Need help understanding BG curve!!

Sofina & Chester

Sofina & Chester

Member Since 2020
Hello my name is Sofina and my bestfriend Chester was diagnosed with diabetes a few months ago. It took me a little while to get him insulin as we don’t have much money. Although, I did switch his diet over to raw food immediately. He was 100% raw for a little while until I noticed he was constipated, and now i mixed his raw food with purée pumpkin to help his poops.

The reason I’m posting here today is because I’ve been having a hard time understanding his readings. And I’m actually concerned since his BG has gone up prior to starting Lantus. Before he started insulin therapy his BG stayed in the 300-350 pretty much all day long. The first thing I noticed was that his pre shot BG started to read up in the 370-400 range. Which seems counterintuitive to what I would expect to happen. I’ve considered the Somogyi affect, but idk if it is relevant here since his BG never goes below about 260.... today I did a curve on him and his 2+ =301, 4+269, and 6+ 315... so like I suspected it definitely doesn’t have a full 6 hour half-life in his metabolism. I’m wondering if these numbers mean he needs more insulin? I’m just so worried because he’s never had a BG in the 400s(unless stressed at vet) until we started insulin.

I hope that’s a good amount of information but please asks me more questions and I don’t know all the things you guys look for!! Thank you so much!!! I’ve been feeling like I’m the only one that can help him but I don’t know enough and I’m scared I’m not doing this right. We don’t have a permanent vet because of my financial situation. I was very fortunate to get his insulin for free from a nonprofit clinic. Thankfully it was a large vial and should last for months.
 
Hello and welcome. Good for you on doing some home testing and getting him on better food.

Do you have a spreadsheet of the blood sugar numbers you've collected so far? Without that data, we won't be able to answer your question. Here is the information on the spreadsheet we use here:
FDMB Spreadsheet Instructions:
  • Please set up a Google Spreadsheet as soon as possible. Always keep spreadsheets up-to-date! Valuable time may be lost looking for information when a spreadsheet is not up to the minute.
  • If you have not been able to transition your kitty off of DRY food yet, please note it on your spreadsheet and in your signature. A dry food diet will often require higher doses of insulin to bring numbers down. Having this information plainly visible will help us help you.
Understanding the Spreadsheet/Grid
 
Wendy&Neko said:
Hello and welcome. Good for you on doing some home testing and getting him on better food.

Do you have a spreadsheet of the blood sugar numbers you've collected so far? Without that data, we won't be able to answer your question. Here is the information on the spreadsheet we use here:
FDMB Spreadsheet Instructions:
  • Please set up a Google Spreadsheet as soon as possible. Always keep spreadsheets up-to-date! Valuable time may be lost looking for information when a spreadsheet is not up to the minute.
  • If you have not been able to transition your kitty off of DRY food yet, please note it on your spreadsheet and in your signature. A dry food diet will often require higher doses of insulin to bring numbers down. Having this information plainly visible will help us help you.
Understanding the Spreadsheet/Grid
Click to expand...
I’m having a hard time figuring out how to edit the chart? I’m on my mobile phone right now. Is that something I should be using a laptop to edit?
 
Okay I think I figured it out now that I downloaded google sheets. I only listed the day I tested him multiple times. I haven’t been testing him every single day since I realized the insulin doesn’t last a full 12 hours in his body. Generally by hour 10 he’s back to the same, if not higher BG than Preshot. And that’s the most concerning thing for me is that before we started insulin he was never above 350(non-stressed) but now his preshots are commonly right at or below 400


https://docs.google.com/spreadsheets/d/1Zn_SjSB-KGoi2XClWn0tF-de6unc_hDxwf8_GeuXOY8/edit

Link to spreadsheet
 
Sofina said:
Okay I think I figured it out now that I downloaded google sheets. I only listed the day I tested him multiple times. I haven’t been testing him every single day since I realized the insulin doesn’t last a full 12 hours in his body. Generally by hour 10 he’s back to the same, if not higher BG than Preshot. And that’s the most concerning thing for me is that before we started insulin he was never above 350(non-stressed) but now his preshots are commonly right at or below 400


https://docs.google.com/spreadsheets/d/1Zn_SjSB-KGoi2XClWn0tF-de6unc_hDxwf8_GeuXOY8/edit

Link to spreadsheet
Click to expand...

this is all I could think to add for now since I just tried my best at a “curve” but if it would be helpful to also add some reading I took in the past. I would take some preshot, some post shot and others a few hours later... but none all in a row like I’d just done.

I’m also getting really worried because his back end seems to be getting more and more boney/skinny looking. He’s still slightly overweight but his back end definitely looks small. And I’m pretty sure he’s affected by neuropathy since he walks all funny and low. He’s not fully plantigrade but almost. Even his front paws look droopy when he’s upright. Granted he’s still able to jump on to our bed and his own beds, not with particular ease however.
 
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Thanks, I can see the spreadsheet now. You might want to read the instructions about putting a link to it in your signature, so you don't have to keep posting the link. It'll be really helpful for us helping with dosing, if you add in what doses he's been getting, evenv without the testing. Maybe go back a week earlier in the spreadsheet, and put in the 1.0 units, then yesterday and today the 1.5 units? Your BG meter history should have results for the last two weeks if you took any additional tests during that time. Two weeks back is long enough to be helpful.

It is very important that you start getting preshot tests each and every day, to make sure it's safe to give insulin. We really can't tell much about how a dose is doing with just one 12 hour segment of data. And even though insulin doesn't last 12 hours one day, doesn't mean it won't last that and more the next.
 
Chesters BG is down to 81 for the first time ever! I’m going to check again in 2 hours and of course right before his shot! I know my chart looks a little spotty in th beginning but we’re really getting the hang of this now I think!
It seems like I raised his dose really quickly. this isn’t the first time I’ve given him 2 units, I restarted once before because his numbers went higher. But now I think it’s just because it wasn’t the right dose. I kept him at 1.5 for over a week just to make sure. I’ve heard that you adjust their dose based on nadir, but given that it’s not extremely low I should still hold the dose right? If his preshot is not too low of course...

His behavior is wonderful! It seems a bit strange because he’s been so grumpy and irritable lately but right now he’s so talkative and his eyes are beaming at me! Before they seems dull and spacey. He just seems like he’s in a really good mood right now which is giving me so much hope! I just want to make sure I take these next steps carefully.

also I think i set up my signature hopefully I did it right.
 
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Sofina said:
Can you see the spreadsheet now?

How will I know when to lower the dose? Or is it possible that he will stay at this dose for a while?
Click to expand...
You're supposed to stay at the same dose for a cycle, which I think is 3 days or maybe 6. I can see your spreadsheet. You should test him now to make sure he didn't go any lower than 81.
 
You will know based on his numbers and by which dosing method you're following.

Since you don't have a signature I can't see what dosing method you're following if any. Have you read the stickies:

for deciding which one you're going to follow?

https://www.felinediabetes.com/FDMB...-low-go-slow-slgs-tight-regulation-tr.210110/

Those discuss thresholds for lowering the dose.

On TR you hold the dose for 3 days or 6 cycles / on SLGS you hold the dose for 7 days or 14 cycles. Please let us know which dosing method you're going to use.

Here's some info on how to set up your signature:

To create your own signature, click on your profile name at the upper right hand corner of the page. Select ‘Signature’ on the left side of the profile menu and write a signature containing the following information:
Your first name (if you want)
Kitty's name, age, & sex
Date of diagnosis
Name of the insulin being used
The name of the blood glucose meter you are using
Has kitty experienced any complications from diabetes? Ex. DKA, Neuropathy
Is kitty currently taking any other medications or supplements?
Does kitty have any health issues (current or in the past)?
Food: What are you currently feeding kitty?
Any information about your cat which is important, but hasn't been covered above
Your country / timezone - this helps for timezone specific advice
If you’re home testing, a link to your kitty’s spreadsheet
Select Save Changes.
 
@Sofina We have two dosing methods we use with Lantus. One one of those dosing methods (Start Low Go Slow method) you would reduce the dose to 2.25 because he went under 90. On the other dosing method (Tight Regulation) you would stay on this dose. That's why it's important for us to determine which type of dosing method you would like to used. The decision should be yours on which dosing method works best for your life style and goals for your kitty. In both dosing methods, we determine how to change the dose based on the nadirs, or how low the dose is taking the cat.

And yeah for green! :D
 
Wendy&Neko said:
@Sofina We have two dosing methods we use with Lantus. One one of those dosing methods (Start Low Go Slow method) you would reduce the dose to 2.25 because he went under 90. On the other dosing method (Tight Regulation) you would stay on this dose. That's why it's important for us to determine which type of dosing method you would like to used. The decision should be yours on which dosing method works best for your life style and goals for your kitty. In both dosing methods, we determine how to change the dose based on the nadirs, or how low the dose is taking the cat.

And yeah for green! :D
Click to expand...

Thank you I’m so excited he’s making it to the greens! I just checked again and his 7+ is 101 so I think it working exactly how we want it to! Finally yay!

I started low and was going slow for the first month, but now we’re getting comfortable taking his BG and giving him shots I think I’m ready for Tight Regulation. His neuropathy is still getting worse and I want so bad for him to walk normally again!! And all the research I’m doing says his levels need to be regulated so his body can heal. Is there a low number that would mean a define reduction? How low is still safe?
 
Sue and Luci said:
You will know based on his numbers and by which dosing method you're following.

Since you don't have a signature I can't see what dosing method you're following if any. Have you read the stickies:

for deciding which one you're going to follow?

https://www.felinediabetes.com/FDMB...-low-go-slow-slgs-tight-regulation-tr.210110/

Those discuss thresholds for lowering the dose.

On TR you hold the dose for 3 days or 6 cycles / on SLGS you hold the dose for 7 days or 14 cycles. Please let us know which dosing method you're going to use.

Here's some info on how to set up your signature:

To create your own signature, click on your profile name at the upper right hand corner of the page. Select ‘Signature’ on the left side of the profile menu and write a signature containing the following information:
Your first name (if you want)
Kitty's name, age, & sex
Date of diagnosis
Name of the insulin being used
The name of the blood glucose meter you are using
Has kitty experienced any complications from diabetes? Ex. DKA, Neuropathy
Is kitty currently taking any other medications or supplements?
Does kitty have any health issues (current or in the past)?
Food: What are you currently feeding kitty?
Any information about your cat which is important, but hasn't been covered above
Your country / timezone - this helps for timezone specific advice
If you’re home testing, a link to your kitty’s spreadsheet
Select Save Changes.
Click to expand...
Thank you for this information I’m going to work on putting it in my signature right now
 
You're supposed to stay at the same dose for a cycle, which I think is 3 days or maybe 6. I can see your spreadsheet. You should test him now to make sure he didn't go any lower than 81.
Click to expand...

Just to clarify, the above is incorrect. A cycle is 12-hours. There are 2 cycles, AM and PM each day.

The numbers that are in the dosing methods are based on a human meter. Depending on which dosing method you use, the point at where you reduce the dose differs. 81 is not a reduction point on either TR or SLGS methods if you're using a human meter.
 
If you want to switch to Tight Regulation, you reduce when they go under 50 on a human meter.
 
He had a bounce! I meant to wake up at 3am to check his sugar but I didn’t wake to my alarm): I heard that bounces could take a couple days to clear but does that mean his sugar went too low?
 
Bounces happen because they saw a number lower than they are used to, or had a fast drop. That lovely 81 yesterday was safe, but lower than he's used to. At least I'm guessing that's what happened. Without night time data it's just a guess.
 
I need some advice! My cats PMPS is 122. Should I give him his full dose or lower it? The vets of course told me not to shoot under 200 so I’m a bit nervous.
 
Sofina & Chester said:
They are called real meat beef jerky treats. Mostly meats and with a little binder
Click to expand...
Ok I don't think that should have raised it much.

If you have plenty of test strips, and high carb food and honey/ Karo and are willing to stay up all night if needed, I think you can go ahead and shoot the full dose, if you are comfortable doing that.
 
Okay I’m going to feed him and give him his shot and test again in an hour
Thank you so much fo your help I going to keep updating
 
Sofina & Chester said:
Thankfully Chester is a reliable eater. he almost never turns away food bless his heart
Okay will do! I really appreciate you folks being here during this stressful time
Click to expand...
Oh no! I’m so frustrated! My cats been giving me a very hard time when giving in his shot he just nipped at me even): the worst part of it all somehow I missed his shot! I watched the needed going into his skin but I must have pierced it or something because my fingers were wet and smelled like insulin afterwards): What a terrible time for our first fur shot)):

I can’t tell if I’m hurting him with a bad technique or something. He use to not notice his shot but lately he’s been growling at me... I’ve been worried about injecting into the muscle by accident I guess that’s why I was trying to be closer to the surface this time and that back fired
 
Never mind, furshots happen. We have all done them.
Are you testing the skin properly so you miss the muscle?
He may have got some of the insulin so I would keep testing for a few hours
 
Bron and Sheba (GA) said:
Never mind, furshots happen. We have all done them.
Are you testing the skin properly so you miss the muscle?
He may have got some of the insulin so I would keep testing for a few hours
Click to expand...
I’ve tried a couple different ways of tenting that I found on YouTube. But none that doesn’t seem to cause him pain. I can’t tell if he’s just a sensitive boy or if I’m doing something wrong. He seems to flinch the moment the needs touches his skin a lot of times
 
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