My cat and his blood glucose

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Okay I didn't realize the whole message board would be updated so taking some time to get used to the new version. With that said, hopefully those that I talked to yesterday comment on my posts for today in relation to my boy. So this morning I fed my boy Fancy Feast around 8am and waited an hour to check his glucose. It was 168. So should I give him any insulin? I know Sue and a couple others said no shot if below 200. It made me think back to the main VET that I talked to at the animal clinic I go to and she said let Science lead the way in regards to when I asked her how often I should check his glucose. However, she like the other VET said only go off insulin if he consistently stays around 100 or slightly below but ones on here say 200. This is a very frustrating period for me because its like most of you on here probably and obviously know more about diabetes in cats then I do but wouldn't you expect a VET to know what he or she is talking about on how much to give and how often to give it and what number my boy needs to be at before he can be off his insulin? Remember, I am using Novalin N and not the other cat insulin products so like what Sue said, it probably spikes 3-6 hours once injected and then the remaining 6 hours its not as effective. The 168 reading this morning was approximately 12 hours since his last injection and I'm sure he didn't eat hardly any food through the night either.
 
We generally advise not to shoot under 200...especially if you don't have much data. Without the data to see how your cat will do, it could cause problems. I don't really have any experience or knowledge of novalin, but since it does spike pretty harshly, I would be really cautious about shooting at that low of a number.

Remember that vets are general practitioners for all animals. I'm not saying it isn't frustrating (it is!) but they have to know a LOT about a LOT of different animals. It's probably hard for them to keep up with one disease for one animal. Also....we live and breathe FD here. We've all treated our feline diabetics daily, so we just know more.
 
Please provide more data. I think you were giving 2 units of N.
Based on what I think was your other post I would say give 1/2 unit. Making a spreadsheet with your BG valves would be very nice so we would know your history.
 
Sorry Larry! Yes I am giving my boy 2 units of Novalin N 2 times a day. Now yesterday I took his glucose at 830am during the time I would give him his insulin shot and it was 129. Since I didn't know, I gave him his insulin shot. I don't think Novalin N works as strong as the cat insulin products but was told that it spikes during the 3-6 hour range and so I took his glucose at 1130am and it was 95. Then I took his glucose again that night at 8pm and it was 204. So I gave him an insulin shot after that but didn't check it after that since I went to bed. I figure it didn't stoop lower than 95 but probably somewhere around 140 or so. Then today this morning I took his glucose and it was 168 which would be around 12 hours since I last gave him a shot. So this time I didn't give him any insulin and so I'll probably check his glucose here shortly and see where it is and then report it to you guys. I just don't want to throw his body out of sync since he has been receiving insulin but not sure what to do without worrying about hurting his health.
 
When you give BGs it is best to give then as
AM PS. AM preshot BG
PM PS. PM preshot BG
Ten yo list mid shot BG as +x then then BG when X is the number of hours after the shot.
That lists makes it easier for others to see what is happening.
 
You guys are going to have to help me with the terminology here. lol. What is PS, preshot BG? Ten yo list mid shot BG as +x? Tell me this in laymen terms because I'm not scientific here on what to do although I am good with Science. lol I didn't realize that the human glucose meter I got from Krogers saves each time I take his BG so I have data back from 11-01-14. Bare in mind that most of these shots that I have done that are around 140 are 6 hours after I gave him his insulin shot. The 1st of November is when he first started on insulin and was diagnosed with diabetes even at 281 which compared to what others have endured with their cats to me doesn't seem diabetic. Also, keep in mind that I didn't take his glucose every day because at the time I was just doing it once a week for the doctor since at the time the doctor said to follow science and that I just needed to take his BG once a week on the weekend.
11-01 215@ 9:45am
11-09 159@ 4:18pm
11-15 96@ 4:51pm
11-16 169@ 5:12pm
11-16 144@ 10:00pm
11-17 140@ 9:53am
11-17 113@ 4:26pm
11-18 205@ 9:59am
11-23 107@ 4:34pm
12-02 139@ 5:21pm
12-07 133@ 5:02pm
12-14 134@ 5:35pm
12-21 141@ 4:51pm
12-23 129@ 9:55am
12-23 95@ 1:42pm
12-23 204@ 9:59pm
12-24 168@ 10:23am
12-24 206@ 5:02pm
 
Let me see if I can put this in English for the lay person.

AMPS: morning preshot test number
+1, +2, +3 etc is the number of hours after the shot was given

So if I was going to write out my Autumn's numbers for today it would look like this:

12/24 Autumn
amps -168
+3-160
+6-69
+8-80
+10-109
pmps-?

we use the +(number) to denote how long since injection because we have members all over the world.

Does that help and make more sense in what Larry is asking you for as far as more information?

Mel and The Fur Gang
 
Yea that clears it up. I just hate having to poke his ears all the time to the point that they are probably really sore hence why he moves when I try to poke his ears. Not to mention taking his BG atleast 4 or 5 times a day. My boy would get severely tired of that and I wouldn't blame him.
 
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Pick up some Neosporin with pain relief (or generic).
Apply a small dab to the ear being tested a minute or two before testing.
Wipe off well.
Test.
Apply direct pressure to the hole to reduce bruising and scabbing.
 
Thanks BJM! Unfortunately I had to give my boy a shot of insulin because I checked his BG at 9pm and it was 287. I am very disappointed because I thought I could not give him any insulin today since he readings today were hovering around 200 but for some reason it kept going up as the day progressed and this is after him eating Fancy Feast too. I thought given the food is low in carbs that it wouldn't spike his glucose too much. Would be nice if I could see him become insulin free one day. :)
 
So you considering it normal for a cat not being on insulin to go up through the day and not go down?
 
I know I got to give him insulin if he is near 300. I don't want to but I also don't want to go through the night and worry his BG rockets above 300.
 
Actually you would be surprised when it comes to testing. Miss Autumn (my Avatar) is a lifer when it comes to being on insulin, she and I have been testing at least 4 times a day some days as many as 10 to 12 times for over 2 years now. She not only doesn't mind, she actually comes looking for me if I'm late for a test.

Mel and The Fur Gang
 
For a diabetic animal, the glucose will increase throughout the day because there is insufficient insulin to get the glucose into the cells to work. Also, the cat is able to break down protein and fat to create glucose. Ketones are a by-product of fat breakdown; too many ketones may indicate diabetic ketoacidosis (DKA), a potentially fatal complication of diabetes.
 
Well I don't see myself testing my boy 10-12 time a day. His ears would be very sore even if I used neosporin on them. I know I had to give him a dosage of insulin tonight because I wasn't happy with seeing it at 281 and that was going all day without a single dose of insulin. I just didn't want to worry going to bed tonight and it creeping higher. With that said, I don't see his number dropping to dangerous levels by being at 281 on Novalin N since its the cheapest and human grade insulin so therefore I wouldn't expect it to drop below 100 within the 3-6 hour time frame. Wait to see what it is in the morning when I test him again.
 
Typically, we always pre-shot test, and get nadir tests as much as possible. That is about 4 tests per day.
When there are low numbers, you may do some extra tests as you intervene to increase the glucose to a safe level.
 
Merry Christmas to all! I checked my boy's glucose around 915am this morning and it was 123. This was preshot and therefore I did not inject any insulin in him. He also ate wet food and some dry food prior to having his BG checked. It was about 12 hours since he had his last insulin shot so I'm sure his body went 6+ hours without insulin so pretty happy to see it at that level. I will check again later to see what it is.
 
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Yes BJM, I have completed all of that except for Dx part. But I have shared my diabetic info with you guys.
 
You want to get two shootable preshots a day, so you don't have to skip shots. It would probably be a good idea to reduce your dose so that is possible. If your preshot is in the 160s, I wouldn't shoot that low, especially with N which can drop pretty fast.

If you reduce the dose and get some tests in that 4-7 period, you'll be able to see how that dose works.
 
Okay so I didn't give my boy any insulin this morning because when I got around to it and took his BG, it was 123 preshot at 11am. 4pm +5 it was 213 and at 10pm +6 it ws 218. I decided to give him 1.5 units of insulin to get his number down to the 130 or so range. I will see what it is come morning again. I just hate that I usually get a good number in the morning and don't know if its due to him not eating much through the night or what but as the day goes on his number keeps going up when I hope it would have stayed below 140 so that I could be lucky and not have to inject him any insulin.
 
So if this was answered before then forgive me for forgetting but why exactly would I not give my boy any insulin if his glucose is below 200 again? This morning I tested it at 9am and it was 186. I fed him wet food around 8am so it was roughly an hour after he ate. I know Novalin N drops the number early but I can't imagine it dropping it to dangerous levels from 186 especially when he was 129 one time and I still gave him his insulin and it dropped it to 95 +4 after the initial shot. I know most of you have dealt with diabetic kitties for quite some time but the thing that doesn't make any sense to me is if most of you here say if its 200 or under do not give any insulin. However, why doesn't someone who actually went to college and is a VET say that but still says to shoot him insulin even if his number is 130?
 
rbrumbaugh82 said:
So if this was answered before then forgive me for forgetting but why exactly would I not give my boy any insulin if his glucose is below 200 again? This morning I tested it at 9am and it was 186. I fed him wet food around 8am so it was roughly an hour after he ate. I know Novalin N drops the number early but I can't imagine it dropping it to dangerous levels from 186 especially when he was 129 one time and I still gave him his insulin and it dropped it to 95 +4 after the initial shot. I know most of you have dealt with diabetic kitties for quite some time but the thing that doesn't make any sense to me is if most of you here say if its 200 or under do not give any insulin. However, why doesn't someone who actually went to college and is a VET say that but still says to shoot him insulin even if his number is 130?
Click to expand...

We generally say not to shoot under 200'at first because you have little data to predict how a given dose might affect his numbers. We are first trying to do no harm with our advice. 186 is certainly up in the area of 200 and it is possible that a shot will not be a problem with that number. BUT I would reduce the dose. N seldom lasts 12 hours and since he is still in these numbers 12 hours later, my first concern is what his numbers were 6 hours ago. Did he drop super low?

If I were you, I would get some numbers and put them into the google spreadsheet we use. Then you (and we) can see what is going on. Does he drop early or is he low somewhere else in the cycle or is this dose keeping him in good numbers the whole time? Then we can tell you what things look like to us, and you can make a good decision on what to do.

We are being cautious because the cats we have seen on N generally have short cycles and fast drops early. We can't tell what pattern he has on the insulin without some more numbers.

I don't know why your vet said to shoot at 130. I would not advise anyone to do that on the insulin you are using. We consider 120 a remission number - a good number for a cat OFF insulin.

All we can do is to give you ideas, based on what we have seen and experienced. And our primary goal is to not tell you to do anything that might put your kitty in danger.
 
I appreciate your kind words Sue and wanting to help my precious boy live a healthy and happy life and ultimately go off insulin. I believe you are right with N. I believe his insulin drops quick within the 3-5 hour time frame. I say that because the other day when I took it when it was at 129 about 4 hours later it was 95 but then after the 6 hour mark it went back up. The glucometer that I have saves all the data on it from when I take his BG.
 
rbrumbaugh82 said:
I appreciate your kind words Sue and wanting to help my precious boy live a healthy and happy life and ultimately go off insulin. I believe you are right with N. I believe his insulin drops quick within the 3-5 hour time frame. I say that because the other day when I took it when it was at 129 about 4 hours later it was 95 but then after the 6 hour mark it went back up. The glucometer that I have saves all the data on it from when I take his BG.
Click to expand...

The one thing I don't understand is why he is at 186 12 hours after the shot. Does he stay in the 100s for most of the cycle? When is his lowest point? That info would be veryhelpful
 
You might want to do a curve, testing from pre-shot to pre-shot, every 2 hours. This will show you the response period to your current dose.
If you have data showing that at a given starting glucose range a given dose is safe, you can begin working out a sliding scale and may cautiously reduce your no shot limit to 150 based on your test data showing it will be safe.
Also, food changes should have improved the glucose levels by as much as 100 mg/dL and home tests read from 100 to 180 mg/dL lower than in a vet's office.
 
Hi Sue. Yeah last night for example I tested his glucose around 10pm and it was 218. So I gave him 2 units but didn't check his glucose afterwards since I went to bed after that. When I woke up this morning and tested his glucose again around 9am which is 11 hours but still close to 12 it was 186. I would make a safe bet that almost every morning when I am about to give him his insulin but instead I take his glucose it usually reads in the 100s. The past few days I've been just giving him 2 units once a day instead of the 2 units twice a day because of you guys saying if its under 200 then don't give him any insulin.
 
Hi BJM, I did the glucose check the other day after 3 hours because Sue mentioned to check it because Novalin lowers the glucose between the 3-6 hour range and when I did check my boy's glucose during that time frame it was 95. The initial reading was 129. So 129 and +4 it was 95. I guess at that time I should have checked it 2 hours later to see if it decreased more or stayed at 95.
 
If you are consistently getting a low am preshot, I would lower the dose. It's best to get two shootable preshots a day so he doesn't get on a roller coaster moving from lows to highs. How about giving 1.5 for a few days and see if you get two preshots high enough to shoot? Yes, I'd try to get a number 4-6 hours after the shot to see when he does go lowest. Once you establish the low point, then you can see how the dose is working and you'll have a better handle on how long the insulin is lasting.

He does seem to have a longer cycle than most cats get on N. if that is the case, you can use that to your advantage to keep him in good numbers the majority of the time and give his pancreas a chance to heal.
 
Okay so you think I should do 2 injections per day so he doesn't go up and down so much. Well I gave him a 1.5 unit shot last night around 9pm because his glucose was 203. +2 hours after the shot it was 154. I went to bed after that and woke up this morning and fed him cat food and waiting an hour before I tested it. So give or take it was 12 hours later and his glucose was 108. So of course I did not give him any insulin because I believe 108 is excellent. I just can't figure out his body. I give him insulin the night before at 2 units and yet I wake up in the morning and his glucose is usually like 130-140. I give him a bit less insulin last night and wake up with a much better reading. So with that said, he is sleeping now which he does most of the day so when do you think I should test his BG again?
 
I know this is a frustrating process, but it is really good news. If 1.5 gave you 12 hours of coverage and a low amps, it looks like he could use a new lower dose. (This is why we like starting at one unit and slowing increasing based on your testing results, rather than starting higher and trying to guess how much to decrease.)

So you skipped this morning. You could wait until his number is closer to 200 and shoot then, but it throws your schedule all off. If you wait until tonight, he is likely to be in the higher ranges (because of the skipped shot) but I think I'd probably wait until then, try one unit and see what happens. What are you thinking?
 
Well I am thinking that I wish he could stay in the 100s all day and night. I mean since I have been on here lately and following you and others I have been just giving 1 shot a day compared to the 2 shots that I was doing. Its because I am checking his sugar more now and since you guys say not to give him any insulin if he is under 200 and seeing that he usually is staying below 200 that has shortened his dosages up now. Usually he doesn't get to 200 or slightly above until evening. He just doesn't eat all that much through the day because he is sleeping. I just can't see how N can drop his glucose from 200s to the lower 100s with just 1.5 units. I'm glad that I checked his glucose this morning instead of just assuming to give him his shot because that 108 with a 1.5 unit shot could have dropped his glucose to like 50 or so. So thank you guys for allowing me to check his glucose more and being better educated with that. I would have just done what my VET suggests and that is just giving him an AM shot and then a PM shot like what I was doing before coming on here.
 
I can wait until this evening and then test his glucose and see and hope that its not around 200 but still like around 160 or so. If it is above 200 then I'll try 1 unit and then how long after that should I wait until I test his sugar to see how far it has dropped?
 
If you give a shot tonight, you might test 4 or 6 hours after the shot to see how much he has dropped. And if he is still not plunging, then try again at 8-10 hours. You checked 2 hours after shooting and he hadn't dropped a lot, so I'd skip that time period. My answer is not definitive because we know less about how N works than the insulins used more often here. The nadir for them is usually 5-7 hours after the shot. His reaction to N is different than I have seen. (which is encouraging)
 
Hi Sue! I checked his BG at 4:11 today and it was 137! His initial glucose testing was 10:50am this morning and it was 108. So + 5.5 hours later it only went up 29 points.
 
Looking good. Maybe you'll be able to get him off insulin!
Normal glucose levels are from 40-130 mg/dL off insulin.
While on insulin, we want them to stay safely above 50 mg/dL.
So he's creeping up on it.
 
So can insulin help to heal the pancreas to the point that if it heals enough that a person or cat will no longer need to take insulin because the body can regulate insulin now? I am hoping for a positive because before I came on here I wasn't checking his BG as often and I was just following the Vets order in giving him a shot in the AM and then 12 hours later in the PM. Then when I would do the weekly weekend check it would be around 140 or so. But now since joining this site and taking your advice somehow my boy's BG is staying in the 100s throughout the day and I know he don't eat all day long but his glucose for the most part is staying below 200. Of course there has been a few times it was above 200 at night. Still I am just giving him 1 insulin shot a day now compared to 2. I am just praying when i take his glucose in another hour or 2 it will be near where it was earlier and not 200 because if its below 200 for the whole day this will be the first time since October that I will not have to give him any insulin for a day.!
 
Yes, giving insulin may allow the pancreas to heal and get the diabetic to a diet-controlled state.
You're not quite there yet, but possibly moving towards it.
You might try decreasing to 1.75 units and see if that gives you 2 shootable numbers each day.
Remember to feed 30 min before you shoot and that you want him to stay above 50 mg/dL at nadir.
 
I wish I was there. It stinks because I just don't understand how glucose can jump so much. I tested it earlier like I said and it was 137 at 4pm. Now 5 hours later it jumps to 230. How is that? SO I guess his pancreas still needs work because for some reason at night his glucose goes above 200 but stays in the 100s all day. Don't know why that happens.
 
N insulin tends to produce steep curves up and down.
It may be that during the day, he is a bit more active and physical activity can improve insulin sensitivity, allowing more glucose to be brought into the cells for use.
 
It is an imprecise process . It seems like the pancreas " wakes up" and helps out for awhile, keeping the levels lower even without insulin. Then it "gets tired" and stops helping out. So your job is to give insulin when he needs it and watch his levels so you know when he needs it.
 
Hi Ryan,

Hank was on Novolin N for 3 months before I made the switch to Prozinc insulin.

I know what you mean, it was frustrating to me that after 5 hours his BG would be over 200 and sometimes 300. Take a look at Hanks SS anything before 10/25/14, Hank was using the Novolin. I started giving Prozinc insulin to Hank on 10/25/14. It didn't happen overnight but gradually his numbers got lower. BUT the big plus was the insulin wasn't wearing off before 5-6 hours after his shot like the Novolin.

I bought the Prozinc and syringes from the vet's office; $88 for Prozinc and $29 for the syringes. The Prozinc will last for 6 months in the refrigerator, so it works out to about $13/month. Not bad.

I'm very glad that I made the switch.

Hang in there, you're getting the hang of this.

Kimmie
 
Thanks everyone! His glucose this morning was 191 so I didn't give him any insulin. It is a bit higher in the morning compared to other mornings with him. I know one thing I hate is poking his ear so much. I think his ears are very sensitive now because of poking them and so I have no idea where else to get blood from him. The Novalin is a tricky insulin to say the least. I know its a human grade insulin and everyone is on prozinc or the other cat insulin so I know it probably works better. Cost wise, its a little steep for me right now. I was just hoping Novalin could regulate his BG to the point that his pancreas can make its own insulin when it needs it so that it can stay in the healthy range without giving him insulin. I know that for now I am only having to give him 1.5 once a day now thanks to Sue and others. I guess I still don't understand why my VET doesn't give the same advice in that if his glucose is under 200 then don't give any insulin unless they don't say that because they know Novalin won't drop his glucose to dangerous levels but low enough that would be fine for him. I mean I was at 130 one time and the VET still wanted me to give him his insulin. Getting back to 191, I know he ate this morning so it could have been a bit lower prior to him eating. Plus, I know I stressed him out trying to get him to sit still so that I could poke his ear and so I don't know if the stress would of made his glucose to go up too.
 
Hey BJM, my boy is far from active during the day. lol. He sleeps most of the day so I don't know if that could be why his glucose remains in the 100s during the day because he is not active and sleeping.
 
You're getting to be an old hand at this. I do think 191 is close enough to 200 that you might consider shooting a reduced dose, if you can monitor him. You don't want him climbing all day. Maybe one unit?

Have you tried Neosporin with pain relief on his ears? A tiny smear after the poke. That will help them. Also, hold onto his ear for a few seconds after poking to help with bruising.

I haven't explained this well enough if you're thinking I'm advocating one shot every 24 hours. I have been nervous that he was going too low on this dose, if he is still under 200 for the am preshot. I haven't wanted you to shoot at those lower numbers (150-180 and below) I think the best way to deal with his situation is to reduce the dose overall. The ideal set up is two shots a day, keeping him under the renal threshold (270/250 and below) so his pancreas can heal. That might be a dose of one unit, monitoring enough so you see when he goes down and how low he goes.
 
Well, it was a guess, but if doesn't jibe with what you're seeing, then it doesn't fit.
As Sue notes, ideally you want 2 shots per day, 12 ours apart, which control the glucose levels, while keeping him safely above 50 mg/dL.
That may mean backing off the dose as you proceed so the glucose doesn't swing too much and so you can shoot twice a day to keep it as low as possible.
And vets are general practitioners who see maybe a couple diabetics a year ... and many folks euthanize the diabetic animal.
Here, our focus is on diabetics and managing them as optimally as possible, working around any other conditions the cat may have. Each of us brings what we've learned or experienced to the board.
 
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Okay thank you! So I guess I will go and give him 1 unit of insulin then and follow up 4 hours later with a BG check to see what his number is then.
 
Hi Ryan,
Believe me, it hurts us more than our sugar kitty's (pricking the ears). I have been blessed from the get go as far as testing goes. Hank has been very cooperative with home testing.

Have you made a rice sock yet? I still use mine every time I test. Here is how to make one; an old cotton sock ( I had a pair of toddler socks), fill (maybe just toe area) with uncooked rice, NOT minute rice, then tie off with a ponytail rubber band or another type of band so that rice doesn't get out. Then heat in microwave for about 20 seconds. Always test on the inside of your wrist to make sure that it isn't too hot. You will use the rice sock to support the ear by placing on the inside of ear. The warmth will make the blood run better to get a blood spot. I now don't heat the rice sock but use it so I don't get pricked and for support for his ear.

I always rub the ear to get the blood flowing. Hank loves having his ears rubbed. :) I sometimes start singing a little song to him about how it's time to rub the kitty ear. Hank lays down when I put the sock in place and then starts purring when I start rubbing. It's so cute!

When I was first learning how to test, I used the Neosporin + pain relief on his ear that I was testing. It also helps to get a good blood spot. After I get the blood on the strip, I grab a Kleenex (that I have ready) and put on spot and apply pressure to minimize bruising as Sue recommended.

What made the difference for me with testing was rubbing long enough and using a 29 gauge lancet. It helped to get a good blood spot so that I didn't have to re-prick.

Think of it like this, by doing home testing, you are keeping your kitty safe. Safe from going to low and not knowing it. You're doing great! You and your sugar kitty will get a little routine worked out too.

Kimmie
 
Okay here is a question. I just got done taking my boy's glucose since he was sleeping all afternoon and he ate a little bit before I took his glucose I was told by my lady. His glucose tested at 166. This is roughly 12 hours since he got 1 unit of insulin. Should I give him any insulin for the night?
 
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