Ok, I'm really confused.

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songbyrdah

songbyrdah

Member Since 2014
Just called the vet because my kitties blood glucose levels have all been upward of 350 and more close to the 490's after 4 weeks on 1 unit of insulin twice a day. (Prozinc) I was concerned that her insulin may need to be raised, but the vet's office said I'm getting such high numbers because I'm testing her prior to eating and her injections. She said I need to test in the middle of the day and that with cats they are more concerned with low numbers. This seems to be contrary to everything I've read and it's definitely opposite to humans. They said I'm not going to get good readings from home testing and that I need to bring her in for fructosamine testing to get a more true number. How can any number be more true than what I am getting on a day to day basis? None of this really adds up for me. What do you guys think? Isn't the point to get her numbers down into a more normal range without going too low?
 
Sounds like they just want to prolong your kitties diabetes and increase your vet visits all costing you more $$$ while never giving your kitty a fighting chance to get regulated and possibly go into remission. You're vet may not be up to speed on the correct feline diabetes treatment protocol. confused_cat
 
We have a protocol for ProZinc that may help:

http://www.felinediabetes.com/FDMB/viewtopic.php?f=24&t=109077

We test, then shoot and feed, often giving the shot while the cat is eating and doesn't notice. If you feed first and it's been longer than 20 minutes or so, the number is likely to be higher because food raises levels. We want a number that is true to base the dose on - not one influenced by food. So disagree with your vet there.

She is right that you should also test during the middle of the day. Insulin lasts about 12 hours in cats and ProZinc tends to have a cycle that looks like a smile - going down in the middle to the lowest point. If you get a number then, you can see how low the insulin is taking your cat and how the dose is working. It is possible that your cat is going low midcyle and then bouncing back up for the number at shot time. So we would suggest you do both - always get a number before giving a shot so you know the dose you are planning to give is safe, and getting a number midcycle (between 5-7 hours after the shot) to see how low the insulin takes her. Then you can decide if the dose is too high or too low or just right.

A frutosamine test will only give you an average over the past few weeks. If you test regularly, you will have that information. We don't like curves done at the vet (curve= getting a number every 2-3 hours during a cycle to see how the dose is working) because stress raises blood glucose levels and most cats are very stressed at the vet.

The other part of this puzzle is food. We feed our cats wet low carb food to help keep their numbers low. A vet explains why here: www.catinfo.org. What are you feeding her?
 
Ok, I have no problem adding a mid-cycle test to see how her insulin is holding. That makes sense. She is currently eating Friskies pates and the ones she is eating are in the 6-7% carb range according to the food chart here. She is 16lbs and she gets half a can at 10am and the other half at 10pm. I tried increasing her feedings and breaking it down during the day into smaller feedings, but she didn't seem to like that and wasn't eating well at insulin time. I just did a check since it's been about 8 hours since her injection and she was at 252. I feel like home testing her is more accurate because she isn't under any stress here while it's being done. She is quite patient and calm about the testing and the injections. She'll come sit on my lap no problem for either. I feel like since I am getting accurate results at home the fructosamine is pointless and a waste of money. I guess for now we will keep testing and re-evaluate her in a week or so. I plan to do a curve test soon, so I can see exactly how she is cycling. Maybe that will get me further with the vet although they seemed kind of put off that I was home testing.
 
Well, if she is in the 300s at preshot and only in the 200s at nadir, I think I'd increase the dose a bit. As long as you can monitor, you could increase by .25 or .5 - depending on what feels better. Many cats need to get more than one unit of insulin, at least at first.

You might also look on our PZI forum. Everyone there is familiar with your insulin. Check out the threads. They all have a spreadsheet so you can see how they have adjusted doses and how their kitties are doing:

http://www.felinediabetes.com/FDMB/viewforum.php?f=24
 
You and your cat will definitely benefit with home testing, not only is a lot less stressful for your cat but you can monitor more closely and do test more often........the more the better at the beginning and then it will show everyone here if you update your SS. We always test, shoot then feed right away........and also remove the food 2 hrs before shooting to insure there are no food spikes which then gives a more accurate reading. Many of us don't listen to our Vet's - their egos are sometimes bigger then their experience and I fired my first one, now have a GREAT Vet who has read up on many topics on this board. A Vet is a great thing to have, but not all are well versed on FD but you can send them some of the links you read here and ask that they read up on FD and what threads are on here so that they can see the knowledge and perhaps learn a thing or two.

You've go lots of support here and people to put you in the right direction...........
 
For reference, we generally consider a cat regulated if they are in the mid to lower 200s at preshot and in double digits at nadir. (but not below 40 which is hypo range). We urge new diabetics not to shoot under 200 but wait 20 minutes and retest, without feeding. We consider a cat in remission if the range from 40-120, off insulin.

What kind of meter are you using?
 
I am using the One Touch Ultra meter. My mom is diabetic and this is one of her old ones that she gave me. I do have a relion here as well, but haven't used it on her because I'm out of strips for that one and have tons of strips for the One Touch.
 
The One Touch is fine (especially if the strips are free :mrgreen: ). Just wondering if you were using the pet meter (in which case we'd need to adjust the numbers because most people here use human meters) or one of the few that don't seem to be accurate (TruTest is one)
 
This may be helpful.

[Glucose reference ranges are unsubstantiated and have been removed by Moderator]


* * * * * * * * * * * * * * *​
Examples of using the chart:

Ex. You are a new insulin user and you test your cat before giving insulin. The test is 300. It probably is safe to give insulin.

Ex. You are an established user of Lantus, following the Tight Regulation protocol. You've tested around +5 to +7 to spot the nadir. It is 200 mg/dL. You probably need to increase the dose, following the instructions for the protocol.

Ex. Your cat is acting funny. The eyes are a bit dilated. You are concerned and test the glucose. The number is 35 mg/dL. ACK! The cat may be in a hypoglycemic state. You quickly follow the HYPO protocol linked in the glucose reference values chart. (which we really, really, suggest you print out and post on your refrigerator.)
 
I have a log book I have been writing all her numbers in, but I notice a lot of people using a nice spreadsheet. Is there a place on here to get the spreadsheet? I have looked around, but haven't found it if it's here. Can anyone point me in that direction?
 
Awesome! Thanks! I will keep tracking her and hopefully presenting my numbers to the vet in such an organized way will be harder to argue with. Thanks to everyone for all the help!
 
Once you get your spreadsheet set up and linked into your signature, we'll have read access to it also. That will really help us to see what is going on with your kitty.

Keep plugging away. We'll help you all we can to get your kitty feeling better.
 
Understanding the spreadsheet/grid:

Each day is 1 row. Each column stores different data for the day.

From left to right, you enter
the Date in the first column
the AMPS (morning pre-shot test) in the 2nd column
the Units given (turquoise column)

Then, there are 11 columns labeled +1 through +11
If you test at +5 (5 hours after the shot), you enter the test number in the +5 column
If you test at +7 (7 hours after the shot), you enter the test number in the +5 column
and so on.

Halfway across the page is the column for PMPS (evening pre-shot)
To the right is another turquoise column for Units given at the evening shot.

There is second set of columns labeled +1 through +11
If you snag a before bed test at +3, you enter the test number in the +3 column.

We separate day and night numbers like that because many cats go lower at night.

It is merely a grid for storing the info; no math required.
 
Well, now she's throwing me low numbers, so I'm glad we didn't increase her dose. Not sure if we're getting her regulated or what. She's a little bit of all over. I'm hoping this weekend I will get a chance to do a curve and maybe I'll get a better feel for what she's doing.
 
Sometimes they do that. It looks like 1 unit will be a safe dose ... for now. That's why we keep testing, because things change.
 
Her levels are looking good but I would try and get some more spot checks day and night as she may well be going lower and you are missing it. If she goes under 50 she earns a dose decrease.

Wendy
 
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