Relion Confirm 1st and 2nd test Advice Please

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Tiggy&Mom

Tiggy&Mom

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I performed our first ever blood sugar test this morning it was our AMPS at 7:30 a.m. using the Relion Confirm and the meter read 231. I reported that number on the forum and was advised to begin a thread here, as we are using the Prozinc . Now I have just completed the + 7 and it is 2 p.m. here and it reads 195. Any advice as we are seeing the vet for a blood sugar test at 3:30 today. At the vet our plan is to ask for them to test him in front of us .
 
Hi, glad you made it to the ProZinc forum. It's hard to tell at this early stage how well the insulin is working. Things will become much clearer when you get some more tests in. Is he still getting Meow Mix on top his Fancy Feast? Are you going to the vet just for a glucose test?
 
Yes we are going in just for the glucose. I am giving him crushed pieces in the wet food which is Fancy Feast Classics , yet I break up the pieces and use no more than 10 pieces total consumption for the day- throughout his meals. I give him snacks too like today he has had his breakfast Fancy Feast with 4-5 pieces of Meow Mix crushed in. Almost ate the entire can. And a snack at 2;30 after I checked his sugar and that was tuna in water from a can, and dinner will be 7:30 pm with Fancy Feast and same. He is so active and playing and just looks wonderful. I wonder though what do the human meter numbers mean that information I cannot seem to find. I think diet alone can put my Tig off of insulin, I also think vets 3 units a day was a bit much. I do not administer more than a unit since July 6. But Sharon please tell me what should he be at as far as a number? I have read some cats can run 250-350 all day and never have a issue.Vets last check read 340. What or where or how do I know if he truly needs insulin. In a hypothetical situation if his afternoon test number of 195 had been the dinner pre shot and if I did not have the information I now have , would I have over dosed my kitty?
 
Not bad numbers. The 195 may not have been the low point of the cycle - there could have been a lower number in the 5-6 range. Someday soon you can do a curve - getting a test every 2 hours - which can give you a good idea of when the insulin starts working, if there is a food spike, when the lowest point comes and when the insulin starts wearing off and the numbers go back up.

Generally we like to see a "smile" curve with ProZinc - starting with the preshot, dropping in the middle of the cycle and then slowing going back up to about the same place as amps for pmps. In the beginning, the smile isn't always perfect. The nadir can be early at first or late; the amps or pmps can be higher or lower than the other. But the data you get helps you figure out how best to work with the insulin.

One number at the vet won't tell you much, but it will give you the chance to compare your meters, to tell him you will be home testing and get his input. But the number itself, when you figure in vet stress, has little meaning. Your biggest argument for no increase is that he was near 200 this morning - a very nice preshot number that reflects a good dose.

In general, you try for regulation first. That is a preshot in the mid/low 200s and a nadir in low 100s or double digits, but not below 50, which is approaching hypo range. Once he is regulated and you have the data to suggest how a given dose works on a given number, you start fine tuning.
 
Normal numbers with a human meter are 50-120. While a cat can feel good at the higher numbers, the internal organs,especially the kidneys, are taking a beating. I'm sure @Sue and Oliver (GA) or @BJM can explain all that better. The no shoot preshot numbers for new diabetics is 200, after you have more data, that number will likely come down some though. Dosing is where Sue and Rachel can help you. When you get back from the vet, post with what he said and Sue and the others will help you with a dosing strategy.
 
Just a footnote to Sharon's post. Normal numbers (50-120) are for a non diabetic cat or a cat in remission off insulin. At first, we suggest not shooting under 200 and watching for any numbers under 50.
 
Highly frustrated and literally disgust. Called the vet to re-schedule The glucose check. The receptionist and I went at it unfortunately. They honestly do not have a clue. The questions I have are endless. I informed them over the phone that I have a meter and what the numbers were today. I also informed them I have been administering 1u since his hospital release and of course they had to challenge me . 3u were initially recommended right after his release July 6. Without the home test today it is a possibility he would of been over dosed. Tonight. I am about to make a decision to remove my cat from insulin , I would like to see where the numbers go with diet alone. They just said you do know the human meters are not calibrated. I gladly informed her that I am very very aware . I also hate to be angry but I am . Where is the standard of care ? Where is the excellence my cat needs and deserves? It is a joke. I know I am no expert on Feline Diabetes , But I also know this forum is well informed. I know if I had of dosed him today with 3u or 2u it would of hurt him. Not happy right now at all. Just a shame.
 
That's too bad. The only defense I'd suggest for them is that vets treat everything from lizards to cats so they are like a gp - not experts in anything. They can't be - too many species, too many diseases. So generally people appreciate a vet if they are willing to listen and learn. And yes, you are absolutely right. Blindly shooting 2/3 units could certainly have caused a hypo.

I'd get some more data before you think about going with diet alone. We generally consider a cat in remission if they range from 40-120 off insulin for 2 weeks. While he has had some nice numbers so far, they are still high enough to suggest a small dose of insulin. The consensus here seems to be that you have a limited window when your cat is optimum for possible remission; if you wait too long, it can be a much longer process. That's why we suggest no longer than a week of trying diet alone, and then usually in the first week of diagnosis. It might be that getting rid of all the kibble will lower the numbers further but the levels you get will help you see that.

Now that you are testing, you can keep him in safe healing numbers with a small dose of insulin. That's what I'd do if he were mine. We can help you with dosing. Set up a spreadsheet, print off the protocol and post daily with your numbers. If we know your time zone, we'll try to be there when you need us.

The lovely thing would be taking him back to the vet, with your spreadsheet in hand, when he is in remission. (anti jinx)
 
Hi there! I agree, the best thing to do would probably be to stick with insulin for now. I totally get the instinct to only do diet, but as Sue said, we tend to think there is a limited amount of time for kitties to go OTJ. It appears already that Tiggy isn't too high in numbers...so I'd think he had a great shot at OTJ.

Trust me, I get the anger at the vet! I do try to give them a bit of slack as they treat so much...but I wish they'd listen to us more! I pretty much took my vet out of the equation. Started dosing, kept the SS, and a few months later went back and showed them my SS. The vet said I was doing great and let me do what I wanted! I was lucky though. She was all for home testing and told me point blank to use a human meter since it was cheaper. They did always try to push the prescription diet, but other than that...we were good.

You're doing a great job being an advocate for Tiggy! He is so lucky to have you.
 
I am shaken up from the two tests today. Now its time for his dinner and should be pre testing but he is just upset. So Im feeding him . and Im scared about the dose. 1 unit.
 
Can you give him a little bit to eat and when he is settled down, try the test. As long as you test less than 15 minutes after eating, your number should still be accurate. One unit should be okay, but I'd feel better if you knew his number.
 
I want to minimize the tests . I suspect the critical times are before his shots to test, at first until I feel more comfortable .
 
Sue and Oliver (GA) said:
Can you give him a little bit to eat and when he is settled down, try the test. As long as you test less than 15 minutes after eating, your number should still be accurate. One unit should be okay, but I'd feel better if you knew his number.
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I tried that , he knows so Im waiting for hubby . To assist me. This is just so nerve wracking. Its horrible.
 
I know how you feel. When I first started testing, I thought I'd never get the hang of it. Have you been giving a bribe...er...treat each time? That's the key for me. Gypsy would do anything for a chicken treat!

What kind of problems are you having with the test? Is it that it's tough to get the blood, or he squirms and fights? I can promise that it gets better...I know you think your cat will never "ask" for a test, but most of our cats eventually do! They know the routine and know the treat comes with the test!
 
Rachel said:
Is it that it's tough to get the blood, or he squirms and fights? I can promise that it gets better...I know you think your cat will never "ask" for a test, but most of our cats eventually do! They know the routine and know the treat comes with the test!
Click to expand...

I agree 100%. It's only been a week or so, and we've already had two instances of Shorty purring during his test. And that was with an aggressive first week of testing, went through 50 strips, and probably close to 20-30 times where we had to lance him a 2nd time to get blood, and hitting the vein twice too. It may be a little longer for your cat. Relax, be calm, try 3 times. If it doesn't work, give him his treat, walk away for 5 or 10 minutes. Go smoke, or go outside and listen to the birds, or something to soothe your nerves. The calmer you are, the calmer kitty will be.
 
Taking a break for tonight, 1 unit . that is what I gave and he is pissed and doesn't trust me because of the poking. I have no idea where this case is heading. The blood testing is difficult. Cat seems absolutely fine and back to his normal self . I want to try diet alone as I just am chained to this disease right now I have not slept, I lost 6 pounds . I just am tired.
 
Take a break, sleep tonight and start new in the morning. Rachel is right. The secret to testing is bribes, I mean, treats. Find one he loves and give it only when you test.
 
I cried a lot in the beginning, everyone said it would get easier, and it has. Have a good nights rest, things will look better in the morning.
 
You might start over with the testing and go slower. Decide where you want to test - some people pick the bed or couch or a kitchen counter or on the floor between your legs on a blanket. Take him there, give him a special treat, play with his ears, warm them (an important part of this) praise and let him go. Do that a few times and then add the poke. If he has some of the treat, even when it is close to dinner time, he may settle enough for you.

Be sure your lancets are big enough (25-27 gauge at first) that the ear is very warm and that you are breathing and relaxed. Some people sing to their kitties (there is a pokey, pokey song floating around somewhere) to relax them both.

You'll get this. Meanwhile you have a safe dose and can monitor. BJ, in her post above, has some alternative monitoring suggestions until things start working smoothly.
 
I hope you got and good night's sleep and are a little less stressed today, @Tiggy&Mom . It is overwhelming in the beginning but with the support from this group you will get the hang of this. I'm only a few months ahead of you. Take it in small bites and be realistic with what you can do.

If you want to see if diet alone is enough, then try that for a few days. While you're trying that use the time to learn how to test Tiggy. I have 3 diabetic cats here and they learned that in order to eat they have to be tested. It didn't happen overnight but with patience and consistency we developed our routine. Just remember the good numbers you've seen so far were influenced by insulin. Some cats can be controlled on diet alone, others need insulin for a period then go into remission, others need insulin for life. There's no crystal ball and the techniques you learn here apply no matter which category you fall into. Believe me every one of us here understands the desire to be in the diet alone category.

Ask a lot of questions. If you see what feels like conflicting information, ask for clarification. There are a lot of members and everyone is at a different place in their journey. The answers to some questions truly depend on your cat and what is/isn't known about him. You will receive advice telling you not to shoot below 200, which is the protocol for all cats starting on Prozinc. 10 minutes later you might see a post from an experienced Prozinc user who is advised that it's OK to start shooting at 175. Both sets of advice are correct because each answer is specific to the cat in question. Reading through old posts, to learn, is great but sometimes I think it leads to information overload.

I feel like the help I received here has taught me to think for myself. I've seen other boards where people just tell you what to do. In this group I feel like I've learned how to be self sufficient.

Big :bighug: for you, you can do this. We all know how you're feeling. I love the letter @Sue and Oliver (GA) posted.
 
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