One meter says hypo, pet meter doesn't

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Critter Mom said:
From the manufacturer's guidelines for starting dose of Caninsulin/Vetsulin:

View attachment 58239

Maximum recommended starting dose per cat is 2 units, and nowadays is linked solely to degree of hyperglycaemia at time of diagnosis. (Note: In an older version of the Merck Caninsulin protocol, starting dose used to be linked to both degree of hyperglycaemia and weight, but even back then the maximum dose was still 2 units IIRC.)


Mogs
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Thanks for this. I'm totally gonna email it to my vet and demand some kinda answers for risking my cat
 
Red & Rover (GA) said:
@Butters & Lyla is another Canuck who uses the OneDrop strip subscription service.

We have all been where you are. :bighug:
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Yes I was looking into the OneDrop subscription. Even with the exchange 100 strips is literally half the price of Shoppers in the GTA. They were $110 before tax. I ended up going to Metro where they were $87. I would love to hear peoples experience with this.
 
Oh that face. What a handsome boy.
Hello, I am also from the GTA.:) Welcome. Red is right, we all have been where you are right now. The vet who diagnosed Butters, who weighs <4 kilos, based her starting dose of 2 U of caninsulin on her weight. He flat out refused to support me if I was going to home test. He also said I had to feed a prescription diet and made me sign a sheet saying I refused it. :banghead: I was so thankful I found this board. I switched her to Lantus...it is a much gentler insulin. The Caninsulin didn't work for her.

Even buying test strips online from a Canadian site like Diabetes Express, which is where I buy my syringes, the test strips are much more expensive. The O.D. is working out well.
 
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A curve done at home is less stressful for the cat, so you will get a truer picture of what the BG levels are for your cat.

Right now, with those low BG readings you are getting, I would not give any insulin.
Sometimes, the diet change is enough to drop the BG numbers back to a normal range.
Plus the antibiotic could have cleared up the infection/inflammation causing the BG numbers to be high in the first place.

It's possible that your cat was not diabetic to begin with, and the infection/inflammation was keeping the glucose levels high. Also, a phenomenon called "vet stress" can artificially inflate the BG levels by quite a lot, for hours. So that is another reason to run the glucose curves yourself at home.

Was your cat also drinking a ton of water, and have a voracious appetite?
Losing a lot of weight?
On any steroid medications?

I'm asking, because there are other reasons for a cat to pee a lot, like kidney disease, a UTI or hyperthyroidism.
 
Deb & Wink said:
A curve done at home is less stressful for the cat, so you will get a truer picture of what the BG levels are for your cat.

Right now, with those low BG readings you are getting, I would not give any insulin.
Sometimes, the diet change is enough to drop the BG numbers back to a normal range.
Plus the antibiotic could have cleared up the infection/inflammation causing the BG numbers to be high in the first place.

It's possible that your cat was not diabetic to begin with, and the infection/inflammation was keeping the glucose levels high. Also, a phenomenon called "vet stress" can artificially inflate the BG levels by quite a lot, for hours. So that is another reason to run the glucose curves yourself at home.

Was your cat also drinking a ton of water, and have a voracious appetite?
Losing a lot of weight?
On any steroid medications?

I'm asking, because there are other reasons for a cat to pee a lot, like kidney disease, a UTI or hyperthyroidism.
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We originally brought Marley to the vet for peeing at least 5 times a day. He's partially an outdoor cat who barely used the litter box before. He was also drinking a ton, especially at night.

Before he was diagnosed with a crystal problem and was prescribed a royal canin dry food for urniary problems. Hes been eating that for a few years and the vet said more frequently pee was normal.

He has also had quite a few corticosteroid shots. With the two most recent shots happening within 2-3 months of the diabetes diagnosis. He had these shots for some lesions on his tongue probably caused by his adventures outside.

When we first brought him to the vet for a blood test, they said that they think he either has a infection or his pancreas was acting up and gave the antibiotics. A few days later, when the blood test came back, they said he has diabetes and ran the same blood for a test that would check his bg for the last couple weeks to be sure. It came back positive.

I made sure to ask if we should continue the antibiotics because I figured diabetes was the problem.

The peeing has now slowed down but I'm not sure which solved the problem.

I'm worried about my cat because while he has no physical symptoms, he just seems more sad and dejected. After testing so much today, he doesn't even want to go outside. Which is not normal.
 
Butters & Lyla said:
Oh that face. What a handsome boy.
Hello, I am also from the GTA.:) Welcome. Red is right, we all have been where you are right now. The vet who diagnosed Butters, who weighs <4 kilos, based her starting dose of 2 U of caninsulin on her weight. He flat out refused to support me if I was going to home test. He also said I had to feed a prescription diet and made me sign a sheet saying I refused it. :banghead: I was so thankful I found this board. I switched her to Lantus...it is a much gentler insulin. The Caninsulin didn't work for her.

Even buying test strips online from a Canadian site like Diabetes Express, which is where I buy my syringes, the test strips are much more expensive. The O.D. is working out well.
Click to expand...

This is the second bad experience I had with a vet in the GTA. Its sad that we can never be sure cause even the reviews lie.
 
Marleysgirl13 said:
He has also had quite a few corticosteroid shots. With the two most recent shots happening within 2-3 months of the diabetes diagnosis.
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The corticosteroid shots may have induced the diabetes. If they were, the positive news is that quite a few cats can go into remission. I hope Marley is one of them. It will require testing vigilance. Some of them have flown down the dosing scale.

Marleysgirl13 said:
I'm worried about my cat because while he has no physical symptoms, he just seems more sad and dejected. After testing so much today, he doesn't even want to go outside. Which is not normal.
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Caninsulin really does hit hard and fast, and can make a cat feel yucky (for lack of a better word).
Give him a treat after each test. He will soon begin to associate testing with a treat. Freeze-dried cats treats are carb free. So is a small piece of tuna or boiled chicken.
 
Red & Rover (GA) said:
The corticosteroid shots may have induced the diabetes. If they were, the positive news is that quite a few cats can go into remission. I hope Marley is one of them. It will require testing vigilance. Some of them have flown down the dosing scale.


Caninsulin really does hit hard and fast, and can make a cat feel yucky (for lack of a better word).
Give him a treat after each test. He will soon begin to associate testing with a treat. Freeze-dried cats treats are carb free. So is a small piece of tuna or boiled chicken.
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Thanks for the good news. I'll make sure to bring that up.

I just tested him again as his PMPS and I was 5.7 on the Freestyle Lite. So I didn't give him any insulin.

I plan to do testing every 2 hours tomorrow for 12 hours, regardless if I give insulin tomorrow and emailing it to my vet with the info here.

Thanks for giving me a real plan of action.
 
Just an FYI in case you missed it. Lantus or Basaglar (both are "Glargine") is a MUCH better insulin for cats than Caninsulin which hasn't been recommended for use in cats for years.

It's also OTC in Canada. You can buy it from any human pharmacy. A 5 pack of pens is about $120 and will last most cats at least 1 year and some up to 2 years.

You would need to get U100 syringes though instead of using the U40 you have now.

Many of us gave up on trying to find a vet that knew what they were doing. My own cat never went back to the vet after I got her script (in the US we're required to have a script). If she did go to the vet for something else, I started the appointment with "She's on X units of Lantus and her blood glucose runs between Y and Z but today we're here for (fill in the blank)"....and that was usually the end of the conversation. If the vet did feel like she just had to say something, I'd smile, nod my head and say "I'll think about that" and come right back here.

Another option for meter/strips is the Bravo. Good points is the price...bad points is they're only available from one place so you have to make sure you order them in time to always have them
 
OK, still think that's too much insulin. I'm glad you're going to test regularly today.

Since your spreadsheet isn't up yet, let's keep a running tally today.

AT2 numbers

AMPS: 25.2 (454 in US numbers), 3U Caninsulin given
+2: 20.2 (364 in US numbers)

human meter numbers

AMPS: 16.5 (297 in US)
+2: 12.3 (221 in US)

You might want to save costs today by sticking to a single meter, unless you think your vet will want to see both sets. Or if you want to do one set for the vet (AT meter) but also keep your own records on the human meter because you plan to use that going forward-- that makes sense too!
 
Nan & Amber (GA) said:
OK, still think that's too much insulin. I'm glad you're going to test regularly today.

Since your spreadsheet isn't up yet, let's keep a running tally today.

AT2 numbers

AMPS: 25.2 (454 in US numbers), 3U Caninsulin given
+2: 20.2 (364 in US numbers)

human meter numbers

AMPS: 16.5 (297 in US)
+2: 12.3 (221 in US)

You might want to save costs today by sticking to a single meter, unless you think your vet will want to see both sets. Or if you want to do one set for the vet (AT meter) but also keep your own records on the human meter because you plan to use that going forward-- that makes sense too!
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Thanks for this! I'm going to set up a spreadsheet today for both the human meter and the pet one.

I'll make sure to post it and any testing update when I do.

I'm using the pet meter just for today because I honestly think my vet will dismiss the results from the human meter. But I plan to show that it gives the same approximate curve so he takes my human meter results more seriously in the future.
 
jt and trouble (GA) said:
Samantha I just wanted to say Marley sure has a regal look to himself ...Very smooooshable. :bighug:
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Yeah he totally thinks he's the king of the castle.
And he's so smooshable. He loves to cuddle for hours so he'll squish his face right against my cheek and start snoring lol

I have some pretty bad anxiety, so finding Marley was the best thing that ever happened to me.
 
Marleysgirl13 said:
Does anyone think doing the antibiotics and the insulin at the same time was a bad idea? Since they were both there to treat the same thing, the overpeeing.
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I'm beginning to think so.

Marley's numbers are looking good. It could be the antibiotics cleared up whatever was going on. It could be that Marley will be a diet controlled diabetic cat. There's a say here – once a diabetic, always a diabetic. Do not go back to the high carb food.

And no insulin without checking here first.
 
Red & Rover (GA) said:
I'm beginning to think so.

Marley's numbers are looking good. It could be the antibiotics cleared up whatever was going on. It could be that Marley will be a diet controlled diabetic cat. There's a say here – once a diabetic, always a diabetic. Do not go back to the high carb food.

And no insulin without checking here first.
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Yeah. I think so too and I'm a little annoyed that they would decide to shoot him with insulin so quickly. Marley is starting to act like himself again.
I never intend to go back to dry food because even if it's not diabetes, I learned from here that dry food can cause a million other problems.

This morning he was 4.7, had no insulin and this evening at his PMPS he was 4.7 again. So he's had no insulin for 3 pre-shots in a row.
He's going for his curve tomorrow, so I'm going to print out his spreadsheet and give it to the vet in case the numbers inflate due to stress.
 
If you want to, you could do the curve yourself at home, and avoid the stress to Marley.
A curve is simply testing from one pre-shot to the next pre-shot time, testing every 2 hours.
Or you can test from one pre-shot time for a total of 18 hours, testing every 3 hours.

Will they be feeding Marley the exact same food as you are doing, and at the same times? You might want to double check with the vet clinic, before you leave him there for a curve. If they give him dry food, that will be a very different type of feeding than you are doing for him. So they would not be getting a true picture of how Marley is doing on a low carb diet.

You've proven that he does so much better on the low carb wet, that he doesn't need insulin right now. I'd hate to see him have a setback, because they change the food for the day.
 
Deb & Wink said:
If you want to, you could do the curve yourself at home, and avoid the stress to Marley.
A curve is simply testing from one pre-shot to the next pre-shot time, testing every 2 hours.
Or you can test from one pre-shot time for a total of 18 hours, testing every 3 hours.

Will they be feeding Marley the exact same food as you are doing, and at the same times? You might want to double check with the vet clinic, before you leave him there for a curve. If they give him dry food, that will be a very different type of feeding than you are doing for him. So they would not be getting a true picture of how Marley is doing on a low carb diet.

You've proven that he does so much better on the low carb wet, that he doesn't need insulin right now. I'd hate to see him have a setback, because they change the food for the day.
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Yeah I did do one curve at home a couple days ago. But that was when he was taking 3u and dropping like crazy after 4-6 hours.
If the numbers are weird from the vet, then I'll do another one the next day and send it to them.

That's a good point about the food. They originally said that he could graze on dry food and I did tell the vet tech that I didn't agree with that earlier. But I will remind them and give them some of the wet food he is currently eating. Right now he gets a can and a little each time he gets the shot. Though he does free feed on it because he doesn't eat all of it before his shot.

We can't talk directly to the vet because of Covid, but I will write all this down and send it in with Marley.

Is there anything else you think I should mention?
 
I agree with @Deb & Wink
I honestly don't see the need for a curve at the clinic at the moment. You can do one at home very cheaply. If they insist that it has to be done with an AlphaTrak. Use that at home for the curve. Vet stress is indeed a thing.

Did the clinic do any blood work or run a urine panel initially? If so, you can ask for a copy of the labs (you are entitled). It would be good to see if it was the antibiotics or the diet change that seemingly did the trick.

Marley does not need a fructosamine test tomorrow. A fructosamine test gives an idea of what the last two weeks or so have been like. It will tell you nothing you don't already know because you have been testing.

They may try to sell you some special diabetic management food. The dry is high carb, though lower than most. The wet pate is low carb but most cats go off the taste quite quickly. The savory selects is too high in carbs. There's nothing special about veterinary diabetic cat food except the price.

Trying to save you a bit of money here. :bighug:

Take a test each day at what would be the shot time for another week or so. If the numbers stay within range, test periodically after that.
 
Red & Rover (GA) said:
I agree with @Deb & Wink
I honestly don't see the need for a curve at the clinic at the moment. You can do one at home very cheaply. If they insist that it has to be done with an AlphaTrak. Use that at home for the curve. Vet stress is indeed a thing.

Did the clinic do any blood work or run a urine panel initially? If so, you can ask for a copy of the labs (you are entitled). It would be good to see if it was the antibiotics or the diet change that seemingly did the trick.

Marley does not need a fructosamine test tomorrow. A fructosamine test gives an idea of what the last two weeks or so have been like. It will tell you nothing you don't already know because you have been testing.

They may try to sell you some special diabetic management food. The dry is high carb, though lower than most. The wet pate is low carb but most cats go off the taste quite quickly. The savory selects is too high in carbs. There's nothing special about veterinary diabetic cat food except the price.

Trying to save you a bit of money here. :bighug:

Take a test each day at what would be the shot time for another week or so. If the numbers stay within range, test periodically after that.
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I think I'll do the one curve tomorrow. But if he's too stressed out I will insist it doesn't happen anymore.

We did do a blood test originally. I don't really understand the results but I posted it to flickr and here is the link if you wanna take a look.

https://flic.kr/s/aHsmStvckP

I'm pretty sure that they are only doing the curve to check if the dose is the right one for him tomorrow. But I will double check before I send him in.

They did try and sell me the DM wet food and dry food. Luckily, the dry food wasn't in stock so I didn't get it. They even tried to sell me diabetic wet food with gravy! Luckily, Marley hates food with the gravy in it. But now looking back, that sounds insane to offer it.

Marley did end up hating the wet food after like 2 days. I now feed him a mix of Chef's Dinner Friskies Pate, Fancy Feast Chicken and Liver, and Canada's President's Choice Extra Meaty. If there isn't a change in flavour Marley will get annoyed lol.
 
Marleysgirl13 said:
Is there anything else you think I should mention?
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Yes, that Marley is not to get any insulin. You don't want the clinic to 'assume' that he needs insulin, because they put him on it a while ago.
Marleysgirl13 said:
We can't talk directly to the vet because of Covid, but I will write all this down and send it in with Marley.
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OK. Most vets will at least communicate with you by phone. Or email, or text.

Parking lot pickups, where a vet tech comes out to your cat to get your cat in it's carrier are pretty common now with covid restrictions in place.
 
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