Numbers All Over

[ajamaistien]

Hello!

My cat, Chewy, was diagnosed on 4/12 and has been on Prozinc since then. I use an Alphatrak 2 meter because I wanted to use the same equipment his vet is.

He started out at 2 units and after a week was increased to 3 units. As of the end of last week he was on a 100% wet food diet and starting to respond amazingly.

Sunday night before his evening dosage he tested at 199 (queue my eyes popping out of my head) and retested at 186 twenty minutes later. I texted his vet and skipped his dose, who suggested that I lower his dose to 2.5 units for now.

Yesterday morning after skipping his Sunday evening shot he was at 468, and yesterday evening he was at 369 after receiving 2.5 units that morning, both preshot. I tested him this morning after another 2.5 units last night and he was at 280, which is right above the "no shot" range listed for Alphatrak 2 and so I'm not giving him his shot this morning since I work and won't be able to monitor him. I also texted his vet and am waiting to hear back.

I don't have a glucose curve yet since I haven't had the time to be home to do one (plan to this weekend), but in general, how should the shots he adjusted as he gets used to his new diet and his numbers adjust? He's thrilled to death he gets wet food all the time now so he is definitely eating.

Thanks in advance!

 

[Kris & Teasel]

Welcome! It's great that you're testing his BG at home. Is he he completely switched to a wet food diet? Is it low carb (under 10%)?

Here's the testing routine we recommend and how dose changes are determined:

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.

 

[ajamaistien]

Welcome! It's great that you're testing his BG at home. Is he he completely switched to a wet food diet? Is it low carb (under 10%)?

Here's the testing routine we recommend and how dose changes are determined:

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.

Thank you! Yes he is completely on a wet food diet with <10% of calories derived from carbs (Fancy Feast and Friskies patés without gravy). How would I tell if the insulin needs to be reduced?

 

[Kris & Teasel]

Thank you! Yes he is completely on a wet food diet with <10% of calories derived from carbs (Fancy Feast and Friskies patés without gravy). How would I tell if the insulin needs to be reduced?

The way we do it here is by collecting data on a spreadsheet. That testing routine meshes with the spreadsheet. We look at the array of BG numbers at dose times and between to assess the effectiveness of the dose. There's really no way to know whether a dose is too high unless you manage to capture a very low number at test time or kitty shows hypo symptoms (spaciness, staggering, sometimes vocalizing, etc.).

Here are some guidelines for assessing a dose:

• nadir (lowest point of BG) about 50% of the BG at the pre shot test
• good numbers are pre shots in the low to mid 200s and nadirs in the high double digits to low 100s.

 

[Rachel]

The more data you get, the more we can help figure out what's going on. Following the testing routine that Kris laid out will definitely help. As you get to know your kitties numbers more, you can detect patterns and have a good idea of what they'll do on any given day (though they can always surprise us!).