Newly diagnosed! Updated post 1st blood test! :X

[Wren]

Hello everyone,

My 14 year old cat Micah was just diagnosed as having early Diabetes after getting the results of a blood/urine test done. I had taken him in because I was afraid that he had kidney failure. He started drinking water until he would throw up and peeing lakes. They said his blood glucose level was ~300 compared to the normal ~150 so twice normal.

I made an appointment to take him in tomorrow and it seems like the vet wants to put him on insulin and give him a prescription diet. Should I tell the vet that instead of a prescription diet, I would like to put him on a regular low carb wet canned food? (I was thinking Purine One Pates, which he loved last time I gave him a sample and had ~2-3% kcal from carb in a chart that I saw). Should I ask to just change his diet for now and come back to retest his sugar levels before putting him on insulin? Or should I put him on insulin right away?

I know that I want to do home tests to monitor his glucose levels.

EDITED:
2 more questions that I just thought of!
1) Once you are in a routine, how often do you take your diabetic cat to the vet?
2) Is there a good pet insurance that helps cover some of the costs?


If you have any advice or an answer to my question please respond ASAP! My vet appointment is tomorrow at 6:20pm EST.

Thanks a lot!
Karen

 

[DebG]

Hi Karen,
Welcome!
Most of us feed either raw or the Purina One Pates or Fancy Feast Classic are fine. Please don't let the vet send you home with prescription food.
I am new and unable to offer dosing advice.
What type of insulin will you be putting him on?
That is excellent that you will be home testing. Some use the Relion meters and strips from Walmart. I personally use the Alpha Trak2 only thing is the strips are $1.00 a piece and we do a lot of testing.
There is a lot of great information to study in this forum.
Please set up a Spread Sheet it will help them to be able to give you guidance.
Someone should come along to answer your questions.

 

[Wren]

Hi Karen,
Welcome!
Most of us feed either raw or the Purina One Pates or Fancy Feast Classic are fine. Please don't let the vet send you home with prescription food.
I am new and unable to offer dosing advice.
What type of insulin will you be putting him on?
That is excellent that you will be home testing. Some use the Relion meters and strips from Walmart. I personally use the Alpha Trak2 only thing is the strips are $1.00 a piece and we do a lot of testing.
There is a lot of great information to study in this forum.
Please set up a Spread Sheet it will help them to be able to give you guidance.
Someone should come along to answer your questions.

Thanks for your lightning fast response DebG! Thank you for the food advice. I will tell the vet that I have his diet under control. What's funny is I will probably be paying less now for his food than before since I was giving him Nutro Soft Loaf which was more than $1/can.

Are the AlphaTrak strips more expensive than the Relion strips? I am on a single teacher salary so need to save as much as possible!

Also, what kind of spread sheet should I be making? Is there a post that will tell me?

Thank you again!
Karen

 

[Wren]

Oh wait I see your attached link now DebG! Sorry I'm on my phone.

For the spreadsheet, what is all the +1, +2? I have not started giving insulin yet so maybe why that's why I don't understand the chart? Is there an explanation somewhere?

 

[Squalliesmom]

Hi Karen, welcome to FDMB! I'm not 100% certain but I think the Nutro Soft Loaf is pretty low in carbs, The chicken flavor is about 3%, if I'm not mistaken. If that's the case then you are good on food - and yes, Fancy Feast, Friskies, 9 Lives, all of those have some pates in the acceptable range. Here is a very handy chart that gives you the percentage of carbs for many popular foods:

http://catinfo.org/docs/FoodChartPublic9-22-12.pdf

A diabetic cat should eat a diet of no more than 10% carbs.

Here is the link to the spreadsheet we use here:

http://www.felinediabetes.com/FDMB/threads/fdmb-spreadsheet-instructions.130337/

If you have trouble setting it up, just sing out, someone will be happy to help you with it.

This is also a good example of how to use the spreadsheet:

http://www.felinediabetes.com/FDMB/threads/understanding-the-spreadsheet-grid.156606/

Sometimes it can be intimidating when you first start out, but it really is very simple to use, and will be an invaluable tool for you to use.

I'm so happy to hear that you want to home test! It really is vital to the well-being and safety of your kitty. Please don't let your vet or anyone else discourage you from testing at home! For some reason some vets don't encourage it, some of them even actively discourage it; I have no idea why. I don't imagine any of them would administer a powerful hormone like insulin to their child without testing first to make sure it was safe! It works the same way with our beloved kitties.

Many of us here use the Walmart Relion brand meters; they are reasonably inexpensive, and the test strips are affordable, but really almost any meter will do. I would advise against the Alphatrak, just because of cost; it is an excellent meter. I bought one when my cat was first diagnosed, and I have hardly ever used it. Once I found out how expensive the strips for it are, I bought a Relion and have happily used it ever since, lol!

I am sure you will have other questions as you go, and please don't hesitate to ask them here. The members here have a great wealth of knowledge and experience, and are more than happy to share it with you and help you to the best of their abilities!

Lucy

 

[Wren]

Hi Karen, welcome to FDMB! I'm not 100% certain but I think the Nutro Soft Loaf is pretty low in carbs, The chicken flavor is about 3%, if I'm not mistaken. If that's the case then you are good on food - and yes, Fancy Feast, Friskies, 9 Lives, all of those have some pates in the acceptable range. Here is a very handy chart that gives you the percentage of carbs for many popular foods:

http://catinfo.org/docs/FoodChartPublic9-22-12.pdf

A diabetic cat should eat a diet of no more than 10% carbs.

Here is the link to the spreadsheet we use here:

http://www.felinediabetes.com/FDMB/threads/fdmb-spreadsheet-instructions.130337/

If you have trouble setting it up, just sing out, someone will be happy to help you with it.

This is also a good example of how to use the spreadsheet:

http://www.felinediabetes.com/FDMB/threads/understanding-the-spreadsheet-grid.156606/

Sometimes it can be intimidating when you first start out, but it really is very simple to use, and will be an invaluable tool for you to use.

I'm so happy to hear that you want to home test! It really is vital to the well-being and safety of your kitty. Please don't let your vet or anyone else discourage you from testing at home! For some reason some vets don't encourage it, some of them even actively discourage it; I have no idea why. I don't imagine any of them would administer a powerful hormone like insulin to their child without testing first to make sure it was safe! It works the same way with our beloved kitties.

Many of us here use the Walmart Relion brand meters; they are reasonably inexpensive, and the test strips are affordable, but really almost any meter will do. I would advise against the Alphatrak, just because of cost; it is an excellent meter. I bought one when my cat was first diagnosed, and I have hardly ever used it. Once I found out how expensive the strips for it are, I bought a Relion and have happily used it ever since, lol!

I am sure you will have other questions as you go, and please don't hesitate to ask them here. The members here have a great wealth of knowledge and experience, and are more than happy to share it with you and help you to the best of their abilities!

Lucy

Thanks Lucy! It's good to know that the food I had him on was already low in carbs. However, he started throwing up the chicken flavor which had been his favorite and then refused to touch it again. He would turn his nose up at the turkey one at first but then go back and eat it when he was hungry, so I figure I should probably just change the food!

Thank you for the information on the spreadsheet and Relion.
2 more questions:
1) Once you are in a routine, how often do you take your diabetic cat to the vet?
2) Is there a good pet insurance that helps cover some of the costs?

 

[Squalliesmom]

How often your cat sees the vet is really something you and your vet will determine. My kitty almost never sees the vet - his vet has a link to Squallie's spreadsheet so he can check on him any time, and it also helps if I call with questions. Our vet is very good, and is fine with me home testing and running curves at home. SO Squallie only sees him if a problem that I can't deal with at home crops up, and it's usually not directly related to his diabetes.

I have insurance on all three of my other cats, but not on Squallie. When I bought the insurance it would have cost me as much to insure him as it did all the other three combined, and I just couldn't afford it. This was due to his age - he was 15 or 16 at the time. If you are going to look into getting insurance, it probably won't cover Micah's diabetes, as they woiuld consider that a pre-existing condition.

 

[Wren]

Is this what I'm looking for?

 

[Wren]

How often your cat sees the vet is really something you and your vet will determine. My kitty almost never sees the vet - his vet has a link to Squallie's spreadsheet so he can check on him any time, and it also helps if I call with questions. Our vet is very good, and is fine with me home testing and running curves at home. SO Squallie only sees him if a problem that I can't deal with at home crops up, and it's usually not directly related to his diabetes.

I have insurance on all three of my other cats, but not on Squallie. When I bought the insurance it would have cost me as much to insure him as it did all the other three combined, and I just couldn't afford it. This was due to his age - he was 15 or 16 at the time. If you are going to look into getting insurance, it probably won't cover Micah's diabetes, as they woiuld consider that a pre-existing condition.

Thank you Squalliesmom. I hope I can be that routine and comfortable with giving him home tests one day! Sucks that insurance probably won't cover him

 

[Squalliesmom]

I can't see the images you posted so I can't answer your question, lol. Try using the button at the bottom of the page that says Upload a File.

It's good to know that the food I had him on was already low in carbs

This is important because when you switch from a high carb diet to a low carb one it can cause blood glucose to drop 100-200 points. If your cat is on insulin and this occurs it can bring on potentially deadly hypoglycemia.
ETA: Another good reason to test at home!

 

[Wren]

Here are the picture again.

 

[Chris & China (GA)]

1) Once you are in a routine, how often do you take your diabetic cat to the vet?

Once we got our script from the vet, China hasn't been back to a vet for her diabetes since (we're on year 4 now)...With the help of the great people here, she's been doing great! (she has been seen for other things and our current vet and I have conversations like this "how much insulin is she on....X.X units and her blood glucose usually runs between 50-120 on a human meter...OK"....and that's it)

2) Is there a good pet insurance that helps cover some of the costs?

Unfortunately, no...Once your cat has been diagnosed, it's a pre-existing condition and pet insurance won't cover it

 

[Chris & China (GA)]

Here are the picture again.

Yes, those are perfect!!

 

[Wren]

Yes, those are perfect!!

Thanks! Does it matter if it's the "Micro" vs the "Confirm" that I see in your info?

 

[Squalliesmom]

Yes. those are good. I use the Confirm. Some people use the Micro because it uses only a tiny drop of blood, but my Confirm also doesn't need much blood. There is also a Prime, but it does use more blood; however it also has the cheapest test strips. You will also need lancets, probably 26-28 gauge to start with. You can decrease the gauge (which is actually an increase in number!) once you are comfortable with testing. I use 30 gauge. It can help to get some Neosporin with pain relief ointment (not creme) to apply. I put a very thin layer on the ear before I use the lancet; it helps to deflect any pain there might be (more on that later) and it helps the blood drop to bead up rather than dispersing through the hair, which makes it harder to test.

 

[Chris & China (GA)]

The Confirm and the Micro both take the same tiny sample and the same strips

The only difference in the two meters is the size of the actual meter....The Confirm is a little bigger and easier for me to hold onto than the Micro is

 

[Wren]

Yes. those are good. I use the Confirm. Some people use the Micro because it uses only a tiny drop of blood, but my Confirm also doesn't need much blood. There is also a Prime, but it does use more blood; however it also has the cheapest test strips. You will also need lancets, probably 26-28 gauge to start with. You can decrease the gauge (which is actually an increase in number!) once you are comfortable with testing. I use 30 gauge. It can help to get some Neosporin with pain relief ointment (not creme) to apply. I put a very thin layer on the ear before I use the lancet; it helps to deflect any pain there might be (more on that later) and it helps the blood drop to bead up rather than dispersing through the hair, which makes it harder to test.

For the lancets, do I need a "Lancing device" as well? Is it hard to start with the 30 gauge? I am seeing that Walmart only carries the ReliOn 30 gauge, though they do have the 28 in a different brand.

 

[Chris & China (GA)]

Look for "Alternate site testing" lancets....they should have them in the Relion brand that are 26 or 28 gauge

You don't HAVE to get the device at all.....I prefer to just freehand myself because I can see exactly where I'm aiming, but some people like them....but the lancets that come with most of them are 33 gauge and those are too tiny for new ears

If you can't find the Relion ones, I'd get the other brand and just don't worry about the lancet device....they're all relatively cheap and will last for at least 50 days

 

[Squalliesmom]

Your meter kit will probably come with a lancing device included. I never use mine as I feel I have more control if I just free-hand it. A lot of people do use the device, though, it's really just a personal decision. As far a the gauge goes, 28 is fine, so is 30, really, it just takes a while for kitties' ears to "learn" to bleed from the capillaries at the edge of the ear, hence the initial use of a larger gauge maybe proving more helpful. And any brand is okay, they are all pretty much the same, for the most part.

 

[Wren]

Aww poor kitty and his ears! Ok thank you both for your advice! I will go pick some up from Walmart tomorrow before the vet appointment!

 

[Squalliesmom]

Aww poor kitty and his ears! Ok thank you both for your advice! I will go pick some up from Walmart tomorrow before the vet appointment!

Kitties actually have very few nerve receptors along the edge of their ears, luckily!

 

[Olive & Paula]

Sounds like your set up to get started. Welcome to the club. I use the Purina One smart blends among others. The chicken is 2% carb and the beef is 5% I believe. I also started with the Alpha Trac meter, but definitely strips are expensive and you just can't run to the store if you run out. I use the micro you pictured above and love it. Just ordered more strips.

 

[Wren]

Hey all! So just got back from the vets and wanted to update! Lol I was a total nerd and brought a screenshot of the data on Purina One Pate but the vet was cool with me not going with the prescription diet. Wasn't too fond of the idea of curving glucose levels at a hospital stay but said I could do it in the home tests. He wasn't very happy that I had gone ahead and gotten the ReliOn monitor but seemed to understand after I told him about how much cheaper the strips were. He was about to recommend Alpha Trac.

We are putting Micah on 2 units of the (sorry forgot the name and I'm on my phone) the insulin that sounds like Zinc? I just gave him his first shot tonight and he was actually still purring while I gave it to him! So good signs!

One concern I have is that he seems like he's starving! I feed him one can at 7:00am and one can at 7:00pm. If I give him a snack in the middle will that mess up his sugar levels? I don't get the monitor and package from Walmart until Friday.

Oh! His blood glucose level today was about 340 on the vets Alpha Trac.

Thanks for your support and wisdom! So far so good!

Oh oops another question: some people in this thread said to prick the edge of the year but the vet said to avoid the edge because it bleeds a lot and stay in the upper center?

 

[Chris & China (GA)]

Sounds like ProZinc is the insulin..it's a good insulin for cats

Until he's better regulated, he's going to be extra hungry. Our diabetic cats are really starving to death. Without insulin, the food they eat can't get into the cells to "feed", so the cat eats more and more trying to stay alive. Think of insulin like a "key"...and there's a "lock" on the door of each cell in the body....without that "key", no matter how much food they eat, the glucose can't get into the cells to nourish them.

It's fine to feed more often than twice a day. It's actually easier on the pancreas to deal with several mini-meals than it is to deal with two huge ones. Most of us feed every few hours. It IS important that you take all food up for the 2 hours before shot times so that when you test, you get a number that's not influenced by food

As for where to poke, it sounds like your vet is thinking of the vein that runs along the edge...and he's right...if you prick there, it'll bleed like crazy and your home could look like a crime scene from NCIS.

But you want to aim for between the vein and the very edge of the ear. We call it the "sweet spot"

At first, it may take more than 1 poke to get blood, but as you poke more and more, new capillaries will grow in and the ears will "learn to bleed"

 

[Wren]

Sounds like ProZinc is the insulin..it's a good insulin for cats

Until he's better regulated, he's going to be extra hungry. Our diabetic cats are really starving to death. Without insulin, the food they eat can't get into the cells to "feed", so the cat eats more and more trying to stay alive. Think of insulin like a "key"...and there's a "lock" on the door of each cell in the body....without that "key", no matter how much food they eat, the glucose can't get into the cells to nourish them.

It's fine to feed more often than twice a day. It's actually easier on the pancreas to deal with several mini-meals than it is to deal with two huge ones. Most of us feed every few hours. It IS important that you take all food up for the 2 hours before shot times so that when you test, you get a number that's not influenced by food

As for where to poke, it sounds like your vet is thinking of the vein that runs along the edge...and he's right...if you prick there, it'll bleed like crazy and your home could look like a crime scene from NCIS.

But you want to aim for between the vein and the very edge of the ear. We call it the "sweet spot"
View attachment 20811

At first, it may take more than 1 poke to get blood, but as you poke more and more, new capillaries will grow in and the ears will "learn to bleed"

Oh wow it seems like a very narrow space. I'll have to take another look at his ear before I try.

If my cat is 10 pounds, would it be too much to feed him 3 cans a day? 1 in AM/PM and maybe 1/2 as like a midnight snack/early afternoon snack?

 

[Wren]

Hm very strange. The way the vet showed me to prick the ear was completely different from all the YouTube videos I'm seeing. He pricked from the front of the ear (inside) in the upper center, but in the videos they all seem to be pricking that sweet spot on the edge from behind (outside of the ear)... Which way should I be doing this? Does it matter?

Thanks!

 

[BJM]

We like using the sweet spot. Whatever works for you is best. With dark fur, poking the inside of the ear may be easier to see.

When you have a moment, could you add a few tidbits to your signature? It will help us give you feedback.

Editing your Signature

In the upper right corner of the screen, within the dark blue bar, you will see ID, Inbox, and Alerts

Click on your ID.

On the left, under Settings, Click on Signature.
This is where you will put information that helps us give you feedback. You are limited to 2 hard returns, so separate pieces by | or -.
This is where you paste the link for your spreadsheet, once it is set up.
Add any other text, such as your name | cat's name | date of Dx (diagnosis) | insulin | meter general location (city and state/province) any other pertinent issues like if there are any food issues, history of DKA, hepatic lipidosis, pancreatitis, allergies, IBD, etc.

Click the Save Changes button at the bottom.

 

[Chris & China (GA)]

What food(s) are you feeding and how big are the cans? There's a "starting formula" for calories needed per day for cats that's [13.6 x weight in pounds] + 70.....the Food Chart at CatInfo.org has a lot of calorie counts for different foods

The best thing you can do is start weighing Micah and start there...If he needs to gain weight, feed a little more...if he needs to lose, feed a little less. A lot of have bought this HomeImage baby scale to keep track of our cat's weight

It actually doesn't matter where you poke, as long as you get blood, but along the edges of the ears there's less pain receptors and it's a lot less likely to bruise than in the "flap". It doesn't matter if you poke on the inside (where there's less hair) or the outside either....blood is blood

 

[Wren]

What food(s) are you feeding and how big are the cans? There's a "starting formula" for calories needed per day for cats that's [13.6 x weight in pounds] + 70.....the Food Chart at CatInfo.org has a lot of calorie counts for different foods

The best thing you can do is start weighing Micah and start there...If he needs to gain weight, feed a little more...if he needs to lose, feed a little less. A lot of have bought this HomeImage baby scale to keep track of our cat's weight

It actually doesn't matter where you poke, as long as you get blood, but along the edges of the ears there's less pain receptors and it's a lot less likely to bruise than in the "flap". It doesn't matter if you poke on the inside (where there's less hair) or the outside either....blood is blood

Okay updated the signature, but I am feeding Purina One Pate which is 3oz/can. At the vets today he was 10 lbs exactly.

So according to your formula I should feed him less than 2.5 cans/day? He should be getting 206 calories/day and each 3oz can was 93 cal. 2 cans would be 186 cal/day and 2.5 would be about 230 cal/day.

 

[Chris & China (GA)]

So according to your formula I should feed him less than 2.5 cans/day? He should be getting 206 calories/day and each 3oz can was 93 cal. 2 cans would be 186 cal/day and 2.5 would be about 230 cal/day.

That formula is just a starting point....for now, since he's not regulated, he'll probably need more to maintain his weight. If you don't want to buy a special scale, you can get an estimate of his weight with a regular bathroom scale...just weigh yourself, pick him up and do the math...that will help you know if he's gaining or losing weight

Is the 10lbs a "good" weight or does he need to gain/lose?

 

[Wren]

He doesn't exercise very much so I think it is a good weight for him. He could gain a pound or two though and still be ok.

Just got the monitor in early... About to test his sugar levels. Wish me luck!

 

[Ruby&Baco]

Good luck Karen! Hope everything will go well for you!

 

[billysmom (GA)]

Good luck!

 

[Wren]

Wow ok so 2 mess up strips, inserting the strip in the wrong way, and almost pricking myself later, Micah got a 348 on the ReliOn Confirm. That seems really high? He hadn't eaten since 7am.

Is there a table of the cat equivalent on the human scale? I can't tell what the colors mean in the spreadsheet. It seems like purple is in the middle so it's average?

Also I will make one tomorrow and add to my signature.

 

[Wren]

Also when I came home today there was either liquid **** or vomit in the litter box and the side of the litter box... Is this common when you all start cats on insulin?

 

[Chris & China (GA)]

On a human meter (like yours) we want them to spend as much time between 50-120 as possible....at those levels, the pancreas can actually heal and (hopefully) resume working like normal!

348 is high, but about average for a newly diagnosed diabetic...It will take time to learn Micah's patterns and find what will be a "good dose" for him

 

[Wren]

On a human meter (like yours) we want them to spend as much time between 50-120 as possible....at those levels, the pancreas can actually heal and (hopefully) resume working like normal!

348 is high, but about average for a newly diagnosed diabetic...It will take time to learn Micah's patterns and find what will be a "good dose" for him

Hm between 50-120 on the human scale? Should I do another test after he eats again (maybe an hour after his insulin shot)?

 

[Chris & China (GA)]

I'd get a test at +2 (2 hours after shot) and see how he's doing...after that, it depends on where he's at when we might want to get another test in

Have you read our Protocol for ProZinc?

 

[Critter Mom]

Congrats on getting your first tests in, Karen.

Also when I came home today there was either liquid **** or vomit in the litter box and the side of the litter box... Is this common when you all start cats on insulin?

Couple of questions for you:

When did Micah last have a solid poop?

Did you change his diet at all?

Have you altered his feeding frequency?

FWIW I have come across several cats here since I joined plus my own cat who did experience GI upsets of some sort after commencement of insulin therapy. I've never found a concrete reason to explain why this may be so.


Mogs
.

 

[Wren]

I'd get a test at +2 (2 hours after shot) and see how he's doing...after that, it depends on where he's at when we might want to get another test in

Have you read our Protocol for ProZinc?

Nope I hadn't read it so thanks for the link! Tested Micah again about 2 hrs after being fed/getting insulin and he was at 275.

I gave him half a can more after I tested him as a treat. I'm giving a total of 3 cans a day.

 

[Wren]

Congrats on getting your first tests in, Karen.


Couple of questions for you:

When did Micah last have a solid poop?

Did you change his diet at all?

Have you altered his feeding frequency?

FWIW I have come across several cats here since I joined plus my own cat who did experience GI upsets of some sort after commencement of insulin therapy. I've never found a concrete reason to explain why this may be so.


Mogs
.

Micah last had solid poop yesterday. Hes been pooping solid and regularly pretty well recently up until today so it was strange to find brown liquid. I did change his diet from mostly Nutro pate to Purina One Smartblends Pate literally the night before I started his insulin. However I think he had one normal poop after starting the food and before the insulin. I was feeding 2 cans a day. Now I'm giving him 3 cans with 1 can split in half as in between treats/snacks.

Is it like an adjustment period thing or do they regularly have diarrhea whenever they're on insulin? Lol I guess time will only tell with Micah. Luckily he made it to his litter box area and I have puppy pee pads all around it since he had been peeing outside the box by accident (before I fixed the situation by getting super high sides for the litter box).

 

[Chris & China (GA)]

No, diarrhea isn't "normal" anytime, but with a recent diet change, that's enough to cause it

Some cats are more sensitive than others to changes in diet and any new ingredient can cause vomiting/diarrhea for a few days

 

[Wren]

I'd get a test at +2 (2 hours after shot) and see how he's doing...after that, it depends on where he's at when we might want to get another test in

Have you read our Protocol for ProZinc?

Quick question. Are the numbers in that link for ProZinc on the human monitor scale or the cat monitor scale?

Also thanks I will see if he poops normal tomorrow.

 

[Wren]

Is 275 good? I see on the spreadsheet it's one step better? Is it still too high, or do I need to wait until mid cycle/nadir to determine if I should ask the vet to change the dosage? My vet said the cats that start at 1 unit always end up going up so he would start us at 2 which is much higher than the .5 in the Protocol thread.

 

[Chris & China (GA)]

Human....all our protocols are written with human meter numbers in mind

 

[Wren]

Human....all our protocols are written with human meter numbers in mind

Okay good to know! Thanks!

 

[Chris & China (GA)]

Is 275 good? I see on the spreadsheet it's one step better? Is it still too high, or do I need to wait until mid cycle/nadir to determine if I should ask the vet to change the dosage?

So he went from 348 to 275 in how long? How many hours since his shot?

275 is still too high....we want the nadir (the lowest point in the cycle) to be between 50 and about 100, and with ProZinc, we'd like to see the dose they're on getting Pre-shot numbers under 250'ish with nadirs in the "target zone" of 50-100.....that's why mid-cycle testing is so important....to see how low the current dose is taking him

It's also really important that you get our spreadsheet started and start keeping track of his numbers on it......The people here will really want to see it before giving much in the way of useful advice. Here are Instructions on Getting the FDMB spreadsheet. When you have it set up, the link will go in your signature so people can quickly see how he's been doing. If you have any trouble, just click on my name and choose "Start Conversation"...that's the same as a private message and I can set it up for you (takes about 30 seconds so it's no big deal if you can't figure it out)

The people here have many years of experience dealing with diabetes and can probably give you better advice than the vast majority of vets....it's not necessarily that they're "bad' vets...it's just that vets only get a total of 5 hours of formal education on diabetes when they're in school and that covers all species. Vets see more diabetic dogs than cats and a lot of them just treat their cat patients like small dogs and they just don't respond the same. Trying to stay up to date on the latest treatments/protocols takes a lot of time and most vets just don't have that kind of time....the people here do nothing but deal with sugarcats!

 

[Critter Mom]

My vet said the cats that start at 1 unit always end up going up so he would start us at 2 which is much higher than the .5 in the Protocol thread.

It is true that a cat who starts on a dose of 1 unit may go up but it is safer to start low and increase the dose by small increments (usually by 0.25IU). Jumping to too high a starting dose can result in 'skipping over' an optimum dose and this can then lead to the cat's body producing counter-regulatory hormones to protect it from hypoglycaemia which may actually drive numbers up, not down - and it can also lead to unexpected hypo numbers. If vets only see high numbers when a cat is in overdose they may then incorrectly prescribe further increases because both too much and too little insulin can lead to high numbers. We see a lot of cats arriving here who have been prescribed too much insulin. With insulin treatment it tends to be very much a case of slow and steady winning the race.


Mogs
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[Wren]

Ok so I feed/give the shots at 7:30am/pm. I tested him around 6:30 today after I got home from work and he was 348. Then I fed/gave him a shot at 7:30pm and waited 2 hrs after, as suggested, to test him again. So the pretest was only 1 hr before the next shot, not mid cycle. I won't be able to do that until this weekend. Unless I do the middle of the night, but he's also less active at night. 1st test 348; 2nd test 275. I wasn't expecting the package from Walmart until Friday so didn't bring my laptop home from work to do the spreadsheet but I'll do it tomorrow.

 

[Wren]

It is true that a cat who starts on a dose of 1 unit may go up but it is safer to start low and increase the dose by small increments (usually by 0.25IU). Jumping to too high a starting dose can result in 'skipping over' an optimum dose and this can then lead to the cat's body producing counter-regulatory hormones to protect it from hypoglycaemia which may actually drive numbers up, not down - and it can also lead to unexpected hypo numbers. If vets only see high numbers when a cat is in overdose they may then incorrectly prescribe further increases because both too much and too little insulin can lead to high numbers. We see a lot of cats arriving here who have been prescribed too much insulin. With insulin treatment it tends to be very much a case of slow and steady winning the race.


Mogs
.

Hm ok so what I'm getting is I should wait and get a nadir reading this weekend before making any decisions on adjustments? Or do you think I should ask the vet to cut back the dosage from 2 units?

I guess I could set an alarm and test again at nadir at 1:30am?