Testing blood levels for the first time

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Liz and Kiki

Liz and Kiki

Member Since 2013
My cat has had diabetes for almost 4 years, I never knew you could test their blood until recently. I just bought a Relion Ultima tester and began testing her levels today. At 4pm her level read 129, at 730pm (after dinner) her level read 190, and at 8pm (after 1.5unit insulin shot) her level read 207. I thought that insulin made levels go down?? I am confused. Can someone please help me out here. I just want to do what is best for my kitty.

Note:She gets 1/2 can on pate cat food as well as a zobaline pill to help with her walking problems
 
Hello and welcome to the board! It's great you have started testing. Can you tell me what kind of insulin you are giving?

Also what time was dinner and her shot in the below ?
4pm 129
7.30pm 190
8pm 207

Insulins can take time to kick in and food spikes the numbers , which is why I am asking, i a, trying to work out what's going on.

Please can you take off the 911 icon? We save that for life threatening emergencies. ? Is better in this situation

Thanks
Wendy
 
Insulin takes a bit of time to start working once it's injected :smile: You won't see much of an effect on bgs for maybe 2 hours or so. Here is generally what happens after you inject insulin:

+0 - PreShot number.
+1 - Usually higher than PreShot number because of the last shot wearing off. May see a food spike in this number.
+2 - Often similar to the PreShot number.
+3 - Lower than the PreShot number, onset has started.
+4 - Lower.
+5 - Lower.
+6 - Nadir/Peak (the lowest number of cycle).
+7 - Surf (hang around the nadir number).
+8 - Slight rise.
+9 - Slight rise.
+10 - Rising.
+11 - Rising (may dip around +10 or +11).
+12 - PreShot number.

At 4pm her level read 129, at 730pm (after dinner) her level read 190, and at 8pm (after 1.5unit insulin shot) her level read 207
Click to expand...

When was insulin given? At 7:30PM? If so,

+9.5 129
PMPS 190, 1.5 units
+0.5 207

What insulin are you using? How long has your cat been diabetic? What brands of food are you feeding? Are you only giving 1/2 can per day?
 
Kiki was diagnosed in summer of 2009. She started on using vetsulin, but then my vet said it was discontinued and she is now on the insulin brand lantus insulin. My vet said that although it is human insulin it would work for her. If this is not the case would you recommend anything different. Kiki gets fed at 630 am and 630 pm every day and gets a 1/2 can of Friskies pate canned cat food. She then get 1.5 units after her night meal of insulin at 7:00pm. Recently her walking has been getting worse. I bought her zobaline which I read is supposed to help with diabetic cats walking problems. I do not know how much of an improvement it is really doing. Would you have any other recommendations for helping her walk better?
A little about kiki
She is a 15 year old main coon cat and means the world to me
she weighs 11lbs
she purrs 24/7
 
Lantus is a great insulin, also a good choice of food.. She isn't losing weight is she? That seems like a small amount of food but if it works for her...

Are you only giving lantus once a day? Lantus is usually given twice a day, every 12 hours...
 
I have been giving her insulin only once a day after her night meal (1.5 units). She does not seem to be losing weight, gaining if anything. But she does also get some soft cat treats a couple times a day.

Do you do home testing?
what number should I be aiming for when I test her?
Thank you again!
 
Oh yes I do since I want to be sure my cats are safe (I have two diabetic cats)

We recommend you test before every shot to make sure she isn't too low to start, and then again spot checks in the day to make sure she doesn't drop too low.

How long has it been since her shot? Can you get another test soon/now?

Lantus usually kicks in about two hours after the shot and then it hits its maximum action around six hours as you can see from squeems post above. We want to see how low she is dropping. A normal cat is roughly 50-130. Under that is too low and can be a hypo. Above 200 isn't good for them long term.

Also I would like an experienced member to come over and have a look at your dose if you are open to it?. Lantus is usually dosed twice a day and so if you give it at 6pm it would wear off by 6am the next morning, yet you still had low (ish)numbers at 4pm...odd.

Let me know, we can help you as little or as much as you like.

Wendy
 
I tested her before I went to bed last night at 9:40 and her level read 154. She is just getting her breakfast now, 7:30am (a little late) and i will test her after she has eaten and post that number. I would love for an experienced member to tell me what they think :)
 
Half of a 5 oz can twice a day is gnerally not enough for most diabetic cats because their bodies can't properly use the food nutrients because of unregulated blood glucose levels. Most people here feed mini meals thorughout the day using a programmable timed feeder.

What brand of treats are you feeding? Many are not suitable for diabetic cats because of all the grains and fillers and sugars in the treat. Here's a list of low carb treats: http://felinediabetes.com/FDMB/viewtopic.php?f=14&t=9172

Nearly everyone here tests their diabetic cat's blood glucose levels :smile: The numbers are kept in an online spreadsheet for sharing with others on the board, even the vet. Here are the instructions on how to make an online spreadsheet for tracking your cat's numbers: http://felinediabetes.com/FDMB/viewtopic.php?f=6&t=50130

It's recommended for newbies not to give any insulin if the blood glucose level is under 200 at insulin time. You don't want to risk a hypo.

When you do "spot checks" durng the day on your cat, ideal blood glucose levels should be in the normal range of roughly 60 to 150 or so. If the numbers are higher, don't worry :smile: It just means that the insulin dose is not quite enough for the cat or maybe the cat ate something a little too high carb or maybe you did a fur shot or a number of other reasons that aren't serious.

Once a day dosing of Lantus doesn't work. Cats have such high metabolisms that giving inslin twice a day is best. I would not give 1.5 units twice a day, though. Depending on what blood glucose numbers your cat is having, a more experienced member may suggest a dose for you.

Please read the info stickes on the Lantus board to understand how Lantus works for cats: http://felinediabetes.com/FDMB/viewforum.php?f=9 There lots of info there that your vet may not even know.
 
Can you get a few tests in today so we can see how she is rising? And tonite you really want to set the alarm and get up at six hours after the shot to see how low she is going. I am concerned she is going too low.

Also squeem is right, you want to be giving her the dose twice a day, 7am AND 7pm but it will be less of the dose you are giving now.

Squeem posted on another board, hopefully we will get some eyes here soon.
 
Thank you so much for the help everyone! Should I increase meals to 3/4 can of food? a full can of food?
Her 8am test read 112 after food, no insulin
 
'112' is a nice normal blood glucose number. :smile:

Can I just clarify a couple of things.. You're giving insulin once a day in the evenings? Is that right? And that '112' reading that you got this morning was about 12 hours after her insulin shot?
 
Welcome to FDMB!

As Wendy pointed out, blood glucose (BG) numbers usually rise after a meal (we call this a food spike) and begin to level off as the insulin onset begins. Depending on the cat, Lantus onset is around 2 hours after a shot, give or take. So don't be alarmed if you tested and found that numbers were higher than your pre-shot test 30 min. after a meal.

The amount of food your cat needs is entirely dependent on the size of your cat and what a good weight is for your cat. It's really no different than in humans -- the amount you feed depends on calories. I'm attaching a recently compiled food chart that will provide you with lots of choices. For a diabetic, you want to be providing food that's below 10% carbs. Most of us feed around 5%. Calories are also listed so you can adjust the amount of food based on calories and whether Kiki is losing or gaining weight.
Dr. Lisa's Food Chart
I'd also encourage you to start putting the test data you're collecting in a spreadsheet. If you click on the spreadsheet link in any of our signatures, you'll see this is a convenient way to keep track of your testing. it also allows us to see how Kiki's doing and to lend a hand if you want help.

There is a huge amount of information about Lantus and it's use, along with dosing, etc. in the starred, sticky notes at the top of the Lantus board. Below is information about the notes along with links.
  • Tight Regulation Protocol: This sticky contains the dosing protocol that we use here. There are also links to the more formal version -- the “Tilly” Protocol developed by the counterpart of this group in Germany, which was also published by Kirsten Roomp & Jacqui Rand, DVM in one of the top vet journals.
  • New to the Group: Everything you wanted to know about this forum and more. Info on our slang, FAQs, links to sites on feline nutrition and to food charts containing carb counts, how to do a curve and the components to look for, important aspects of diabetes such as ketones, DKA, and neuropathy, and most important, info on hypoglycemia.
  • Handling Lantus: how to get the maximum use from your insulin and what to not do with it!
  • Lantus depot: This is an important concept for understanding how Lantus works.
  • Lantus & Levemir: Shooting & Handling Low Numbers: What data you need in order to be able to work toward remission or tight regulation as well as information if you have a low pre-shot number or a drop into low numbers during the cycle.
 
112?? I wonder how low she went last night! The inslin would have brought her to her lowest point roughly around 1am and then she climbs back up after that.

Sorry I don't know your name? But kikis mom, sienne is a VERY experienced member here, I would read everything she has provided and have a serious conversation with your vet. Lantus is supposed to be dosed TWICE a day as it only lasts twelve hours.

Elizabeth/sienne my understanding is she is dosing SID.
 
Yes I give lantus once a day, after night meal, 1.5 units
Her 112 reading was almost exactly 12 hours after her insulin.
So should I wait until tonight and give her a lower dose, then continue to test to see how low she goes, then again give her another dose in the morning?

On another note, do any of you use zobaline or know how long it takes to kick in and start working?

Thank you again so much, I will start using the spread sheet
 
Hi Liz!! Nice pic of you and Kiki.

Yes I definitely think you should lower her dose and do twice a day. But I want Sienne or someone to comment on that.

You said she is 11lb.. do you think that is a good weight for her or could she stand to lose or gain weight? That will help dosing.

Zobaline takes a few months but really her blood glucose needs to be under control first and I am not sure it is.. so its great you are now testing!

Get rid of those pounce treats and get some low carb ones as suggested above by Squeem, they are just adding to your problems. Even a few high carb treats can make a huge difference. A lot of people here feed freeze dried chicken like Pure Bites.

While we wait on Sienne to get back, let me know on her weight and please set up a spreadsheet - instructions are above by Squeem too.

Let me know
Thanks!
Wendy
 
I just weighed her, she is actually 12 pounds. She is a chunker and has quite the belly, but the other areas of her body are not as fatty. When she was first diagnosed she got down to a scary 8 lbs. I think she is a good weight where she currently is. I will start on the spreadsheet and when I am in town next will pick up some purebites from petco.
Thank you!
 
another question, is it okay to give kiki a tiny bit of milk, like a tablespoon? she whines for it every time i have cereal
 
Great job on the spreadsheet and wow!!!!.. good green numbers given she only gets insulin once a day!! Can you put 1.5 in the U column for last night? (the column in light blue beside PMPS is for dose)

I sent Sienne a message about dose to give tonite.. can you do another test at +8 or so? Want to see if she keeps dropping.... I am thinking Sienne might even say skip tonite if she is under 200 but lets see what she says.

thanks
Wendy

PS A tablespoon of milk might spike her blood sugar - you would be better buying Catsip ( Lowfat (1%) Grade A milk, Lactase Enzyme, and Taurine.) and i would test her blood before and after (30mins to an hour) to see if it has an impact.
 
Hi, Liz.

I'm a bit perplexed as to why your vet would suggest that you dose only once a day. In humans, Lantus is a once a day insulin. Given that a cat's metabolism is twice as fast as a humans, Lantus is dosed twice a day. From the note on your spreadsheet, it looks like you were already planning on shifting to twice a day (BID) dosing. What I would suggest is one of two options. You could cut your current 1.5u dose in half and giving 0.75u twice a day -- every 12 hours. If you don't have syringes that are in 1/2 unit increments, it may be easier to measure 1.0u. Typically, you can calculate the initial dose of Lantus using the following formula:
initial dose = 0.25 x cat's ideal weight in kilograms​
For Kiki, if you feel that 12 lbs is a good weight, this would calculate out to 1.36u. So, 1.0u BID would be a safe place to start. Halving the 1.5u dose may end up being a bit low but the choice is yours to make.
 
I do already use syringes that are in 1/2 units. I will monitor her blood levels and if she is high I will give her a little less than 1 unit.
Thank you for your help :)
 
I think sienne is saying you should shoot one unit for now twice a day, and we will see how she goes and then make dose change recommendations.

however Now that you have a spreadsheet though can I invite you over to the tight regulation forum? I think it would really help you!!! http://felinediabetes.com/FDMB/viewforum.php?f=9

There are a lot of very experienced people there who will look at your sheet every day and comment, especially if you post a thread daily . We do like you to post there often so maybe tonite you can start a thread ie
1/26 new member KIKI PMPS 200 or whatever her PMPS is
And then give us an update on how she is doing

Wendy
 
The only problem is unfortunately I am a college student and can only come home to see Kiki about every other weekend, my parents take care of her when I am gone and they are not comfortable testing her :(
I will continue to use the spreadsheet, but I can only do it a little when I am home
 
PMPS is PM pre shot. Ie her level before her evening shot. Are you able to test her tonite at around +6 if need be? I will ask some experts to see what they think
 
Yes I can stay up to test her. I feel so bad, she hates the pokes. I cant seem to get enough blood out of her ear, so I poke her foot pads (I read that this is also another place you can get blood from)
 
This is just my opinion, and I'm not an expert, nor did I use Lantus. But if that reading is after feeding (151), I'd be inclined to say "skip the shot". There isn't enough data yet to even guess what .75u would do. People with more experience than I have may feel differently though.

Can you wait a few more minutes?

Carl
 
Ok if nobody shows within the next hour then maybe you skip. Chances are you would need to stay up during the night to test to make sure she doesn't drop anyway so this would avoid that.

Tomorrow morning test again and shoot if over 150 (1 unit) and then there will be people around to help no matter what happens. If under 150, just post and someone can advise what to do.

This is all good news and good data.
 
Tomorrow mornin? So you won't be around to deal with this for two weeks?

Ok change of plans.

Please keep checking here but if they won't be able to test you will be a lot safer doing 1/2unit twice a day, not 1 unit.

You can't persuade them to test? It's really important to keep her safe.
 
Ok I will tell them 1/2 unit twice a day.
They know that it is best for her to be tested, they just are not comfortable doing it
 
Yes, Kiki has had seizures before when she was first diagnosed and we have kyro syrup on hand. They know what the signs look like, she hasn't had a seizure in probably 2 years (knock on wood).
 
Hi Liz

Wendy sent me a PM and asked if I could pop over to look at KiKi's SS.

I know you state your parents are uncomfortable testing but would they be able to? Let me give you an example. We had a new member come on the board the other day and he had not been hometesting even though the kitty had been diabetic a while. His first test, the kitty was at 75. He shot the full 1u dose and then found FDMB. I had him test the kitty at +1 and he was at 33. I asked him to go to the ER immediately. That is a low number mid cycle but for it to be that low, that early was more than we felt we could handle here since there was really no data on this kitty and how he responds to food, karo, etc. Thankfully, the kitty was fine. But it just shows you what can happen if you are shooting "blind". It's like we frequently say...if you had a diabetic child, would you give him/her insulin without first checking the BG.

What do you think?
 
Liz

Not sure where to catch you so I am posting this on this condo and the one in the Lantus ISG, too.

Sienne and I discussed this and here's what we think. If your parents won't test her, you should take her dose down to .5u twice a day shot as closely to every 12 hours as they can. We understand that sometimes the shot time has to be adjusted. But, for the most part, if they can pick a shot time that they can do am and pm, every 12 hours, that would help Kiki.

But....in reality, we'd really love to see them test her for reasons I posted above.
 
Ok thank you very much, I will start her on .5 units in the morning and test her again before I head back to school.
I will continue to test her myself when I am home from school and I will talk to my parents more about testing her:)
What times would they need to be testing her? Just before her shots?
 
Definitely before the shots. I will leave it to Marje but maybe best for them to skip if she is under 150. Spot checks midday would be good too, especially if she is closer to 150 before her shot.
Wendy
 
One of the big things is they need to change the sequence of events. You want to test, feed, and shoot within about 15 mins. By feeding her, waiting 30 mins, testing her, and then shooting, you are most likely shooting food influenced numbers.

So the correct way to do it is to test her and then immediately shoot. Because lantus doesn't onset until about +2, she doesn't have to eat right then but it's best to feed her then and most of us will shoot while the kitties face is in their plate.

It would be great if we even had a few days data so we could tell what a reasonable no shoot number would be. I hate to stop her progress but we need to keep her safe. Any chance your parents would post here if they got a 150 or below so we could help them?
 
I'm not surprised. She still has the depot from the 1.5u you were shooting at night. A higher dose can affect up to six subsequent cycles so you may see her numbers go up a tad as the depot drains from that higher dose.
 
Can you get a test at +6 or are you gone by then? If you are, make sure your parents keep a close eye on her. Did they say they would test? Do they know how to get in touch with us if there is a problem?

Please get in touch as soon as you are back next time as we can do lots of measurements then to see how she is doing.
Wendy
 
I already left this morning.
I talked to my mom and she said Kiki is acting normal.
If there is a problem she will call me and I will post on here :)
Thank you everyone for your help, I really appreciate it!!!

I will be home for a short weekend in two weeks, and a long weekend in four weeks.
I will keep you guys posted :)
 
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