May 7 - New Member - Home Monitoring after Hospitalization

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justanother

justanother

Member Since 2020
Hi!


My cat Peppy was diagnosed about a month ago and I’ve been reading lots of stuff online (both this website and other sources) and I’m getting a little confused. Hoping you can help me!


Peppy’s background -

She was diagnosed last month (April 10) and was severely diabetic. Her numbers were too high to get a reading. She was very dehydrated with kidney problems and needed to be hospitalized for 4 days.


The vet started her with 1 unit of Lantus every 12 hours and we were told that if she only ate half a meal, we should only give her .5 units. Once she came home, she was still weak and not able to eat a full meal so we were only giving her .5 units every 12 hours until her recheck at the vet 2 weeks later. She had only just started eating a full meal the night before, so we gave her one unit the night before and the morning before her blood glucose curve at the vet.


During the second check (April 25), they found she was still dehydrated and missing electrolytes so we need to give her SC fluids every other day plus electrolytes with her meals. Now she’s on 2 units and she’s eating full meals. We’re feeding her 5.5oz of Weruva wet food at 7am and 7pm. She’s 11.5 lbs. (Once we received the Alpha Trak we changed her diet from 1oz Hills/4.5oz Weruva to 100% Weruva)



TL: DR - Severely diabetic cat hospitalized 4 days. After 1 month, she’s on 2 units of Lantus every 12 hours, plus fluids and electrolytes. 5.5oz wet food every 12 hours, no dry food.


Now that she’s on 2 units and eating well, she’s doing so much better. Her water intake is normal, she’s purring and seems great. However, I just started home testing and have some questions.


  1. I read the SLGS instructions, but they’re written for a human meter. What are the numbers to reference using an Alpha Trak?
  2. How often should we be checking her blood glucose? Is it every time before her insulin shot as well as a weekly curve?
  3. How long does it take for a newly diabetic cat to regulate to the insulin? I’m concerned that we took a blood glucose curve and at +6 the BG was higher than the AMPS number. Is this because she’s still adjusting to the insulin?
  4. The vet told us to feed her every 12 hours and base the insulin dose according to whether she ate a full meal. (full meal, full dose/ half meal, half dose). She’s eating 100% wet food so we’re feeding her 5.5oz twice a day. I saw some comments about smaller meals to control the glucose, but not understanding the reasoning and when to time the smaller meals. Is it risky to give her 2 units of insulin if she isn’t eating a big meal at the time of insulin injection?


Thank you in advance!!!

I’ve been so worried about my baby I’m having dreams about doing blood glucose curves lol.
 
Welcome to you and Peppy!

didn’t catch your name... my cat Minnie is also on Lantus. I can’t answer all your questions so I’ll let more experienced members fill in the rest, but one thing I’ll say is Peppy may do better with more meals throughout the day. We see a lot of new folks who join in here and have gotten the same advice you did from the vet about 2 meals a day. I feel these vets are perhaps more used to treating dogs who do great on that regime, but not cats who are typically grazers. So my suggestion would be to feed Peppy the bulk of her meals around shot times but also offer a few smaller meals in between. The reasoning is a) cats just do better eating more often and b) it keeps your cat’s BG from dropping too low in between those two meals. There may be more I’m not aware of, let’s see what others say

I use a human meter and I believe the numbers on alphatrak or a pet meter, are typically lower but again I’ll let folks who use it chime in.

I see that you got your signature and a ss going, that’s great! And you’re home testing which is wonderful!! :bighug: We suggest testing before giving insulin so amps and pmps as well as a midday test at +6 or +7, which sounds you’re already doing, and a +2 after the evening shot so you can gauge where the BG level are headed to overnight. You don’t need to do a weekly curve if everything looks normal.

As far as how long it takes for a cat to get regulated, it really depends on each cat. Each situation is unique. I think you’re off to a good start home testing and feeding wet food only so hopefully not that long. I did everything wrong with Minnie and it took about 6 months but I think that was unusually longer and again, because I was clueless and hadn’t found this amazing place

Do you mind just adding a bit more info to the signature? Think of it as a snapshot so members can get the basics about your cat at a glance. Take a look at mine below. I’d suggest adding her bday, diagnosis date, the meter you use and also any other meds Peppy may be on along with the dosages.
Hang on for more replies and welcome again! :cat:
 
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justanother said:
Hi!


My cat Peppy was diagnosed about a month ago and I’ve been reading lots of stuff online (both this website and other sources) and I’m getting a little confused. Hoping you can help me!


Peppy’s background -

She was diagnosed last month (April 10) and was severely diabetic. Her numbers were too high to get a reading. She was very dehydrated with kidney problems and needed to be hospitalized for 4 days.


The vet started her with 1 unit of Lantus every 12 hours and we were told that if she only ate half a meal, we should only give her .5 units. Once she came home, she was still weak and not able to eat a full meal so we were only giving her .5 units every 12 hours until her recheck at the vet 2 weeks later. She had only just started eating a full meal the night before, so we gave her one unit the night before and the morning before her blood glucose curve at the vet.


During the second check (April 25), they found she was still dehydrated and missing electrolytes so we need to give her SC fluids every other day plus electrolytes with her meals. Now she’s on 2 units and she’s eating full meals. We’re feeding her 5.5oz of Weruva wet food at 7am and 7pm. She’s 11.5 lbs. (Once we received the Alpha Trak we changed her diet from 1oz Hills/4.5oz Weruva to 100% Weruva)



TL: DR - Severely diabetic cat hospitalized 4 days. After 1 month, she’s on 2 units of Lantus every 12 hours, plus fluids and electrolytes. 5.5oz wet food every 12 hours, no dry food.


Now that she’s on 2 units and eating well, she’s doing so much better. Her water intake is normal, she’s purring and seems great. However, I just started home testing and have some questions.


  1. I read the SLGS instructions, but they’re written for a human meter. What are the numbers to reference using an Alpha Trak?
  2. How often should we be checking her blood glucose? Is it every time before her insulin shot as well as a weekly curve?
  3. How long does it take for a newly diabetic cat to regulate to the insulin? I’m concerned that we took a blood glucose curve and at +6 the BG was higher than the AMPS number. Is this because she’s still adjusting to the insulin?
  4. The vet told us to feed her every 12 hours and base the insulin dose according to whether she ate a full meal. (full meal, full dose/ half meal, half dose). She’s eating 100% wet food so we’re feeding her 5.5oz twice a day. I saw some comments about smaller meals to control the glucose, but not understanding the reasoning and when to time the smaller meals. Is it risky to give her 2 units of insulin if she isn’t eating a big meal at the time of insulin injection?


Thank you in advance!!!

I’ve been so worried about my baby I’m having dreams about doing blood glucose curves lol.
Click to expand...
@Chris & China (GA) do you use alphatrak? Can you answer some of her questions? Thanks!
 
justanother said:
Hi!


My cat Peppy was diagnosed about a month ago and I’ve been reading lots of stuff online (both this website and other sources) and I’m getting a little confused. Hoping you can help me!


Peppy’s background -

She was diagnosed last month (April 10) and was severely diabetic. Her numbers were too high to get a reading. She was very dehydrated with kidney problems and needed to be hospitalized for 4 days.


The vet started her with 1 unit of Lantus every 12 hours and we were told that if she only ate half a meal, we should only give her .5 units. Once she came home, she was still weak and not able to eat a full meal so we were only giving her .5 units every 12 hours until her recheck at the vet 2 weeks later. She had only just started eating a full meal the night before, so we gave her one unit the night before and the morning before her blood glucose curve at the vet.


During the second check (April 25), they found she was still dehydrated and missing electrolytes so we need to give her SC fluids every other day plus electrolytes with her meals. Now she’s on 2 units and she’s eating full meals. We’re feeding her 5.5oz of Weruva wet food at 7am and 7pm. She’s 11.5 lbs. (Once we received the Alpha Trak we changed her diet from 1oz Hills/4.5oz Weruva to 100% Weruva)



TL: DR - Severely diabetic cat hospitalized 4 days. After 1 month, she’s on 2 units of Lantus every 12 hours, plus fluids and electrolytes. 5.5oz wet food every 12 hours, no dry food.


Now that she’s on 2 units and eating well, she’s doing so much better. Her water intake is normal, she’s purring and seems great. However, I just started home testing and have some questions.


  1. I read the SLGS instructions, but they’re written for a human meter. What are the numbers to reference using an Alpha Trak?
  2. How often should we be checking her blood glucose? Is it every time before her insulin shot as well as a weekly curve?
  3. How long does it take for a newly diabetic cat to regulate to the insulin? I’m concerned that we took a blood glucose curve and at +6 the BG was higher than the AMPS number. Is this because she’s still adjusting to the insulin?
  4. The vet told us to feed her every 12 hours and base the insulin dose according to whether she ate a full meal. (full meal, full dose/ half meal, half dose). She’s eating 100% wet food so we’re feeding her 5.5oz twice a day. I saw some comments about smaller meals to control the glucose, but not understanding the reasoning and when to time the smaller meals. Is it risky to give her 2 units of insulin if she isn’t eating a big meal at the time of insulin injection?


Thank you in advance!!!

I’ve been so worried about my baby I’m having dreams about doing blood glucose curves lol.
Click to expand...
Btw, I’ve had nightmares about home testing so you’re not alone there LOL how is it going? Are you doing ok or have issues? We have tons of tips for testing as well and you may have already found those when browsing :)
 
justanother said:
I read the SLGS instructions, but they’re written for a human meter. What are the numbers to reference using an Alpha Trak?
Click to expand...

On SLGS, the point where you reduce the dose is when they drop below 90....whatever meter you use, pet or human

justanother said:
How often should we be checking her blood glucose? Is it every time before her insulin shot as well as a weekly curve?
Click to expand...

Always before every shot and if possible, at least once mid-cycle on the AM cycle and at least one "before bed" test on the PM cycle. If you can test more often, it's even better! Testing at different points in the cycle will help you learn how she reacts to the insulin. Testing = knowledge and Knowledge = power against this disease.

justanother said:
How long does it take for a newly diabetic cat to regulate to the insulin? I’m concerned that we took a blood glucose curve and at +6 the BG was higher than the AMPS number. Is this because she’s still adjusting to the insulin?
Click to expand...

There's no pat answer. ECID (Every Cat Is Different)....some will regulate fairly quickly while others may take months before you see anything that even vaguely resembles some kind of pattern.

justanother said:
The vet told us to feed her every 12 hours and base the insulin dose according to whether she ate a full meal. (full meal, full dose/ half meal, half dose). She’s eating 100% wet food so we’re feeding her 5.5oz twice a day. I saw some comments about smaller meals to control the glucose, but not understanding the reasoning and when to time the smaller meals. Is it risky to give her 2 units of insulin if she isn’t eating a big meal at the time of insulin injection?
Click to expand...

Old school thinking....With Lantus being a gentler insulin, it's not as important for them to eat a certain amount before shooting. As long as they're willing to eat, that's what matters. The shot doesn't usually start to "kick in" for 2-3 hours after it's given, so as long as she's not sick and refusing food completely, there's no reason she can't take her time and eat like a lady.

Just like humans are told to eat 6 small means instead of 3 big ones, it's fine for our sugarcats to eat multiple, smaller meals. You're not feeding any more, you're just splitting it up. Smaller meals are easier for the pancreas to deal with. Small, frequent meals will also keep kitty a lot happier.
Happy Cat= Happy bean!

Only time we ask that you not feed is the 2 hours immediately before shot times so that when you test, you get a number that's not influenced by food. You Test (to make sure they're high enough for insulin) Feed (to make sure they're willing to eat) and Shoot.....all within 5-10 minutes.
 
Chris & China (GA) said:
On SLGS, the point where you reduce the dose is when they drop below 90....whatever meter you use, pet or human



Always before every shot and if possible, at least once mid-cycle on the AM cycle and at least one "before bed" test on the PM cycle. If you can test more often, it's even better! Testing at different points in the cycle will help you learn how she reacts to the insulin. Testing = knowledge and Knowledge = power against this disease.



There's no pat answer. ECID (Every Cat Is Different)....some will regulate fairly quickly while others may take months before you see anything that even vaguely resembles some kind of pattern.



Old school thinking....With Lantus being a gentler insulin, it's not as important for them to eat a certain amount before shooting. As long as they're willing to eat, that's what matters. The shot doesn't usually start to "kick in" for 2-3 hours after it's given, so as long as she's not sick and refusing food completely, there's no reason she can't take her time and eat like a lady.

Just like humans are told to eat 6 small means instead of 3 big ones, it's fine for our sugarcats to eat multiple, smaller meals. You're not feeding any more, you're just splitting it up. Smaller meals are easier for the pancreas to deal with. Small, frequent meals will also keep kitty a lot happier.
Happy Cat= Happy bean!

Only time we ask that you not feed is the 2 hours immediately before shot times so that when you test, you get a number that's not influenced by food. You Test (to make sure they're high enough for insulin) Feed (to make sure they're willing to eat) and Shoot.....all within 5-10 minutes.
Click to expand...
So well said, thank you Chris! :)
 
We just took her PMPS reading and it was 586! Gave her her insulin and a smaller meal. Will give her the other half in a few hours.

The testing itself has been fine, but I'm having trouble making sense of the readings since they're all over the place.
 
Just commenting on your SS and the BG numbers. You need to be getting more tests in during the cycles to see how low the dose is taking Peppy. For example today you had AMPS 203 And a PMPS 586. With no test in between to see how low he went it is impossible to say. But I would strongly suspect he dropped lower and is now bouncing from the lower number.
Bounces can happen when the cat 1. Drops too fast. 2. Drops too low. 3. Drops lower than he is used to and his body panics and he thinks he has to save himself. When any of these things happen the cat will dump glucose and regulatory hormones into his system and his BG will skyrocket. It can take from 1 to 6 cycles for the bounce to stop and there is nothing you can do about it.

I would also not neglect the PM cycle. At the moment you have no tests done overnight so we don’t know what is happening. Cats often drop lower at night so a good idea is to always get a before bed test done. If that test is lower than the preshot BG than it will probably be an active cycle so it would be a good idea to set the alarm and get up later to check Peppy has not dropped too low.

if you are doing. SLGS you need to hold the cycle for 7 days, then do a curve before deciding if you need to increase. However getting one test in during each cycle will give you a much better idea what is happening.

I would also feed several small meals during the day instead on one and also leave some food out during the night time cycle.
 
Bron and Sheba (GA) said:
Just commenting on your SS and the BG numbers. You need to be getting more tests in during the cycles to see how low the dose is taking Peppy. For example today you had AMPS 203 And a PMPS 586. With no test in between to see how low he went it is impossible to say. But I would strongly suspect he dropped lower and is now bouncing from the lower number.
Bounces can happen when the cat 1. Drops too fast. 2. Drops too low. 3. Drops lower than he is used to and his body panics and he thinks he has to save himself. When any of these things happen the cat will dump glucose and regulatory hormones into his system and his BG will skyrocket. It can take from 1 to 6 cycles for the bounce to stop and there is nothing you can do about it.

I would also not neglect the PM cycle. At the moment you have no tests done overnight so we don’t know what is happening. Cats often drop lower at night so a good idea is to always get a before bed test done. If that test is lower than the preshot BG than it will probably be an active cycle so it would be a good idea to set the alarm and get up later to check Peppy has not dropped too low.

if you are doing. SLGS you need to hold the cycle for 7 days, then do a curve before deciding if you need to increase. However getting one test in during each cycle will give you a much better idea what is happening.

I would also feed several small meals during the day instead on one and also leave some food out during the night time cycle.
Click to expand...
I was just thinking I forgot to tag Bron ha! Thanks!!
 
Bron and Sheba (GA) said:
Just commenting on your SS and the BG numbers. You need to be getting more tests in during the cycles to see how low the dose is taking Peppy. For example today you had AMPS 203 And a PMPS 586. With no test in between to see how low he went it is impossible to say. But I would strongly suspect he dropped lower and is now bouncing from the lower number.
Bounces can happen when the cat 1. Drops too fast. 2. Drops too low. 3. Drops lower than he is used to and his body panics and he thinks he has to save himself. When any of these things happen the cat will dump glucose and regulatory hormones into his system and his BG will skyrocket. It can take from 1 to 6 cycles for the bounce to stop and there is nothing you can do about it.
Click to expand...

Thanks for your response! I'm trying to understand what the bounce is caused by, but I couldn't figure it out on the website and I'm not sure I'm understanding. Is the bounce because she's adjusting or because the insulin dose was too high or other?

Since we need more tests to predict her cycle should we have given a smaller insulin dose when her pre-shot numbers were near 200?

Bron and Sheba (GA) said:
if you are doing. SLGS you need to hold the cycle for 7 days, then do a curve before deciding if you need to increase. However getting one test in during each cycle will give you a much better idea what is happening.
Click to expand...

Are you saying the dose might need to be increased once we get a better idea on her numbers because her nadirs are still above 150? Trying to understand the reasoning so I have a better grasp on things. Thank you!
 
justanother said:
Thanks for your response! I'm trying to understand what the bounce is caused by, but I couldn't figure it out on the website and I'm not sure I'm understanding. Is the bounce because she's adjusting or because the insulin dose was too high or other?

Since we need more tests to predict her cycle should we have given a smaller insulin dose when her pre-shot numbers were near 200?



Are you saying the dose might need to be increased once we get a better idea on her numbers because her nadirs are still above 150? Trying to understand the reasoning so I have a better grasp on things. Thank you!
Click to expand...

I can only talk about bouncing because I had the same confusion and questions as you. The way it was explained to me, it happens when the cat’s BG level falls too low at any one point during a cycle. That’s why it’s a good idea to test more to learn when the lowest point for your cat is. It could be at +6, and most are, but it could also be at +7 or +5. The only way to know is to test. It could also be at +6 overnight and you may not catch it unless you’re testing at night and that’s why that +2 test at night is a good idea to clue you in on where the BG level is headed. Take a look at my ss. You’ll see Minnie’s +2 at night are typically “flat” not much lower than the ps BG so I know she’ll have a good night. The 195 you’ll see happened only because she refused to eat before bedtime that night but after the test I was able to feed her so again I knew I wouldn’t have to worry. So not easy to avoid a bounce until your cat is regulated and even then as it starts to require less insulin gradually, bounces can still happen. It’s the life of a diabetic cat.

the main thing to keep in mind is as Bron said is you wait 7 days and do a curve before increasing the dose. On the other hand, to decrease you wait 6 cycles/ 3 days at least and you don’t really need to do a curve for a decrease because higher numbers are less dangerous than low numbers that can take your cat into hypo. Either way, you don’t want to be adjusting the dose all the time because it affects the depot. hope some of this helps, but Bron will explain more I’m sure :cat:
 
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Here is a good explanation of bouncing, from another post:
"Bouncing - Bouncing is simply a natural reaction to what the cat's system perceives as a BG value that is "too low". "Too low" is relative. If a cat is used to BGs in the 200's, 300's, or higher for a long time, then even a BG that drops to 150 can trigger a "bounce". Bouncing can also be triggered if the blood glucose drops too low and/or too fast.The pancreas, then the liver, release glucagon, glycogen and counter-regulatory hormones. The end result is a dumping of "sugar" into the bloodstream to save the cat from going hypoglycemic from a perceived low. The action is often referred to as "liver panic" or "panicky liver". *Usually*, a bounce will clear kitty's system within 3 days (6 cycles)."
 
Answers lead to more questions from me lol.

I think I'm understanding the bouncing, but she's been on the same dose for 12 days now. I updated my spreadsheet with her dosage before we received the glucose meter even though there's no BG numbers. I've been wondering if her dose was increased too fast because she wasn't eating.

Will continue to get more readings, but I read in an old thread (can't find it anymore) that if you take the +2 and it's higher than the PS, don't take a curve because you're not getting accurate numbers anyway. Wait until the bouncing stops to do a full curve. Does that sound right? Trying to find a balance so I'm not sticking her with the lancet unnecessarily. I think she's getting a higher +2 number because she's eating two big meals and now that she's used to it it's hard to break it up into smaller meals. She keeps begging for food lol.
 
I see Shelley gave you a good explanation of bouncing. once a bounce starts thee is nothing you can do about it but wait.
That’s where we all learn patience.
To prevent a bounce, it depends what caused it. If it was because the BG dropped too fast, the you can try feeding Peppy some food BEFORE the drop so that you can slow down the drops and hopefully stop the bouncing. This will take time and patience and trial and error. we really need more data in the SS before we can tell you much.
If the bounces are because she thinks she is dropping too low, but she really isn’t.....it’s just because she has been in high numbers for so long her body thinks the high numbers are normal and when she drops, she sends out a 911 to her body and it dumps the stored glucose into her system to “save her”. The way to stop that is to get her down into more normal numbers so she gets used to them again..
This also takes time as she won’t stop the bouncing just because she drops down into lower numbers once or twice.
Again you need to have patience. Regulating a diabetic cat takes time and if you try and rush it, it will only take longer.
The main thing I learnt about FD was patience, patience, patience.

If you get a before bed test like you did a couple of days ago and it is a lot lower 275 than the preshot 586, I would get another test done to see it is not dropping more.
 
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