiIVLby8dDUzZmMzUmNmVUtWWERST2xidWxnUVE... get the relion prime strips as soon as you can! I have been reading about it and it looks good and cheap!

Not sure why you got sent a free one true2go that isn't good but maybe they think its better than nothing...

I am having issues today too, my hubbie gave Tiggy mozzarella and bits of pork on New Year's Eve, didnt affect his BG but it did upset his stomach we think and now he has diarrhea bad... Last time this happened he stopped eating and it caused all sorts of problems... Paws crossed it clears up soon!!
 
Wendy&Tiggy said:
Check this out https://docs.google.com/spreadsheet/lv?key=0AjcBiiIVLby8dDUzZmMzUmNmVUtWWERST2xidWxnUVE... get the relion prime strips as soon as you can! I have been reading about it and it looks good and cheap!

Not sure why you got sent a free one true2go that isn't good but maybe they think its better than nothing...

I am having issues today too, my hubbie gave Tiggy mozzarella and bits of pork on New Year's Eve, didnt affect his BG but it did upset his stomach we think and now he has diarrhea bad... Last time this happened he stopped eating and it caused all sorts of problems... Paws crossed it clears up soon!!
Click to expand...
Thanks for the SS-enlightening! I will get the Reli-On Prime tomorrow and also get another box of strips....should be home about AMPS +6 or +7....to test (but will also test AMPS) Yes, it certainly is better none and my Gobbles just loves the little catnip pillow she sent me and I truly appreciate the gift (and lancets, rice bag and strips were included!!!) as the Reli-On I had was actually borrowed (have to return it!!!)...Poor Tiggy! Sounds like something my husband would do...LOL....so is it OK to give the kitty milk to Gobbles now & then--doesn't it have carbs in it? Also, I'v e read that there is absolutely NO okay dry food--including Wellness?
 
No dry food ever! None. Only dry they can have is freeze dried chicken or liver ;)

Kitty milk is ok but you have to find the right kind of cat milk so I don't use it any more... Unless they are dehydrated like Tiggy will be soon if the diarrhea keeps up.. And then worry about his BG later. Whiskas cat milk has corn syrup in it supposedly .

I am home tomorrow so will be around to see how it's going!

Can I persuade you though to come over and start posting regularly on the lantus tight regulation forum? You get a lot of eyes there and they give a lot of advice.. They can be tough on you at times if you do something they disagree with, but they only have your kitty's welfare at heart and you can choose to ignore them.. Not as if they can reach through the computer and smack you ... Lol.
 
Wendy&Tiggy said:
No dry food ever! None. Only dry they can have is freeze dried chicken or liver ;)

Kitty milk is ok but you have to find the right kind of cat milk so I don't use it any more... Unless they are dehydrated like Tiggy will be soon if the diarrhea keeps up.. And then worry about his BG later. Whiskas cat milk has corn syrup in it supposedly .

I am home tomorrow so will be around to see how it's going!

Can I persuade you though to come over and start posting regularly on the lantus tight regulation forum? You get a lot of eyes there and they give a lot of advice.. They can be tough on you at times if you do something they disagree with, but they only have your kitty's welfare at heart and you can choose to ignore them.. Not as if they can reach through the computer and smack you ... Lol.
Click to expand...
i figured the dry was out, but thought i 'd ask...he hasn't had any since dx and has been eating wet food 7% or lower (a few cans 8%) excepting the day i accidentally gave him a serving of 18%...and won't bother with the kitty milk because it would maybe give him the squirts. From what i read some raw food is ok...does that include beef, venison, chicken? We had deerburgers for dinner and he begged at the table (always has been his norm) and so i gave him some cooked venison (no spices)...was that okay? I also give it to him sometimes raw but he likes it cooked better. So you're a Lantus mom? What exactly is the "tight regulation" about? I"ll be home for a few hours then back home later with a Reli-On Prime! Hopefully I can be back by AMPS +6...I got a chance to check for keytones from his stream last night, which was negative...I noticed that when after he eats is the time that he goes downstairs to the litter box...right now he is at the water bowl and seems a little excessive...on my way to litter box to check urine output...
 
Wendy&Tiggy said:
Sounds like a good idea, it's cheaper and it looks like a number of people use it on the forum and are happy once they get the hang of it. You might want to look online to see if you can get a coupon as some meters come free when you buy xx strips. And you'll probably use them!
Click to expand...
forget to ask...what meter do you use?
 
From what i read some raw food is ok...does that include beef, venison, chicken? We had deerburgers for dinner and he begged at the table (always has been his norm) and so i gave him some cooked venison (no spices)...was that okay? I also give it to him sometimes raw but he likes it cooked better.
Click to expand...

Raw food is considered better by some people although if you feed it exclusively there are nutrients you need to add. I give my boys pieces of raw and cooked meat often.. beef venison chicken turkey rabbit!. I dont give pork only because Tiggy is sensitive too it and bacon and stuff can be salty - and some countries it can have parasites in it if uncooked. Here is more info on a raw food diet http://www.catinfo.org/?link=makingcatfood

So you're a Lantus mom? What exactly is the "tight regulation" about?
Click to expand...
Tight regulation is a way to get cats regulated and possibly into remission. It ideally gets them down to normal cat blood glucose levels. Many vets like diabetic cats to stay higher than a normal cat BG because of the fear of hypos, but tight regulation forces them into that range to allow the pancreas to heal . As such it requires more testing to watch for hypos, and dose changes are based on the nadir or lowest point of the day. Here is more info http://www.felinediabetes.com/FDMB/viewtopic.php?f=9&t=1581
 
shite---just checked wet he ate yesterday: FF turkey & giblets feast = 8 carbs & Friskies mixed grill = 11 carbs...can be reason for amps today?
 
Until you get the new strips I wouldnt assume anything. He could be bouncing from a lower number overnight. But the 11% doesnt help. Try and keep him under 10% - I aim for under 8% usually.

Dont throw out any cans of higher carb though - they may come in useful later on (if/when we get him into lower numbers he may try and drop too low sometimes and higher carb is great for bringing them up).
 
Wendy&Tiggy said:
Until you get the new strips I wouldnt assume anything. He could be bouncing from a lower number overnight. But the 11% doesnt help. Try and keep him under 10% - I aim for under 8% usually.

Dont throw out any cans of higher carb though - they may come in useful later on (if/when we get him into lower numbers he may try and drop too low sometimes and higher carb is great for bringing them up).
Click to expand...
I bought a new Reli-On Prime glucometer this afternoon. AMPS +6 = 253. I went through all food and double-checked % of those in there...I did find one Friskies Tuna & Egg, which I set aside. At the initial appointment with my (new) vet, he gave me a Tripod Binky's Food list and said he would like me to keep his diet under 7%....
 
If you look at Gobbles' SS, either a coincidence or trend: for the last 3 days the AMPS is about 90 higher than the AMPS +6...just an observation as I was just now taking a look at his SS...
 
That's good.. Means the insulin is working. But the big question is, how high is he really going, and how low. Once we know the low especially we can see if a dose change is required..
 
Wendy&Tiggy said:
That's good.. Means the insulin is working. But the big question is, how high is he really going, and how low. Once we know the low especially we can see if a dose change is required..
Click to expand...
Well, his +6 was with the spanking brand new Reli-On Prime....I will check him PMPS and update his SS...I'm still doing the 1.00f...
 
Wendy&Tiggy said:
How was his PMPS?
Click to expand...
294...poor little guy--it took 6 jabs and 3 strips before I got enough blood on the strip....then to make matters worse, he flinched slightly when I shot him, and I fear it may have been a fur/partial fur shot :(
 
Did it feel wet? Can you smell the insulin from the fur?

Poor boy, make sure his ear is warm first before you test so that you get enough blood. Do you use neosporin on his ears?
 
Wendy&Tiggy said:
Did it feel wet? Can you smell the insulin from the fur?

Poor boy, make sure his ear is warm first before you test so that you get enough blood. Do you use neosporin on his ears?
Click to expand...
It didn't feel/look wet but I did smell insulin--I mean, I'm pretty sure I got him--I tent and then kinda move the fur out of the way...Yeah, poor little guy :( I did his foot four times, then ear twice...The Reli-On takes a little more blood than the TrueResult; after the disaster this evening, I will make sure there is a bit more blood. Well, off to bed for me. Sidenote: I got the grand (not) news today at my neuorsurgeon's that I need a test where I have to lie still for 48 hours thereafter AND get another back surgery which entails 3 or more days in hospital, then totally in pain/laid up the first few days thereafter, then another few weeks in/out of bed...(though it can always be much worse :) My husband said he can do the testing and shots, but I just don't feel comfortable with anyone (except myself) doing that. My cousin (who had a sugarcat for years) said I can bring him to her house for a few days (not going to happen though because, God bless her, she has 3 Danes and 8 cats and I know it would totally stress him out. I am waiting for the test to be scheduled and then the surgery will be scheduled....I think hubby and I should start practicing soon :(
 
Sorry to hear that, I hope the surgeries go well. Sounds like a good time to train your husband anyway.. Unless your friend can pop over and do it?

It's good to have support. My husband is ok at it although he struggles still to get blood from bailey..
Enjoy your sleep, I might ask for a PMPS +6 one of these nights :) just as a spot check.

Also I would really like you to come over to the tight regulation forum. Every day start a new topic with the subject
Date, gobbles name and reading ie today would be "1/4 gobbles AMPS 347" and then in the post you put a note but about how he is doing etc ie "got a new meter today, gobbles is peeing a lot ....etc...." And add a link to the prior day post. Then update the subject when you do a test ie 1/4 gobbles AMPS 347 +6 253 PMPS 294.
That way you get support from us all, and more than just my eyes on him.

Here is an example of mine from today http://felinediabetes.com/FDMB/viewtopic.php?f=9&t=86291

Wendy
 
Wendy&Tiggy said:
Sorry to hear that, I hope the surgeries go well. Sounds like a good time to train your husband anyway.. Unless your friend can pop over and do it?

It's good to have support. My husband is ok at it although he struggles still to get blood from bailey..
Enjoy your sleep, I might ask for a PMPS +6 one of these nights :) just as a spot check.

Also I would really like you to come over to the tight regulation forum. Every day start a new topic with the subject
Date, gobbles name and reading ie today would be "1/4 gobbles AMPS 347" and then in the post you put a note but about how he is doing etc ie "got a new meter today, gobbles is peeing a lot ....etc...." And add a link to the prior day post. Then update the subject when you do a test ie 1/4 gobbles AMPS 347 +6 253 PMPS 294.
That way you get support from us all, and more than just my eyes on him.

Here is an example of mine from today http://felinediabetes.com/FDMB/viewtopic.php?f=9&t=86291I'll do that today! i looked at Tiggy's and Bailey's SS. I noticed that that they have been dose increases..is that common! Also, I noticed a few fur shots....did you withhold shots when this happened? When fur so hot, does the fur absorb any of the insulin? Sidenote: looks like you get up several times a night to test (p.s. yes, I do put the pain relief on his ears/feet after blood testing)Also, do you always use the ear?

Wendy
Click to expand...
 
i looked at Tiggy's and Bailey's SS. I noticed that that they have been dose increases..is that common!
Click to expand...
Yes - if you read the sticky on the protocol http://felinediabetes.com/FDMB/viewtopic.php?f=9&t=1581 you can see the logic for increase and decrease. I am trying to get them into green and stay green without going too low. The more green they are, the more recovery the pancreas can have and the more likely remission.

Also, I noticed a few fur shots....did you withhold shots when this happened?
Click to expand...
Not sure what you mean here.. when I gave a fur shot I had to assume some may have gone in... and so I would just shrug and give the next shot 12 hours later as per schedule.

When fur so hot, does the fur absorb any of the insulin?
Click to expand...
The cat probably cleans it off if its outside the body. But even with a fur shot, some insulin may still have gone in to him, and you dont know how much so you dont want to shoot again in case you overdose. So you just wait the 12 hours till the next shot.

Sidenote: looks like you get up several times a night to test
Click to expand...
Yes, many cats have their nadir during the night and you can see a few lows with both my boys at night. One time Bailey had a hypo at night and was almost comatose (September 5th) so now I am too scared to sleep through. I tend to wake up at night anyway to go pee and whatever so I poke them then. Although I do set the alarm just in case but it rarely goes off since I am up before it. Plus I dont want to miss it if they got under 40/50 at night because that means a decrease!

Also, do you always use the ear?
Click to expand...
Yes, I use the ear all the time. It doesnt seem to bother them except if I do it too much in one spot and then I move or switch ears. I dont like using paw pads since it means they have a wound on their feet, and they are walking on the litter tray etc so i worry about infection. Plus Tiggy HATES having his feet touched.
 
Status
Not open for further replies.
Back
Top