Testing question

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CarolandTigger

CarolandTigger

Member Since 2015
Tigger was diagnosed the week before we started a cross country road trip with less than ideal conditions with a newly diagnosed kitty! Time zone changes...long days in an RV....long days sightseeing, then rushing home to feed/shoot (2 units 2xDay..Vetsulin). We're doing ok..and he's been stable. However we don't test like a lot of people on here do, in regards to frequency of testing. Our vet...who I trust....said testing Tigger once a week would be fine. She said cats can have looser control than dogs. I don't understand when I see some of the spreadsheets that people have, where they're testing MANY times during the day. I understand testing in the morning before a meal..and at night before his dinner. Maybe in the middle of the day sometimes. But I see some spreadsheets where testing is done at 1+,2+,3+,4+....and so on....and I don't get it. I just can't see myself trying to test him..he hates it....several times a day! his poor ears!! Maybe I'm being naive or stupid..but what is the point of SO many tests per day?
 
The spreadsheets you're seeing with a lot of tests on them are likely for cats who are on the Tight Regulation protocol. With that, we keep the cats in the normal range of numbers for as much of the day as possible using one of the depot insulins. More testing is needed both to make sure the cat doesn't drop into hypo territory because they're running only maybe 30-40 points above that most of the time and also because with the depot insulins, dosing adjustments are made based on how low the dose takes the cat not on the pre-shot number. As the nadir, or low point, can change from cycle to cycle, capturing that lowest point also requires more testing.

I don't think you're going to find many people on here who would agree with your vet's opinion that testing once a week is sufficient as, no matter what insulin you use, each cycle will vary. Insulin is a hormone so the injections we give aren't like giving an antibiotic or a pain medication where the effect remains the same day after day - with hormone treatment like insulin, a cat will vary in how it uses the insulin every time. The reason that we recommend getting mid-cycle tests is to find out how low the dose is taking a cat - the pre-shot number may be quite high, but that doesn't guarantee that a cat can't drop into hypo territory around nadir which as you know is dangerous. I have personally seen drops of 300+ points in 6 hours (and I know other people have had their cats drop even bigger amounts in a shorter time) meaning that a number that looks perfectly safe (in fact higher than is ideal) can turn into a potential hypo very quickly if not monitored.

While your vet does have a valid point in saying that many cats can cope with being less regulated than dogs, that does depend on the cat and on your ultimate goals for your cat. If remission is something you would like to achieve, then regulating loosely is very unlikely to allow that to happen. On the other hand, if you are happy for Tigger to be on insulin long term and aren't too concerned about trying to get him OTJ then keeping him above normal range but below the renal threshold may be sufficient for you. That's a choice that no-one else can, or should even try to, make for you.
 
Most caretakers here test before each shot. I can maintain my Patches II below 120 with abut 1.3 units of Lantus twice daily and test before each shot. I very seldom test between shots. My MurrFee and Badger who are not that well controlled, I also test before each shot.
 
I do a curve about once a week ie test at +2,4 etc. but primarily I test before shooting, twice a day. Today is an exception. FRED has been meowing for the last hour and he had food on his plate but it was crusty, so he wanted fresh food. So I tested him to make sure he wasn't too low as sometimes they drop really low in the wee hours. He's at 210. I gave him 2 tsp of FF. His shot last night was at 9:30 so this test was +9. He's not due for a shot for 3 hours so I'll test again, feed the rest of the can of FF and shoot. I won't do another curve til I get back from Mexico. Hope yall have a fun day. We're going back to sleep zzzzz.
 
If I were at home, this would be so much easier! I would like to try an afternoon test, but because of our schedule it's been hard. My husband doesn't help..he gives shots and is the one who tests him in the ear....but he agrees with our vet about less frequent testing. Now my vet did know we were going to be traveling, and her words were "while you're on the road, testing once a week would be fine". I'll talk to her again soon and question her on this. Maybe she just thought she was making it easier on us, given our situation. But I wouldn't know how to adjust his insulin amount depending on his numbers....do you figure that out yourself, or call the vet every time?
 
I learned the hard way---TEST BEFORE YOU SHOOT! You never know when Tigger's system will decide to wake up and start making its own insulin after all. I listened to my (former) vet when I shouldn't have and I shot him once when he was borderline hypo, but didn't know it until AFTER the shot. I spent the day scared out of my mind. Fortunately his liver kicked in and I didn't have to rush him to the ER.
 
Hi Carol and Tigger,
Welcome. I didn't start testing regularly for several months after my cat was diagnosed - just couldn't work up the nerve. When I finally did, her numbers were sky-high. This was 1 month after a fructosamine test at the vet and they'd said everything looked fine. The high numbers scared me so I started testing everyday and with the vet's guidance raised her insulin dose. After a couple of months of dose adjustments up and then back down, she's doing well. Now I'm comfortable (because I've got a lot of data on Mitz's spreadsheet to guide me) making very small dose adjustments. I'll text my vet and post here for advice when I'm not sure. I usually test before each shot and before I go to bed, and then on weekends I try to get at least one test around +5, which is normally Mitz's nadir. One thing I learned along the way is that for my cat, holding a particular dose for a few days resulted in better numbers overall and doing a true sliding scale. Every cat is different and time and data all the collective knowledge on this site will help you figure it out.

I think it's great that you get to take Tigger on vacation with you!

Joan
 
I never call my vet. I email my SS to her every once in a while just to keep her in the loop but I make the decisions myself re dosing based on testing, with the advise of folks on here. I'm learning more every day. It's been almost 3 months.
 
Jamye and Fred said:
I never call my vet. I email my SS to her every once in a while just to keep her in the loop but I make the decisions myself re dosing based on testing, with the advise of folks on here. I'm learning more every day. It's been almost 3 months.
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That's exactly what I did. The vet called me a couple of times (they weren't too happy with me not just blindly shooting 2u twice per day and having a curve done in their office every couple of weeks so they kept wanting to ask me what I thought I was doing) but they stopped doing that after the first twice once they realized they weren't going to change my mind. I can honestly say if I'd followed their instructions I'd have been lucky not to have Rosa either seriously ill or worse by the end of the first week and I certainly wouldn't have been able to get her off insulin if I'd followed their instructions instead of making use of the wealth of advice and information available here.
 
Maybe send your vet a copy of the Roomp and Rand article on tight regulation.
 
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My vet prescribed Lantus and then treated it like an old style insulin for instructions too. And really didn't understand why I was doing what I was doing, but also can't deny that it worked!! They weren't happy with the Tight Regulation protocol and, in fact, remain unconvinced even now despite the information I provided for them showing the study and research that had gone into developing it. They do now understand how I was working out dosing, but they still don't much like the protocol as they think it's dangerous to aim for a target BG in the normal range (their standard advice is to aim for 180) and they couldn't understand why I kept letting Rosa go below 50 then reducing her dose - the first time it happened and they saw it on her spreadsheet, they were very insistent that she must have been showing severe hypo symptoms (she wasn't) and that she should have been put on a glucose drip to bring her numbers back up. The owner of the practice didn't seem worried at all about what I was doing when I spoke with her briefly during a visit with one of the other cats, but our regular vet wasn't comfortable with it at all (whether she didn't really read the research, didn't check with the owner who apparently understands it better and has a number of years more experience, or just didn't like the numbers on Rosa's ss because it's not what she learned in vet school I'm not sure).
 
Do most of you test on the ear or the paw? I have to almost fight with him to test him on the ear..I tried to do it myself tonight, and my husband ended up having to help.
 
Ears...was always too concerned with possible infection with paws/litterboxes, but you have to use what works best for you.

Here's some tips on ear testing though:

It can be really helpful to establish a routine with testing. Pick one spot that you want your "testing spot" to be (I like the kitchen counter because it's got good light and it's at a good height....it also already blocked 2 escape routes due to the wall and the backsplash) It can be anywhere though...a rug on the floor, a table, a particular spot on the couch...wherever is good for you. Take him there as many times a day as you can and just give his ears a quick rub and then he gets a yummy (low carb) treat. Most cats aren't objecting so much with the poking..it's the fooling with their ears they don't like, but once they're desensitized to it and learn to associate a certain place with the treats, they usually start to come when they're called! Or even when they hear us opening the test kit!

You also have to remember...you're not poking him to hurt him...you're testing him to keep him safe and understand what's going on inside his body. There's just nothing better than truly understanding what's going on inside your kitty's body and with this disease, the more knowledge you have, the more power you have against it. The edges of the ears have very few pain receptors, so it really doesn't hurt them. Also, if you're nervous and tense, it's going to make your kitty nervous and tense too. As silly as it might seem, try singing! It forces you to use a different part of your brain!

It's also important to make sure his ear is warm. A small sock filled with a little rice and microwaved or a small pill bottle filled with warm water (check temp against your wrist like you would a baby bottle) works well
 
On my first test, I poked right thru Goofs ear, dang near threw up, then cried for an hour, total meltdown. Called my vet, he calmed me down, then suggested the paw pad. That worked much better. I also test every morning and evening right before feeding, but not during the day, unless I'm doing a curve which is about every 2 months. Hmm, that means Goof is due for one....
 
When we first started, I poked all the way through China's ear several times too....got to thinking I should just buy her a pair of diamond stud earrings...LOL

It does get better though...after about 2 weeks, new capillaries grow in and it's much easier to get blood. At this point, I think I could just tell China's ears to bleed and they'd do it
 
I have done the paw pad since day one. I tried the ear once and that was enough. Oddly enough, it has to be the left paw; if I try the right, I end up having to poke him 2-3 times to get a drop.
 
I've been testing Fred on his left ear. He doesn't fuss about it. I get him wherever he is, at the time. I've gotten pretty quick, so I'm in and out in a flash. I put a cotton ball behind the ear and I free hand test with the primed/clicked pen, without the number guide thingy. I always put antibiotic ointment on afterwards. His ear looks great. Can barely tell he's being poked. He won't let me touch his paws !
 
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