Newbie day 2 of insulin.....question

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macal

macal

Member Since 2012
Hi, I have a newly diagnosed kitty (female calico 11yrs. approx 10 lbs) who is just starting off on insulin injections (first one was last night). She's a rather headstrong difficult to deal with cat so regular blood glucose monitoring is not the easiest (rarely possible). The vet suggested I try a beginning dose of 1 Unit every 12 hrs and to return in one to two weeks to check fructosamine and see how she's doing.
This morning all seemed well and I gave her her 2nd shot after breakfast, but this afternoon
12 hours later, her appetite was a lot less vigorous than usual and I became a little suspicious so did a BG test. She's at 138 mg/dl. It seems like I shouldn't give insulin to be on the safe side, but why is it so low 12 hours after her morning dose?
A glucose curve has not been done on her because she gets so wound up in the vet's office that the results would not yield much value, and at home, I'm just having a difficult time getting the hang of using the meter and getting her to sit still and not turn it into a traumatic event. this is not a cooperative easy to handle type of kitty
sorry this is so long but I'm just trying to figure out what is best here....should she be on insulin at all? I'm terrified of her crashing from too low a blood sugar.
For reference, her last fructosamine 4 days ago was 570.
Thanks in advance for any advice.
 
We suggest that new diabetics not get insulin under 200, so no, I would not give insulin tonight. If she is in the low 100s at preshot time, she could have gone quite low at midcycle.

What kind of insulin? Have you changed to wet low carb lately?
 
She is on Lantus insulin.
I put her on a canned only diet about 3 weeks ago which is either Fancy Feast classic or Purina DM. I've been alternating between the two as I read that nutrient quality in DM is not the greatest. I've also been varying flavours of the Fancy feast....perhaps I should not do this?
the insulin doses were only started last night.
 
In perusing this forum it also appears I may have bought a crappy glucose meter....so I'm not too sure I can trust the 138 reading......her behavior and moderate appetite (it is usually insatiable) do suggest though that it might be true.
I bought a Rite Aid True Test meter. It was the only one that came with a few strips...all the other meters you had to have a prescription to get the strips.
I've been practicing lancing and using the meter while I was acclimating her to the canned only diet (mostly on myself, but getting better at it!)
 
What did you get when you tested your BG on the meter?

Opinions on that meter differ. I don't think Consumer Reports had any issue with it, although some people here have.

It's fine to try different flavors of the Fancy Feast, as long as they say "classic" on the can. They are all low carb. You may find she likes some more than others, and you shouldn't use the seafood flavors too often. My cats love them all. And the canned Purina DM is okay, just overpriced and I think it only comes in one flavor. Some cats eat it for a while, then decide they don't like it anymore.

It's odd that you need a prescription for the meter strips. Where do you live? Here, Walmart has them on the shelf next to the meters (although they do put them in theft-proof containers so you have to get the service desk to unlock the case).

Carl
 
Some pharmacies keep the test strips behind the counter but no prescription is needed at all to purchase them.

Most meter kits include 10 test strips and lancets. You have to check the box to see what is included. Do you have a Walgreens? This week the AccuChek Aviva and the AccuChek Nano meter kits are $14.99 plus there is a $14.99 mail in rebate on the box. Both are good meters to use.
 
The meter gave me readings in the 90s . I just tried it again and it's 89. Seems fairly right for after supper?
 
Should've added, I'm in Virginia The strips are definitely not on the shelf and this was the only meter that included free ones....maybe you don't need a prescription and they're behind the counter, I didn't ask.
 
Looks like your BGs are good. :smile: If you have a walmart close by, you can pick up a Relion Prime. A lot of people buy Relion meters because the strips are probably the cheapest you'll find anywhere. Relion meters all get good reviews from us too. You can compare the two, then you'll know if your Rite Aid meter is reliable, plus you'll have a backup in case you run out of strips or the battery dies in the middle of the night.

Carl
 
Ok so it's now day 3 and under stressful conditions I took her BG before breakfast (upset cat and upset me) so the reading was probably a little high, but
she came out at 188. I opted not to dose her. She ate well. An hour and 1/2 after her breakfast I checked BG again (much more relaxed...she was snoozing)
and she's at 153. Is this even possible? Not sure how I can be getting these readings when she comes out in the 300s at the vet for BG, and fructosamine indicates there's some really high spikes in the averages (fructosamine's in the 500s)

Going to buy another meter at Wal Mart this evening and see how the two meters compare.
Thanks for all of your advice. This is really tricky....just want to be sure I don't kill her by giving her insulin when she doesn't need it!

I guess the best thing to do is do a BG curve (as much as I am able) for 12 hrs with no insulin just to see how she responds to food?
 
I guess the best thing to do is do a BG curve (as much as I am able) for 12 hrs with no insulin just to see how she responds to food
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?

That is not a bad idea. Assuming your meter is okay, a drop in BG after feeding can mean that her pancreas is producing some insulin and her body is able to use it correctly.

Carl
 
You can look on the bright side- maybe the jolt of insulin jump started the pancreas again.

I would definitely do a curve so see what is going on.
 
That's exactly what I'm hoping for, but from all I've read on these forums and the website, it seems like it's an odd thing to happen.
She's only had 2 doses of 1U and for all purposes, her BG is still higher than it should be in a non diabetic.
I've got a call in to my vet, waiting to hear back. I just want her to know what's going on.
Being really cautious as Thanksgiving holiday is approaching and everyone's going to have odd hours.
 
Some cats just need insulin for a very short time before they reach remission after the diet change--the sooner you catch the diabetes, change the diet and start treating with the right insulins (and Lantus is one of the right ones), the sooner and more likely it is that your cat will reach remission.

With those lower preshots, I would consider reducing the dose to .5u or .25u twice a day. These are good numbers, but you may also just need to shoot a smaller dose. Cats are pretty small animals, and many need finer dosing. When Bandit went into remission, I shot .5u, then .25u, and then .1u until he was done.

macal said:
Not sure how I can be getting these readings when she comes out in the 300s at the vet for BG, and fructosamine indicates there's some really high spikes in the averages (fructosamine's in the 500s)
Click to expand...

Stress elevates BG for cats. Bandit always tests in the 200-300 range at the vet (sometimes even higher--when he had his tail accident he was in the 400s at the vet). However, at home his BG is in a perfectly normal range. That's why dose adjustments should not be made off BG tests at the vet--they are very inaccurate and usually lead to overdosing. That's why home testing is so vital to caring for your diabetic cat. Also that fructosamine was taken close to when the diet was changed, right? Dry food keeps BG steadily elevated, so it wouldn't be surprising that his BG averaged that high because it would have included dry-food influenced numbers.
 
Ok, I've just started one of the spreadsheets, this is a wonderful board. Thank you to whoever came up with the template. It will be very useful. I'm going to monitor Molly without insulin for the next couple of days before deciding anything unless her BG levels go up significantly. Seems right now that while she's over the green zone, it's not too awful
 
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