New to home testing but not to Diabetes

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PakRatJo

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Okay, I've read so much and have learned so much through this site that it made me realize how much more I need to do. My bad......I guess I put too much faith into my vet, who is one of those vets that apparently resists home testing. Anyway with that being said, my Diesel, 12 years old was diagnosed just over 1 year ago. We have followed all of the vets directions, changed his dry food to Hills M/D and I feed Fancy Feast Classics. He has been to the vets so much that now he has becomed so worked up when he knows he's going, he pees all over the place and if he could flatten himself out and disappear into the floor, he would. I know he's stressed from going because he has been with us since he was only just a baby and going to the vets never bothered him. My husband and I did ask our vet about home testing to alleviate some of his stress and they basically told us it wasn't necessary or that accurate. Okay, they've been my vets for many, many years and through several felines and never have they sent me in the wrong direction, so we'll continue as is. Anyway, it has been a little over a year now and he is still up & down. He went so low at one point, he went into remission, which lasted about 2 weeks and then we had to start the whole mess all over again increasing and increasing and now he's back on his way down again and we're still at the point of bringing him in every 2 weeks and for the last 2 months have been decreasing his insulin.
Anyway (sorry for the long post)....I found this site and WOW is all I can say. I now have 2 glucose monitors. I have the Relion Confirm and Freestyle Freedom. I have tested with both and get readings within a just 2 to 3 difference of each other. I'm still reading the information on this site and there is so much of it I just want to make sure I'm understanding what I'm reading along with hypoglycemia (thanks, I have it posted to my fridge). Thanks to this site, I had no problem what-so-ever getting a blood sample from Diesel's ear the very first time. Piece of cake. This was done last night after eating, pre-shot. I got readings of 84 and 82....okay...hmmm. This morning about an hour after eating, his pre-shot glucose was 73 & 75. Our next visit is scheduled for next Wed. According to what I have read, if he's under 100, I should not give him his shot. If I give him his shot at this number could I possibly send him into hypo? He is on Lantus and we are down to 1 1/2 U bid. If I continue with what the vet wants us to do, I would have no knowledge of this number and continue on. Am I jumping the gun on this thought? I haven't done a home curve yet, because I just started this week with the montiors and plan to do one on the weekend when I'm home all day. Should I just continue testing for a couple of more days? I feel like I'm playing Russian Roulette right now. My husband and I plan on having a more "in-depth conversation on Wed. with our vet which might also mean finding a new vet.

Any thoughts would be greatly appreciated.

Jo Ann & Diesel
 
Welcome! What a great job you are doing for your kitty. The food is good, the insulin is a good choice and the hometesting is excellent. Clearly your vet is wrong about the hometesting. If you gave insulin at 73, you could be looking at a dangerous hypo later this morning.

We generally tell newbies not to shoot when the number is under 200, but to wait 30 minutes (without feeding which can raise the levels) and see if the number has risen. If it is over 200, you could then shoot. If you have testing data, you can consider a reduced dose on a number under 200, but since you are new to the testing, I would not consider that. Your 70-80 numbers are very low for preshot numbers and I imagine you need to reduce your dose. I don't use your insulin so suggest you ask at the Lantus support group. Their page has excellent information on how Lantus works and even information on what to do with a low number at preshot. viewforum.php?f=9 Be sure to read the stickies at the top. Then you can post and ask your dose question.
 
Welcome Jo Ann! You're doing a great job taking the initiative home testing. I was lucky in that my vet told me from the beginning I needed to home test, and that it was the only way to get accurate numbers because of vet stress. I've attached an article for you to print out and give to your vet. It discusses that the combination of tight regulation via home testing, diet and the insulin you're using (Lantus) brings most diabetic cats into remission.

One thing I would recommend is to ditch the prescription dry food and just feed the Fancy Feast. Even though the dry M/D is lower in carbs than most dry foods, it's still too high in carbs for a diabetic cat and it contains corn gluten meal, rice, and whole grain corn. All of these will boost a diabetic cat's numbers up because they don't belong in a cat's diet. You should be able to return the bag of food, even if it's opened. Just say that your cat won't eat it anymore.

If you are keeping the dry because need to leave food out for him when you're away or sleeping, there are many things you can do instead. One is to add a little water to his canned food and just leave it out. If he's a gobbler, you can freeze his portion of Fancy Feast and leave out the frozen piece for later. If he's a crazy gobbler like my Bandit who will try to eat the frozen piece of food anyway, there are many different kinds of affordable automatic feeders that you can buy to release the thawed food at the right feeding time.
 

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If/once you remove the dry food, you should see a reduction in BG levels. In that case, the doses will most likely need to be reduced a lot, or possibly stopped completely. This last little bit, you may be able to regulate solely with diet. Before giving any more shots, I would post here asking for "dose advice".
Right now, those numbers are non-diabetic levels.
Carl
 
Thank you so much for the information. It makes me feel better that I seem to be getting on the right track with this. Funny that you all mention getting rid of the dry if possible, and as of yesterday, from reading as many articles from this site that I've been able to get to this past week, I made the decision yesterday that I will eventually get all of my kitties off of the dry completely. I was always made to think that the dry was a good thing to have around and since I've never had a problem with an overweight cat, I never gave it a second thought. Funny, (not really), but since we have the hills m/d out, I've started to notice that my Harry is starting to get "plump" now and before his health becomes an issue, I really want to get them away from the dry. I guess he really, really likes that $40/bag prescription...lol..

My only next stumbling block will be how to decide to do that. I did read the transitioning article and I don't think it will be a problem since all of my kitties eat both wet & dry. I don't want to do anything too drastic with Diesel until I have a better handle on how I should do it.

I think next week will be a good week to try it out. I'm on vacation next week, plus seeing the vet, and will be home and able to monitor how he does. I hate leaving in the morning, wondering if he's going to crash after I leave for work.
 
I understand your waiting to do the diet change when you are home. But your numbers are very low for preshots (especially if you are feeding dry) and I think you need some guidance on possible doses. I hope you will post on the Lantus support group and ask for dosing help.
 
That sounds like a good plan to me. The more data you get, the better, because it will help reveal how much insulin is actually needed. With Lantus, you want to test at least three times a day--once before each shot, and once at the nadir, or lowest number of the cycle, usually about 6 hours in (and you can get the test during either cycle--I work during the day so for me that meant setting an alarm to get up at 1am, doing the test, and going right back to sleep). Of course, you can test more than that if you can manage to get a couple more tests in in each cycle. You'll want to do a curve at least once a week.

Here's a link that shows you how to set up a spreadsheet, like the one I have in my signature: http://felinediabetes.com/FDMB/viewtopic.php?f=6&t=18207. It's a great way to keep track of your data, and once you get it up and running you can ask for dosing advice in the Lantus forum, where there's many people very experienced with this insulin.

I agree that the dose may be too high right now. Getting some mid-cycle tests will help tell if this is the case.
 
Again, Thank you all. I set up my google account and got my template set up today. (thanks for the step-by-step) I will be doing a curve tomorrow for the first time, so we'll see how it goes. I went to the Lantus board and did some more reading on Lantus and issues with shooting low, that low is 50 and down and that is when it becomes a bigger issue of to shoot or not shoot. We're seeing the vet this week and I'll be able to check my meter against hers and see if there's a difference there. I'm trying to keep my nerves down from seeing the 70's because he seems to be doing and acting as normal and healthy. His weight is back up to normal and he looks good and healthy again.

So tomorrow's the day and little Diesel becomes my pin cushion for the day.... cat_pet_icon
 
Don't worry about 70's. The high end of normal is. 120. A kitty who lives all day under 100 does not require any insulin.
Carl
 
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