New and I Need Help

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Jan and Topper

Member Since 2013
I'm trying to find out if I should increase or decrease the insulin dose.

My cat Topper was diagnosed with diabetes 9 months ago. Several years ago I had another diabetic cat, I home tested him but this time , with Topper, I didn't feel up to it. I'm old, not well, can't see well,can't hear well, can't think, can't figure things out. I decided to just have the vet take care of it. I've gone through 4 vets, spent thousands of dollars I'm struggling to pay off and Topper is a mess. I'm on a low fixed income and have no more money to spend and I'm crying my eyes out. This is my last attempt to save Topper.

I was taking Topper in to be curved and dose adjustment every 10-14 days. All of the vets wanted to raise the dose by 1 unit at a time. I refused and raised by .25u. According to the vets this is what *I* did to mess Topper up.
Last Fall he had a UTI that required two rounds of antibiotic. His bg was dropping so his dose was lowered. He went from 3.5u to 2u. The infection cleared up and his bg started coming up again. His dose was slowly increased again. Someone gave me a Bayer meter and test strips so I could test him but my hands don't work well and Topper faught the testing and I didn't test.
His dose got up to 4.25u twice daily, he was not "right", I had someone help me test and his bg was PS 320 +3 296 +7 294 +9 316. Other cycles were similar with no real movement.
Vet said he was getting too much insulin and to reduce dose to 3.75. Did that, I saw little change in numbers then he dropped from a PS 315 to +6 70. Vet said to lower dose to 3.25.
Bg has been this on 3.25:
4/3 PMPS 254 +6 285
4/4 AMPS 318 +5 229 PMPS 362 +6 316
4/5 AMPS 326 +6 224 PMPS 338 +5.5 174
4/6 AMPS 333 +5.5 391 PMPS 303 +6 240
4/7 AMPS 311 +6 305 PMPS 338 +5.5 251
4/8 AMPS 325 +7 300 PMPS 305 +6 285
4/9 AMPS 351 +5 290 PMPS 385 +6 351
4/10 AMPS 385 +6 351 PMPS 331 +6 270
4/11 AMPS 420 +6 281 PMPS 349 +5.5 285
4/12 AMPS 325 +6 299

I realize I am supposed to start a "Spreadsheet" but I'm exhausted, I can't do it right now. I don't understand ANY of this computer stuff, and the computer I'm using belongs to someone who told me I should come here to FDMB and the computer is rickety and doesn't work right.

I'm so desparate to get help for Topper, I thought maybe if I posted someone could help me know what to do.

I have so few of his bg numbers.
I had someone here with me and we did a curve on Topper yesterday.
Before I post the curve here I have to explain that I went out to buy test strips for the Bayer meter but I cannot afford them. I saw on FDMB that the Relion meters seem to be popular, so I went and bought a "Prime". I'm comparing it to the Bayer "Contour" and the numbers are really different. I did on two occassions in the past check the Bayer result against the lab result of Topper's bg and they were very close. So I'm really confused about the difference between the Bayer and Relion! I understand there is varience in bg numbers even if you test with the same meter twice in a row, but the varience I'm getting between the Bayer and Relion seems a lot. SO I am including the results of the curve with both meters:

Bayer
PMPS 312
+2 289
+4 280
+6 272
+8 306
+10 339
AMPS 358

Relion
PMPS 262
+2 203
+4 175
+6 216
+8 209
+10 219
AMPS 239
Oh how I want to think the Relion is the correct one. I see people here buying meters and beginning testing with no mention of checking their meter against lab results. Maybe I should just use the Relion and not worry? I HAVE to use it because it's all I can afford. I'm so confused now.

The REASON I'm posting all of this is because I do not know if I should increase the dose, or possibly decrease it more. Can anyone tell anything at all from the information I have provided??? PLEASE. I can't lose Topper and I've got to get him out of these awful numbers I'm getting on the Bayer.

Background: Topper was a neutered stray I took in 6 years ago, he was abandoned by his people when they moved. He's around 9 years old. Since I've had him he's only been fed Fancy Feast Beef Feast Classic and Fancy Feast Chicken Feast Classic. No dry food. Bites of chicken at shot and test. This was the diet my other diabetic went on after diagnosis and I thought it might keep Topper from developing diabetes. He's been healthy except for the diabetes and UTI. He's gained a pound and a half since starting insulin and isn't losing it despite being fed less. He has Lantus insulin 3.25u 2x a day.
Thank you, Jan
Please help if you can.
 
Hello Jan and Topper, and welcome to FDMB.

You obviously love Topper very much, and he is a lucky kitty to have you care for him like this.

I don't use the same insulin as you (Lantus) but there are lots of people on this forum who do have experience with Lantus and I'm sure they'll be along to help you very soon.

Hang in there, Jan. And (((hugs))) to you.

Eliz in UK
 
First of all, you only can afford what you can afford, and you can drive yourself crazy comparing two different meters, so stick with one. I have heard I think that some people have had problems with the relion prime. I used to use the OneTouch meter and I loved it. It was always right on with the vet's meter and labs, and just so trustworthy. But alas, the test strips were just too expensive, even when trying to get the best deal I could buying them off of EBay. Eventually, I went to the Arkray Vital which I order through the link at the top of this FDMB web site (as FDMB gets a percentage) via American Diabetes Wholesale. You can get a free meter with 200 test strips for $44.42, and then once you have the meter, you can get 250 test strips for $45.99 (that's something like .18 cents a strip). The meter is pretty good. Sometimes I get errors, and have to waste a strip. It does give me numbers a little lower than my beloved OneTouch, but I have to do what I have to do.

You did a pretty good job of posting, for using a rickety old computer :smile: ;-)

bbl
 
Welcome Jan and Topper,

You are now in our family and we'll do our best to help you both. There should be more people on today with Lantus experience who can help re dosing (I am not a Lantus user). You are doing all the right things for Topper - good food, ood insulin and hometesting.

I can help with the spreadsheet. I will send you a pm. You should see "1 new message" at the top of the page. Click on it and we'll get the spreadsheet up and running.
 
The Bayer Contour is a good meter. Relion is a good meter too - I haven't used Relion but it is what I hear - I don't know if one type of relion meter is better than another.

One of our members put this link together about additional tools for monitoring BG's - if using a meter is too difficult - https://docs.google.com/document/pub?id ... fQqL3zX_88

please click on this link and read through it, you may find some helpful information there.

Have you done things to acclimate Topper to testing - such as play with his ears, warm his ears, give him treats after testing (even if unsuccessful). Many cats will start to associate the testing process with treats and actually look forward to it. It is possible to get to that point with him.

I have also seen on TV meters that have a larger monitor to make it easier to see as well as meters that talk to you and tell you the BG. Might any of those work for you?

Regarding how much to dose, I am having trouble understanding what the current dose amount is - would you please provide the current dose again.

I do agree that you do not want to adjust the dose by 1 unit increments. As you could possibly skip over the ideal dose.
 
Once Sue gets your Spreadsheet set up we will take a look and see if we can get an idea of whats going on. I do agree I would stick to the Relion and not worry about the differences in meters.

Dont worry - we can help here. Lets just take it one step at a time.

Wendy
 
I use the Relion Confirm but I also have the Prime.
When I compared the 2, the numbers were within meter variance at low numbers (less than 150).
I believe several members use the Prime and are happy with it.
 
Thanks everyone, I have to go give Topper his shot, I have someone who fills the syringe for me (she has a diabetic cat who sails along with a bg between 85 -225), so I'll be back here later.

Topper's current dose is 3.25u twice a day.
 
Hi Jan and Welcome to our family!

I use a ReliOn Prime or an Arkray Gluocard (which is a generic ReliOn Ultima). I have had both tested at my vet's office and they run pretty close to his. I used to use a TrueResult, but it read way lower than my vet's, and my others, did.
Anyways, just stick with one. And actually, when you consider 20% meter variance, your ReliOn and Bayer really aren't that far off. And my ReliOn and Arkray--coincidentally, they are never 3 points apart!!!

You are doing a fantastic job! Do you give the Lantus every 12 hours (you had mentioned 2x a day, but that doesn't necessarily mean every 12 hours; I'm just curious)?
 
Thank you all so much for your comments, I want to reply individually but the person who's computer I'm using wants me to leave so she can go to bed. It took me an hour and a half to set up the Google account. I hope I'll be able to do what I need to do after Sue emails the Spreadsheet to me. I'm really anxious to get going on this.

You are all so kind, it really helps me to not feel so alone.

And yes, Topper is having a shot every 12 hours. We were very late a couple days ago because I have someone who fills the syringe for me, she was delayed so we are off schedule and inching back to the correct time!
When Topper first came to me, he had horrible earmites and badly infected ears, I think because of that, he has never tolerated having his ears touched, even when he's getting neck and cheek rubs, if I touch around the ears, he's gone.

Some of the bg numbers are not that different between the Bayer Contour and Relion Prime, but the ones that are close to 100 point difference disturb me. I just don't want to think at some point that Topper is in acceptable numbers and have it turn out that he is really very high. That happened to me with my other diabetic cat when I changed meters. I thought he was in the 100's, turned out he was in the high 300's and he ended up dying from DKA. That's why the difference is such a big thing to me.
I'll be back tomorrow!
Thanks again and big hugs to all of you.
Jan
 
Maybe if you give sue your google docs account info she can upload it for you etc, you can change your password afterward.

Does he still have the ear infection?

Maybe you want to pick up some urine testing ketone strips to check for ketones to be safe twice a week or when he is high, that way you can catch any issue early.

Wendy
 
It seems to me (and I'm sure others will agree) that when numbers get more into the normal range, the meters will run closer together. When Gobbles gets really low and I use more than one meter (sometimes the TrueResult vs. the Arkray or Prime), the numbers are very close and within a 10 point range. I noticed that with the TrueResult, as the numbers get higher, so does the gap between the numbers...seems to start around 150..
 
I'm just very worried and discouraged. His PS today was 380 on the Bayer. That's higher than when he was diagnosed. What I'm thinking is that the Relion is not accurate on the very high bg's, so he probably really is as high as the Bayer is showing. On the other hand, he is not having any symptoms, previously when he was high, he did have symptoms.
I was going to say to Wendy that the ear infection was years ago, but now his ear is bothering him so he just might have an infection. I just don't know what to do about anything.
 
It's okay. You'll get this worked out.
If his ears are bothering him, then have him checked out by the vet.
 
I'm having trouble with the Spreadsheet. I have so few numbers anyway, don't know what anyone can tell from it. Having trouble with the computer. I have no more money for the vet. Very discouraged right now.
 
On your spreadsheet, you only list the amount of insulin in the morning. There should be another amount in the evening column since you say you are giving insulin every 12 hours.

For each shot cycle, there is a preshot number, number of units given, and then +1, +2 etc numbers for other readings taken.

AMPS = morning pre-shot blood glucose reading and
column just to the right U = number of units given in the morning


PMPS = evening pre-shot blood glucose reading and
column just to the right U = number of units given in the evening

If you skip a shot, you can either write skip or 0 in the units column.

Most of us keep a notebook and pen for writing down the information after the test and shot and then put it in the spreadsheet. Do you have these records somewhere so you could fill in the spreadsheet a little more?
 
Deb, I have the few that are up, Sue put those dates in and I'm trying to put AM and PM. The reason I have so few is because I have not been hometesting as I mentioned in this original post, the vets were just doing curves. I don't know how to let everyone who looks at the Spreadsheet know why the dates are so few or that the dose is so high after 9 months rather than it looking like the dose is so high after only a few days.
 
Jan, so sorry to hear you are discouraged. It's very difficult to deal with this sugardance with our kitties. All I can tell you is to try to hang in there and take it day by day. Keep asking us questions. We are here to help.

The Relion Prime will read those high numbers just fine. We have another member here who was getting consistently high numbers on her Prime, 400's, 500's and even HI which means the reading is over 600. Yes, sometimes the test strips on the Prime give you an error reading but the strips are so inexpensive that wasting one now and then is worth the lower cost IMHO.

For now, you can always list the numbers in your post like you did the first time you posted.

You could add a comment over to the right of the spreadsheet in the REMARKS column to indicate that these were curves done at the vet.

Once you get the hang of getting more data in the spreadsheet, you can enter more rows, filling in some of the gaps.

I understand that computer access is an issue for you. Other members here have this same issue. Not the biggest priority for now, but something to do for later.

Is there a shot of insulin being given every day, twice a day? With only the number of units showing in the morning units column, I was not sure if this was the entire insulin dose for the day or if it was only the morning dose.

One way to give people a better idea of what is going on, is to go back into your spreadsheet and insert a row for each date where you gave insulin, and put the number of units in the morning units column and the number of units in the evening units column. This would be useful information to have even if you do not have BG (blood glucose) readings for those dates.

I would start at the most recent dates and work back no more than a month. I certainly would not go back for the entire 9 months and enter data. The most current 30 days or so would be enough for now, even if that is simply the doses given day and night.

You also mentioned that the vet had been doing curves. You could get all those numbers from the vet and type those numbers into the spreadsheet. Or are those the numbers that are in the spreadsheet now?
 
You are doing fine with the spreadsheet, Jan Amps is the number in the am before you shoot; pmps is the number in the pm before you shoot. The numbers past the pmps to the right of the spreadsheet are the numbers after your number and shot at night. People will understand with your first comment that you weren't getting numbers before that date except at the vet.
 
Thanks for the encouragement. I've put what I have in the Spreadsheet. There have been 4 vets and all idiots. I'll get the numbers they got on their curves.

How can I insert an earlier date into the Spreadsheet without retyping the whole thing??

I have not gotten a later test on Topper today. After his 380 PS, I know I'll see another high number and right now I can't deal with it.

Regarding the Prime - there are a bunch of people as ancient as I am around here and most of them are diabetic, word has spread and poor Topper has all these shaky people coming over offering him their meters. Anyway, at +6 yesterday when he was 358 on my Bayer Contour, I tested on a different Bayer Contour "USB" and the number was about the same as on mine (within a few points), I tested on the Relion Prime at 257, and a Relion Micro at 271. So the two Relions are basically the same. Just thought I'd throw that in. To me it makes a big difference if he is 358 or 257.

Should I start a new post since the Spreadsheet is up?
 
Jan, that is so heartwarming to learn that all your diabetic friends are letting you use their meters to get another reading. So sweet!

Here are some hugs for you from far away :YMHUG: :YMHUG: :YMHUG: :YMHUG: :YMHUG:


To add rows in your spreadsheet, you need to sign into Google. Once there, at the top of the screen should be a list of commands including DRIVE. That is where your documents are stored. Click on that word DRIVE to open your storage place.

There should be a list of documents there, maybe only your spreadsheet and perhaps a profile that tells us more about your cat.

click on the document which is your spreadsheet. That will open the ss.

1. Place your cursor on the row of your spreadsheet where you need to add more rows.
2. There is a list of commands towards the top File, Edit, View, Insert, Format, Data, Tools, Help
3. You want to select the Insert command
4. and then Row Above or Row Below command
5. Clicking on Row Above inserts a new row above where your cursor is on the spreadsheet. Clicking on Row Below inserts a row below where your cursor is on the spreadsheet. do this multiple times to insert as many rows as you need.

Let me know if you need more help.
 
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