(Now In Remission) - Human Glucometer comparing to vets readings

Hi,

We are in Thailand and have a few rescue cats, this is the first time we have had to deal with diabetes.

She was quite ill and wasn't sure she would survive just under 6 months ago with a liver issue also.

Her liver is now back into the normal range and she has been having caninsulin 7 units twice a day with a u100 syringe. The last 2 weeks though she has been suffering from low blood sugar a few hours after insulin.

Last week at the vet her fasting blood sugar was 202 at 7.30AM, she ate and took insulin around 8AM and when we went back to the vet around 6PM it was down to 92. This is the vets reading from blood taken in the leg vein. Vet said it was too low and suggested to give 7u just once a day. But she is still having low blood sugar episodes 3 out of 7 days this week (by observation not testing).

We have now got a human glucometer (Sinocare) so we are trying to match it up to the vets readings.

Today fasting blood sugar was 125 at the vet from the leg vein at 7.30AM (vet says too low), our human meter was 83 from the same blood sample. We also tested a sample from an ear prick which was 59 on our meter.

We are confused how to compare our readings to the vets.
Vets leg vein reading is 66 or 110% higher than our ear prick reading of 59.

We will go back to the vet at 6PM evening so we will have another chance to compare readings.

Any tips on how to convert our ear prick reading to the vets leg vein readings?
What would be considered too low for our home test, I read 80-120 is normal range for a cat but they don't say how this test is done leg or ear.

Any advice?

 

Therre is no direct correlation between a pet and a human meter. They measure different components of the blood.
So many people have tried to come up with a formula between the two meters without success.
What we know is that the two meters are farther apart at the high end and closer together at the lower end.

It doesn't matter if you test from the ear or the leg.

The amount of insulin being given is very scary.

And low blood sugar is very dangerous. It can turn from no symptoms to seizures (and more) in an instant.

Can you print off our dosing regulations on vetsulin to show to the vet?

BEGINNER'S GUIDE TO CANINSULIN/VETSULIN

And here are the instructions for a low numbers situation:

• How to treat HYPOS - THEY CAN KILL! Print this Out!!
• jojo and bunny's HYPO TOOL BOX

 

I would advise that you go back to 1 unit twice a day -- and only if the test before the shot is over 200. If the test before the shot is under 200, do not shoot.

If you set up a spreadsheet, it would be very helpful. We are pretty much data driven and the spreadsheet is the first place someone will look.

 

I'm tagging a couple of very experienced people.
@Suzanne & Darcy
@Wendy&Neko

And thank you for rescuing the cat.

 

@chingching
I agree with Red & Rover 7 units is crazy high.
It would be helpful if you can tell us about your kitty
Tap in this blue link
Here is a link helping us to help you link. If you noticed, our members have some basic information about their cat's in their signature. This helps us to not pester you by asking the same questions (your cat's name, insulin type, date of diagnosis, etc.) repeatedly. We also have a link to our spreadsheet in our signature. We are very numbers driven. The spreadsheet is a record of your cat's progress. By linking it in your signature, we can follow along and provide feedback should you need the help

It will also explain how to set up our spreadsheet and explain how to use it, it's really very easy. I would continue to test your kitty at home with the human meter that's what our numbers are based on.

Take a look at anyone's spreadsheet
If you want help setting up the spreadsheet just ask, we have a member who would be happy to set it up for you

 

Sorry, Not sure I am right saying 7 Units?

To be clear it is to the 7 mark on a U100 syringe

Looking at the conversion chart 7 on a u100 is 2.8 on a u40 syringe. The vet kept our cat for a few days when she was first diagnosed with regular checking to establish the dosage.

The syringe is U-100 0.5ml 30G X 5/16" (8mm)

(not been able to get u40 syringe even the vet)

Thanks

 

With Vetsulin you should be using U-40 syringes ,preferably with half unit markings

 

Welcome to the forum . If you are using U-100 syringes drawing up to 7u with Vestulin which is a U-40 insulin means you are giving 2.8u. Regardless, it appears with the numbers you are getting that it’s worth reducing the dose. With the dosing method we follow here, that @Red & Rover (GA) posted above, if you get a BG test of under 90, that would warrant a reduction.

 

Vetsulin is know to hit hard and fast, which means it can affect blood glucose levels shortly after giving the dose, so it is important that you make sure she eats before giving insulin. You want to 1) test to be sure BG is safe to shoot 2) feed then wait 20-30 minutes, then 3) shoot. You’ll likely see a quick drop so, depending on your feeding schedule, it would also be worth making sure that you feed small snacks early in the cycle to help prop up the numbers.

 

My apologies. I read rather quickly and was trying to get information to you as fast as I could.
Welcome to the best place you never thought you would ever be. The people here have done the research and have lived feline diabetes 24/7.
Waving from Canada.

 

Here's the conversion chart

 

Don't shoot Vetsulin just once a day, it doesn't even last the full 12 hours in a cat. Much better to reduce the dose for both the AM and PM shots. 2.5 units on the U-100 syringe will get you 1.0 units of Vetsulin.

 

Didn't know you were using the conversion chart
Do the U-100 syringes you are using have the half unit markings?
@chingching
U-100 syrings with half unit markings

 

Thanks for all the replies.

She has been fine on 7 units twice daily (u100 syringe) for a few months with regular vet checks, its just this last couple of weeks we have been having problems.

We reduced to 6 units twice daily ourselves whilst waiting to get back to the vet. After the vet checked he suggested 7 units once a day as a trial to see, this was a week ago.

Now we have our own glucometer the vet has said to test every 4 hours today and go back at 6PM today, but if it looks like she is low BS again we will go back earlier.

Originally the vet supplied us U100 syringes in 1ml but markings were spaced every 2, but its really hard to measure, The vet and us have been unable to source u40 syringes here. But I have been able to order in u100 0.5ml syringes which is a bit easier as they have markings every 1. 0.5 spacing would be better but not found any.

 

Once we start home testing with our own meters, most of us stop going the vet frequently.

 

Thanks yes we are hoping so, less stressful for the cat.

We will go to the vet again today as we are trying to see how our readings compare to his. Checking at home is more about convenience, our check up for BG today was 80 Baht (US$2.25),

 

Update...

Yesterday (Mon 11 Mar)
7.40AM @ Vet
Vets Fasting BS (fasting since 22.00 day before) reading 125 from leg vein, Our reading from same blood 83, Our reading from ear prick 59.

7.55AM Eat, 8.00AM Insulin (7u with u100 equiv to 2.8u on u40)
10.40AM BS LO <20 ear prick @ home (No symptoms of low BS)
by around 13.00PM showing small signs of low BS, so we went to the vet again
13.40PM 36 from leg vein, our reading from same blood LO <20, Our reading from ear prick LO <20

Vet suggested this was very low, perhaps she does not need insulin at all. He wants us to stop insulin for 2 days, daily test at home and then repeat Fasting blood sugar on Thursday @ vet

Today (Tue 12 Mar)
6.40AM (before food) ear prick @ home 115.

 

When did you last give insulin? 7 units is WAY too much insulin. I wouldn't test at the vet but offer to do a curve at home. Cats often test higher at the vet due to stress.

 

7u on a u100 syringe so equivalent to 2.8 on a u40. Originally twice a day since 5/6 months ago but changed to once daily a week ago as experiment, no insulin for next couple of days with testing at home (last insulin dose was yesterday 8.00AM, so 24 hours ago)

 

So she went LO, two and a half hours after getting the 2.8 units (7 unit on U100 syringe) of Vetsulin yesterday. And was still very low 5 hours later. I would keep periodically testing the next couple of days. It's possible that she'll do what we call a bounce and have high numbers in reaction to the low numbers she saw. Don't give insulin in response to the high numbers if you see them. The bounce and high numbers will go away on their own. It may take longer than 2 days for the numbers come down. We've seen cats take longer when greatly overdosed, to come back down to normal numbers. I'd still reconsider going to the vet after a couple days, it might be too soon. And the vet visit might not be needed at all. You can test at home. And share those numbers with the vet, without the cat going in.

 

Thanks,
I'll see what the numbers are like before deciding to go back to the vet. Concerned about the accuracy of our home meter as it was not expensive so I really want to be sure of its accuracy.
I think the vet is thinking along similar lines he wants to clear the insulin out for a couple of days and monitor at home to establish new dosage if any is needed, its around 6 months since diagnosis so this seems to be the time some cats go into remission. I'm having a go at adding a spreadsheet.

 

If you are not giving any insulin at all I would still test first thing in the AM and put that reading in the AMPS cell ( or square) just don't feed your cat any food 2 hours prior to testing the AMPS or PMPS you don't want the BG to be influence by food.
I would also get a few tests at night after the PMPS test
@chingching

 

Than

thanks I wasn't sure what that that AMPS / PMPS box was.

Vet said to test in the morning before food, but I thought I would try it a bit more when I can - maybe not necessary.

If I am not giving insulin shall I count the hours from feed time?
today we tested 6.40AM before food (will put in AMPS), eat around 7.30, tested again 10.40 (I have put in +3)

 

The AMPS means AM Pre Shot
PMPS means PM Pre Shot
Yes you can test a bit more after that if you can

Can you tap on this blue link and add your signature
Here is a link helping us to help you link. If you noticed, our members have some basic information about their cat's in their signature. This helps us to not pester you by asking the same questions (your cat's name, insulin type, date of diagnosis, etc.) repeatedly. We also have a link to our spreadsheet in our signature. We are very numbers driven. The spreadsheet is a record of your cat's progress. By linking it in your signature, we can follow along and provide feedback should you need the help

 

I think the meter you are using is fine. Most of us in the US use human meters that only cost nine dollars .
As long as your test strips are not expired you are fine
@chingching

 

In general, human meters read lower than pet meters, though they are closer as they get to lower numbers. Our dosing methods were developed with human meters, before pet meters were even around. So we are used to deciding what to do with the insulin dose based on human meter numbers.

Good job getting that spreadsheet set up. Thank you, it really helps us see what is happening.

 

Readings are decreasing today, with no insulin today last was 8.00AM yesterday

AMPS 115 6.40AM (before food),
Food at 7.30AM, Liver Supplement Hepaphos at 7.50AM (only take every 3rd day now, was daily then every 2nd)
+3 10.40AM 102
PMPS 6.50PM 83 (First reading was LO so redid)
Food at 7.30 PM

 

Excellent numbers so far. If numbers stay under 120 like this, you will not have to go back to the vet.

 

With a human meter am I right with...
<50 Hypo
<90 Insulin reduction needed
<200 AMPS PMPS Dont give insulin
<120 Don't have diabetes/ remission

How does this compare to the ranges on the spreadsheet, what are we aiming for?
Blue BG 100-199 - Peak?
Dark Green BG 50-99 - Trough?
If she stays within 50-199 all the time does she not need insulin anymore?

Thanks for all the help

 

With a human meter, cats not on insulin can test in the 40's, but we don't want a cat on insulin to go that low as it leaves no room for error. The number a cat shows a hypo may differ by cat somewhat. For remission, you want to see 14 days without insulin, and numbers generally below 100. If they are above 100, feed a small meal and test 3 hours later to see if the pancreas started working to bring the numbers to below 100. I said 120 as you can get periodic numbers above 100 and there could be some minor differences between meters.

 

Readings are still looking good to me. She has had no insulin since 8AM Monday, its now 8AM Thursday, so we have delayed going back to the vet until Friday.

This morning 7.20AM 84, but she won't eat this morning. She last ate 7.10PM yesterday and there were a few pieces left in her bowl which she had eaten overnight sometime.
She has never been a big eater even before diabetes. Since diagnosis she has been eating Canin Diabetes dry food, a few months go we slowly started mixing in with some normal food 10%,25% and now almost 50% (to save costs), but not every day a couple of days she eats just the RoyalCanin.

When she didn't eat some days when on insulin we ground the food and mixed with water to spoon feed her so we could inject her. Should I do that again now, or my thinking is just leave it be as her numbers are ok- its just one missed meal and she may eat it later. Thanks

 

Some cats get tired of the so called diabetes food. You can switch her to any low carb wet food at this point. Will she eat wet food instead of dry? Almost all dry food is really too high for a diabetic cat, even one in remission.

 

Thanks,

Yes she just ate a little wet food, but only a few mouths full.

Most of the canned food here seems to low/zero carbs using a calculation I found online.
The one we have now is Protein 13%, Fat 0.3%, Fibre 0.1%, Moisture 84.5%, Ash is not given but we estimated at 3%.
So this comes out with an estimate of Zero carbs.

RoyalCanin is hugely expensive which is why we started mixing it, our regular food that our other cats eats is around 30% carbs, not sure what RoyalCanin diabetic is surprised the pack does not say and doesn't list moisture either.

We have a large cage that she stays in overnight (so we can see what she's had drunk and eaten etc away from our other cats). She always eats better in the morning than PM and if we feed her before letting her out she is much better, but if we need let her out to do some procedure before food like the ear prick test then she is reluctant to eat after it, whether back in the cage or outside it.

 

Chings numbers are still looking good.

We went to the vet the end of last week, his own BG check at 7.40AM after fasting since 10PM the night before was 104, at the same time our human meter ear prick test was 66.

The vet agreed her numbers were good without insulin, last insulin was 8AM 11 March, its 19 March now. He asked us to monitor at home AM / PM before food every 3 days, I've been doing every 2 just to be sure.

 

7 days of beautiful normal blood sugar numbers. One more week like this and she's officially in remission. A cat in remission is a diet controlled diabetic, so she will have to stay on low carb food.

Once she's in remission, you can move to weekly tests for a month, then monthly. Check sooner if anything seems off.

 

Today is the 16th day that ChingChing has had no insulin

All the numbers look good, been testing every 2 days, then 3 and now I will move to weekly testing.

Hope it stays this way. Thanks for the advice.

 

Congratulations! Officially in remission. Ching Ching should stay on a low carb diet as she's now a diet controlled diabetic. Try to avoid steroids at all possible if you can. If anything seems off, check her blood sugar.