Watching Jose's PM BG need to know if he is dropping too fas

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Rebecca & Jose

Member Since 2014
Hi everyone! My name is Rebecca.

My family rescued Jose from a cat shelter when he was about 2 years old. He lived in my family's home with other cats and a dog until he was diagnosed in July of 2011. After his diagnosis I took on full responsibility for his care and moved him to my apartment in the town where I was going to college. I switched his diet from free fed dry kibble to a canned low carb high protein diet. Because of a drastic change in diet and a lack of knowledge he unfortunately had one episode of hypoglycemia resulting in a seizure. Soon after that his diet and insulin became regulated. He gradually lost some weight and was an active and healthy kitty (aside from the diabetes).

This past year I graduated and Jose and I moved back into my parent's house. My parents now have 6 cats that are free fed a dry kibble all day. Because of the access to this food, Jose's insulin dosages increased. When we first end moved back in, Jose began urinating outside of the litter boxes as we'll. This was never an issue before. After being tested for a UTI and finding it to be negative I decided he needed his own litter box that no other cats use. This transition back proved to be quite stressful for the both of us :sad:

Trying to regain control of his diet and to lower his stress from the many cats, I moved us into the basement and now keep the door shut to keep the other cats away from his food and litter box and to keep him away from their food. This has helped a lot! :razz: Although this has helped, his insulin needs are still higher than they were when we lived alone. I believe this has been because of his increased weight and he does come upstairs occasionally throughout the day and will snack on the dry kibble.

I have now started to research a better quality diet such as a raw diet. I have also looked into making my own raw cat food at home. Along with this I have started to think about doing at home glucose testing to monitor his levels better. Since he was diagnosed I brought him to the vet for glucose curves every 3 to 5 weeks until his levels were under control and then ever 6 months after that until I noticed any changes.

I consider myself a young responsible cat owner doing much more than I know many of my college peers would have. Jose is my baby and I try to do as much as I can to keep him as healthy as possible. When he was first diagnosed I had my heart set on getting him off the juice but it hasn't worked out yet. I'm really hoping that I can lower his dosages with whatever new diet I try next.

I welcome any advice and am willing to give advice to new diabetic cat parents as we'll :smile:
 
Re: New to FDMB mommy to Jose diagnosed July 2011

Maybe try educating your parents with printouts from Cat Info on proper nutrition for an obligate carnivore.

See if you can get them to switch to Evo Cat and Kitten kibble, which is about 8% calories from carbohydrates. Then the food isn't contraband.

Move out into your own place.
 
Re: New to FDMB mommy to Jose diagnosed July 2011

Hi Rebecca and Jose,

It sounds like you are trying to do the very best you can for Jose in difficult circumstances. Hometesting will definitely be a good idea, for him and for your wallet. You can see exactly how the insulin is working, whether you need to give a little more or a little less and try to get him regulated. Here is a video of how we do it: Video for hometesting
It may not be as easy as the cat in the video the first time. :mrgreen: Some of us took many tries to get it. But we have hundreds to tips that helped us so just ask for help.

Here is a shopping list for testing at home

A human glucometer. Any one that sips and takes a tiny sample is fine. Some members stay away from any meter with True in the name and the Freestyle meters. Some people think they are unreliable and read lower than other meters. The meters are often free at drug stores; it’s the strips that are expensive. You can, however, buy them on ebay at less than half the price of stores. Lots of people here also like the ReliOn from Walmart. It is an inexpensive meter and its strips are the cheapest around. Try the meter out on yourself or someone else before you try it on your cat. You want to be familiar with it before you poke the cat.

Lancets and a lancet device. Usually, until the ears “learn” to bleed, a 26-28 gauge is good. Any brand will work as long as the lancets match your device.

Ketone strips. (Ketostix) Just like human diabetics use. You will sometimes need to test urine if the numbers are high.

Rice sack. Make this out of thinnish sock, filled with raw rice or oatmeal and then knotted. You heat this in the microwave until very warm but not hot. Then heat the ears before poking. You can also use a prescription bottle filled with very warm water. It provides a good surface to poke against.

Also nice to have. Flashlight: so you can look at the ears and find the little capillaries that come off the vein running down the ear. Vaseline: Put a tiny smear where you want to poke. It will help the blood bead up.

And some lo carb treats to give your kitty, successful test or not Lo carb treats

How to get the cat ready for home testing

First pick a place where you want to test. Some people use the kitchen counter, a blanket on the floor, between your legs while sitting – whatever works for you. Take the kitty there and give him/her lots of praise while you play with his/her ears. Give a treat and release. Next time, add the rice sack (thin sock filled with raw rice, heated in the microwave until very warm but not hot) or a prescription pill bottle filled with very warm water. Lots of praise, treat and release. Finally add the lancet so he/she will get used to the noise. The hope is that when you finally poke, they will be used to the process and know a treat is coming!

Welcome and let us know how we can help! PS What kind of insulin?
 
Re: New to FDMB mommy to Jose diagnosed July 2011

BJM said:
Maybe try educating your parents with printouts from Cat Info on proper nutrition for an obligate carnivore.

See if you can get them to switch to Evo Cat and Kitten kibble, which is about 8% calories from carbohydrates. Then the food isn't contraband.

Move out into your own place.


That is my plan. I eventually want to try my parents to get all the cats on appropriate canned food. Thank you for the link.

Moving into my own place really isn't an option at the moment. I graduated in December and am currently searching for teaching jobs. Although it would be the ideal situation it's not possible to live on my own yet.
 
Re: New to FDMB mommy to Jose diagnosed July 2011

Sue and Oliver (GA) said:
Hi Rebecca and Jose,

It sounds like you are trying to do the very best you can for Jose in difficult circumstances. Hometesting will definitely be a good idea, for him and for your wallet. You can see exactly how the insulin is working, whether you need to give a little more or a little less and try to get him regulated. Here is a video of how we do it: Video for hometesting
It may not be as easy as the cat in the video the first time. :mrgreen: Some of us took many tries to get it. But we have hundreds to tips that helped us so just ask for help.

Welcome and let us know how we can help! PS What kind of insulin?

Thank you for all the information and links on home testing! :razz:

Jose has been on ProZinc insulin. He's currently getting 3 units with breakfast and 3 units with a meal 12 hours later. When we were in my apartment he was at 2 units twice a day.
 
Re: New to FDMB mommy to Jose diagnosed July 2011

I went out and bought all the supplies for my home testing kit yesterday! I have a ReliOn Micro and 28g lancers as well as a few 30g that came with the monitor. I was pretty nervous to try it on myself but was able to get over it.

I started this morning with bringing Jose to his favorite couch and playing with his ears and giving him a freeze dried turkey treat. An hour or so later I did that again and added the heated rice sock and ended with a treat. He didn't really like it at first but didn't fuss too much. Next I'm going to add Vaseline to his ear (he has long fur and I saw that this will keep the blood from spreading into his fur) and the clicking noise of the lancet. I'm going to add one more step each time I work with him today.

Hopefully by the end of the day I can try to actually get some blood. Jose is a pretty chill cat. He has never hissed or bit anyone. The most he does is walk away with a disapproving meow. So hopefully this will go smoothly. I'll post an update later today or tomorrow.
 
Re: New to FDMB mommy to Jose diagnosed July 2011

Sounds like you are ready. The only other thing you might do is to try the meter on yourself so you are confident using it the first time you poke Jose.

And remember, not every one gets it on the first try. We spent an entire weekend poking poor Oliver before getting a drop. If you don't get blood, three tries, then treats for both of you. And come back on and tell us what is hard and we'll have ideas for you.
 
Re: New to FDMB mommy to Jose diagnosed July 2011

Thanks! I spent time yesterday reading through the manual and instructions and did end up trying it on myself and was able to get a read on the monitor. It took some courage but I did manage to draw my own blood and test it. I'm not one for needles and blood. It took me almost a week to work up enough courage to actually give Jose his insulin myself because I was afraid of the needle and hurting him. My mom was in charge until I could do it and then supervised me until I was 100% comfortable.

Thanks again! I just introduced Jose to another step and he did fine. He likes the treats I bought for him, but this time he was less interested and just jumped off the couch without eating it. Do you think I should try to find something more rewarding for him? I bought PureBites freeze dried turkey and a bag of the freeze dried shrimp. He loved the turkey but wouldn't even touch the shrimp. He'll eat the turkey but its not as if its something he's super excited about.
 
Re: New to FDMB mommy to Jose diagnosed July 2011

Can you think of anything he loves? Being scratched, being brushed, people tuna or chicken? The trick is to find something low carb or no carb that he loves, and save that only for testing time.
 
Re: New to FDMB mommy to Jose diagnosed July 2011

He really likes people tuna. I'll try that next. Thanks for the suggestion.
 
Re: New to FDMB mommy to Jose diagnosed July 2011

You mentioned that your kitty Jose has long fur. My Wink has long fur on his ears too, and that fur is black, so it made it harder to find the blood drop. What I did to help me in the beginning, is to shave a tiny patch of fur on his ear. It sure did make it easier to see the blood in the beginning.
 
Re: New to FDMB mommy to Jose diagnosed July 2011

Thank you for that tip!

As I was playing with his ears I also noticed that on the inside of one ear the skin where his vein is is black and it makes if very difficult to see unless I use my flash light. The skin on the edge of the other ear, however, is not black so it's easier. I know it is best to switch ears but I'm starting with the easier one first, until we both get comfortable with it.
 
Re: New to FDMB mommy to Jose diagnosed July 2011

I have a question about the lancing device I am going to be using.

I have the lancing device that came with the ReliOn Micro Meter. There is an adjustable top on it for the depth of the puncture. What should I set it to? I am going to be using a 28g lancet. Thank you!
 
Re: New to FDMB mommy to Jose diagnosed July 2011

No help from me here on what to set the lancing device at. You'll have to try different settings to see what works for you. I always free handed the lancet.
 
Re: New to FDMB mommy to Jose diagnosed July 2011

I'll have to try those other flavors too. I did review that link, thank you!

Just finished our first attempt! He didn't flinch one bit! It wasn't until I took my fingers off his ear after getting the blood into the strip that he shook his head. I set the lancing device to the middle setting, the third notch, and it worked but not much blood came from it; so I quickly changed the setting to the fourth notch and it worked and produced a droplet big enough for the meter to read.

Home testing will be very easy for us! I honestly wasn't expecting it to be this easy! I wish I would have started this when he was first diagnosed, better late than never I guess.

His reading was 117. His last shot of ProZinc was 3units with a U-40 syringe at 9:00 this morning. His next shot is due at 9:00 pm which is in 30 minutes. I'm not sure where to go from here though. I will be reading the forum on the ProZinc protocol shortly.

Thank you to everyone that gave me tips and links today!
 
Re: New to FDMB mommy to Jose diagnosed July 2011

That is a prety low number for 11. We suggest that new diabetics not shoot under 200, but to wait 20 minutes, without feeding and retest. You want to be sure the number is rising, not falling, and over 200. Feeding raises the number - you want one that is not influenced by food.

Post your number in 30 minutes and we will try to help.
 
Re: New to FDMB mommy to Jose diagnosed July 2011

He's not a new diabetic, we are just new to the FDMB. He's had diabetes since 2011.

Thank you for the quick response. I will retest and post the numbers.

What did you mean by "That's a pretty low number for 11?"
 
Re: New to FDMB mommy to Jose diagnosed July 2011

We reference glucose levels by how many hours it has been since the shot because we are in so many different time zones.

A 117 mg/dL at +11 hours (or 1 hour before the next shot) seems low.
 
Re: New to FDMB mommy to Jose diagnosed July 2011

Nevermind! I understand that 11 means 11 hours after the AM dose. I just opened up the spread sheet and it all makes sense now! I will work on getting it into my signature.
 
Re: New to FDMB mommy to Jose diagnosed July 2011

It's a low number for 11 hours after the shot. ProZinc has sort of a smile cycle - higher at preshots, down to the lowest point about 5-7 hours after the shot (called a nadir) and then back up to about the same range at the morning preshot, at night. So we'd want him 200 or above at preshot and he is pretty low, 30 minutes away.

By new diabetic, I mean one without any data to help figure out doses.
 
Re: New to FDMB mommy to Jose diagnosed July 2011

I would stall 30 minutes without feeding and retest.
 
Re: New to FDMB mommy to Jose diagnosed July 2011

Ok. Thank you.

I started a spreadsheet but I did it off of my iPad so I'm not sure if it works correctly.
 
Re: New to FDMB mommy to Jose diagnosed July 2011

When you upload it, you tell Google Docs to convert it to their format.

You're almost there.
 
Re: New to FDMB mommy to Jose diagnosed July 2011

No shot.

Time to reduce the dose 0.25 units.
 
Re: New to FDMB mommy to Jose diagnosed July 2011

Hi Rebecca and Jose,

How are things today? I saw on the spreadsheet that the 2 units lasted a full 24 hours, which is usually a sign that the dose is too high. I am a little nervous that you shot 2 units this am. I hope you can get a mid cycle number to be sure he doesn't drop too low.

For reference: We consider a cat regulated if they range from the low 200s at preshot to double digits at nadir, but not below 40 (which is hypo territory). If you see a 50 or lower, post for help.
 
Re: New to FDMB mommy to Jose diagnosed July 2011

Looking at Jose's SS it looks like 2u or maybe even less gets nadirs that are plenty low.
 
Re: New to FDMB mommy to Jose diagnosed July 2011

Hi Rebecca!

Jose's +2 of 116 is awfully low for that early in the cycle. Nadir (or the lowest point), is usually around +6 or +7 on ProZinc. I'd strongly encourage you to test at least hourly and post here. If Jose nears 50 or goes below, please edit your very first post with a "911" symbol to get eyes on Jose. I'm going to be away for a bit, but will check back in a while.
 
Re: New to FDMB mommy to Jose diagnosed July 2011

You may find you need to steer the numbers if it looks like he is heading too low (below 50 mg/dL).
Here's how to intervene:

Upon getting a very low number of concern;
Feed 1-2 teaspoons of high carb gravy, or add a couple drops of Karo or other syrup to low carb food
Wait 20-30 minutes
Re-test
If still too low, repeat.
Generally, you continue this until past nadir and numbers are heading up 2 or more times in a row and are above 50 mg/dL.

Caution: gravy and syrup wear off quickly. This why you keep checking until you are sure the cat is safe. For Lantus and Levemir, this can be needed for hours due to how long they last in the body.
 
Re: New to FDMB mommy to Jose diagnosed July 2011

Jose is currently at 68. I did not realize his numbers got this low throughout the day. I have been giving him the same dosage at the same times with the same amount of food since our last BG curve at the vet on 2/12/14. Aside from not giving it to him last night. When he was at 220 this morning I thought that was high enough for me to give him his insulin. I've never seen any hypo symptoms so thought he would be fine. I wanted to see what his actual numbers so I could bring them to the vet. I was testing every hour throughout the day. Seeing these numbers scares me. When he was at 27 at +3 I gave him corn syrup canned food and wet food and treats and kept testing him every 15 minutes. I'm testing him every 30 minutes now that he's above 50. Will his numbers keep rising or could they fall low again? I feel like an idiot that this happened!
 
Re: New to FDMB mommy to Jose diagnosed July 2011

You're going to want to continue to test at least hourly for the time being. Syrup typically brings up numbers quickly, but can wear off fast. Jose may go back down when the all the corn syrup and honey wears off. I'd strongly encourage you to post here with your next reading to get guidance on whether and what to feed to keep him up.
 
Re: New to FDMB mommy to Jose diagnosed July 2011

Ok, good. :smile: Keep testing and posting. How long has it been since you fed Jose?
 
Re: New to FDMB mommy to Jose diagnosed July 2011

He ate half a 5.5 oz can with his am dose this morning. Then he ate another half of a 5.5 oz can when his numbers dropped along with some dry kibble that's pretty high carb along with the syrup. I put out another half can for him to eat and he's been nibbling on it here and there. The last time I saw him eat some was about 45 minutes ago.

He usually only get half a can in the morning half a can 6 hours later and half a can at night. He's at 85 now.
 
Re: New to FDMB mommy to Jose diagnosed July 2011

What kind of food is he nibbling on? Low carb? I'd put up the food for now to ensure that he's still rising without the food keeping his numbers propped up. You also don't him to get overfull so that he vomits, or won't eat if you need to get him eating again. Generally, if you need to feed to bring up low numbers, you're going to want to feed in very small portions. Are you seven hours post shot now? If so, you should be past nadir or close, so the insulin should passing its peak action.

Generally, you're going to want to see two rising numbers after nadir to ensure that they are on the rise. He's high enough at this point that you should be ok to slow down to one test per hour. Let's see where he's at at +8.

Talk about trial by fire! Great job testing. :smile:
 
Re: New to FDMB mommy to Jose diagnosed July 2011

For future reference:

[Glucose reference ranges are unsubstantiated and have been removed by Moderator]

* * * * * * * * * * * * * * *​

How to use the glucose reference values chart:

When you get a test, look for the number on the chart that either equals, or contains, the test value you have. Read the information. As needed, make a decision and act.

Ex. You are a new insulin user and you test your cat before giving insulin. The test is 300. It probably is safe to give insulin.

Ex. You are an established user of Lantus, following the Tight Regulation protocol. You've tested around +5 to +7 to spot the nadir. It is 200 mg/dL. You probably need to increase the dose, following the instructions for the protocol.

Ex. Your cat is acting funny. The eyes are a bit dilated. You are concerned and test the glucose. The number is 35 mg/dL. ACK! The cat may be in a hypoglycemic state. You quickly follow the HYPO protocol linked in the glucose reference values chart. (which we really, really, suggest you print out and post on your refrigerator.)
 
Re: New to FDMB mommy to Jose diagnosed July 2011

Thank you. I had a family emergency and needed to leave the house so I was not able to monitor Jose's levels after +8 of his AM dose. I have just returned home and tested him. He is now at 378! I'm assuming this is from all the extra food and carbs I gave him earlier to treat his hypo. What do I do now? He has been getting 3 units but based on what happened today that is clearly too much. How much insulin should I give?
 
Re: New to FDMB mommy to Jose diagnosed July 2011

Drop the ProZinc at least 0.25 units to 2.75. Since you might want to sleep tonight, maybe drop 0.5 units tonight to 2.5 units.

You may have to eyeball 0.25, as most syringes don't measure quarter units.

If the morning pre-shot is below 150 mg/dL, stall 30 minutes without feeding and re-test. If still under 150 mg/dL, don't shoot.

Any time you test below 50 mg/dL, you earn a dose reduction of 0.25 units; when you hit the 49 on 02/12/2014, you could have reduced then.
 
Re: New to FDMB mommy to Jose diagnosed July 2011

Thank you. I gave him 2.5 units. .5 less than what I had been doing.

On 2/12/14 he was at 3.5 units and the vet instructed me to reduce to 3 which is what I did. At that point I wasn't home testing. Now that I'm home testing I'll be able to see right away when he needs to be reduced again instead of waiting 3-5 weeks for another curve at the vet.
 
Re: New to FDMB mommy to Jose diagnosed July 2011

Hi Rebecca!

If you can, try to get a few tests in tonight as well so you can see how Jose does on 2.5u. Ideally, if you can get a +3 and a +4, that should give you an idea of how fast he's dropping.
 
Re: New to FDMB mommy to Jose diagnosed July 2011

At +2 Jose was at 250 at +4 he is at 143. Should I do another test at +5 or +6 to see how he continues to respond or will he be alright for the remainder of the night?
 
Re: Watching Jose's PM BG need to know if he is dropping too

He dropped 100 mg/dl in 2 hours. In another 2 hours, he could drop another 100, taking him down to around 40-50 mg/dL.

Hope you checked later in the night and/ or fed him to help steer the numbers.
 
Re: Watching Jose's PM BG need to know if he is dropping too

Rachel, I definitely think you need to reduce the dose. He is dropping fast and going low. Please get some advice on dosing.
 
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