meters

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rkkruk

Member Since 2013
Hi everyone,

I am so thankful to have found this board. I'm feeling a bit overwhelmed with life right now, but trying to do what is best for my cat. My cat, Leo, was just diagnosed with diabetes. He is 13 and just went for his " curve appointment" today. he did very well and was put on two units twice daily. Pray that I get this right tomorrow when I try to inject him for the first time. I have two questions, well more than that, but one day at a time. First question is does the injections have to be exactly twelve hours apart or could it be eleven or thirteen? Does one hour make a huge difference? The second question is about the meters. My vet seemed to be against human meters and said they are very unreliable and thus recommended the one for cats. From what I have read here it indicates the opposite. What are your recommendations for discussing the discrepancy with the doctor without making him feel defensive or that I am one of those people " who believes everything I read on the internet?" Leo is my rock and I am going to give this all I got. My schedule is VERY erratic at work and any advice would be greatly appreciated. Does an hour one way or another make a huge difference and what are your thoughts on the meter question?
 
We try to recommend as close to 12 hours apart as you can manage, but it depends on what type of insulin the vet prescribed as well. What insulin did he give you?

As far as meters go.... the pet meters are technically "more accurate" because they are designed for pets. But we "work that into" our thinking here. Generally, the vet meter will read 30 or so points higher than a human meter. And the lower the BG reading, the less variance there seems to be between human and pet meters. Probably 95% of us or more use human meters. They are accurate enough for what we use them for, which is to safely treat the diabetes, and to monitor in case the BG drops to low for comfort (less than 50 on a human meter, or 80 on a pet meter like an Alpha Track). The big benefit to human meters is that they cost a lot less, especially the test strips, and you can get strips quickly if you run low or run out of them. With pet meters, you can only get more test strips from the vet, and on a Friday night when you find you only have a couple of strips, that matters a great deal. There are many good meters, and some that don't seem to be all that great. Walmart sells the Relion brand, and a lot of us (me included) use the Micro, the Confirm, or the Prime, all sold by Walmart.

Just curious, but what sort of numbers did the curve contain?

Welcome to the board, and lots of other folks will chime in soon, or by morning at least!

edit to add - when I said we work the meter difference into our thinking...one way is the range of numbers that we consider to be "normal BG for a cat".
On a pet meter, we'd say 80-150, while on a human meter, we usually say 50-120 is "normal".
That's what you would see in a cat that doesn't have diabetes, or is in remission.

The other thing to consider is where you are getting the numbers from. If you are at the vet, it's likely that your kitty is stressed out, and stress can raise BG significantly. Most of us find that if we test them at home, where they feel safe and are in familiar surroundings and with familiar people. we see lower numbers than the vet would see at the clinic. If a cat is in a place with strange smells and sounds, and has strangers handling him, he's likely to feel pretty stressed.
 
Honestly it really depends on the insulin your vet has chosen to use for Leo some are more forgiving than others. The human depot insulins like Lantus and Levemir are a little less forgiving just by the nature of how they work and do best when they are dosed on a 12/12 schedule with a window of about 30 minutes either way. I believe as I have never use it but Prozinc is probably the most forgiving for late or early shots.

You do want to try to avoid things like NPH/Humulin N or Caninsulin as they work well in humans and dogs but are rather harsh and don't last a full 12 hours in cats because of the fast metabolizm rate of cats. They hit hard at onset and drop the BGs very quickly but wear off equally quickly. They just don't have a very duration in cats.

Mel, Maxwell, Autumn & The Fur Gang
 
Think of human vs pet-specific meters like reading a thermometer in Celsius vs Fahrenheit.

The numbers are just spread out differently and you need to know which system you are reading. Both are valid ways of measuring.

The FDA stipulates that glucometers sold in the US must read within 20% of
what a lab value would be. Here is a 2 page spreadsheet and graph to show you what that looks like. The page tabs are at the bottom of the display.
 
My vet seemed to be against human meters and said they are very unreliable and thus recommended the one for cats. From what I have read here it indicates the opposite. What are your recommendations for discussing the discrepancy with the doctor without making him feel defensive or that I am one of those people " who believes everything I read on the internet?"
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Human meters are unreliable? Unreliable in what way? I do not believe the millions of human diabetics using them or the thousands of diabetic cat owners would agree with your vet. I would say the vet specific and human glucometers are simply different.

Until Abbott Laboratories came out with the Alphatrak and now the Alpahtrak 2, I don't believe there were any pet specific meters.

The various human glucometers are used by a majority of the members on this board. I used an Alphatrak 2 at first because that is what the shelter gave me to use with my foster kitty. The shelter was telling me to hoard the test strips because of the cost and I was not comfortable doing that. Needed more data at a lower cost for my piece of mind. I soon bought a Relion Confirm and test strips so I could do more testing. I even did parallel testing on the exact same blood drop for a long period.

I eventually switched entirely to the Relion Confirm but it was a tough sell to the shelter to pay for the test strips, even though they were 1/3 the price of the Alphatrak test strips. It simply made no sense to me to pay that higher cost for the test strips when there were other options available. The Alphatrak meter is also very expensive, over $100.

I would simply explain to the vet that your budget does not extend to paying the higher cost for the Alphatrak meter and those expensive test strips so you have decided to use a human glucometer.

I see that other people have given you some information on your other question.

Please, don't let us overwhelm you with information. If we giving you too much information to digest at once, please feel free to tell us to back off a little. This new sugardance with your kitty is overwhelming at first and we don't want to stress you out anymore than you already are.

Keep asking questions and we will try to pass along good information.
 
Hi everyone,

Thanks for getting back to me so quickly! I gave my first injection today. I think I did it right, but it is difficult to stick the syringe in and pull the plunger back ( to make sure you don't get blood) and then inject. Is it necessary to pull the plunger back to make sure there is no blood? Leo is on Novolin. The vet said keep it in the fridge, but he pharmacist said not necessary. The vet said the bottle should last me two months because he is on two units every twelve hours, but the pharmacist said the insulin doesn't last more than a month due to contamination. The contradictions are fustrating to say the least. I did ask the vet about longer acting insulin and he said he could check into it. What are your thoughts? My job sometimes requires me to be away sixteen hours at a time and I do not have a set schedule, but for now I am taking it one day at a time as close to twelve hours apart as I can get. I appreciate all of the information, guidance and time you have taken to respond.

Rachel and Leo
 
Oh I forgot to add that his sugar level was 550 at diagnosis and after the curve was done ( he stayed all day at the vet) he was down to about 230. Thanks.
 
Hi Rachel,

You asked
Is it necessary to pull the plunger back to make sure there is no blood
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No, I never did this. It's probably more important to make sure you did not push the needle all the way through your tent of skin and end up squirting the insulin into the fur instead ofsubq. This miss is known as a fur shot.

Novolin N is a very quick acting, harsh insulin for a cat. It drops the BG (blood glucose) very quickly, in about one hour and a steep drop. A 100 to 200 point drop in an hour or so is not uncommon. The duration of Novolin N (same thing as Humulin) one of the NPH insulins, is usually only 5-6 hours in most cats. Every cat is different and this insulin may have a longer duration in your cat. The only way to know is to home test your cat.

I would strongly advise you to home test the BG before every shot. That is because of the steep and rapid drop with this insulin. If your cat is below 200 on the pre-shot BG test, we recommend that you do not shoot.

With this insulin, the order of steps is different than the longer lasting insulins. You need to test, feed, wait at least 30 minutes to 45 minutes and then shoot this insulin. Sufficient food on board, at least one ounce to 2 ounces, is very important when using this insulin.

This insulin is an in and out type. In other words, it acts quickly and then is gone and your cat is back in high numbers. Because of this quick action and short duration, it is important that you do not feed your cat after the insulin has been used up, has stopped working. Food will simply spike the BG numbers even higher. T.I.D. dosing is often used with this insulin but it does not sound like that is an option with your work schedule.

All insulins will last longer if stored in the refrigerator as opposed to storage at room temperature. Store it in a little used spot, not in the door where it will be shaken frequently. Protect it by keeping it in the original carton, inside a coffee mug or something similar and maybe paper towels stuffed between the sides of the box and the inside of the mug.

Contamination can come from two sources.
1. Bacteria introduced through the rubber stopper with repeated punctures with the syringe. It is not recommended to swab the stopper with alcohol because the alcohol can detiorate the rubber.
2. From the sulicone lubricant coating the inside of the syringe.To cut down on the lubricant contamination, it is recommended that you slowly draw the insulin out, a little bit more than your dose, withdraw the needle syringe from the insulin vial and then tap to remove any bubbles and slowly twist the plunger up until you only have your dosage amount in the syringe. Squirt the excess insulin into the sink or a tissue.

There are 3 insulins with longer duration and a better chance of remission with your cat. These are lantus, levimir and Prozinc (also called PZI). They are more expensive than the Novolin but we have other ways to save money in treating this disease. I have bookmarked plenty of sites with some of this information on these longer lasting insulins, mainly lantus and levimir. Please ask and I will include them in a post to you.

Would you please put some more information in your user control panel, profile, edit signature? There is some information you can put in that free form text box. Whatever you put in there will show up at the bottom of each of your posts. You can see an example at the end of my post to you.

Some items that other members put in there are their name and their cats name, date of diagnosis, any other health issues, glucometer brand used, insulin type used, special diet restrictions due to other health issues. Be sure to note that you are using the Novolin. There are not many people on this board that use that anymore or have much experience in using it.

Think of this information in your user control panel as a quick and ready to hand method for those advising you to get some very basic information about your cat.

Another item I like to see is a location added to your profile. It can be as basic as the country you live in, maybe the state/province if you are willing to share that. We have members in the US, Canada, UK, Australia and other places. There may be someone close to you that can help you with this sugardance.

his sugar level was 550 at diagnosis and after the curve was done ( he stayed all day at the vet) he was down to about 230
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Was this ending level at the vets after receiving insulin? How many data points did the vet do and if you could get those numbers and times the tests were taken they would be helpful.

Many cats experience what is often called "vet stress" or elevated BG numbers while at the vet. Numbers can be elevated 100-180 points in less than 5 minutes and last for 90 minutes or more. That is one reason we like to see people home testing because cats are usually calmer in their home environment.

Sorry this is so long but there was a lot to say. Let us know how else we can help you in learning this sugardance with your cat Leo.
 
Hello there

What size of syringes are you using? Short or 1/2inch? Even with the regular 1/2inch if you go in at a 45degree angle and tent the skin it's unlikely you will hit a vein so you shouldn't need to aspirate. I don't think many of us here do. I use the short needles and never have in the years I have been treating both my diabetic cats.


What kind of food are you feeding?
Wendy
 
You guys are amazing! I'm not purposely trying to leave out information. Your questions are great so keep them coming. I didn't realize there was a profile. I just filled it out so that should help, although I wasn't sure what else to include. please let me know if you would like to see anything else added to it.

I didn't even know what a curve was until after I found this board. My head was spinning so I don't even know what the numbers were. Now that I understand this concept I fully intend to get a copy when I take Leo back tho the vet on two weeks. I don't have a meter yet as that was not even a suggestion by my vet. I read some of the information here and brought it up to the vet and that is when he told me the human meters were not accurate. I WILL get a meter in the upcoming weeks because I am sure lots of adjustments have to be made and my hope is that someday Leo won't need insulin once on the proper diet and with a bit of weight loss ( he is 16.5lbs).

On to the next question of what I am feeding him. First of all, I have four other cats ( three litter mates 3 yr one girl and two boots and a 16 yr female). My cats have always been dry food grazers. I am now beginning to realize this is not the best for their health. Secondly, as I stated previously, my schedule is crazy and I have no one to help. this is why I came here for advice. Some days I leave the house at 7 am and don't return home until midnight this the reason I feed them dry food. Other days I can be gone for a norma ten tol twelve hours ( those shifts could be first or second shift). They have been eating everything from the Hills W/D that the vet pushed on me for years to Science diet to friskies. now I am realizing the damage that has caused and hope to eventually do better in that end. Right now I am focused on just getting Leo on a regular schedule of insulin injections and becoming comfortable with that.

My very recommended the following schedule for the next two weeks: I pick up all the dry food at night, at 6am I put the food down and he eats, I give him the two units of Novolin, I leave the dry food down ( the vet said it was fine for him Yahoo graze for a while as long as he was hungry when the next injection needed to be given), I pick up the dry food by noon, I have someone come at 5pm to put the food back down to make sure he eats, give him the next insulin injection, leave the food down until I get home at midnight and pick it up again and repeat the next day.

I know this is not optimal and that is why I am here. I hope that you all have patience with me and I can see already that everyone here is knowledgeable and CARES. I take Leo back to the vet in two weeks for them to test his BG and adjust insulinif needed. I plan on bringing up many of the points that are being discussed here like the kind of insulin and meter.

I know low carb wet food is the way to go, but do you think that the Purina DM dry food is a step in the right direction?
 
Hello rkkruk,

You do not need to aspirate when giving the needle. I know others have answered your question, but I'll answer as to why from a paramedic's standpoint.

The subcutaneous needle is short. Lifting the skin on your cat almost virtually guarantees you will not hit any veins. Aspiration is generally regarded as more necessary with a intramuscular needle. Though it sounds simple, aspirate and see blood, you've hit a vein. Right? Actually most of the time when that happens, it's not a vein you hit (provided you aren't aiming at a highly vascular area - but where you're injecting the insulin into a cat is mostly fat ), rather it probably accidentally went into the muscle. IM injections will absorb faster, so that may throw your control off. That's more an issue with people though. As long as you have a good skin flap, 45 degrees injection, you will not have problems.

I must say that while I do not aspirate on my cat, I do on my human patients. Most commonly I give epinephrine subcutaneously, absolutely dangerous if it accidentally goes IV, so I do not risk the chance, even though I know it likely accidentally went IM. We don't give insulin, but rather IV fluids or dextrose for our diabetic patients.

Numerous studies have shown that aspiration is not a good indicator of whether your needle is in the right place or not. Here is the quick abstract of one of them. (http://www.ncbi.nlm.nih.gov/pubmed/7621730).

Hope this helps. You can PM me if you'd like more references or the such. I'll have to go dig them up.
 
This is more great information, thanks guys. I was feeling rather barbaric trying to do that (aspirating), and had mostly given up the practice already. Woo, one more guilt to check off the list ;-)
 
Canned food may be left out all day; I do it for my 14 cats. Some actually prefer it when it is more dried out.

Freeze part of it to thaw during the day and/or put it in a chilled container to keep it fresher. Also, keep it away from the refrigerator exhaust as that dries it out and wafts the odor throughout the room.
 
Thanks! I was feeling SO clumsy trying to pull the plunger back plug while holding the skin with the other hand. Leo has lent of skin on the back of his neck and the syringes seem small/ short enough (ReliOn 29 gauge/12.7mm). Is that a good size?
 
rkkruk said:
Thanks! I was feeling SO clumsy trying to pull the plunger back plug while holding the skin with the other hand. Leo has lent of skin on the back of his neck and the syringes seem small/ short enough (ReliOn 29 gauge/12.7mm). Is that a good size?
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Yes that syringe you're using is perfectly fine. the 1/2 inch or 12.7mm is commonly used. The important thing is that the skin flap virtually guarantees against accidental intramuscular and intravenous injection in a cat alongside a 45 degree angle of insertion.

I'm using a slightly larger gauge at 28g, 1/2inch. My April doesn't feel a thing. Not having to aspirate means the needle is pretty much just in and out and you're done!
 
Hey Rachel,

Thank you so much for adding those bits of information to your user control panel profile. Lots of new people don't know about those things and it is one thing I like to see happen with new members. Gives us a little bit of info to work with.

I have some more 'homework' for you to do if you are willing.

The next thing I would like to ask you do is to set up a spreadsheet. This is where you track the number of units of insulin you are giving, any BG test numbers you get, notes over in the remarks column of what you are feeding, the fact that you are not testing yet, things like that. It's optional but gets you great suggestions.

I realize that you do not have a meter yet, but you are giving insulin, so it would be good to have that SS (spreadsheet) started when you have a chance. We will know not to expect any test numbers quite yet. :smile:

Here is the link to the post in the Tech Support forum that talks about setting up a spreadsheet and putting the link in your signature within the user control panel. http://felinediabetes.com/FDMB/viewtopic.php?f=6&t=18207

Then there is this document to create a mini history for your cat. You can put a lot more information here then in the user control panel, profile, signature so we suggest doing this for new members also. Just more information about your cat to help us help you better.
http://felinediabetes.com/FDMB/viewtopic.php?f=6&t=79123

I know low carb wet food is the way to go, but do you think that the Purina DM dry food is a step in the right direction?
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Yes the Purina DM is a step in the right direction and is lower in carbs than the Hill's m/d dry. If I remember correctly, the DM has something like 4-6% carbs and the m/d has something like 14-16% carbs. We like cats to be <10% carbs.

We recommend the canned low carb for additional reasons such as more water content. Cats have a difficult time drinking enough water to compensate for the low water content of a dry food. With the high BG numbers, the excess glucose spills into the urine creating a richer environment for bacterial growth. That contributes to the higher incidence of UTI's in daibetic cats.

It took me 3 weeks to transition my dry food addict Wink from dry to wet, pulling out every trick in the book. This book.http://www.catinfo.org/docs/TipsForTransitioning1-14-11.pdf I had to switch all my other cats to a canned food diet also. They were a piece of cake switching compared to Wink. Don't stress over doing the switch for now. If it happens quickly, it happens quickly.

I WOULD RECOMMEND YOU BE HOME TESTING BEFORE YOU SWITCH TO A LOWER CARB FOOD, EVEN THE DRY. Yes, I'm shouting but cats BG's can drop over 100 points when switched to a low carb food. If the cat is already on insulin, expecially a fast acting one like the Novolin N, you need to be careful of hypoglycemia, too low blood glucose, and be prepared to treat it.

What food are you feeding now?
 
Hi everyone,

Today I had to rush Leo back to the vet. When I first took him in last week, when he was diagnosed with diabetes, he also had a UTI and was placed on on antibiotics. This morning I noticed in the span of two hours he was in and out of the litter box every other minute. He would squat and nothing would come out. He seemed a bit listless and then would look for a spot on the bedroom floor to go. He moved to like 20 different spots. The vet said he could have a blockage and to bring him in. After an xray and a culture they sent me home with a different antibiotic. It will be about a week for the culture to come back. Leo has never acted that way and with him just being placed on insulin yesterday I was worried it was something serious. I am exhausted to say the least, but I am hoping that the other behavior I am noticing is a good sign. He has been up and moving around and actually being a bit playful. I have not seen him like that in a long time. He never used to get off the bed except to eat, drink or pee. What are your thoughts on the UTI and his behavior?

Thanks again!
 
Thoughts? These:
1) A UTI or other infection can raise glucose.
2) The wrong antibiotic is worthless.
3) A culture & sensitivity always should be done to ID what type of bacteria & what will kill it.
4) Providing the correct amount of insulin to a cat that needs it should return the cat to its customary behaviors.
 
That's good that you caught the UTI, once you have treated it it may cause his blood glucose to drop... Might be an idea to go get that blood glucose meter now since you might well see a drop in sugar over the next few days.
 
Hi Rachel and Leo,

How are you two doing? Any clarifications that you need on what we have said so far?

Are you doing all your homework for this graduate level crash course in managing feliine diabetes? :o :lol: :o It is a ton of new information to learn to help your cat but you will feel so much more confident and your cat Leo will feel better and better every day.

Be sure to take some breaks for yourself and treat yourself. A piece of chocolate, a glass of wine, a few slow deep breaths, whatever you need to do to help you relax for a bit in this very stressful time of caring for your well loved family member Leo.

{{{{hugs}}}}
 
I'm so glad to see you (Rachel & Leo) here, because you ask a lot of the questions I have. I'm new too and all this information is a lot to take in. I am a worrier and want to do everything right, but sometimes my kitty, Rocky, just doesn't cooperate...like with his eating habits.
Rocky also had a UTI when first diagnosed. I took him back for a shot (expensive $50) and was told this should do the trick. He seems fine and is no longer peeing on the floor.
I am still working on getting a good meter, since we've been using one my mother had before she passed away and now I find I can't get new strips for it. My husband actually is the one doing the testing. I haven't had the courage yet, but am working on it.
My question....is how do you put information in the control panel for each post?
 
pteacher said:
My question....is how do you put information in the control panel for each post?
Click to expand...

If you look up near the top of the page (not far under the FDMB logo) you'll see the link showing which forum you're browsing... then right underneath of that is a link to the control panel. Click into there, then click the 'profile' tab...... in that tab, you can choose 'edit profile' and then again, choose 'edit signature' ... Anything you put in your signature box, shows up at the end of all your posts.
 
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