Smiffy's numbers getting higher

[Looby & Smiffy]

Since I posted about Smiffy's recent trip to the Vet, she has been really well in herself and back to her normal self - sitting in her bed, coming for walks with me and spending time with us downstairs instead of hiding upstairs .......

You would have to read my thread 'Smiffy's trip to the Vet' for all the lastest information about her ....

Her loose stools cleared up in a day thanks to putting her on Hills i/d dry food and sprinking fortiflora on her food for a couple of days ..

However her +7 numbers are creeping up a bit more so I am wondering if I should call the Vet and see if I should be giving her 1 1/2 units instead of the 1 unit twice a day she has been well on (2 units was too much as she had at least two hypo episodes) and she wasn't herself ...

I know it would be better if I could home test her more often especially a preshot number but it is sooo difficult to get her to eat enough before I give her her shot ...she has got me trained to follow her around or upstairs with her bowl of food until she has eaten enough for me to give her her shot .... if I tried to test her before her food she would run off and I would not be able to give her her shot if she hasn't eaten.

The only thing I can think of is to test her and not give her her shot one morning just to see what her preshot number is ......

Shame I can't increase the dose of Caninsulin less than by 1/2 unit .....

As I say she is really well in herself .....maybe because she has less Caninsulin in her .... she might feel poorly on the higher dose because it doesn't suit her ....

The next meeting we have with the Vet I will be discussing changing to Glargine.

I have tried for weeks to get her to like wet food but she is adamant she won't eat it - just licks the jelly and doen't want the meat .... have offered her chicken off our plates and she is not interested ...

So the question is what can I do .... shall I take a preshot number in the morning and not worry too much if she missed one shot? Just to see how high she is going?

 

[Larry and Kitties]

However her +7 numbers are creeping up a bit more so I am wondering if I should call the Vet and see if I should be giving her 1 1/2 units instead of the 1 unit twice a day she has been well on (2 units was too much as she had at least two hypo episodes) and she wasn't herself ...

Without knowing any BGs I really can't judge if

So the question is what can I do .... shall I take a preshot number in the morning and not worry too much if she missed one shot? Just to see how high she is going?

Creating a spreadsheet and would really be a help.

If Smiffy will not eat canned then feed the lowest carb food that Smiffy will eat. If you need to feed ID for other reasons then do that.

 

[Looby & Smiffy]

Without knowing any BGs I really can't judge if


Creating a spreadsheet and would really be a help.

If Smiffy will not eat canned then feed the lowest carb food that Smiffy will eat. If you need to feed ID for other reasons then do that.

I know a spread sheet would help but as I have explained she is difficult to test preshot as well as give her an injection so I am think that one night I might test and leave the shot to find out just how high she is getting ........ what do you think?

I have other restrictions due to my illness so I can't do a full curve during the day .... as well as her being really difficult to test ...

She is on Hill's prescription m/d for Diabetic cats so the lowest I can give her that she will eat - I give her 100% protein treats ....

 

[Larry and Kitties]

But do you have any other numbers to compare with shot and w/o shot BG values?
While desirable to test BG before each shot, if that can't be done just do the best you can.
With infrequent BG measures it is likely easier to just record those in a simple document file with the date, the insulin dose, and how long after sht the BG was taken. Then you can just copy and past that in your post.
I myself do not use a Google SS since it is too slow and tedious especially with three insulin-dependent diabetic cats. I use a Number spreadsheet on my iPad and a Pages document for general observations.

 

[Looby & Smiffy]

OK so You mean don't give her a shot one day and do some numbers then do tests at the same time AFTER a shot ....... what is that going to prove or is that just to see the difference? Surely missing just one shot is not going to give me the numbers as if she were not on insulin at all?!

I was thinking of doing a reading before she eats one evening (which would probably mean I wouldn't be able to shot her too) but that would give me an idea of the highest number she is having on just one unit per day?

Scoobydoox suggested I post this thread on the Vetsulin forum so I did that several hours ago before I got your replies here by the way.

Sorry I am not very ept on the computer ...... I haven't uploaded and share the spreadsheet thing yet and don't understand your last comments of your post ....paper girl

 

[Looby & Smiffy]

I swear to God I really find this Forum more difficult to read and use than Face ok but I will persevere! I know I am not the only one so I don't feel too bad ..... I will let you know what her pre meal number is

 

[Alexi]

@Looby & Smiify it would really help if you can let us know what numbers you are getting. Can you just list in a post the date, time, readings, and when the insulin was given and how much. Ideally you should do a curve but I do appreciate you and Smiffy are just getting the hang of testing and it can be a bit hit and miss at first. We need a number 4-6 hours after her injection which in theory at least should be the low point of her blood sugar. Pre-meal numbers would be great provided she has not eaten for at least 2 hours before and you should be aiming to test before each meal. I know you are using a pen which makes small dose adjustments difficult - how do you feel about drawing up insulin with a needle and syringe? I am just about to start trialling syringes with a 1/2 unit marking and if they are ok I can let you know where to get them but I do want to check the quality first.

 

[Looby & Smiffy]

@Looby & Smiify it would really help if you can let us know what numbers you are getting. Can you just list in a post the date, time, readings, and when the insulin was given and how much. Ideally you should do a curve but I do appreciate you and Smiffy are just getting the hang of testing and it can be a bit hit and miss at first. We need a number 4-6 hours after her injection which in theory at least should be the low point of her blood sugar. Pre-meal numbers would be great provided she has not eaten for at least 2 hours before and you should be aiming to test before each meal. I know you are using a pen which makes small dose adjustments difficult - how do you feel about drawing up insulin with a needle and syringe? I am just about to start trialling syringes with a 1/2 unit marking and if they are ok I can let you know where to get them but I do want to check the quality first.

Thanks Alexi ........ her estimated Nadir is about 3-4 hours after her food .... I inject between 9.30 and 10 in the morning and the same in the evening ..... I am going to try to get a preshot number tonight even if it means she doesn't get her shot .....

(Vets on 2 units of Caninsulin was 405)

Here are some of her readings so far on one unit of Caninsulin with an AccuChek Aviva Easyclick Glucometer:

Mon 30th June 20 minutes after eating and before her shot 15
Tues 31st June +7.5 14.8
Weds 1st June +7.5 14.8
Thurs 2nd June +7.5 14.8 Took urine sample negative keytones and negative glucose
Sat 5th June +8 14.8
Mon 6th +8 10.7
Tues 7th +8 11.9
Thurs 9th +7.5 12.3
Fri 10th +3 (aroud her Nadir time when she was at the Vet but this is at home) 8.5 Took urine sample ketones negative and glucose high (dark brown on keto diastrix)
Sat 11th +8 14.8
Mond 13th +3 13.5 +8 16.3
Tues 14th +7 15
Weds 15th +5 12 Check up at Vet Fructosamine 436
Thurs 17th loose stools - treated with high carb i/d and fortiflora for two days
Mon 20th +7 14.4
Thurs 23rd +7 16.3

That's it so far .... shall I paste this onto a new thread Alexi?
Do you think it is a good idea to try to get a preshot number even if I it means I have to miss giving her a shot just for one day?

 

[Alexi]

No lets stick to this thread so others can see. Nothing about those numbers look alarming, and they seem steady enough. Renal threshold for glucose (the level at which kidneys start leaking glucose into the urine) is around 15 and you have had one urine which showed no glucose at all so she must have been lower while her bladder was filling up. At +7 there is still some insulin working so pre shot numbers are likely to be a little higher than the +7 reading you have had. Any particular reason you are doing +8 readings? We could do with some more readings around her nadir so if she doesn't like being tested too much you could maybe try a +4 number instead of a +8. Ideally you should test before every meal as what we don't know yet is how far her glucose drops from her pre shot level. She does appear to be dropping as the single +3 reading would indicate which means the insulin is working. What you don't want is to push her insulin dose up until you know the difference between the pre shot and nadir readings given her history. Normal behaviour is good. I would be inclined to take things slowly and get more readings before deciding what to do with her dose.

 

[Looby & Smiffy]

No lets stick to this thread so others can see. Nothing about those numbers look alarming, and they seem steady enough. Renal threshold for glucose (the level at which kidneys start leaking glucose into the urine) is around 15 and you have had one urine which showed no glucose at all so she must have been lower while her bladder was filling up. At +7 there is still some insulin working so pre shot numbers are likely to be a little higher than the +7 reading you have had. Any particular reason you are doing +8 readings? We could do with some more readings around her nadir so if she doesn't like being tested too much you could maybe try a +4 number instead of a +8. Ideally you should test before every meal as what we don't know yet is how far her glucose drops from her pre shot level. She does appear to be dropping as the single +3 reading would indicate which means the insulin is working. What you don't want is to push her insulin dose up until you know the difference between the pre shot and nadir readings given her history. Normal behaviour is good. I would be inclined to take things slowly and get more readings before deciding what to do with her dose.

I have posted this information along with more details on a separate thread called 'Smiffy's numbers so far end June' so that I know where to find them and to that the comments are all together.

I was told by the Vet and somebody else here and I googled it that the renal threshold is between 12 and 14 .....

I know that her preshot numbers are going to be higher than her +7.5/8 as that is when I was told the Caninsulin begins to wear off ....

I am give her her shot at 9.30/10 in the morning ... then I am out of action until about 3pm ....... I could try to take a reading then which would be +5 ......

The reason I take reading at +7/8 is because I try to get out to the garden with Smiffy for and hour or so for her to be outside and to exercise a bit .... she won't go out without me as she is scared of coming across neighbours (including a toddler that she hates!) using the communal passage way between our bottom gardens ... she LOVES these walks and then I test her with a treat when we get in when she is in a good mood (she doesn't like to be pampered much but is otherwise adorable).

I was also told that her Nadir could be an hour earlier at the Vets and that would coincide with her having a snack at about 1.30/2pm sometimes.

I have a lot of difficulty giving her her shot ........ I put her food down and she is already on the stairs next to her food station ..... I put it in front of her and she stares at it before eating ...... I have to wait quietly with the pen primed for her to have eaten enough for me to shoot her .... sometimes she only has a nibble and wanders off upstairs or into the bathroom (we have a tiny tiny house) ... I follow her with the bowl of food and the pen and a treat and after three goes she has eaten enough for me to shoot her and she goes off for a bit either upstiars or outside and comes back in about 15 minutes to have some more to eat ....... if I were to try to test her before her food I would be suprised if she didn't run away and then I would almost certainly miss her shot ..... you have to be here to see the run around ..... when I give her the shot she most of the time doesn't even notice but if she does she gives me a hiss ........ that is why I am proposing to take a preshot test one night and not worry if I miss her shot as a result as I don't think she will allow me to do test and shot and have eaten enough (don't want to run the risk of a hypo even though she seems to know to eat when her BG is low) ........

Her Nadir in the evening would be about 1 or 2 in the morning so that is not very practical as she is normally upstairs under the chair in the bedroom by then. It's so difficult ....

I completely agree with you ... a Nadir reading in the morning is not normally possible as I am in bed .... (I sleep during the day like Smiffy and stay up all night like a cat!!!) ..... She follows me everywhere so at her Nadir in the morning she is in the bedroom with me under the chair and then we both come down at about 3 ..... I will do my best ... see if I can get a Nadir one evening at 1am ......

I think you are probably right not to raise the dose ,.... I was getting worried as her Fructosamine was so much higher on one unit and her +7.5/8 was rising but you will see today that her +7 is back down to 14.3 so I am pleased about that ....

I have posted on FB that I have posted Smiffy's numbers here under 'Smiffy's numbers so far end June' as some of the girls there that have been so helpful especially when she had her two hypo episodes on 2 units are also members here but I don't know what their profile names are here ....

Do you think changing to Glargine would help to lower her numbers?