Low numbers without shooting + Bruce’s Glucose Curve

OMG! Bruce is being a real little monkey. I'd skip tonight. Feed him his usual meal and then test him again 3 hours post meal to see if his BG is down or not. If it is down, his pancreas is working better which is a good sign. The problem is he is still going higher than ideal part of the time. You'll get him sorted but right now he's holding his cards very close to his chest.:rolleyes:
 
This has been Bruce’s history with me! :cat: We dealt with a botched PU surgery for four years; we can deal with weird glucose counts now.

I wasn’t even thinking of giving him even the smallest dose tonight after seeing that number. I feel like I have forgotten to add that he is in good spirits (we are all a bit lazy these past few days with the heat). He looks good and gained weight back (in a good way—when we went to the vet, you could feel his spine). His fur is softer than it ever has been. He’s currently wrestling with his brother. :) I also forgot to add that I did get control solution to test his glucose meter, and we are on a new container of strips. My biggest concern right now is the fact that he hasn’t had much insulin in a bit, and that the vet wants him back for another glucose curve in a few weeks. But hey oh, we’ll deal with that when we need to deal with that.
 
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When you are testing at home, there really isn't any good reason to take him to the vet for a curve. Too often, kitty's BG rises just from the stress of the vet visit (can rise 100 points or more) and this often leads to the vet prescribing more insulin than kitty needs. Have you considered doing the curve at home yourself and sending the results to the vet? OR taking this matter into your own hands as so many of us have done before you. Your vet is not with Bruce 24/7 but you are and you are handling him very well even though he is throwing you curve balls. ;)
 
Post dinner +3 of.... drumroll please... 83.

I think my vet would be okay with me doing a curve at home if I was using an Alphatrak or some other pet meter. During the last curve, the difference in my meter and their meter was pointed out to me. I wish they would have used our meter for more than the first two times. Honestly, the cost of an Alphatrak is more or less the cost of a curve at the vet.

When I say this little guy hates the vet, he hates the vet. As soon as he sees or hears the carrier, he runs. As soon as I grab him, he pees on me. EVERY TIME. :smuggrin: I know stress spiked his levels last week. If his first test was at 8:50 and 374 and his second was 11:00 am 213, and Gabapentin takes 2ish hours to kick in... my guess is they gave it to him around his first test and by the second one rolled around he was feeling relaxed. Now, I know his sugar would be dipping anyway, but I know numbers were elevated.

Our vet told me she trusts my judgement, as I know B best. She was thoroughly impressed when I told her I was pH testing his pee. Since I’ve started taking our squad to her, she has never pressured or guilted me to make certain choices if it was not a financially sound decision for me. I appreciate that about her.

Yeah, I think I just talked myself into a Alphatrak.
 
Doing a drumroll! Great BG! :joyful:

It shouldn't be necessary to get an AT2 meter just to do curves for the vet but in the long run, you're right.......it would be cheaper over time than trips to the vet for curves. Even if Bruce is getting some sedation during his vet visit, it's not a normal environment for him and that could be skewing the readings taken at the vet. Never mind the stress you deal with from Bruce getting stressed out.

The vet just needs to know what is considered "normal" BG range on a human meter and then look at the pattern of the curve readings rather than focusing on the actual numbers. I started out with the AT2 never knowing I could use a human meter. The first time I showed my vet a human meter spreadsheet she looked at me like I had horns growing out of my head. I had also done testing with the AT2 to show her and that was what she focused on. Fast forward and she had another client who insisted on using a human meter so my vet emailed me for information, knowing I had the reference numbers for human meters. While my vet still prefers the AT2, she is now open to the use of a human meter.
 
AT2 ordered. Same price as a curve + gas money to our vet. Less stress on him. Less pee on me. :p Far less stress on me, actually. I get really upset when I have to burrito him in a towel and see him not want to go in a carrier.

It will be interesting to see his BG in about an hour (8 AM/8 PM are our feeding times). He usually avoids bed during the summer, but decided to pay me a visit around 6 AM. He usually does that when he’s hungry.
 
AMPS: 176. Unfortunately, I can’t monitor him today even if I wanted to give him a small dose, so I’m nervous to even give him that .25 dose due to how quickly he dropped two days ago after .5 at 153. He also may have eaten some dry food. Thoughts?
 
I can understand your concern if you are not going to be able to monitor. I also would want to be cautious if you're not sure if he got into dry food or not. Hate to skip again but you've not had an opportunity yet to try a 0.10u or drop dose with him and he's been dropping right to the edge of safety. You can skip and see what he does. You'd probably be fine to give him a drop dose but again, with his recent history, I think it would be safer to do that when you can monitor.
 
I am going to skip. Depending on the number tonight, I’ll try the drop dose then. That way I can monitor his +2 and +4/before bed BG. I hate having him without insulin for 3 times in a row, but I also know how much and how quickly he dropped with .25 on 7/16 PM. I’m panicking that I’m doing something wrong with testing or insulin shot giving, but I’m doing the exact same thing as we were when we started with all of this.
 
You're not doing anything wrong and Bruce is just being a cat....doing his own thing at his own time just to leave you scratching your head or worse! :rolleyes:
 
My casual plan (in my head at least) was a drop of insulin if it was around 150. 113 just seems way too low to chance that. You think it’s okay? I’ll test him before bed (approx +4) and see if he dropped.

I jokingly told him last week after his curve that maybe he should get his pancreas working a bit better if he hates the vet so much. A man finally listened to me! I know things are still not where they need to be, but for today, I’m okay with this.
 
Cheeserball said:
I jokingly told him last week after his curve that maybe he should get his pancreas working a bit better if he hates the vet so much. A man finally listened to me!
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LOL! And a cat man to boot! Looks like he's trying his best to take you up on the suggestion!
Given how much he dropped on the 0.25u dose, while he might be OK with a drop, I'm sure you don't want to be up all night steering him either and he is definitely all over the map lately so it's hard to predict what he might do. It's your call but last night he went down to 83 with no shot from 116 at PMPS!
 
+4 (with no shot) is 93... I guess technically it’s somewhere between +3 and +4, because he didn’t quite finish all of his dinner at 8 but finished the rest of it at 9 when I offered it to him.

Mr. Sugar Booger will not eat food on the sides of his dish; he likes it scooped down into the center. What a diva!
 
Looks like Bruce is on a mission and a very good one. All you can do is take this day by day at this point in time. The one thing none of us ever have with our kitties is a baseline of what their BG was like before diagnosis. While some non-diabetic cats can run as low as the 40s, you have no way of knowing what Bruce's BG used to average. He may have normally been in the upper range of normal. How are his other clinical signs these days? Less water intake, less peeing, a little more active/social? He's obviously not ravenous or he'd be finishing his food quickly. All of your observations of those factors are important too. Fingers crossed, this BG lowering trend continues. :D
 
Wow, I am so thrilled with the progress that Bruce is making wowowow!! Just sharing my experience with microdosing, I've been able to shoot a drop dose on Kyo at 88-107 readings and she responded really well to it. You can look at my spreadsheet for reference if you'd like, I feel like you're practically in the place we were in where I was very quickly reducing the dose and having to make sure I was available to test through the microdosing. But I think it really helped Kyo's numbers stick nice and low in the long run when I stopped giving her insulin. Every cat is different, and I'm glad you're making dosing decisions based on your best availability and health as well! I think those are very important to consider as I was so dead tired after Kyo threw me a couple PJ parties in one weeks time :coffee::coffee: but it ended up being so worth it to see all the hard work you've both put in to getting better reflected in the spreadsheet and the numbers you end up seeing. Keep up the great work and Bruce, stay out of the kibble! Lol :p
 
He has no clinical signs, or at least no signs like he had before. Pre-insulin, he was drinking a lot (and subsequently, peeing a lot) and eating a lot. In fact, I made a vet appointment for him the day after he stole a cheeseburger from my hands! :rolleyes: He had gained a good amount of weight about two years ago, and earlier this year, lost weight. At the vet on May 14, he was down to 10 or 11 lbs., which the vet said should be normal to high for most cats, but way below weight for him. He filled out and his spine is not noticeable like it was. He's definitely social, not so much active, but we're also in a heat wave, so I'm taking that into consideration. And honestly, he's never been an active cat--even as a kitten.

Years ago (circa summer 2012), when B started having problems, his first vet said his sugar was high. I had to take him back a few days later for a redo, and he was lower. Then his pee issues after that...

I'm sickened and shocked at how carb heavy his moderate calorie dry SO and even the wet SO food was. I had no clue. And he was never really interested in the wet SO. He loves Fancy Feast, though!

I am hopefully going to be getting the AT2 next week--I didn't want quick shipping because of how hot it is. I am going to take off work for a day and curve him myself when we get it. I work full time (plus a few hours a week second job and and pick up hours here and there with a third job), but my day job is very understanding and my supervisor is an animal lover. :)
 
That is a great overall report. If your little one has had issues with higher BG long before his diagnosis, maybe he's just a high side of normal guy!

Cheeserball said:
I'm sickened and shocked at how carb heavy his moderate calorie dry SO and even the wet SO food was. I had no clue.
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Don't beat yourself up. None of us have a clue until we end up on the diabetic journey. While we may look for good quality food, no one thinks to check out the carb content. And very few vets it seems have a clue. My vet recommended a food for my girl who is in remission, that was 15% or more carbs. I had to correct the vet as to how she calculated carbs! If not for the diabetes, I wouldn't have even thought to check the carb %.

Hopefully by the time you get the AT2, Bruce's BG will have dropped a little more. Even now, I think your vet would be impressed. :D
 
Sugar Booger update:

Decent Caturday! 117 and 151 yesterday. Chose not to shoot.

This morning, he is 217. Considering a super small dose, as I will be home until +6 and then back at +10.25 (our times got changed up a bit because I worked 2+ hours after our normal feeding time last night, but my plan is to bump up to 11.5 hours between feedings to get us back to normal.
 
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It looks like he still needs a bit of support and a tiny dose when you can monitor would be a good place to start. Are you still using U40 syringes or did you get some U100's? If you don't have the U100s now might be a good time to consider them if you can obtain them easily (ie no Rx needed).
 
+3.25ish is 87, so I’ll be keeping an eye on him.

I am going to order the U100 right now. As I recall, the brand of U40 we use have a U100 version. I was playing around with the U40 syringes, and he got the equivalent of about two drops of insulin.

Interestingly enough, this was a Facebook memory of mine today from seven years ago:

“Urinalysis is back. Trace of blood was found, which means UTI (he already got an antibiotic shot yesterday)... but even more concerning is that there were noticeable amounts of sugar in his urine, which means diabetes. We are going back on Monday for blood tests.”

That vet center was such a terrible place. :( so glad we don’t go there anymore!
 
Man he really swings a lot. Can you try to keep the spreadsheet updated? I know it's a PIA but the first thing many of us do is look at the SS for info.

FYI sugar in the urine is not necessarily indicative of diabetes if that's what you are thinking. ;)
 
No, I don’t think he’s had diabetes for the past seven years, but I do think that stress hits him heavier than our vet can imagine.

+5ish is 125. There is the chance he may have grazed a bit on some dry while his siblings and I took a nap. He is living his best life by himself—he has always been my cat that gravitates to the hottest spots in the house. Thank goodness today is the last day of this. :facepalm:

I work a short shift tonight, and then we’ll see where he is tonight. I doubt anywhere where I would expect him to be! :D He’s always been a finicky (but the sweetest!) little dude.
 
PMPS of 220. Gave him a dose that was under .5 but more than a drop. I lined up the plunger right above the last line... I wish I knew how to explain it. Tomorrow I’ll see if I can attempt to measure. +3 of 103. Definitely eager for those U100s to come in. Glad he’s not doing his early drop into the 50s! Mama is going to get some sleep tonight!
 
If you are lining up the plunger with the first line on the barrel (Zero line) then I would call that dose 0.10u just for clarity sake. Can you please fill in the doses given on the spreadsheet when you have a minute? :)

The other thing you can do, is hold in the plunger in as tightly as you can. Insert the needle into the vial while securely holding the plunger in. Then with the vial inverted just let go of the plunger. This sucks up a teensy bit of insulin in the needle that you can't see. We call that a drop dose. When you inject, push the plunger as far as you can and keep the needle in place for a second or so before withdrawing to allow any dregs on the needle tip to be released.

You might want to take a used needle and practice these draws with coloured water. You can inject onto a tissue to ensure you are getting some insulin into the needle.
 
I think everything is filled in now (or at least from recent times).

191 this morning. I gave him that .1ish dose. He didn’t eat quite all of his food this morning, so he’s finishing the rest of the quarter or so of a can now. I’m home for most of the day, so I’m able to keep an eye on him.

I was practicing the drop dose, and I feel like I’m not getting anywhere. I would assume I’d see a drop or no?
 
You'd have to push the fluid out into a tissue to see it....you won't see anything in the syringe. You have to really push the plunger in hard and let go fast once in the vial to suck up a drop of two.
 
+3.5 of 92.

I will try letting go of the plunger fast. I’ve not been doing that part.

Also, I discovered this Greenie cat proof container on the floor, complete with cat tooth marks, scratches, and lid ripped off. Bruce’s sister is checking out the damage, but his brother was the one found eating out of it. I would not be surprised if Bruce is somehow involved in this! He went many years without any treats at all, and now he gets one every time his mom pokes his ear. He has the life!

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Wonder if it's been sitting there for awhile and explains yesterday's readings too! Those higher carb treats and kibble tend to stay in the system longer than higher carb wet food.
 
Looks like the 0.10u is a pretty good dose for him but he's a bit lower tonight at PMPS so I'd make sure to get a +3 or before bed test tonight to ensure Bruce doesn't tread into dangerous waters. Fingers crossed he behaves himself! :)
 
That was my plan! He’s such a sugar booger.

I accidentally fell asleep right around a +4 test, so it was +4.75 with a 59. I gave him some kibble and added a bit more food to the food tree.

Because he keeps dropping so low before +6, would it be beneficial to maybe add a little smidge of moderate calorie food to his breakfast and lunch? I don’t mind keeping an eye on him this evening, but I won’t be able to do this tomorrow during the day due to work.
 
You can try adjusting food times, carb levels and amount to see if you can slow down that drop a bit. That's actually a really nice number albeit a little disconcerting for you! Try to keep the majority if not all feeding in the first half of the cycle. Sometimes feeding pre-shot and then giving another snack at +1,2 or 3 will help slow down the drop. All you can do is experiment a bit and see what works for Bruce.
I would try to keep the kibble out of the picture and use different carb levels of wet food if possible because the kibble lasts longer in the system and will wear off at an unknown time which could lead to higher pre-shots but then lower mid cycle tests.
 
He hates cleaning his plate all at once! Of course he does! He eats about three quarters of a can of fancy feast in a sitting. When he taps out, I grab the dish and put it in the fridge before anybody else eats it. I get ready for work, and then when I'm ready to head out the door, I give him the rest of his food and he eats it. I also need to push the pate to the middle of the dish because if it's on the sides, he won't eat it. He's such a diva and he knows it.
 
Mr. Sugar Booger is at 153 AMPS. I’m going to attempt to give him that drop dose. I’ll also be home a good chunk of the day, so I’ll can keep an eye on him.
 
Sugar Booger!

AMPS of 241. Where did that come from, Bruce?! I did hear him fighting with his sister before I got out of bed, so I passed it off as just some stress/adrenaline and gave him his drop dose.

+3 of 76. Keeping an eye on him... may give him a spoonful of his normal FF for a snack and see if that balances him out a bit. I get nervous when he’s hitting that sort of number only 3 hours post shot.
 
Looks like Bruce is vying for the title of Best Dramatic Kitty! Hopefully that higher AMPS was just a product of some tiff or excessively rousing playtime.
 
He was 110 at +6.

PMPS is 208. He seems to be a bit hungrier today and yesterday than normal.

U100s came in today!
 
:banghead:

Things were going okay Friday until I unexpectedly had to work much later than anticipated. Fearing it would throw off our feeding schedule way too much, I skipped his shot (and my mistake of skipping BG). I still fed him his normal meal and figured he’d be a bit higher the next morning. Since then, he’s been in the mid 200s and he’s been in blues afterward (compared to his greens last week). And of course, now I’m clueless as to what is going on. And even more of course, my anxiety sends me to a bad place. Argh!

Photo because he’s so darn cute. :kiss:
 

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Yes he is a cutie! I just want to give that chin some scritches! :kiss:

I don't think the missed shot is still impacting Bruce's numbers. Sometimes dosing needs change for an unknown reason so when you can monitor Bruce and his pre-shot is high enough, you could try the 0.1u dose again to see if you can get him back into some green numbers.

We've all missed shots or given fur shots at times so don't beat yourself up. BG is not static....it changes from time to time so the impact of missing a shot is usually not the reason behind a slight increase in BG.

Try not to miss getting a test in before bed though. There can be clues in those numbers that help you understand what is going on.
 
Argh! Was hoping we were at least somewhat steady and then Bruce is like “LOL Hold my Fancy Feast and watch this!”

Because he’s been steadily climbing and reaching numbers that scared me so I bumped him to .25. I feel like that may have been a mistake. :( Not sure why he’s not going any lower. He’s still not cleaning his plate at mealtimes but he finishes up about 30 to 60 minutes later when I set his dish in front of him again. I’m wondering if maybe his ProZinc lost efficiency or something? It looks okay to me but I’m not sure why he’s swinging so much. A few days ago he seemed hungrier than normal but besides that everything seems the same. I swear his numbers started fluctuating the day I got the AT2! (Still using the ReliOn for everything.)
 
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