Low fructosamine, frustrated, unsure what to do, really appreciate advice

[dexter2010]

Hello,

I've been a lurker on this forum since my cat Dexter (16 years old) was diagnosed with diabetes a few months ago. It's been incredibly helpful, thank you. Since then, I've changed him to a low-carbohydrate, low-phosphorus food (Weruva Wx Phos-focused) because he also has CKD. It's so expensive but his energy and fur quality are so much better so I'll keep him on it.

The vet started him off at 2 units of Lantus (!) which after reading the forum, I disregarded and put him at 1.5 units as just a guess because I hadn't seen the "start low go slow protocol yet"... there was an overwhelming amount of information.

As for blood testing, I was able to get a good bead of blood the first 5 or so times I poked his ear, but then that just stopped. I'll warm his ear for 60+ seconds, nothing. I'll poke it on the highest lancet setting 10x, massage it, nothing. So I've been having to rely on very expensive fructosamine testing. I lurked the forum a bit today and realized his lancets are 30G so I ordered some 25G, but if anyone has any other ideas I'd really appreciate advice. It's not dehydration, I asked the vet about it and they said his gums and skin are fine... but I take everything they say with skepticism.

So after a while at 1.5 units, the fructosamine test was very low, vet said "wow, he's hypoglycemic, has he been wobbling?" I said no, he seemed fine... vet seemed surprised at him being alive. I don't remember the number, sorry. So lowered to 1 unit, come back, test again a few weeks later. The new number is 264. The vet has been sick so a vet tech told me the number, said "that's within normal range, keep going, bring him back in 3 weeks for another test" ... but according to numbers here, that's hypoglycemic. It seems like they have no idea what they are doing and I'm tempted to just stop the insulin completely, give up, why am I wasting so much time and money on this @#$@# if this medicine is causing hypoglycemia anyway?!? I'm unemployed, vet bills have been crazy expensive, I have a thanksgiving trip coming up and the sitter I've hired is going to cost about $500 to come twice a day because my roommate refuses to give my cat the insulin (scared of needles). Plus I NEED to start working soon and with a 1.5+hr commute I have no idea how I'm going to keep up with a 12 hr schedule. I really am considering stopping the insulin for the trip, is that irresponsible? I love my cat very much, I don't want him to have a hypoglycemic episode while I am gone, he tends to eat less when I'm not home and it's a crazy amount of money. I need to decide tomorrow.

Sorry, I'm just so frustrated. I think the best thing is just to wait for the 25G lancets to come and do a curve. But what if I still can't get blood. Ugh, I would really appreciate any other ideas

 

[Connie & Parker & Moonie]

I am so sorry that you’re dealing with all of this. Feline diabetes has such a steep learning curve and it can be really stressful, especially in the beginning.

I think it could potentially be very dangerous to stop insulin for your trip.

When a diabetic cat doesn’t have enough insulin, their body can start breaking down fat for energy, producing ketones. If those ketones build up, it can lead to diabetic ketoacidosis (DKA), which is a life-threatening emergency.

I completely understand your concerns about hypoglycemia, especially when you won’t be there to monitor him. But both too much insulin and too little insulin can be very dangerous, so I really think it’s important to get a better picture of Dexter’s blood glucose before making any decisions.

The good news is that I think you’re going to have much better luck with the 25G lancets! When I first started testing, I couldn’t get any blood from Moonie’s ears until I switched to 26G lancets, and even now I still use 28G (not 30G).

The things that helped me most were warming her ears really well, using a larger lancet (like you’re planning to do!), applying a thin layer of Vaseline to help the blood bead up instead of getting absorbed into Moonie’s black fur, and trying both ears. Sometimes one ear just bleeds better than the other.

You may have seen this already but this link has a lot of tips and tricks for testing - Info - TESTING AND SHOOTING TIPS

I’ll pause here because I know this is already a lot of information! Maybe once you’re able to get a few blood glucose readings, you could post again to get some advice on a vacation dose? The more experienced members here can help you think through a conservative dosing plan, but they’ll probably need some home testing data to do that safely, especially if your sitter won’t be able to test.

I really hope the new lancets make things easier for you and Dexter!

 

[Wendy&Neko]

Hello and welcome to you and Dexter.

A normal cat has a fructosamine up to 349. That varies a bit based on labs, but the bloodwork results should give you the lab range. For a diabetic cat on insulin, good control is 300-400. I can see why the vet would be concerned at 264. I would consider lowering the dose to 0.5 units. Has Dexter been tested for or found to have ketones at any point? I more concerned about lowering the dose if he's seen any ketones. Ketones should be on the urinalysis results. You can also pick up urine testing sticks such as Ketostix to test Tips to catch and test a urine sample. You can even get urine test sticks that test for glucose, such as Ketodiastix.

 

[dexter2010]

I am so sorry that you’re dealing with all of this. Feline diabetes has such a steep learning curve and it can be really stressful, especially in the beginning.

I think it could potentially be very dangerous to stop insulin for your trip.

When a diabetic cat doesn’t have enough insulin, their body can start breaking down fat for energy, producing ketones. If those ketones build up, it can lead to diabetic ketoacidosis (DKA), which is a life-threatening emergency.

I completely understand your concerns about hypoglycemia, especially when you won’t be there to monitor him. But both too much insulin and too little insulin can be very dangerous, so I really think it’s important to get a better picture of Dexter’s blood glucose before making any decisions.

The good news is that I think you’re going to have much better luck with the 25G lancets! When I first started testing, I couldn’t get any blood from Moonie’s ears until I switched to 26G lancets, and even now I still use 28G (not 30G).

The things that helped me most were warming her ears really well, using a larger lancet (like you’re planning to do!), applying a thin layer of Vaseline to help the blood bead up instead of getting absorbed into Moonie’s black fur, and trying both ears. Sometimes one ear just bleeds better than the other.

You may have seen this already but this link has a lot of tips and tricks for testing - Info - TESTING AND SHOOTING TIPS

I’ll pause here because I know this is already a lot of information! Maybe once you’re able to get a few blood glucose readings, you could post again to get some advice on a vacation dose? The more experienced members here can help you think through a conservative dosing plan, but they’ll probably need some home testing data to do that safely, especially if your sitter won’t be able to test.

I really hope the new lancets make things easier for you and Dexter!

I won't stop the insulin then, and good to hear about the thicker lancets, hopefully they work!

 

[dexter2010]

Hello and welcome to you and Dexter.

A normal cat has a fructosamine up to 349. That varies a bit based on labs, but the bloodwork results should give you the lab range. For a diabetic cat on insulin, good control is 300-400. I can see why the vet would be concerned at 264. I would consider lowering the dose to 0.5 units. Has Dexter been tested for or found to have ketones at any point? I more concerned about lowering the dose if he's seen any ketones. Ketones should be on the urinalysis results. You can also pick up urine testing sticks such as Ketostix to test Tips to catch and test a urine sample. You can even get urine test sticks that test for glucose, such as Ketodiastix.

The vet wasn't concerned at all, which is why I am concerned. I'll lower the dose, thank you - and hopefully ear testing will work
They've never found ketones, which is good