Please point me to the right place

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msfast3

Member Since 2016
I'm prepared to begin home testing. However, I need to understand how to adjust insulin dosage based on glucose readings.

I simply cannot see the place where it is explained! I've followed a number of threads with little success in understanding. I have the Alphatrak tester but that has nothing.

Maybe I'm stupid or blind, but is there a simple explanation someplace.
 
Adjusting the dose is done based on the lowest BG between shots. The time of the lowest BG depends upon the type insulin and also varies from cat-to-cat. You want the lowest to be about 70-100 for your AlphaTrak meter. For human meters a lower BG is permitted since human meters seem to read lower than pet meters.
Most of us here test our cat's blood glucose at home using a human meter. We test before each shot and periodically between shots. We record our reading and other info in a spreadsheet. See:
http://www.felinediabetes.com/FDMB/threads/fdmb-spreadsheet-instructions.130337/
The spreadsheet also allows other to give you advice..
 
Larry and Kitties said:
Adjusting the dose is done based on the lowest BG between shots. The time of the lowest BG depends upon the type insulin and also varies from cat-to-cat. You want the lowest to be about 70-100 for your AlphaTrak meter. For human meters a lower BG is permitted since human meters seem to read lower than pet meters.
Most of us here test our cat's blood glucose at home using a human meter. We test before each shot and periodically between shots. We record our reading and other info in a spreadsheet. See:
http://www.felinediabetes.com/FDMB/threads/fdmb-spreadsheet-instructions.130337/
The spreadsheet also allows other to give you advice..
Click to expand...


Thanks, that helps. I've read so much, I've confused myself.

Previously used the "start low, go slow" method from 1 unit with no home testing. We are up to 4 units in the morning 3 at night, but want to begin home testing. First vet was not an advocate. We did our first ear prick today, but didn't have the meter coded properly, so the reading we got was meaningless. We will try again tomorrow taking a reading before the evening shot just to get a fix on what is happening.

I appreciate that there is LOTS of information her, and I've been reading off and on for about two weeks, but I am still having trouble getting my mind wrapped around the process! It doesn't help that we are already dosing at a given level, but I've just gotta work with what I have for now.

We are using the Lantus pen and may have to switch to using syringes with the pens.

His last fructosimine test was not good, so I believe we have to continue on with our current dosage and just begin testing as best we can.
 
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I'm in the same boat. My kitty boy was just diagnosed less than two weeks ago. I want to give this home testing and adjusting based on the reading a go, but so far I'm not quite getting it, and don't feel confident in my ability to do it right. Also, I'm at work all day Monday through Friday, so I'm nervous about making a mistake and not knowing there's an issue because I'm at work. My vet wants me to just give him two units of insulin twice a day, leave his diet as it is, and bring him in for periodic checks. But everything I'm reading seems to indicate I should be doing so much more, and I just don't know how.
 
It seems very complicated and intimidating before you begin and there is definitely a learning curve involved. However if you use the "start low, go slow" approach for yourself as you tackle this new world of feline diabetes you'll get there one bit of information at a time.

The approach we use here in a nutshell is:
  1. learn to test blood glucose at home (we can help you with that)
  2. test BG before each dose to see whether it's too much insulin for the BG level (no food for at least 2 hours before testing)
  3. test once near the middle of the 12 hour span between doses to see how low the BG goes (or test before bed, on weekends)
  4. do a full BG curve periodically for more detailed info on how a dose is working.
The time commitment is much less than you think. AM and PM: test/feed/shoot - 15-30 minutes depending on insulin used; other tests - 5 minutes each maybe. Curve days are a bit busier and can be done on a weekend.

I suggest posting again with some specific questions so you can get more concrete information.
 
msfast3 said:
Maybe I'm stupid or blind, but is there a simple explanation someplace.
Click to expand...
No you're neither stupid nor blind. Learning to adjust dose according to BG readings takes experience and lots of BG test data. Many people post their BG readings here and request advice on dosing until they feel more confident in their ability to decide for themselves.
 
RainyOcean said:
I want to give this home testing and adjusting based on the reading a go, but so far I'm not quite getting it, and don't feel confident in my ability to do it right.
Click to expand...
First you learn to home test and log the data at the dose you're using. There are guidelines we can give you to know whether your BG numbers are telling you the dose is too much or too little. As you accumulate a lot of BG data for a range of doses you'll be able to see trends and patterns which you can use to decide on further dose changes. It takes time and data to help you feel more confident.
 
Thank you for your replies. I didn't even think of doing it before bed! I was sitting here trying to think how I could do it when I have to be at work. I'm currently broke from my rent plus the cost of the vet and the insulin, but as soon as I can get the money together I'm going to buy a home test meter. He seems to be doing better so far, but I'm so afraid of something going wrong. I also want to do the high protein low carb diet, but my vet said she didn't think I should make any diet changes until he's stable on the insulin, and when I do change it I definitely want to make sure I'm testing him along the way.
 
RainyOcean said:
everything I'm reading seems to indicate I should be doing so much more, and I just don't know how.
Click to expand...
We can help you learn about the condition, teach you how to test, provide tools for helping you to track how your boy is responding to his insulin (see the spreadsheet links in member signatures for a preview), and also help you with interpreting your kitty's data and helping you with dosing adjustments based on that data.

I, and many more besides me, arrived here as nervous novices but members further along the path took us by the hand and helped us to learn. Now we pay that forward by reaching out a helping hand to the next generation of nervous novices. :) There is something of a vertical learning curve in the early days, but you'll have many hands giving you a helpful push up the steep incline. Diabetes is do-able; we'll help you get there. :)


Mogs
.
 
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RainyOcean said:
as soon as I can get the money together I'm going to buy a home test meter.
Click to expand...
If you're in the US Walmart's Relion range Confirm or Micro glucometers are very popular here. The strips are affordable and they only need a very small blood sample. Relion do ketone test strips, too.

We can help you with all manner of money-saving hints and tips. :)


Mogs
.
 
RainyOcean said:
Thank you for your replies. I didn't even think of doing it before bed! I was sitting here trying to think how I could do it when I have to be at work. I'm currently broke from my rent plus the cost of the vet and the insulin, but as soon as I can get the money together I'm going to buy a home test meter. He seems to be doing better so far, but I'm so afraid of something going wrong. I also want to do the high protein low carb diet, but my vet said she didn't think I should make any diet changes until he's stable on the insulin, and when I do change it I definitely want to make sure I'm testing him along the way.
Click to expand...
If your kitty is eating kibble of any type, changing to canned low carb food can cause a significant drop in blood glucose level so that the dose you're giving is suddenly too high. Very careful monitoring by blood glucose testing is essential during the transition.
 
Critter Mom said:
If you're in the US Walmart's Relion range Confirm or Micro glucometers are very popular here. The strips are affordable and they only need a very small blood sample. Relion do ketone test strips, too.

We can help you with all manner of money-saving hints and tips. :)


Mogs
.
Click to expand...

Thanks! I'm in Pennsylvania, plenty of Walmarts here. I'll check that out!
 
Kris & Teasel said:
If your kitty is eating kibble of any type, changing to canned low carb food can cause a significant drop in blood glucose level so that the dose you're giving is suddenly too high. Very careful monitoring by blood glucose testing is essential during the transition.
Click to expand...

Makes sense. I'm going to do it, but I want to get comfortable with testing his glucose first to be safe.
 
RainyOcean said:
Makes sense. I'm going to do it, but I want to get comfortable with testing his glucose first to be safe.
Click to expand...
That's a great plan.
I just want to add that I felt much the same way that you have described when I first started out. I knew nothing about Feline Diabetes, testing, giving insulin, etc. The best advice I could give you is to ask as many questions as you have as you go along and don't feel like there is anything wrong with your cognitive abilities!!! This stuff can feel a bit complicated at first but hopefully all of us here can help you navigate your way.
 
RainyOcean said:
I'm in the same boat. My kitty boy was just diagnosed less than two weeks ago. I want to give this home testing and adjusting based on the reading a go, but so far I'm not quite getting it, and don't feel confident in my ability to do it right. Also, I'm at work all day Monday through Friday, so I'm nervous about making a mistake and not knowing there's an issue because I'm at work. My vet wants me to just give him two units of insulin twice a day, leave his diet as it is, and bring him in for periodic checks. But everything I'm reading seems to indicate I should be doing so much more, and I just don't know how.
Click to expand...


Good morning,

And thanks to ALL for the responses. Right now, we are just trying to focus on getting at least one test a day.

The first thing my vet suggested was to switch to low carb food by using pates and I did. I did read up on different brands. I did eliminate the kibble they were getting and now, I have switched to Forever Young zero carb kibble, but my boys still prefer the wet food. Only one is diabetic, but everyone eats the Fancy Feast pates, but they change their taste from day to day. That's my fault for offering too many choices.

My biggest mistake was free feeding junk kibble. Arty got overweight and here we are today with diabetes.

For me, the most important thing right now is to get a regular schedule of testing and go from there.

Arty has been getting insulin since June, but the October fructosamine test wasn't good so on we go. He is 15, so I want him to be as healthy as possible for his remaining years.

I'm going to try to tackle the chart creation today.
 
Barbara & Uncle said:
That's a great plan.
I just want to add that I felt much the same way that you have described when I first started out. I knew nothing about Feline Diabetes, testing, giving insulin, etc. The best advice I could give you is to ask as many questions as you have as you go along and don't feel like there is anything wrong with your cognitive abilities!!! This stuff can feel a bit complicated at first but hopefully all of us here can help you navigate your way.
Click to expand...

You read my mind with the cognitive abilities! I was reading the info about how to do a curve, and I was just not understanding it at all! I still don't understand it, to be honest, and I was starting to think something was wrong with me!
 
RainyOcean said:
I was reading the info about how to do a curve, and I was just not understanding it at all! I still don't understand it, to be honest,
Click to expand...
A blood glucose curve is a fancy name for something very simple: it's just a series of blood glucose checks carried out at regular intervals starting just before the dose is given, usually for the next 12 hours.

Put at its simplest, doing a series of tests like this helps you to see how low the dose takes your cat, how long your cat remains in lower numbers overall between doses, and also whether or not the dose lasts for the full 12 hours.


Mogs
.
 
Critter Mom said:
A blood glucose curve is a fancy name for something very simple: it's just a series of blood glucose checks carried out at regular intervals starting just before the dose is given, usually for the next 12 hours.

Put at its simplest, doing a series of tests like this helps you to see how low the dose takes your cat, how long your cat remains in lower numbers overall between doses, and also whether or not the dose lasts for the full 12 hours.


Mogs
.
Click to expand...

That makes so much sense. Thank you. I think it was the graph that threw me off. Pretty sure I have a math disability. As soon as I saw that my mind just went blank.
 
Welcome. I suggest you read all the stickies at the lantus/lev forum and start posting daily condos there. There is a lot of info to absorb so don't get overwhelmed. I also suggest you start a spreadsheet as we all use them to help guide others. Read the two protocols as well. When you get syringes get the ones with half unit markings. It makes it easier to get the dose right since we increase/decrease in .25 unit amounts.
 
RainyOcean said:
Forgive me, condos? I'm trying to figure out the logistics of the spreadsheet. It seems like a great idea though. As soon as I get the meter I'll try and set it up.
Click to expand...
If you have trouble setting up the spreadsheet, there are people here that can help you. Get a human meter. The strips are half the price. I used a Relion Micro and bought strips on eBay. It's a Walmart brand and since I don't live close to one I bought the meter on line.
 
Kris & Teasel said:
It seems very complicated and intimidating before you begin and there is definitely a learning curve involved. However if you use the "start low, go slow" approach for yourself as you tackle this new world of feline diabetes you'll get there one bit of information at a time.

The approach we use here in a nutshell is:
  1. learn to test blood glucose at home (we can help you with that)
  2. test BG before each dose to see whether it's too much insulin for the BG level (no food for at least 2 hours before testing)
  3. test once near the middle of the 12 hour span between doses to see how low the BG goes (or test before bed, on weekends)
  4. do a full BG curve periodically for more detailed info on how a dose is working.
The time commitment is much less than you think. AM and PM: test/feed/shoot - 15-30 minutes depending on insulin used; other tests - 5 minutes each maybe. Curve days are a bit busier and can be done on a weekend.

I suggest posting again with some specific questions so you can get more concrete information.
Click to expand...

I would add to this list is to bring your meter with you each time you go to the vet. Then when they draw blood also have them put a drop on your meter. This way you will see your meter's reading compared to the lab value and have some idea how the two differ (and it may not be a linear difference - the one I use there is less of a difference at low glucose readings than at high ones). That will be helpful for you to know so that you have some sense what is a your cat's "real" glucose is when the meter reads 40 or 50 and at what level it really is too low (remember these meters vary plus or minus around 10% in their consecutive readings - eg test, retest with the same blood a bunch of times, too).
 
tiffmaxee said:
If you have trouble setting up the spreadsheet, there are people here that can help you. Get a human meter. The strips are half the price. I used a Relion Micro and bought strips on eBay. It's a Walmart brand and since I don't live close to one I bought the meter on line.
Click to expand...

Thank you. I think setting up the meter is where I'm going to struggle the most. That is pretty much the opposite of my area.
 
kidsandliz said:
I would add to this list is to bring your meter with you each time you go to the vet. Then when they draw blood also have them put a drop on your meter. This way you will see your meter's reading compared to the lab value and have some idea how the two differ (and it may not be a linear difference - the one I use there is less of a difference at low glucose readings than at high ones). That will be helpful for you to know so that you have some sense what is a your cat's "real" glucose is when the meter reads 40 or 50 and at what level it really is too low (remember these meters vary plus or minus around 10% in their consecutive readings - eg test, retest with the same blood a bunch of times, too).
Click to expand...

That's a great idea! I like that. Thanks!
 
Woodsywife said:
Sorry if this has been said already. Do NOT change food until you have the home testing down. It can drop glucose level into serious territory.
Click to expand...

Thank you. That's what I've been worrying about. I want to put him on the low carb diet, but I'm afraid of hypoglycemia. Any advice on how you know when it's safe to do so? How experienced should I be with home testing? Do I need to take time off work to make sure he's monitored?
 
RainyOcean said:
Thank you. That's what I've been worrying about. I want to put him on the low carb diet, but I'm afraid of hypoglycemia. Any advice on how you know when it's safe to do so? How experienced should I be with home testing? Do I need to take time off work to make sure he's monitored?
Click to expand...
It would be wise to get the home testing under your belt first. Then start a routine of testing BG before any food/shot in the AM and the PM. Grab extra tests when you can in the evenings and on days off. Once you have some data on how your current dose acts with the way you've been feeding, you can set aside a weekend (so you can test more) and start introducing the wet low carb food. A weekend's worth of data should tell you how his BG is on that mix of old and new food. Then increase the amount of wet low car food when you can do more testing. Proceed this way until he's fully converted to wet low carb food. You might find that you have to alter the dose somewhere along this regimen if he's carb sensitive and his BG drops when there's more LC food in his meals.
 
You will need to monitor closely while transitioning food. Carbs can take 24-72 to clear their system. Most kitties will require a change in dose during or after transition. You should be able to get a reading every time you test and be able to test in between your two preshot tests when you start.
 
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