Hi, I am new to posting but I often check in at the web site very helpful. I am the caretaker of Pookie, he is a 14 year old 14 pound neutered Maine Coon male house cat and he was diagnosed with diabetes in July 2010 and has been taking Lantus insulin (vial) ever since and last dosage in January was changed to 5 units morning and 5 units evening which for me EST is between 6:00 am 7:00am and same in the PM. He has no other health issues I feed him the non gravy and sauce forms of Fancy feast and I get grain free dry food but I can't seem to get him and his non-diabetic companion Vegas totally of dry food Kit and Kaboodle which I know is not good but that is what they ate for years with Fancy feast until 2010. My question is how to determine the correct amount of Levemir to give since he has already beenon Lantus? I am doing this without the Vet's approval I just started 10-23-13 with evening dose of Levemir he ate about 5-6 ounces of wet food throughout the night and the next morning I let him eat some and then he vomited all the food up so I decided not to give him a shot and I checked his blood 1 hour later 8:00am and it was 127. I decided not to dose at all because of the vomiting and his normal pre shot level is 299-360. That same evening at 5:30pm I checked his bllod it was 363 so I figured it was safe to dose, but I only gave him 3 units of Levemir instead of the 5unit he normally gets with Lantus. Immediately upon giving the shot he ate 1 ounce Fancy feast and then he vomited this food up and I gave him Pepto Bismal 2 units and hair ball treatment because part of it was hairball.He was fine the rest of the evening and this morning I gave him 3 units of Levemir at 6:45 am and he ate chicken Breast and broth and had no vomiting and about three hours later at 9:30am I checked his blood level (using Alpha Trak Meter) and it was 192. He has been as low as 90 two-three hours after shot. I will also be getting a new meter from Walmrt reli-on hopefully, the Alpha trak is getting old and strips very hard to find and expensive. Is there a chart that gives some guidance on this?
Lantus vs. Levemir
- Thread starter Mckenzi
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BJM
Member Since 2010
I believe you go with about 70% or the Lantus dose when converting, since both are depot insulins.
0.7 * 5 = 3.5 units; you started a bit lower, so should be OK.
Did your vet say to use Pepto bismal? it has a salicylate in it which is bad for cats! You're better off sticking with the 1/4 tablet of Pepcid about 30 minutes before eating. Also, to reduce scarf 'n' barf, spread the food thinly across the plate so it takes longer to eat.
0.7 * 5 = 3.5 units; you started a bit lower, so should be OK.
Did your vet say to use Pepto bismal? it has a salicylate in it which is bad for cats! You're better off sticking with the 1/4 tablet of Pepcid about 30 minutes before eating. Also, to reduce scarf 'n' barf, spread the food thinly across the plate so it takes longer to eat.
Wendy&Tiggy(GA)
Member Since 2011
Hello and welcome to the board
Which exact flavours of fancy feast is he getting and what exact dry? I suspect they may be higher carb than you think, which could be causing the high blood glucose levels. We might be able to recommend better flavours.
Relion confirm and micro are cheap and dont need a lot of blood.
Maybe read the stickys on here to learn more about levemir ...http://www.felinediabetes.com/FDMB/viewforum.php?f=9
Wendy
Which exact flavours of fancy feast is he getting and what exact dry? I suspect they may be higher carb than you think, which could be causing the high blood glucose levels. We might be able to recommend better flavours.
Relion confirm and micro are cheap and dont need a lot of blood.
Maybe read the stickys on here to learn more about levemir ...http://www.felinediabetes.com/FDMB/viewforum.php?f=9
Wendy
I have been trying him on Wellness core Grain Free, anything with more than 20% fat gives him the squirts so I watch the fat content. He, unlike my (brought in the house) feral cat does not eat dry food much, he prefers the can food, but he will pick around with it. With Fancy feast I have to stay away from Salmon and beef because again he will have stomach issues. I try to stay with the classic non gravy formulas that I heard gravy had more carbs, chicken and tuna flaked, kitten formula turkey, chopped grill, chunky chopped grill, roasted chicken and turkey, fish and shrimp feast, Mornings turkey or chicken and egg, medleys on occasion turkey with spinach, chicken or turkey florentine. My vet did suggest speading the food out across the bowl, I actually bought him plate like bowls to effect this and it helped getting him to stop gobbling. I work at home 4 days a week which allows me to watch him and I may only give him 1/2 can fancy feast 1 1/2 ounces at first and see how it sits with him before givng more. The first day I actully gave him 4 units of Levemir in the am and when he got sick to his stomach I thought it was the dose so I dropped back to 3 units, he was taking 5 2x a day with Lantus. My vet original vet said not to give more than 3 units of Pepto Bismal, my new vet said she did not really like it not to use regularly and suggested Pepcid< I will look for some at Walmart it is only once every 3 months or so that I use it and only one time but I would not want to make matters worse.
I also bought a new Reli-on meter it is the Reli-on Ultima got it at Walmart have not used it yet, have a few strips for Alpha trak left and want to try and keep balanced readings until I see what his blood sugar is doing. Since I have been giving 3 units 12 hours apart of the Levemir I have tested 10/24/13 2 hours after shot and food 9:30am was at 192 and 10:00 at night after shot at 7:00pm he was at 244 and this morning baseline no meds no food he was at 169, I was anxious about giving more Levemir so I just did 3 units. He seems to be doing well but I don't think he is eating as much and he sleeps more. My old vet said he needed to eat 5 cans of Fancy Feasy (3oz) a day to maintain his weight of 14 pounds, he had dropped to 12 pounds when diagnosed in 2010 but has since gained some. He might eat 3 and one half cans during the course of the day and I give maybe 5 grain free Authority treats.
I also bought a new Reli-on meter it is the Reli-on Ultima got it at Walmart have not used it yet, have a few strips for Alpha trak left and want to try and keep balanced readings until I see what his blood sugar is doing. Since I have been giving 3 units 12 hours apart of the Levemir I have tested 10/24/13 2 hours after shot and food 9:30am was at 192 and 10:00 at night after shot at 7:00pm he was at 244 and this morning baseline no meds no food he was at 169, I was anxious about giving more Levemir so I just did 3 units. He seems to be doing well but I don't think he is eating as much and he sleeps more. My old vet said he needed to eat 5 cans of Fancy Feasy (3oz) a day to maintain his weight of 14 pounds, he had dropped to 12 pounds when diagnosed in 2010 but has since gained some. He might eat 3 and one half cans during the course of the day and I give maybe 5 grain free Authority treats.
dodgingwrenches
Member Since 2010
Dry food has a much bigger impact on BG than you would think, even the "high protein" stuff. A few anecdotes from my cat below, who was diagnosed in July 2010 just like yours, and also part Maine Coon and around 14 pounds when healthy. Others have read me say this before, but I will say it again because I think it is important and I didn't believe the impact of dry until I saw it - won't stop preaching it ;-) :
1. Even only getting a bit of dry and mostly eating wet (both diabetic foods as well), it wasn't until I completely cut out that bit of dry that my cat went from 3.5 units twice a day to no insulin (OTJ) within ten days. It dropped that quickly.
2. 2011 my parents started letting him have a bit of dry (high protein) here and there when I moved back home. We were briefly out of remission again. They now learned their lesson.
3. Last night, his BG was 59, so I let him sneak a few bites of Wellness Core (!) from my other cat. This morning he is the highest he's been in a week again.
If you can at all, cut out all dry food altogether - even Wellness Core - but do it carefully, because BGs can drop FAST. Dry food by nature is much higher carb than wet, even the grain free stuff. I realize you have other complications to deal with as well (fat content), so is more difficult, but there must be some solution - maybe a medication he can take to keep the poop chute less busy. Best of luck!
1. Even only getting a bit of dry and mostly eating wet (both diabetic foods as well), it wasn't until I completely cut out that bit of dry that my cat went from 3.5 units twice a day to no insulin (OTJ) within ten days. It dropped that quickly.
2. 2011 my parents started letting him have a bit of dry (high protein) here and there when I moved back home. We were briefly out of remission again. They now learned their lesson.
3. Last night, his BG was 59, so I let him sneak a few bites of Wellness Core (!) from my other cat. This morning he is the highest he's been in a week again.
If you can at all, cut out all dry food altogether - even Wellness Core - but do it carefully, because BGs can drop FAST. Dry food by nature is much higher carb than wet, even the grain free stuff. I realize you have other complications to deal with as well (fat content), so is more difficult, but there must be some solution - maybe a medication he can take to keep the poop chute less busy. Best of luck!
Well thanks so much I will try maybe reduce it some each day ( the dry food) would be best, my other cat will have a fit he already turns the rugs upset down when there is not enough for both, but it is better for both of them not to be eating the dry food. My vet though said a little was okay because it helped keep the tartar off the teeth, but she had some prescription dry food she wanted me to buy.
BJM
Member Since 2010
Its a myth that dry food cleans cat's teeth. The food splinters and is swallowed - cats don't chew it.
If you're looking to help the dental health, get some chicken gizzards, lightly dunk them in boiling water to kill any surface bacteria if they exist, and let your cat eat it mostly raw. The fibrous meat of the gizzard will help scrape the teeth clean.
Or teach your cat to allow tooth brushing with pet-specific toothpaste and brush.
If you're looking to help the dental health, get some chicken gizzards, lightly dunk them in boiling water to kill any surface bacteria if they exist, and let your cat eat it mostly raw. The fibrous meat of the gizzard will help scrape the teeth clean.
Or teach your cat to allow tooth brushing with pet-specific toothpaste and brush.
I see, I will try the Gizzards altough I ahve never had much luck getting either Pookie or Vegas to eat raw or close to raw meat. I go have Cat specific toothpaste and soft toothbrushes and those cap you put on your finger , hard to get in the back where the tartar gets on molars. I also started using "Be Fresh" dental liquid from Pet Meds, you pour a but in dirnking water, suppose to assit with tartar control and gingivitus.
I tested Pookie's blood glucose using Alpha Trak Meter yesterday at 2pm after giving him 3 units of Levemir at 7:30am and he had about 2 ounces of Fancy Feast, it was up to 250. He just did not seem to have much appetite, only nibbled at food, but no noticeable stomach issue. He was very restless. This morning I increased his dose to 3 1/2 units and he appears to be much better, is eating more and has had no stomach upset.
I tested Pookie's blood glucose using Alpha Trak Meter yesterday at 2pm after giving him 3 units of Levemir at 7:30am and he had about 2 ounces of Fancy Feast, it was up to 250. He just did not seem to have much appetite, only nibbled at food, but no noticeable stomach issue. He was very restless. This morning I increased his dose to 3 1/2 units and he appears to be much better, is eating more and has had no stomach upset.
BJM
Member Since 2010
Levemir is a depot insulin. This means the effects are cummulative - they build up over 3-5 days.
Only make changes after a full 3 -5 days based on the nadir, the lowest glucose level between shots (usually around +6 to +9 hours after a shot of Levemir, though some cats vary) .
Also, if the pre-shot number suggests it would be unsafe to shoot at that level and you are frequently skipping shots, the insulin dose is too high, OR, you need to reduce your pre-shot limit so that you can shoot low to stay low.
If your pre-shot limit is 200 mg/dL and the nadir tests don't go below 50 mg/d, you might lower the pre-shot limit by 25 mg/dL to 175 mg/dL this week and see how that works. Then next week, lower it to 150 mg/dL, so long as the nadirs are in a safe range.
If you follow the Tight Regulation protocol outlined in the Lantus forum, you can learn how to shoot safely below a pre-shot of 150 mg/dL, too.
Only make changes after a full 3 -5 days based on the nadir, the lowest glucose level between shots (usually around +6 to +9 hours after a shot of Levemir, though some cats vary) .
Also, if the pre-shot number suggests it would be unsafe to shoot at that level and you are frequently skipping shots, the insulin dose is too high, OR, you need to reduce your pre-shot limit so that you can shoot low to stay low.
If your pre-shot limit is 200 mg/dL and the nadir tests don't go below 50 mg/d, you might lower the pre-shot limit by 25 mg/dL to 175 mg/dL this week and see how that works. Then next week, lower it to 150 mg/dL, so long as the nadirs are in a safe range.
If you follow the Tight Regulation protocol outlined in the Lantus forum, you can learn how to shoot safely below a pre-shot of 150 mg/dL, too.
Wendy&Tiggy(GA)
Member Since 2011
Take a look at this sheet - column C (% calories from carbs) For a diabetic cat you need the food to be under 10% calories from carbs. http://www.catinfo.org/docs/FoodChartPublic9-22-12.pdf
As you can see...
- Wellness core grain free indoor is 12% - too high
- Fancy feast - classic pates, flaked , chunky and kitten are fine
- ALL the medleys and roasted ones are too high carb - set those aside for hypo emergencies only.
Can you set up a spreadsheet? It will help us advice you better and allow you track trends etc. Heres how but let us know if you need help with it http://www.felinediabetes.com/FDMB/viewtopic.php?f=6&t=18207
Wendy
As you can see...
- Wellness core grain free indoor is 12% - too high
- Fancy feast - classic pates, flaked , chunky and kitten are fine
- ALL the medleys and roasted ones are too high carb - set those aside for hypo emergencies only.
Can you set up a spreadsheet? It will help us advice you better and allow you track trends etc. Heres how but let us know if you need help with it http://www.felinediabetes.com/FDMB/viewtopic.php?f=6&t=18207
Wendy
I am working on the spreadsheet and thanks for the info on Fancy Feast, for some reason he never cared much for the roasted.Pookie is doing well appears to have increased his appetite some and I am not seeing as much urine in the Breeze liiterbox. He appears a bit more active for his age of 13. I have reduced slightly the amount of dry food I think he is eating about 1/3 to 1/2 cup a day of dry at the most, my other cat, non diabetic Vegas eats a bit more, but I have taken kit and kaboodle aside and have mostly wellness left, I know that is too high but I am weaning them away from it.
I do have a problem with the blood glucose testing meters. I have been using the vet suggested Alphatrak meter ($280) since July 2010, the last time I bought strips (50) they were near $60.00. I was thinking that I have not always been happy with the meter requiring (my opinion) so much blood and that the lifeline of the meter may be expiring and I thought I would try one of the meters from Walmart that everyone on the forum has been raving about. Well first I tried the Reli-on Ultima and over and over again I get the "not enough blood" error and I finally tried it on myself and I had to get up quite a bit a blood. Next I bought the Reli-on Micro and of course the strips because they are not the same and BTW Walmart will not take back meters or strips have to contact reli-on and you have to pay shipping back to them and refund maybe 6-8 weeks. The micro also gives me the E-7 not enough blood message, I am pretty overwhelmed at this especially when I am approaching 5 days on Levemir and would like to know what his llevels are before I make any changes to his current 3 1/2 units every 12 hours. I am all out of strips for Alphatrak I will try to locate some and order because I don't know if this micro is going to work out and I am also anxious about the difference in readings between the human and animal meters; I have heard there is a difference but have seen no explanation as to what it is do the human meters give lower results than the animal meters?
I do have a problem with the blood glucose testing meters. I have been using the vet suggested Alphatrak meter ($280) since July 2010, the last time I bought strips (50) they were near $60.00. I was thinking that I have not always been happy with the meter requiring (my opinion) so much blood and that the lifeline of the meter may be expiring and I thought I would try one of the meters from Walmart that everyone on the forum has been raving about. Well first I tried the Reli-on Ultima and over and over again I get the "not enough blood" error and I finally tried it on myself and I had to get up quite a bit a blood. Next I bought the Reli-on Micro and of course the strips because they are not the same and BTW Walmart will not take back meters or strips have to contact reli-on and you have to pay shipping back to them and refund maybe 6-8 weeks. The micro also gives me the E-7 not enough blood message, I am pretty overwhelmed at this especially when I am approaching 5 days on Levemir and would like to know what his llevels are before I make any changes to his current 3 1/2 units every 12 hours. I am all out of strips for Alphatrak I will try to locate some and order because I don't know if this micro is going to work out and I am also anxious about the difference in readings between the human and animal meters; I have heard there is a difference but have seen no explanation as to what it is do the human meters give lower results than the animal meters?
BJM
Member Since 2010
While you work on home testing, it may be helpful to use some of the Secondary Monitoring Tools in my Signature Link.
Urine ketone testing is very important and if you get KetoDiaStix, you get a rough indicator of glucose, both since the previous void. Ketones form as a by-product of fat breakdown for calories. Too many ketones may indicate diabetic ketoacidosis, a potentially fatal complication of diabetes.
Appetite, thirst, defecation and urination also give clues to health status.
Urine ketone testing is very important and if you get KetoDiaStix, you get a rough indicator of glucose, both since the previous void. Ketones form as a by-product of fat breakdown for calories. Too many ketones may indicate diabetic ketoacidosis, a potentially fatal complication of diabetes.
Appetite, thirst, defecation and urination also give clues to health status.
Wendy&Tiggy(GA)
Member Since 2011
Let us know if you need help with the spreadsheet!
Thats good news on the wet food -keep weaning him off that dry....
The relion Ultima needs 0.6microlitres of blood - twice as much as the Relion micro or confirm. The micro needs the same amount of blood as the alphatrak. The difference isn't huge between the alphatrak and relion so I wouldn't worry - just use the relion and don't sweat the difference.
E7 is not a blood amount issue - its a strip issue - btw you can't use the same strips in the ultima as the micro....
Wendy
Thats good news on the wet food -keep weaning him off that dry....
The relion Ultima needs 0.6microlitres of blood - twice as much as the Relion micro or confirm. The micro needs the same amount of blood as the alphatrak. The difference isn't huge between the alphatrak and relion so I wouldn't worry - just use the relion and don't sweat the difference.
E7 is not a blood amount issue - its a strip issue - btw you can't use the same strips in the ultima as the micro....
Wendy
dodgingwrenches
Member Since 2010
Mckenzi said:
I'm curious how different the two read. I wish I could get the relion meter and strip here since they are so cheap, but they don't sell them in Canada
The difference has something to do with the actual size of the blood cells. Animal have larger blood cells than humans. Why that affects it - no clue. I did read somewhere that this will be a factor when using a human meter when your BG drops to 30 or lower, that is is less reliable then because of the difference in cell size.
Thank Goodness I got the reli-on micro meter to work,and I understand from reading link to University of Queensland Australia Centre for companion animal health that the human meters measure about 30mg lower than the animal meters Alphatrak so if my human meter said his baseline this morning at 6am before meds and food was 159, it was really in comparison to alphatrak 189, I just checked him at 9:00am which was 3 hours after 3 1/2 units of Levemir Insulin and one 3oz can of fancy feast chopped grill and he was at 266 on reli-on micro which I guess is about 296 on animal meter. I did order more alphatrak strips found some at amazon.com for $54.00 for 50 strips. I am going to try and compare the reli-0n with the alpha trak. I did do comparisons a year ago between the alpha trak and Freestyle meter for humans and I could not figure out how to compare the readings were soemtimes 50mg difference and sometimes 20...in other words I could not determine an exact difference all readings done at the same time with the same blood from the same paw at different times during the day were different 150 on Alpha trak and 50 on Freestyle and then later the alpha trak would read 180 and the freestyle would be at 162...50mg difference first time 18 next time, can't fugure so I went back to the alpha trak until now. Thank for all the help and I plan to work more on the spreadsheet today. Another issue that has come up is since I have been testing Pookie more for glucose level he has been defecating on the carpet in the living room (same room as I am doing testing) I have cleaned up 3 times this week and his litter box (in basement) is clean (use the Breeze system) he is urinating in the box (pads underneath) but he is doing #2 on my carpet.
Wendy&Tiggy(GA)
Member Since 2011
Comparing meters like that is just going to give you a headache. 
Meters all have an error of around 20% anyway. I would just put the AT away and use it as a backup and use the Relion. The Relion is a good meter and you can trust it.
If his blood sugar is high it could be making him feel rough and so he just poops where he is. My Bailey was like that. What are the poops like? normal?
Wendy
Meters all have an error of around 20% anyway. I would just put the AT away and use it as a backup and use the Relion. The Relion is a good meter and you can trust it.If his blood sugar is high it could be making him feel rough and so he just poops where he is. My Bailey was like that. What are the poops like? normal?
Wendy
Wendy&Tiggy(GA)
Member Since 2011
I can't access it - it says "access denied" can you click on "share" and choose"anyone with a link"?
KPassa
Member Since 2012
You want to go to File ->Publish to Web. Check the box to "Automatically republish when changes are made" and copy the address that appears under the "Get a link to the published data" section. It should start with "https://docs.google.com/spreadsheet/pub..." and that's the link you want to share.
Wendy&Tiggy(GA)
Member Since 2011
yay I can see it now!! Although I don't see any readings after the 4th?
Can you update it so we can get abetter idea of how this new dose is going? 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 he is going. The low point "nadir" is what you base dose changes on since you don't want him dropping too low (under 50).
- before bed (2-3hours after Pm shot) to get an idea of what his 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
Can you update it so we can get abetter idea of how this new dose is going? 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 he is going. The low point "nadir" is what you base dose changes on since you don't want him dropping too low (under 50).
- before bed (2-3hours after Pm shot) to get an idea of what his 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
Pookie has been doing well, I have seen no Ketones in his urine. I am trying to get more tests done and I wanted to let you all know that I did a test this morning baseline using both the reli-on and Alphatrak meters and I came up with 271 from the reli-on and 335 from the alphatrak and this was using the same blood from the same rear paw pad. I won't be comparing them in the future it is not always easy to get enough blood, but I wanted to just "see" again for myself how much a difference it was in the two meters. Hope all had a wonderful Thanksgiving.
Wendy&Tiggy(GA)
Member Since 2011
When you got the 79 was that with the Alphatrak? Anything under 80 on that means the dose is too high and you need a reduction.
Are you only dosing once a day? Thats not the normal way to dose insulin.
Wendy
Are you only dosing once a day? Thats not the normal way to dose insulin.
Wendy
BJM
Member Since 2010
Here are some glucose reference ranges used for decision making using glucometers. Human glucometer numbers are given first. Numbers in parentheses are for non-US meters. Numbers in curly braces are estimates for an AlphaTrak.
< 40 mg/dL (2.2 mmol/L) {< 70 mg/dL for an AlphaTrak}
- Treat as if HYPO if on insulin
- At nadir (lowest point between shots) in a long term diabetic (more than a year), may earn a reduction.
< 50 mg/dL (2.8 mmol/L) {< 80 mg/dL for an AlphaTrak}
- If before nadir, steer with food, ie, give modest amounts of medium carb food to keep from going below 50 (2.8).
- At nadir, often indicates dose reduction is earned.
50 - 130 mg/dL (2.8 - 7.2 mmol/L) {80 - 160 mg/dL for an AlphaTrak}
- On insulin - great control when following a tight regulation protocol.
- Off insulin - normal numbers. (May even go as low as the upper 30s (1.7 mmol/L){60s for an AlphaTrak}; if not on insulin, this can be safe.
= 150 mg/dL (8.3 mmol/L) {> 180 mg/dL for an AlphaTrak}
- no shot limit for ProZinc, PZI, or other non-depot insulins
> 150 mg/dL (8.3 mmol/L) {> 180 mg/dL for an AlphaTrak}
- At nadir, indicates a dose increase may be needed when following a tight regulation protocol.
200 mg/dL (11.1 mmol/L) {230 mg/dL for an AlphaTrak}
- no shot level for beginners; may slowly reduce to 150 mg/dL (8.3 mmol/L) {180 mg/dL} for long-acting insulins (Lantus, Levemir, and ProZinc) as data collection shows it is safe
180 - 280 mg/dL (10 - 15.6 mmol/L) {may be 210 - 310 mg/dL for an AlphaTrak}- Any time - The renal threshold (depending on data source and cat's renal function) where glucose spills into the urine.
- Test for ketones, glucose is too high.
>= 280 mg/dL (15.6 mmol/L) {may be >=310 mg/dL for an AlphaTrak}, if for most of the cycle between shots
- Uncontrolled diabetes and thus at risk for diabetic ketoacidosis and hepatic lipidosis
- Follow your insulin protocol for dose adjustments
- Test for ketones; if more than a trace level of ketones, go to vet ASAP.
< 40 mg/dL (2.2 mmol/L) {< 70 mg/dL for an AlphaTrak}
- Treat as if HYPO if on insulin
- At nadir (lowest point between shots) in a long term diabetic (more than a year), may earn a reduction.
< 50 mg/dL (2.8 mmol/L) {< 80 mg/dL for an AlphaTrak}
- If before nadir, steer with food, ie, give modest amounts of medium carb food to keep from going below 50 (2.8).
- At nadir, often indicates dose reduction is earned.
50 - 130 mg/dL (2.8 - 7.2 mmol/L) {80 - 160 mg/dL for an AlphaTrak}
- On insulin - great control when following a tight regulation protocol.
- Off insulin - normal numbers. (May even go as low as the upper 30s (1.7 mmol/L){60s for an AlphaTrak}; if not on insulin, this can be safe.
= 150 mg/dL (8.3 mmol/L) {> 180 mg/dL for an AlphaTrak}
- no shot limit for ProZinc, PZI, or other non-depot insulins
> 150 mg/dL (8.3 mmol/L) {> 180 mg/dL for an AlphaTrak}
- At nadir, indicates a dose increase may be needed when following a tight regulation protocol.
200 mg/dL (11.1 mmol/L) {230 mg/dL for an AlphaTrak}
- no shot level for beginners; may slowly reduce to 150 mg/dL (8.3 mmol/L) {180 mg/dL} for long-acting insulins (Lantus, Levemir, and ProZinc) as data collection shows it is safe
180 - 280 mg/dL (10 - 15.6 mmol/L) {may be 210 - 310 mg/dL for an AlphaTrak}- Any time - The renal threshold (depending on data source and cat's renal function) where glucose spills into the urine.
- Test for ketones, glucose is too high.
>= 280 mg/dL (15.6 mmol/L) {may be >=310 mg/dL for an AlphaTrak}, if for most of the cycle between shots
- Uncontrolled diabetes and thus at risk for diabetic ketoacidosis and hepatic lipidosis
- Follow your insulin protocol for dose adjustments
- Test for ketones; if more than a trace level of ketones, go to vet ASAP.
Thanks so much for that info and I switched to a new bottle of Levemir because I was thinking the old bottle which was opened 10/23/13 was losing potency based on the high level this morning of 430 at baseline using alpha trak meter 6:00am. This was my first bottle of Levemir used lantus before and I know that gave me about 37 days before it stopped working and I would notice a difference in levels and his demeanor.
I started giving Pookie 5 units of Levemir twice a day as I was only giving 4.50 before first shot is between 6 and 6:30 in the monring and then 12 hours later in evening.
I checked today at 11:30am with Alapha trak and he was at 325. Looks like I will need to increase a little bit and check further.
I checked today at 11:30am with Alapha trak and he was at 325. Looks like I will need to increase a little bit and check further.
KPassa
Member Since 2012
Had you been giving Pookie Levemir only once a day before?
5u twice a day seems like a lot and especially with the low pre-shots you had been getting at lower doses, it makes me think that you might have skipped the right dose (i.e. the 3u or even the 3.5u seemed like it might have been a better dose).
What foods are you currently feeding him? Were you able to get him off the dry?
5u twice a day seems like a lot and especially with the low pre-shots you had been getting at lower doses, it makes me think that you might have skipped the right dose (i.e. the 3u or even the 3.5u seemed like it might have been a better dose).
What foods are you currently feeding him? Were you able to get him off the dry?
No, originally he was on Lantus 5 units twice a day and when I switched to Levemir I started at 4 units because of the possible difference in strenght and gradually came back up to 5 units twice a day of Levemir. He is not completely off dry food but I have got him down to about 3/4 of a cup a day. He eats Fancy Feast classic and mornings and kitten food when he has issues with his tummy. I use the strips to test his urine and so far no ketones. His last Vet visit in September showed no ketones in urine and the flutosome test indicated an average of 400, this is why vet increased the dose from 4.5 to 5 units, she said she was confused that the flutosome test was showing a much higher average than what I was getting in my curves when I did them and she expected ketones to show in urine at those levels. I am confused some times also at the low pre shots levels in the past I thought maybe the insulin had lost its potentcy when I started getting over 300 levels. If he is at 325 5 hours after shot and food should I give him maybe 1 unit to keep it from going higher?
Deb & Wink
Member Since 2013
The Fancy Feast Mornings, both the Medleys and the Souffles look like they have a lot of grains and veggies in them which make them too high in carbs for a diabetic cat. You might want to try a food trial for at least a week or more, eliminating those suspected higher carb foods from his diet and see how the BG levels trend.
Also, cut back on the dry food slowly, about 1 tablespoon less a day. Before you know it, you will have eliminated the dry food from his diet. That should help to bring the BG numbers down too.
Since the L insulins are cumulative, building up the insulin depot, it is not a good idea to give any additional insulin during the 12 hour cycle.
Also, cut back on the dry food slowly, about 1 tablespoon less a day. Before you know it, you will have eliminated the dry food from his diet. That should help to bring the BG numbers down too.
Since the L insulins are cumulative, building up the insulin depot, it is not a good idea to give any additional insulin during the 12 hour cycle.
Okay I will do that I already cut out all the gravy containing foods but I hadn't thought about the veggies, I am trying to get him and my other cat Vegas who is not diabetic off the dry food. Vegas insists on eating dry and the only wet food he will eat is Fancey Feast fish and shrimp feast and when he does not want that he resorts to dry food and if I take it away to keep Pookie from eating it he tried to tear the house apart. I know it is best that he not have the dry even though he is not diabetic but 8 years ago when I found him as a feral kitten I didn't know any better and I gave them both dry and wet.
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