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Ceebats

Member Since 2013
Hello All,

My baby boy Lucky (not really a baby anymore, he is 11) was diagnosed last week.

I have no trouble giving him the insulin shots, but I am having a seriously hard time testing his BG.

I am using the AlphaTrak monitor and I have tried his ears, his paws, heating both areas and I just can't seem to get enough blood.

I have to test him twice a day, and it usually takes 3-4 sticks before I can get a reading, if I can get one at all. This typically leaves me in tears, my poor boy aggravated and in pain and way too many wasted strips.

Is this typical? Does it just take a long time to get the hang of this?

Is there a better monitor that I should perhaps look into?

Thank you for your help!

I am keeping my fingers crossed that I can get a good sample. It is time for his evening dose :?
 
Welcome! Sorry you're having a hard time doing the testing. I think nearly everyone struggles with it at first.

My big problem at first was just being stressed about it, which made the cat stressed and squirmy and just turned into a bad scene :shock: Usually I also suggest warming the ear, as that made a big difference for me, but I see you're doing that already. Hometesting Links and Tips has all kinds of good information, in case you aren't familiar with any of it.

Ears should be a lot easier to get a blood drop from than paws so I would concentrate on those. Have you seen this photo of The Sweet Spot? Aiming for that area should work the best.

Hmm, what else could I suggest . . . how are you using the lancet? If you're not already poking the ear freehand (rather than putting the lancet device up to the ear and clicking for the spring action), that might help. And make sure you have something firm behind the ear, like folded tissue, for some resistance so you actually can poke the ear instead of just moving it.

I haven't used the AlphaTrak so I'm not sure how much blood it requires relative to other meters. I first used the OneTouch Ultra, and it was okay, but I like the Relion Prime better because it is fine with a really tiny drop. A drop that would have been iffy for the OneTouch Ultra is fine for the Relion Prime (plus the strips are really cheap, 50 for $9).

In what general area are you located? There may even be someone close by who would be willing to come over and help you get comfortable with the testing. I'm really glad that you are working on hometesting - it's so important to keep Lucky safe. Don't give up!
 
Thank you all so much for your quick replies!

This time, I placed the warm washcloth inside of a plastic bag. Still no luck with the ears though, and he has a bunch of spots on both ears from previous attempts :-(

I was able to get it on his back paw, which he does not seem to mind so much but I have read that this is not suggested because it might get infected. I clean the area off with alcohol before I test and hold a piece of gauze with peroxide on it afterwards.

Since he does not seem to mind as much, I would prefer to test on his paw pads. Do others routinely test on the paws?

Thank you again, and I will check out those links, as well as the relion strips from Walmart!

Thank you, thank you!

Lucky's Mommy
 
Hi Lucky and Lucky's mom and welcome to the FDMB. What is your name?

I'm Deb and that picture over to the right is my foster sugardude Wink. He's been living with me for about 7 months now and no longer needs insulin. It's possible for many cats, if you get them on a good diet <10% carbs, like Fancy Feast classic pates and Friskies pates, to get them not only regulated but diet controlled.

If you let us know where you live, country, state/province, city or general area, we could give country specific advice and maybe know someone that lives close to you to help you learn with your home testing issues. If you are interested that is.
 
Ceebats said:
... Since he does not seem to mind as much, I would prefer to test on his paw pads. Do others routinely test on the paws?
Click to expand...
Hi there and welcome! I used to test my cat, Gobbles (now in remission), very regularly on his back paw pads, especially the first month or so. Then I'd test on his ears and paws. My method was to rub the paw pad a little, then poke quick) and then slowly "milk" the poked area, test, and put about 10 seconds of pressure on poked area. In my experience, it takes the blood longer to seep on the paw pad verses the ear. You can rub a little triple antibiotic ointment with pain relief on the paw pad before poking (to numb it). And always put the ointment on afterwards--even if you don't draw blood--that will help with keeping infection at bay. I tested Gobbles on his paw pads for 6 months, and he never had an infection. I hope this helps :-D
 
Hi - welcome! I'm pretty new here myself, but I can tell you what works with my cat, Tootoo. You might have already solved the problem, if so, ignore this. I set up first on the bathroom counter with a cosmetic pad with Neosporin (with pain relief) on it, the tiny lancet, the meter with strip plugged in (I use Relion Confirm), and a bag of low carb treats.

I let him sniff the treats first. Then I massage his ears and under his chin (which he loves) and his ears some more. This gets the blood flowing in the ears and calms him down. Then, I take one ear and hold it taut between my fingers with one hand and prick the edge of the ear (you should look at a video to see the best spot) with the other hand. Then, after I get the reading, I keep massaging a bit to keep him calm, clamp the cosmetic pad gently on the ear and hold for 10-20 seconds. Then treats and more petting.

Maybe that will help.:-) Stay with this board. I've been following the protocol recommended by the members of this board, and my kitty is doing well. There's lots and lots of good advice here. Stay with it!
 
Wendy&Tiggy said:
Hello and welcome to the board!

The alphatrak is a good meter but its strips are expensive so many people here use the Walmart relion brands (if you are in the US)

Here are some testing tips https://docs.google.com/document/d/13c_CPZVKz27fD_6aVbsguadJKvjSrSAkD7flgPPhEag/pub

Are you free handing the lancet or using a tool?

Wendy
Click to expand...

I am using the lancet pen, and I just checked the price on then strips for the alphatrak. They ARE very expensive!
I do not think we will be able to continue with that monitor. Is the Relion a good replacement? The AlphaTrak only requires 0.3 units of blood to test and we have a hard enough time getting that amount. :(
 
TheBowHuntress said:
Ceebats said:
... Since he does not seem to mind as much, I would prefer to test on his paw pads. Do others routinely test on the paws?
Click to expand...
Hi there and welcome! I used to test my cat, Gobbles (now in remission), very regularly on his back paw pads, especially the first month or so. Then I'd test on his ears and paws. My method was to rub the paw pad a little, then poke quick) and then slowly "milk" the poked area, test, and put about 10 seconds of pressure on poked area. In my experience, it takes the blood longer to seep on the paw pad verses the ear. You can rub a little triple antibiotic ointment with pain relief on the paw pad before poking (to numb it). And always put the ointment on afterwards--even if you don't draw blood--that will help with keeping infection at bay. I tested Gobbles on his paw pads for 6 months, and he never had an infection. I hope this helps :-D
Click to expand...

I will definitely try the ointment in the morning. Thank you for the tip!
 
The relion confirm uses the same small sample size as the alphatrak and is a good meter.

If you do use the ear you might find more control by freehanding instead of the tool

Wendy
 
Arkray USA Glucocard 01 or 01 Mini is the unbranded/generic version of the WalMart ReliOn Confirm or Confirm Micro.

The former are available from our shopping partner ADW (link at top of board) and they have some free shipping deals if you order enough stuff at one time.
 
Thank you all again for your help!

I can't tell you how much I appreciate it!

We tried the ointment this morning, and testing on the TOP of his ear instead of underneath and it went MUCH better!

I think I will look into the ReliOn monitor as others have suggested. The strips are only sold at my vet locally and will cost $67 for 50 :(

Thank you again!
 
You can get 100 Relion Confirm/Micro test strips at Wal-Mart for $36. Tiny bit of cost savings for 100 instead of 50. So twice as many strips, for about half the cost of the Alphatrak strips.
 
How are things going otherwise? What insulin are you using and what are you feeding? These are key if your goal is remission...

Wendy
 
Wendy&Tiggy said:
How are things going otherwise? What insulin are you using and what are you feeding? These are key if your goal is remission...

Wendy
Click to expand...

Hi Wendy,

Things are going much better! He still squirms a lot, but I can pretty much get a sample with one prick now!

We started wet food, Hills M/D and the insulin is Lantus and he gets 1ml twice a day. I bought the ReliOn meter this week and that seems to be working. I just wonder if the BG is as accurate as it was on the AlphaTrak since that's made for animals.

His numbers have been pretty good. For the past few days he has been below 200. Our vet suggests doing. Curve as soon as possible.
 
Ceebats said:
...ReliOn meter this week and that seems to be working. I just wonder if the BG is as accurate as it was on the AlphaTrak since that's made for animals....
Click to expand...

Think of it as reading temperature in Celsius vs Fahrenheit. Both are correct.

Human glucometers read roughly 30 points lower than the AlphaTrak at the low end, which is where the numbers are most important.

All retail glucometers read within 20% of what a lab value would get. This range of possible values gets wider as the number gets higher.
Ex
50 -> 40 to 60, a span of 20
500 -> 400 to 600, a span of 200

At high numbers, the actual number isn't important. High is high and you follow the protocol for your insulin.
 
Can we see some numbers? Would like to check what's going on. The key thing is his nadir or low point. How low is he going during the day? Under 50 and a small dose decrease is needed. The nadir is usually 5-7hours after the shot.. But can vary. Many cats drop even lower at night.

We recommend you track readings in a spreadsheet like this to watch for trends etc, and you can even share it With us if you want eyes on it... http://www.felinediabetes.com/FDMB/viewtopic.php?f=6&t=18207

Wendy
 
Wendy&Tiggy said:
Can we see some numbers? Would like to check what's going on. The key thing is his nadir or low point. How low is he going during the day? Under 50 and a small dose decrease is needed. The nadir is usually 5-7hours after the shot.. But can vary. Many cats drop even lower at night.

We recommend you track readings in a spreadsheet like this to watch for trends etc, and you can even share it With us if you want eyes on it... http://www.felinediabetes.com/FDMB/viewtopic.php?f=6&t=18207

Wendy
Click to expand...

Hi Wendy,

Thank you again for all of your help! I would love to get someone elses take on his numbers.

I completed the spreadsheet, and posted it in my signature. But just in case that does not work: https://docs.google.com/spreadsheet/pub ... utput=html

Looking at his numbers from yesterday and today, I think I need to do the curve as soon as possible and get the numbers to my vet. We haven't changed anything (except for the monitor) since he started getting the insulin so I am not sure what would account for the drastic drop yesterday morning, and again this morning :/
 
His numbers look pretty good... It's nice always to see blue and green... These are healing numbers which help the chances of remission. And it looks like his numbers are dropping over time into more normal cat numbers... He just is not ready to be off the juice yet.

However you can't assume that the morning low number is the lowest point of the cycle. He is probably dropping lower overnight. Maybe dangerously so.

So I would strongly suggest you get some more tests in on a daily basis to keep him safe.. I would recommend a test every night before bed 2-3 hours after his evening shot. If his before bed test is lower than the preshot number you may also want to set the alarm for a test later on that night. Plus do a mid day test around 5-7hours after his morning shot if you can do it with your schedule

What we are trying to do here is see how low he is going. If he goes below 50, he needs a dose decrease ..We usually decrease in 0.25 unit increments.

Wendy
 
Which meter where you using when you got that 77 this morning? The Alphatrak or the Relion Confirm? If the Alphatrak, Lucky earns an automatic dose reduction.

We really need to see some mid-cycle numbers. If Lucky was that low, 77, at pre-shot, how much lower did he go with the insulin. Possibly, dangerously low.

My recommendations are:
1. get those mid-cycle tests
2. drop the dose to 0.5U max

We don't want Lucky to drop dangerously low and have a hypo.
 
Deb & Wink said:
Which meter where you using when you got that 77 this morning? The Alphatrak or the Relion Confirm? If the Alphatrak, Lucky earns an automatic dose reduction.

We really need to see some mid-cycle numbers. If Lucky was that low, 77, at pre-shot, how much lower did he go with the insulin. Possibly, dangerously low.

My recommendations are:
1. get those mid-cycle tests
2. drop the dose to 0.5U max

We don't want Lucky to drop dangerously low and have a hypo.
Click to expand...

Thank you both for your help! I am definitely going to try testing him a few hours after the evening shot from now, but unfortunately, I live to far away to check his numbers during the day. I plan to do the glucose curve with him on Sunday.

This morning he was at 321!

Also, the days that he tested 67 and 77, I had already been using the ReliOn monitor for two days.
 
If you note on your SS, when you switched to the Relion meter, that would be helpful.

Thanks for the reassurance on which meter you were using when you got those lower 77 and 67 numbers. Those low numbers are ok with a human meter, getting a little worried if that was the Alphatrak. Now I can breathe a sigh of relief.
 
Deb & Wink said:
If you note on your SS, when you switched to the Relion meter, that would be helpful.

Thanks for the reassurance on which meter you were using when you got those lower 77 and 67 numbers. Those low numbers are ok with a human meter, getting a little worried if that was the Alphatrak. Now I can breathe a sigh of relief.
Click to expand...

Hi Deb,

I noted in the Comments that switched to the ReliOn meter on 8/9, but I bolded it so it would stand out. I am going to send this sheet to my vet once we do the curve, so that will be good for her to know as well. From BJM's post above, I understand a little better how the numbers will be different on the human meter, but I am still concerned about what is going on at night.

He was 114 last night and 66 this morning, so I am planning to check him a few hours after he gets his PM shot tonight and go from there and stay up for additional readings if I need to!
 
We really need to see a few more test numbers. It's great that you are getting those pre-shots now, but we need to see some more numbers after that time. We often suggest that someone get a before bed test as a regular test every day. It helps to fill in our knowledge of how the insulin is affecting your cat.

Many people are not able to get those mid-cycle numbers during the day when they are working, but can do some on the weekends. That may mean, setting the alarm to wake you up at night around +5 or +6 to get some tests at night, or staying up later to test.

I'm betting that the numbers in the middle of the cycle are really low, but don't know that for sure without some tests. Your cat Lucky may have earned a reduction, by dropping under 50, and you have not caught it with a test.

I would not be at all surprised to see higher numbers with a bounce through this evening. I'm thinking Lucky may need a dose reduction.

Please, let us know how those tests this evening go. After your PMPS test, I'd recommend a +2 to start, and go from there.
 
Here are some glucose reference ranges used for decision making using glucometers. Human glucometer numbers are given first. Numbers in parentheses are for non-US meters. Numbers in curly braces are estimates for an AlphaTrak.

< 40 mg/dL (2.2 mmol/L) {< 70 mg/dL for an AlphaTrak}
- Treat as if HYPO if on insulin
- At nadir (lowest point between shots) in a long term diabetic (more than a year), may earn a reduction.

< 50 mg/dL (2.8 mmol/L) {< 80 mg/dL for an AlphaTrak}
- If before nadir, steer with food, ie, give modest amounts of medium carb food to keep from going below 50 (2.8).
- At nadir, often indicates dose reduction is earned.

50 - 130 mg/dL (2.8 - 7.2 mmol/L) {80 - 160 mg/dL for an AlphaTrak}
- On insulin - great control when following a tight regulation protocol.
- Off insulin - normal numbers. (May even go as low as the upper 30s (1.7 mmol/L){60s for an AlphaTrak}; if not on insulin, this can be safe.

> 150 mg/dL (8.3 mmol/L) {> 180 mg/dL for an AlphaTrak}
- At nadir, indicates a dose increase may be needed when following a tight regulation protocol.

200 mg/dL (11.1 mmol/L) {230 mg/dL for an AlphaTrak}
- no shot level for beginners; may slowly reduce to 150 mg/dL (8.3 mmol/L) {180 mg/dL} for long-acting insulins (Lantus, Levemir, and ProZinc) as data collection shows it is safe

180 - 280 mg/dL (10 - 15.6 mmol/L) {may be 210 - 310 mg/dL for an AlphaTrak}
- Any time - The renal threshold (depending on data source and cat's renal function) where glucose spills into the urine.
- Test for ketones, glucose is too high.

>= 280 mg/dL (15.6 mmol/L) {may be >=310 mf/dL for an AlphaTrak}, if for most of the cycle between shots
- Uncontrolled diabetes and thus at risk for diabetic ketoacidosis and hepatic lipidosis
- Follow your insulin protocol for dose adjustments
- Test for ketones; if more than a trace level of ketones, go to vet ASAP.
 
Deb & Wink said:
We really need to see a few more test numbers. It's great that you are getting those pre-shots now, but we need to see some more numbers after that time. We often suggest that someone get a before bed test as a regular test every day. It helps to fill in our knowledge of how the insulin is affecting your cat.

Many people are not able to get those mid-cycle numbers during the day when they are working, but can do some on the weekends. That may mean, setting the alarm to wake you up at night around +5 or +6 to get some tests at night, or staying up later to test.

I'm betting that the numbers in the middle of the cycle are really low, but don't know that for sure without some tests. Your cat Lucky may have earned a reduction, by dropping under 50, and you have not caught it with a test.

I would not be at all surprised to see higher numbers with a bounce through this evening. I'm thinking Lucky may need a dose reduction.

Please, let us know how those tests this evening go. After your PMPS test, I'd recommend a +2 to start, and go from there.
Click to expand...

Overslept a little, but we just got started. He went from 462 at 7:30pm (no insulin this morning because of low BG) to 309 now at 10:00pm. Lucky is definitely not happy with the extra pricks, but It will be worth it to see his numbers.

Looking forward to getting feedback in the AM. Back to bed for a few more zzz's before the next test!

Thank you so much!
 
BJM said:
Here are some glucose reference ranges used for decision making using a human glucometer:

< 40 mg/dL
- Treat as if HYPO if on insulin
- At nadir (lowest point between shots) in a long term diabetic (more than a year), may earn a reduction.

< 50 mg/dL
- If before nadir, steer with food, ie, give modest amounts of medium carb food to keep from going below 50.
- At nadir, often indicates dose reduction is earned.

50 - 130 mg/dL
- On insulin - great control when following a tight regulation protocol.
- Off insulin - normal numbers. (May even go as low as the upper 30s; if not on insulin, this can be safe.

> 150 mg/dL
- At nadir, indicates a dose increase may be needed when following a tight regulation protocol.

200 mg/dL
- no shot level for beginners; may slowly reduce to 150 mg/dL for long-acting insulins (Lantus, Levemir, and ProZinc) as data collection shows it is safe

180 - 280 mg/dL
- Any time - The renal threshold (depending on data source and cat's renal function) where glucose spills into the urine.
- Test for ketones, glucose is too high.

>= 280 mg/dL, if for most of the cycle between shots
- Uncontrolled diabetes and thus at risk for diabetic ketoacidosis and hepatic lipidosis
- Follow your insulin protocol for dose adjustments
- Test for ketones; if more than a trace level of ketones, go to vet ASAP.
Click to expand...

Thank you for this BJ, this is VERY helpful. I was just speaking with my mother this morning about this, and she mentioned that I needed to understand what numbers are acceptable for cats. Mom has diabetes, so she is a big help as well.

My vet did not discuss testing his urine at all, so I am going to ask about this as well.

I look forward to your feedback, as well as the vets in the AM.

thank you so much!
 
So the +2.5 was down 153 points or about a 33% drop from PMPS.

I'd get a +4 next.

Where do you live? Time Zone?

Want to know how long until your next test.

Would you be willing to add your location to your user control panel, profile tab, edit profile, location field?

With the skipped shot, the numbers will probably remain higher this evening. Don't let your vet raise the dose based on this atypical cycle.
 
See my signature link Secondary Monitoring Tools for tips on urine testing and other assessments you may wish to track.
 
Deb & Wink said:
So the +2.5 was down 153 points or about a 33% drop from PMPS.

I'd get a +4 next.

Where do you live? Time Zone?

Want to know how long until your next test.

Would you be willing to add your location to your user control panel, profile tab, edit profile, location field?

With the skipped shot, the numbers will probably remain higher this evening. Don't let your vet raise the dose based on this atypical cycle.
Click to expand...

Hi Deb,

I thought he would stay higher this evening as well, but he is down to 83 now at 5 hours after his pm shot.

I am in Delaware, so EST zone. His next text will be at 2:30am.

Thank you so much for your concern. This board and its members have been more helpful than my recent visits to the vet!
 
Ceebats said:
Deb & Wink said:
So the +2.5 was down 153 points or about a 33% drop from PMPS.

I'd get a +4 next.

Where do you live? Time Zone?

Want to know how long until your next test.

Would you be willing to add your location to your user control panel, profile tab, edit profile, location field?

With the skipped shot, the numbers will probably remain higher this evening. Don't let your vet raise the dose based on this atypical cycle.
Click to expand...
Click to expand...

Hi All,

Everyone has been so helpful, and I am looking for some more advice at this point :/

So you can see from his numbers that he dropped pretty low as the night (8/14) went on. After he dropped to 39, I pretty much stayed up to keep an eye on him. He was not walking or acting very funny, but he definitely did not fight with me as much when we did the next shot, and his BG went up a little bit.

I sent the spreadsheet to my vet and expressed my concern about the low numbers during the night. The response I received was that I should not be using the ReliOn meter as the numbers are not accurate for cats. She said that the low numbers were probably not that low and they recommend that I go back to using the AlphaTrak, which I really can't afford to do. She also mentioned that the 1 unit every 12 hours should be fine to keep him regulated, given how high his numbers were in the beginning, but I am just very nervous to continue as is!
 
With that 39 BG you got 2 days ago, that is an automatic reduction by 0.25U with the Tight Regulation protocol we use. This is the only scientifically researched and sanctioned protocol for Lantus insulin and has been vet journal published.

Dropping that low, tells us that 1U is too much insulin for Lucky. Did you follow the hypo protocol, feeding and testing every 30 minutes to raise his numbers up? He's fortunate he did not have a seizure or fall into a coma. Lucky lived up to his name.

Please, print a copy of this and keep with your hypo kit Hypo instructions and keep them with your hypo toolkit of Karo syrup/honey and high carb gravy type wet food and lots of spare test strips.

If you ever get a low number like that again, please post here, use the 911 icon and yell for help. We'll walk you through the hypo protocol.

You are endangering your cat if you continue to give him that much insulin. I strongly recommend that you reduce the dose immediately to 0.75U.

Please, please keep your cat Lucky safe and decrease the dose immediately.

ETA: Please add the insulin you are using and the meter you are using to your signature. Thanks.
 
Are you home to test? I'm concerned because you gave Lucky 1U with a BG reading of 74 this morning. That is likely to take Lucky very, very low and in danger of a possible hypo.

My recommendation is to get another test ASAP.
 
hey there

I second Deb - every time he goes under 50 you want to drop by 0.25IU. Plus with that low preshot today I really hope you got more tests.. we dont want a hypo and the 39 you got the other day is low!!!


Wendy
 
Deb & Wink said:
With that 39 BG you got 2 days ago, that is an automatic reduction by 0.25U with the Tight Regulation protocol we use. This is the only scientifically researched and sanctioned protocol for Lantus insulin and has been vet journal published.

Dropping that low, tells us that 1U is too much insulin for Lucky. Did you follow the hypo protocol, feeding and testing every 30 minutes to raise his numbers up? He's fortunate he did not have a seizure or fall into a coma. Lucky lived up to his name.

Please, print a copy of this and keep with your hypo kit Hypo instructions and keep them with your hypo toolkit of Karo syrup/honey and high carb gravy type wet food and lots of spare test strips.

If you ever get a low number like that again, please post here, use the 911 icon and yell for help. We'll walk you through the hypo protocol.

You are endangering your cat if you continue to give him that much insulin. I strongly recommend that you reduce the dose immediately to 0.75U.

Please, please keep your cat Lucky safe and decrease the dose immediately.

ETA: Please add the insulin you are using and the meter you are using to your signature. Thanks.
Click to expand...

Thank you both for your input. I will be putting a hypo kit together ASAP.

I was very concerned about Lucky's numbers but the vet tech seems adamant that the monitor is not giving accurate results and he is not that low. She also mentioned that 1 unit should be fine when I asked what I should do next, based on those numbers.

When I went for the diabetes consultation right after he was diagnosed, the way it was explained to me is that he needed to get insulin if he was going to eat, regardless of numbers. That's why I gave him the shot this morning. His PMPS was 53, so I am glad he lived up to his name as well! I did not give him a PM shot, and will be watching him ths evening and testing again in a few more hours. His +2 was 108.
 
You might want a second opinion. Ask your vet, not the tech.. Techs aren't as experienced, they dont have the school or experince, and these numbers are very low. He could be going into remission!!

My bailey has a hypo only on 1/2 unit. He was in a coma, I was lucky to find him and give him syrup.he measured at 19.

It's better to be safe than sorry.. Please.

I look at hundreds of cats and I am worried here.

If it was my cat I would be giving 1/2unit starting tomorrow but only if he is over 150... Since 50-130 are normal cat numbers.


Wendy
 
At the lower numbers,
A 40 on a human glucometer is about equal to a 70 on an AlphaTrak.
A 50 on a human glucometer is about equal to a 80 on an AlphaTrak.

At higher numbers, the differences become wider and it doesn't matter - high is high. You follow the protocol for dose adjustments and check for ketones.
 
Wendy&Tiggy said:
You might want a second opinion. Ask your vet, not the tech.. Techs aren't as experienced, they dont have the school or experince, and these numbers are very low. He could be going into remission!!

My bailey has a hypo only on 1/2 unit. He was in a coma, I was lucky to find him and give him syrup.he measured at 19.

It's better to be safe than sorry.. Please.

I look at hundreds of cats and I am worried here.

If it was my cat I would be giving 1/2unit starting tomorrow but only if he is over 150... Since 50-130 are normal cat numbers.


Wendy
Click to expand...
Hi Wendy,

The vet tech asked me to email her, because the vet doesn't check emails and she would share everything with him. She said that she shared the SS with him, but I guess I can't be sure?

I hate to say it, but I didn't know what normal cat numbers were! I planned to ask when I called the office tomorrow to try and speak with the vet directly, so thank you for that. I just talked everything over with my mom and we both agreed that reducing his insulin is a good idea. I agree it's better to be safe than sorry.

Thank you again for your help. This board is a life saver. I have received some negative feedback from people when I told them that my Lucky had diabetes and what we were going through. It is so comforting to know that I'm not the only one!
 
BJM said:
At the lower numbers,
A 40 on a human glucometer is about equal to a 70 on an AlphaTrak.
A 50 on a human glucometer is about equal to a 80 on an AlphaTrak.

At higher numbers, the differences become wider and it doesn't matter - high is high. You follow the protocol for dose adjustments and check for ketones.
Click to expand...

Hi BJ,

I printed out your information on the differences between the monitors and planned to speak with the vet.

Thank you so much!

If they won't give me any guidance becausevI am using a human monitor, I may need to find another vet.
 
I was very concerned about Lucky's numbers but the vet tech seems adamant that the monitor is not giving accurate results and he is not that low.
Click to expand...
Sorry, but I strongly disagree with that vet tech telling you the meter you are using is inaccurate and you should not be using it or relying on the numbers it gives you. Probably 95% of people here use human glucometers to test their cats. We have the reference ranges to use with human glucometers. BJM gave those to you earlier in this post.

She also mentioned that 1 unit should be fine when I asked what I should do next, based on those numbers.
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With that BG of 39, your cat has already told you quite clearly that 1U is too much insulin. What protocol is that vet tech using to base her recommendation on?

Many cats show no symptoms of hypoglycemia until they start convulsions and go into a coma. We certainly do not want to see that with your cat.

She also mentioned that the 1 unit every 12 hours should be fine to keep him regulated, given how high his numbers were in the beginning, but I am just very nervous to continue as is!
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You don't base the dose on what the BG numbers used to be. You base the dose on the nadir or lowest BG reading in the cycle and what the trends are over time.

Please reduce the dose, and ask here first if you get a number below 200. "Better too high for a day, than too low for a minute."

We started wet food, Hills M/D
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A diet change can dramatically lower the BG readings. The Hill's M/D is 14% carbs and may be the only thing keeping his numbers high enough so he does not hypo with that 1U dose of insulin.

Lantus has a cumulative effect, and you do not see the full effects of the dose for 6 cycles, 12 hours in a cycle. Lantus is a depot insulin, so only part of the shot you give goes to work right away, the rest goes into storage aka the depot, for later use. Once the depot is full, you will see the full effects of the dose. What we are seeing, is that the 1U dose is too high.
 
Normal cat numbers - see the chart I posted previously. It's listed. In fact, print it out and share it with the vet.
 
Good morning. The pink today was likely a result of a bounce from a low yesterday ( bounce explained below). Since we dont know how low the low was, this was a good idea to drop the dose. He may bounce for a day or more so just hold the dose for now and dont worry if you see a lot of yellows or pinks but start getting more tests once you see him starting to drop.

Also it will likely take a day or two before we see how this dose is working so lets wait and see (because Lantus takes a few days to build or drain from his system - its a "depot" insulin)

Wendy

Bounces - what are they and is my cat doing them?
When a cat is first diagnosed, the blood glucose has probably been high for a while. As the insulin starts to take effect and numbers start to come down, the liver has to learn to adjust to the lower numbers. We call this "liver training school". But before it relearns that low numbers are ok, when the BG drops to a number lower than the liver is accustomed, or if BGs drop low, or if the BG drops suddenly, the liver”panics” and reacts by releasing counterregulatory hormones and glucagon. This drives the BG back up. This is what we call a "bounce". Bounces can take up to 72 hours to clear so we are generally careful about increasing doses during the bounce. Once the bounce clears, then you can see the "real" numbers and determine if the dose needs to go up or down.
 
Wendy&Tiggy said:
Good morning. The pink today was likely a result of a bounce from a low yesterday ( bounce explained below). Since we dont know how low the low was, this was a good idea to drop the dose. He may bounce for a day or more so just hold the dose for now and dont worry if you see a lot of yellows or pinks but start getting more tests once you see him starting to drop.

Also it will likely take a day or two before we see how this dose is working so lets wait and see (because Lantus takes a few days to build or drain from his system - its a "depot" insulin)

Wendy

Bounces - what are they and is my cat doing them?
When a cat is first diagnosed, the blood glucose has probably been high for a while. As the insulin starts to take effect and numbers start to come down, the liver has to learn to adjust to the lower numbers. We call this "liver training school". But before it relearns that low numbers are ok, when the BG drops to a number lower than the liver is accustomed, or if BGs drop low, or if the BG drops suddenly, the liver”panics” and reacts by releasing counterregulatory hormones and glucagon. This drives the BG back up. This is what we call a "bounce". Bounces can take up to 72 hours to clear so we are generally careful about increasing doses during the bounce. Once the bounce clears, then you can see the "real" numbers and determine if the dose needs to go up or down.
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Thank you, Wendy!

I am going to continue testing him every couple hours. He seems to be dropping pretty slowly, which is a huge inference from before. At +8, he is down to 199, so we will be doing another test about 3:30.

Thank you again!
 
Wendy&Tiggy said:
You might be heading to a low PMPS too. So definately get a +11 and come here and post so we can coach you through shooting low if need be. No food after +10.

Read this http://www.felinediabetes.com/FDMB/viewtopic.php?f=9&t=147

Wendy
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Hi Wendy,

I lost my internet connection for a while there. I have been testing him since 5:00am so we are already past +10

The feeding schedule Lucky is on per the vet is 1/2 can of Hils M/D every 12 hours, so he has not had dinner yet. We agreed that 7 & 7 would be the best with my work schedule during the week. I expect him to be lower when I test again, so should he get insulin?
 
We won't know if Lucky should get insulin until you get the PMPS (evening pre-shot) test. If it's over 200, then you are safe to shoot the insulin. If it's lower than 200, we advise new members to hold off on feeding, retest in 30 minutes to see if the number is rising or falling.

Depending on now low the number is, it may be best to skip the dose or give a reduced dose.

Since it is early days yet, you do not have a much test data to know how your cat reacts to the insulin and how low his dose takes him.

We'll have to wait a bit and see that PMPS number.
 
Hi Deb & Wendy,

Thank you both again.

Wendy, I apologize, I got anxious and did not read the post that you included!

I do not know what Lucky and I would be doing right now, without your help. My vet is just not that helpful.

I just tested Lucky and his BG is 310, so I can continue with the reduced dose of .5, correct?
 
Wow, he bounced right up again!

Yes, that 310 BG reading is high enough to give him his 0.5U dose. I recommend getting a test at +2, to see how Lucky is doing.

Vets look at the big picture, we here on the message board, look at the day-to-day management of feline diabetes. Glad we could help you and Lucky. We're pretty successful in getting kitty's OTJ too. Hope that is possible for Lucky. We'll have to wait and see.

You're doing great! But, your head is probably spinning and you feel a bit like this. :dizcat :dizcat :dizcat It's ok. That's normal when you are starting out, but let me reassure you, it does get easier and you will develop a routine.
 
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