New, Questions on managing my cat's blood glucose

I just set up my spreadsheet! Thanks!
That's great! Give the 2 u dose for now. Here's a pile of info I put together for new members. Read it over and ask any/all questions you have:
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It would help us if you set up your signature (light grey text under a post). Here's how: This is very useful for us.
  • click on your name in the upper right corner of this page
  • click on "signature" in the men that drops down
  • type the following in the box that opens: kitty's name/age/date of diabetes diagnosis/insulin you're using /glucose meter you're using/what he eats/any other meds or health issues he has.
Another thing that will help us help you now that you've started BG testing at home is to set up a spreadsheet like the one we use here. We can all see it and look at it before offering advice: http://www.felinediabetes.com/FDMB/threads/fdmb-spreadsheet-instructions.130337/
You just did this.
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Here's the basic testing routine we recommend:
  1. test every day AM and PM before feeding and injecting (no food at least 2 hours before) to see if the planned dose is safe
  2. test at least once near mid cycle or at bedtime daily to see how low the BG goes
  3. do extra tests on days off to fill in the response picture
  4. if indicated by consistently high numbers on your spreadsheet, increase the dose by no more than 0.25 u at a time so you don't accidentally go right past a good dose
  5. post here for advice whenever you're confused or unsure of what to do.
This is useful: http://www.felinediabetes.com/FDMB/threads/hometesting-links-and-tips.287/ You seem to have the testing thing well in hand.
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Here's an explanation of what we call "bouncing". It explains why a kitty's BG can go from low to sky high:
  1. BG goes low OR lower than usual OR drops too quickly.
  2. Kitty's body panics and thinks there's danger (OMG! My BG is too low!).
  3. Complex physiologic processes take glycogen stored in the liver (I think of it as "bounce fuel"), convert it to glucose and dump it into the bloodstream to counteract the perceived dangerously low BG.
  4. These processes go into overdrive in kitties who are bounce prone and keep the BG propped up varying lengths of time (AKA bouncing).
  5. Bounce prone kitty repeats this until his body learns that healthy low numbers are safe. Some kitties are slow learners.
  6. Too high a dose of insulin can keep them bouncing over and over until the " bounce fuel" runs out and they crash - ie., have a hypo episode. That's why we worry so much about kitties that have had too high a starting dose prescribed by the vet and the owner isn't home testing.
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Here are some tips on how to do urine ketone testing (VERY important if BG is high and kitty isn't eating well!):
  • put the end of the test strip right in his urine stream as he's peeing
  • slip a shallow, long handled spoon under his backside to catch a little pee - you don't need much
  • put a double layer of plastic wrap over his favourite part of the litter box and poke some depressions in it too catch pee.
Most test strips have to be dipped and allowed to develop for 15 seconds before viewing the colour change in very good light.
 
Thank you all!! I just updated the spreadsheet with grape’s BG before and +2 after shooting this morning. How many times do you all feed your cats? Should there be a set feeding schedule? Since Grape is so picky and oftentimes just take a couple licks, I would feed her multiple times whenever she’s hungry on top of the set schedule of feeding AM and PM.

Another question I have is I have four cats in the house (Pepper, Grape, Chili, Cheese- all girls) so whenever Grape doesn’t finish her food, the other cats finish it. The other cats have regular dry food but since they’ve been finishing Grape’s food, they’ve gained a lot of weight- especially Cheese.... That also means I can’t just leave Grape food hanging around because they will just finish it. Other than the AM and PM feeds, I am unable to feed her snacks or broth packs during the day when I am at work. Are snacking a requirement for diabetic cats or should there just be two set scheduled meals? I know many of you mentioned that I should feed her multiple times as long as she’s hungry but how will that affect the insulin and BG? Since she will be snacking multiple times, wouldn’t her BG be continuously high?
 
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Thank you all!! I just updated the spreadsheet with grape’s BG before and +2 after shooting this morning. How many times do you all feed your cats? Should there be a set feeding schedule? Since Grape is so picky and oftentimes just take a couple licks, I would feed her multiple times whenever she’s hungry on top of the set schedule of feeding AM and PM.

Another question I have is I have four cats in the house (Pepper, Grape, Chili, Cheese- all girls) so whenever Grape doesn’t finish her food, the other cats finish it. The other cats have regular dry food but since they’ve been finishing Grape’s food, they’ve gained a lot of weight- especially Cheese.... That also means I can’t just leave Grape food hanging around because they will just finish it. Other than the AM and PM feeds, I am unable to feed her snacks or broth packs during the day when I am at work. Are snacking a requirement for diabetic cats or should there just be two set scheduled meals? I know many of you mentioned that I should feed her multiple times as long as she’s hungry but how will that affect the insulin and BG? Since she will be snacking multiple times, wouldn’t her BG be continuously high?
Most of us feed several small meals a day. Kitty is generally more satisfied and it can help stabilize BG levels. Just make sure you take away all food in the two hours prior to the pre shot BG test so you get a proper, non food influenced reading. Is there any way all your girls would eat the same low carb wet food - it's a great diet for all kitties. Failing that you could invest in one of those microchipped feeders for Grape. I love your kitties' names! :)
 
Great job getting the spreadsheet and you signature set up! That was a very pretty +9 number she gave you last cycle.

And I think we all should just take a minute to acknowledge how adorable your Grape is. I just love her asymmetrical blaze!

Convincing all your girls to eat the same low carb (LC) food, as Kris suggests, would be very good for everyone, including you since then you wouldn’t have to worry about them stealing Grape’s food or her getting into their higher carb food.

Our two cats don’t actually want to hang out together all that much, and so we are able to keep Josie in a spare room (with her own food, litter box, window, cat bed, etc) when we’re at work. We use a PetSafe timed feeder for her “snacks”: she gets 1/4 of a 3 oz can of FF at +3 and another 1/4 at +5. It makes me feel better to know she definitely has access to her own food as she’s headed into the lower part of the cycle (or what should be. Josie doesn’t really have smile-shaped curves like other cats do :rolleyes: ). We like this one bc it is small, is digital and therefore pretty accurate, and has a low battery indicator for peace of mind.
 
I'll chime in too on the suggestion to get the kitties all on a low carb diet. My two ended up not liking the same food, so I feed two different low carb foods, but I still have the peace of mind of knowing that whoever eats whichever food, they'll be fine. Plus, I really really didn't want to end up with TWO diabetics, so I made my non-diabetic switch to something safer when Sam was diagnosed. :stop: One kitty on insulin is enough!

Great job getting your spreadsheet set up, and also hooray for a blue number! In answer to your earlier questions, if you get to 50, it's time to get out some food and monitor a little more closely until you are sure the number is rising. They are still safe at 50, but you don't really want them going much below that. As far as the number being too high, there isn't much you can do about that except wait for the next shot time. Hopefully Grape will get out of those high numbers soon and you won't have to worry about that anyway.

Keep trying to get those ketone tests in at least once/week, but more if Grape isn't eating well, or if her numbers are high. As you have already experienced, those are bad news, so you want to stay on top of it.

I love your kitties' names! and that picture of Grape is precious!!!
 
Hi, so I just checked her glucose and it’s >600 so the glucometer doesn’t read and just says HIGH. Do I still wait for her shooting time or shoot her cuz it’s so high right now? She’s unable to walk right now because of how high it is....
 
We rely pretty heavily on the spreadsheet around here, so could you input your data from last night as well?
 
We rely pretty heavily on the spreadsheet around here, so could you input your data from last night as well?

I wasn’t able to check her last night because my petsitter gave her the insulin at the right time since I was out. And I just checked her at 8:30AM with the HIGH (>600).
 
So it looks like 8:30am in your timezone is +10, or two hours before your usual shot time, is that correct?
 
I am heading to work right now so my sitter will be the one shooting her. I just don’t know if I should tell her to give it at regular time or right now..
 
If you are able to adjust your shot time tonight, I would say go ahead and shoot now, If your shot time tonight needs to stay at it's regular time, then you might wait and have the pet sitter do it. She is high enough and late enough in the cycle that you can shoot safely.
 
If you are able to adjust your shot time tonight, I would say go ahead and shoot now, If your shot time tonight needs to stay at it's regular time, then you might wait and have the pet sitter do it. She is high enough and late enough in the cycle that you can shoot safely.
Okay! I will go ahead to shoot now. Thank you!
 
Given the numbers that you have so far, it's unlikely that you will need to adjust your evening shot time, but just in case she starts to run a little lower, you want to make sure you have you can wait the full 12 hours before the next shot.
 
This will be helpful, Dianna, bc it will move you closer to what you want to have as your ideal shot time.
Ah! Didn't realize she was trying to adjust anyway! Glad you are following that, Jenna! It doesn't look like the insulin is lasting 12 hours anyway right now, so adjusting backwards should be pretty easy.
 
Is 2 units enough? I don’t understand why her BG is so high before the 12 hrs is up....and also she can’t walk anymore...she seems a lot weaker now after starting the 2units twice a day instead of 4 units once a day. I’m confused and worried.
 
So here is the hard part: we can't tell if it's too much or too little without a mid-cycle test - somewhere between +4 and +7. When is your next day off? Or is it possible to get a +4 before you go to bed? My hunch is that we need to increase the dose, but you don't really want to start raising the insulin on a hunch.

I would recommend starting her on zobaline (b12 methylcobalimin). That will help with the neuropathy. It takes time to heal though, so you'll need to be consistent and patient.
 
So here is the hard part: we can't tell if it's too much or too little without a mid-cycle test - somewhere between +4 and +7. When is your next day off? Or is it possible to get a +4 before you go to bed? My hunch is that we need to increase the dose, but you don't really want to start raising the insulin on a hunch.

I would recommend starting her on zobaline (b12 methylcobalimin). That will help with the neuropathy. It takes time to heal though, so you'll need to be consistent and patient.

I will try to get a +4 test tonight when I get home. Do I need a prescription for zobaline? What does it do for her? Also, is there anything that can help increase her appetite? This morning she wasn't really into eating...I'm not sure if it is because she is just feeling too weak with the high BG or not. I will try switching all my cats to low carb wet food too. I have tomorrow off so I should be able to get the + 3, + 4 tests tomorrow too. I also have the hunch that the insulin dose is too low right now but I'll decide after checking her +4 BG tonight. My sitter will try to get the PMPS BG before shooting.

Do any of you have issues with your cats getting stressed out and overgrooming? Grape has been overgrooming her legs since her DKA. She also haven't been grooming her self regularly anymore. I have put up the feliway diffuser at home to try and help with her stress but it hasn't really made much of a difference for her. I'm really worried that she will just continue to get weaker and then I'll end up losing her...
 
No prescription needed for the zobaline. I don't know the physiology of what B12 does, but it helps with healing neuropathy which is what causes the back leg weakness in diabetic cats. Zobaline is the brand, there are other brands you could get too, just make sure it's methylcobalamin form of B12. B12 comes in like three different forms, but that's the one that helps with neuropathy.

There are meds that help increase appetite for cats with pancreatitis, but given her history of DKA, I would be more concerned about that having a recurrence (one of the leading symptoms is a lack of appetite). Have you been able to get a ketone test at home? If she isn't eating, please get her into the clinic where they can do the blood test for ketones. If she's eating, but just not enthusiastically, then there are a bunch of things you can try to make the food more enticing:

Fortiflora is a probiotic which isn't great at being a probiotic, but it's super good at getting cats to eat. It acts as a flavor enhancer and lots of cats love it!
Bonito flakes - you can buy them off amazon or most grocery stores. Thin little freeze-dried flakes of fish that cats love and if you put them on food, they'll usually eat more.
Brewer's Yeast or Nutrtional Yeast - not the same as bread yeast - these are often in the health food section or the bulk section of grocery stores. Sprinkle on food. Cats love it.
Parmesan cheese - the cheap powdery kind works best I've heard - my kitties don't like this one so I don't know much about it
Tuna juice - the water that you drain off the can of tuna - pour a little on top of canned food

I know this is all really scary right now. Sending you lots of hugs :bighug:

If you're going to test tonight anyway, why dont' you go ahead and increase to 2.25u tonight?
 
Oh, and the overgrooming could also be connected to the neuropathy. It can make their legs tingle or hurt a little, so sometimes they'll groom them extra to try to self-soothe.

Are you in the US, or somewhere else?
 
Oh, and the overgrooming could also be connected to the neuropathy. It can make their legs tingle or hurt a little, so sometimes they'll groom them extra to try to self-soothe.

Are you in the US, or somewhere else?

Thank you! I'll try the fortiflora or tuna juice tonight. I am in the US. How do you all manage to catch the urine at the right time to do a ketone test? I know she goes to potty but I never catch the urine in time. I'll go ahead and increase the dose of insulin to 2.25 tonight. I'll also order the zobaline on amazon right now. I am just really worried. She got better when I just started giving insulin but now its like going back to losing weight and being weak.
 
If you're in the US, you might also try getting some CBD oil (charlotte's web is a popular brand that is legal in all 50 states). It can help with pain, anxiety, and appetite, so might be something to consider adding into your supplements/food. Not necessary at this point, just something to think about/learn about in case you decide she needs it.

The urine tests can be hard to catch when you have multiple cats, that's for sure. Part of dealing with a diabetic cat is that you learn their patterns in infinite detail. For example, I know that my diabetic cat eats, washes his face, goes to the litter box, grooms, and goes to sleep. In that order. Every single morning. I honestly have no idea when my non-diabetic cat uses the litter box. But knowing my diabetic's patterns makes it easy to grab a ketone test. You'll learn Grape's patterns the longer you're at this.

One trick is to lock him in a room with a litter box, and put wrinkled up plastic wrap in the box. Then you know it's him, that peed. The trick is to try to catch him before he buries the whole thing in litter though.

Some folks with cats who have a history of DKA will get a blood ketone meter for home use. The test is just like testing the BG, except that the strips are kind of expensive. It does save the trouble of stalking your kitty to the litter box though. If you're prioritizing budget, I would get a ketone meter before the CBD. :)
 
Thank you for everyone’s replies...Grape passed away at midnight today. I rushed her to the emergency vet. She had a lot going on and was very very sick. I couldn’t watch her suffer anymore and treating her would put her at the risk of brain damage with the condition she was in. She waited till she saw me again after work and meowed at me a couple times. I knew it was time and she had held on long enough for me... I love her so much and she will forever be with me. I will see her again up on the rainbow bridge. Thank you again to everyone who has helped me on this forum.
 

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Oh Dianna, I am sorry to read this. You did everything you knew how to do, and then had the love and courage to let her go. Peace and comfort for your sorrowful heart, she said her goodbye and gave her permission. She loved and knew she was loved. Tears for you, smiles for Grape cavorting in the wonderful place where our furbabies spirits go. :bighug::bighug::bighug:
 
Oh Dianna! My heart is breaking for you. I am so sorry to hear that Grape has passed. Sending you so much love today as you grieve and remember your sweet girl.
cat_wings>o:rb_icon::bighug::(:bighug:
 
Oh Dianna! I'm so so sorry to hear that. You did such a wonderful job taking care of Grape and I know she had the best mama she possibly could have had. Sending you lots of hugs.

Fly free, sweet Grape! Land softly.
 
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