Should I hold insulin

[Dewey’s Mom]

Last evening Dewey’s blood sugar was 70 at 4pm. His last insulin was at 6:30 that morning. He is on Lantus 1 u twice a day. I gave him some wet food with gravy and 2 Temptations treats. It came up to 80 20 minutes later. He showed no symptoms. I held the insulin and fed him his pate food at 6:30. He has been up since 4am looking for food. His blood glucose is 190. Should I give his regular dose at 6:30 this morning? He has no vet appointments and she told me they will do a curve in 3 months. I have no guidance as to what to do.

 

[squeem3]

Your previous thread: Need help

Are you doing TR or SLGS? Both are explained here: Sticky - Dosing Methods: Start Low, Go Slow (SLGS) & Tight Regulation (TR) SLGS is best for most newbies to start with.

Are you still using the CGM? Are you able to download the data and share that with us or create a Google spreadsheet and manually enter the blood glucose numbers in? Without seeing your cat's numbers, it's hard for members to help you.

In general, it's ok to skip a shot. Blood glucose levels will likely get high but that's ok. Give the next insulin dose at the usual time so you can stay on schedule.

What was your cat's blood glucose level yesterday morning? At +9.5 (9 and a half hours later) he was at 70 which is a fine healthy number for that late in the cycle. No hypo treatment is needed. If you're following SLGS, any number under 90 means an immediate dose reduction by 0.25 units. Your cat's dose starting today is now 0.75 units. If the syringes have half unit markings, you just eyeball 0.75 between the 0.5 line and the 1 line. If the syringes are only marked in whole units, it's harder. You'll want to get half unit marked syringes as soon as you can.

You don't need the vet to do a curve which is not only expensive but also inaccurate because stress affects blood glucose levels. You have your cat's daily numbers on the CGM. Just share that data with the vet.

Did you decide to give insulin this morning? What was your cat's blood glucose level?

 

[Dewey’s Mom]

I have not been doing regular blood glucose levels. So I have no chart. My cat is very stressed when held and I have to hold him and take the blood and use the Relion monitor. So it is very difficult. I have had many issues with error messages. So I try to test when possible or I feel something is off. I gave him 0.5U this morning instead of his usual 1U. We tried the Libra initially but he would run every time I tried to get a reading, so it was removed. He has always been this was when he had to be picked up or held.

 

[squeem3]

I think the Libre automatically sends reading to an app on a phone that is kept near the cat? @Staci & Ivy can help but it might be a day or two due to the holiday tomorrow and the typical holiday plans people have around this time of year. In the meantime you can look through this thread and post new thread for questions: Getting Started With Continuous Glucose Monitors (CGMs) for Diabetic Cats

Most error messages are from not enough blood on the test strip or the meter timing out before you get the blood drop applied. Tips here: Hometesting Links and Tips

 

[Connie & Moonie]

I have not been doing regular blood glucose levels. So I have no chart. My cat is very stressed when held and I have to hold him and take the blood and use the Relion monitor. So it is very difficult. I have had many issues with error messages. So I try to test when possible or I feel something is off. I gave him 0.5U this morning instead of his usual 1U. We tried the Libra initially but he would run every time I tried to get a reading, so it was removed. He has always been this was when he had to be picked up or held.

I see that our resident Libre expert has been tagged . Staci will be able to offer great advice. Ivy is gorgeous and magnificent and fluffy, and being as beautiful as she is, she knows she can get away with quite a lot. So my understanding is that she is almost as spicy as she is beautiful.

For manual testing though, something I’ve done is save our highest value treats only for testing. I don’t know how food motivated Dewey is. But I get one of those slow lickers and squirt churu on it, and Moonie is so busy licking that she doesn’t even notice the lancet. This is the only time Moonie gets churu. No testing = no churu.

I also started out by rewarding her with churu every time I would massage her ears with warm hands. (Reward for just massage, no testing). Because for us, warming her little ears made all the difference in getting a blood drop in one prick with a much smaller gauge.

Not sure if this helps but sharing what has worked for me at least.

 

[Staci & Ivy]

I think the Libre automatically sends reading to an app on a phone that is kept near the cat? @Staci & Ivy can help but it might be a day or two due to the holiday tomorrow and the typical holiday plans people have around this time of year. In the meantime you can look through this thread and post new thread for questions: Getting Started With Continuous Glucose Monitors (CGMs) for Diabetic Cats

Most error messages are from not enough blood on the test strip or the meter timing out before you get the blood drop applied. Tips here: Hometesting Links and Tips

Yes, when using the Libre, if you are using a reader, then you have to manually scan the cat to get a reading.
However, I strongly suggest using a dedicated phone that you leave at home all the time within 33 feet of your cat and it automatically takes readings of the Libre and that way you do not have to bother your cat by taking a physical reading of their sensor.
(you can use an older phone as long as it is compatible with the Libre sensor. You can check the phone you would like to use on Abbott‘s website. You do not need a data plan so there are no costs involved in using a phone as the reader).
Perhaps you have an older phone that you don’t use any longer or someone you know has a phone they do not use.
Or you can purchase them pretty inexpensively either on eBay or through other channels.

The phone acts as a scanner and sends the data from the Libre up to the cloud and you receive it through the LibreLinkUp app on your phone and that way you can see the cats glucose 24/7.

I hope this helps.

 

[Sienne and Gabby (GA)]

Chances are that Dewey is reacting to the lower numbers with what we refer to as a "bounce." If numbers drop low, drop into a range that is lower than what your cat's body is used to, or if numbers drop fast, your cat's system may react by releasing a stored form of glucose along with counterregulatory hormones. These cause blood glucose numbers to spike upward. While it's hugely annoying to us, it's a normal response. You did a good job by using food to prevent numbers from dropping too low. (Numbers in the 70s are still within normal range.)

I would encourage you to keep a record of Dewey's blood glucose numbers. It's truly hard to offer any guidance without having some idea of what your cat's numbers look like. Staci offered great suggestions about using the Libre. That will help you to keep track of the numbers and if you can enter the numbers into our spreadsheet, we can follow along and offer better informed suggestions.

 

[Dewey’s Mom]

I have downloaded an app called mySugr which is tracking the glucose levels on my phone. I have tried to test him before his 2 bigger meals and about 6 hours after his morning dose,but sometimes I am not able to get a reading because of my errors.
Attached are the results for the testing done. At first I was not testing. This morning I gave his 0.5u and this evening I held his dose.

 

[squeem3]

The two most common reasons for a meter error: not enough blood and the meter times out before you get blood onto the strip.

Are you warming your cat's ear before poking? If not, that will really help. Most people use what is called a "rice sock": a small sock filled with a spoonful or two of uncooked rice or dried beans, knotted close, and heated in the microwave until just warm but not so warm that it will burn your hand or cat's ear. Try 10 seconds in the microwave and adjust as needed. A baby sized sock is all you need but use whatever cotton sock you have. Wrap the warm sock around the edge of the cat's ear and hold in place for a minute if you can. Then hold the sock inside the ear to use as a firm surface to poke against and also keep your fingers safe. Press the lancet device firmly against the edge of the ear and poke. You are aiming for the space between the edge and the vein. If you hit the vein, no big deal. Still no blood? Adjust the depth setting of the device. Still no blood even on the highest setting? The lancet might be too thin. 27 gauge is an ideal size to use. If your lancet device only uses thin lancets, you'll need to buy a different device that uses larger gauze lancets. Or, maybe you need to adjust the placement of the device on the ear. Move the device a little further so the hole where the lancet pokes out of is hitting the ear and not empty air.

If you do get blood but only a pin drop size, try gently pushing on either side of the drop to help it bead up more. You can also try warming the ear for longer and poking in a different spot.

If the meter is timing out, the easy fix is to put the test strip just far enough into the meter so that it holds in place but doesn't turn the meter on. Set aside while you warm the cat's ear. When you are ready to poke, push the test strip all the way into the meter to turn it on. In the few seconds it takes for the meter to turn on and be ready for a blood drop, poke the ear with the lancet device to get blood. Once you get a nice drop of blood (too much is better than too little IMO), apply the drop to the test strip in the ready and waiting meter. If you don't get the blood on because you're poking and not getting blood, just turn the meter off and pull the test strip out just enough so it holds in place. Alternative is to get the blood first and then push the test strip into the meter, wait for the meter to be ready and hope you don't lose the blood because your cat decides to shake his head. It's entirely doable to push the test strip into the meter with one hand while the other hand is holding the ear. Try practicing this. I use my knee as a sort of brace to hold the meter steady while my free hand pushes the test strip in.

What brand of meter do you have?

Additional testing tips: Hometesting Links and Tips

 

[Dewey’s Mom]

I have the ReLion meter. I do warm the ear. I have a little bag I can microwave. I put him in my bathroom sink ( he likes to sleep there often). I have difficulty keeping him still. I have the monitor close and the strip partly in, a cotton ball and my lancet all ready. Even my vet and her tech took 3 tries to get blood. But I am getting better.

 

[squeem3]

Don't be afraid to press the device firmly against the ear. This is where holding the rice sock inside the ear helps. Some people use a cotton ball or something else but why waste one of those when you have the rice sock right there? Ears do learn to bleed after awhile so it will get easier.

I tuck my cat in between my knees to test. Some people offer a treat or catnip to distract the cat while they test.