When to test glucose level?

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kldanzi

kldanzi

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Hello! Newbie so first some background info:

I am the caretaker of Bear, a 13 yr old Siamese/American Bobtail. He belongs to my boyfriend and when I first moved in he was quite a fattie. About a year ago, I put him on a diet and he lost A LOT of weight. We contributed it to the diet but then learned that two of his kittens had been diagnosed with diabetes. I started watching him more closely and realized he was drinking excessive water and looked unhealthy. We took him to the vet and told them we suspected diabetes and sure enough, it was true. We got an insulin prescription and he has been on insulin for about 6 months. This is going to sound weird but luckily my Grandmother is diabetic so injection were no problem for me. (Once you have given your Grandmom an injection a cat is no big deal!!!)

Now I'm not sure if my vet in undereducated and just doesn't care but after browsing this site I'm starting to realize that Bear is not receiving the proper care. They have NEVER required him to stay for a whole day and never done an glucose curve. After the initial appointment they only scheduled one follow-up where they tested his glucose levels with blood and upped his insulin dosage.

We absolutely do not have the money right now to go to a new vet so I bought a meter. (Once again, after Grandmom, this was no big deal.) I am just a little unsure about WHEN I should be testing him to make sure that everything is going well. I tested before he was fed dinner..... should I test about an hour or two later to see if the insulin is having an effect or should I wait until next time I feed him? I feel like for the first few days I should test before and after just to see what's going on with his glucose levels at the current dosage. Any advice?
 
Before anyone says it, I know, I know, we should find a new vet but until I save up some money for the initial testing that is just not an option.

Also, his insulin is Lantis.
 
A couple questions here to help with getting proper answers.

1. what insulin are you giving?
2. what was the starting dose and how often did you inject?
3. what was the number from the test at the vet when they upped the dose?
4. what dose are you giving now?
5. VERY important ... what are you feeding and how frequently?

You said you tested a few times already - can you please post what numbers you got form your tests with the times. Also, what times are you giving shots is needed as it will relate to the test results you got.

testing should be done just before EVERY shot, no earlier than 15min prior to the shot.
You need to know what the cat's BG number is before giving the shot.
Depending on the insulin, you will see reaction at different times.
There are fast acting insulins and others that are longer lasting.
Lantus and Levemir are longer lasting and the ones that I am using, but others here can say more about other insulins.
 
always test before each shot.
try to get at least one spot check some time after the shot. i'd alternate times so i'd have a better idea of how he's doing. for example, one day test 4 hrs after the shot. another time test 5 hrs after the shot, etc.l
you can do your own periodic glucose curves at home. in that case you'd test every 2 hours or do a mini curve in which you test every 3 hours.

generally, you're looking to discover your cat's onset (when insulin first starts to work), nadir (when glucose is lowest), and duration (when insulin starts to run out). for every cat it's different, but many lantus cats have an onset at about 2.5 hrs after injection, nadir at about 5-7 hrs after injection, and duration of 12 hours. so you could do spot checks to discover these.

re onset: when you first inject, normally your cat's glucose level continues to rise until the insulin kicks in. so you could spot test 1, 2, and 3 hrs after shooting to see when the number starts to go lower.

re: nadir, you could spot test 4, 5, and 6 hrs after shooting to see when number is lowest.

re duration, you could spot test 9, 10, 11 hrs after shooting to see how his numbers compare to the test number you got right before you gave insulin.

cats can be very different. for example, cleo's onset is at about 1.5 hrs after the shot, her nadir is at about 4.25 hrs after the shot, and she gets about 13 hrs duration out of the lantus. other kitties can have a nadir at 3 or 11 hrs after the shot. so by spot testing you'll know more about how your cat responds.
 
I would like to comment on the getting a new vet .... if you have your meter, and your insulin, syringes, test strips, and low carb wet food, you certainly don't need to rush to a new vet because for now, you know what you need: your cat is diabetic and needs insulin.

You are testing and giving shots, so that's a BIG plus already. Lantus is a good longer lasting insulin, so you can get set up here with a spreadsheet where you can record your test results, and others can help you when you need it.

I take my cats to the vet only when I need meds or some kind of tests; otherwise, I handle everything myself at home. And so can you.
 
Aaaaalllllright.... I just tested again and I can't give a specific number because I cheaped out and bought the Target brand glucometer and right now it is just telling me "high". I did test it on myself and it is in good working order, heehee! (132. Poor Grandmom! That stings!)

From what everyone is saying I'm guessing the Lantis hasn't kicked in yet so I'm going to check again in another hour.... I'm also a little iffy about the vial we have because my boyfriend has a bad habit of leaving it sit on the counter. I am going to have him go get a new one tomorrow.

The insulin is Lantis, the starting dose was 5 units (3/10cc syringe).
He is only supposed to get one shot a day.... I really feel like he should be getting 2? Or is the Lantis that long acting?
The dose now is 7 units.
We feed him Friskies Meaty Bits wet food twice a day.... 7:30 AM and PM and there is a small amount of dry food available throughout the day but since switching to the canned stuff he very rarely goes near that, it is mostly for the other cat.

Thanks for all the help everyone, it is so AWESOME to be able to have advice and feedback from people who understand!!
 
Update:

First test at 7:30 - HIGH
Insulin shot and meal
Second test at 8:30 - HIGH
Third test at 9:30 - 446

Hooray! Still waaaaaaay too high but at least we know the insulin is working! I guess that means that between one and two hours after the shot is his onset?
 
Hi there,

Welcome to the FDMB! I'm going to throw you some links (highlighted in bold blue), sorry it's long, but I like to write! :lol:

Are you testing for ketones too? If not, you may want to, just to be safe.

Lantus works best on a 12/12 schedule.
If you're interested check out the Lantus forum Lantus Forum
Lots of information stickies there to help you with Lantus. You're more than welcomed to open a thread there, ask all you need to, as it is specific to Lantus users.
In the meantime, posting here in Health is good too!

As for how to handle/store Lantus, check this stickie from the Lantus forum:
Proper Handling & Storage of Lantus/Levemir



The following chart might help you with a curve and spot checks....I highly recommend you attempt a curve when you are home to monitor. Record your numbers and post here in Health and/or the Lantus forum if you like, for feedback.

You can find this chart in the Lantus forum stickie New To The Group I've included all the links for Onset, Peak, Duration etc.


Learn how YOUR kitty is responding to insulin:
Onset ---> the length of time before insulin reaches the bloodstream & begins lowering blood glucose

Peak/Nadir ---> the lowest point in the cycle
Duration ---> the length of time insulin continues to lower blood glucose

How to do a Curve: you don't have to test every hour. Typically curves are every 2 hours in a 12/12 cycle. Or a mini-curve, about every 3 hours.
Depending on where the numbers are, you may have to re-test frequently and offer food to help steer numbers.

Example of a typical curve:
+0 - PreShot number. (AMPS +12)
+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. *recommended spot check*
+4 - Lower.
+5 - Lower.
+6 - Nadir/Peak (the lowest number of cycle). *recommended spot check*
+7 - Surf (hang around the nadir number).
+8 - Slight rise.
+9 - Slight rise. *recommended spot check*
+10 - Rising.
+11 - Rising (may dip around +10 or +11).
+12 - PreShot number. (PMPS +12)

Carryover ---> insulin effects lasting past the insulin's official duration
Overlap---> the period of time when the effect of one insulin shot is diminishing & the next insulin shot is taking effect
Insulin Depot ---> (aka "storage shed" in Lantus Land) "spare tank" of insulin, which has yet to be used by the body
More on the Shed ---> Lantus & Levemir Insulin Depot AKA Storage Shed

Lots of members here to help you out, so post as often as you like! Good luck!
 
UGH, your answers are what I feared.

OK, 7 units is CRAZY HIGH. I doubt very much that you need that much for your cat.
Also once a day is not right; for cats, it's TWICE A DAY.

Read the stickys for Lantus, see below links.
Tight Regulation Protocol
LANTUS & LEVEMIR – INSULIN DEPOT –AKA- STORAGE SHED
Lantus&Levemir – Data Ready to Shoot Low Numbers

Here are some links about Hypo situations, what are the signs and what to do:
List of Hypo symptoms
How to treat HYPOS – They can kill! Print this out!
Jojo’s HYPO TOOLKIT

Foods - NO DRY as it's just kitty krack for your diabetic kitty. Dry foods, no matter how little is eaten can cause HIGH BG numbers, so best to remove it.

I don't know what others may suggest but it may be an idea, now that you are testing, to cut back that dose to something like 1unit, twice a day, 12hours apart.

Now, about the Lantus, it needs to be in the frig. How old is your vial? Lantus is good for about 28days guaranteed by the mfgr I believe, but if left out of frig, it may no longer be good. If you can, you would do better to get a package of the 5 cartridges.
Keep the cartridges in the frig and you will get your money's worth.

Seriously, 7units once a day it so wrong. My knee jerk reaction is that the 7units is knocking your kitty really low and then his numbers are bouncing really high. UGH.

what is a good time for you for the two shots? I go with 6am/6pm as it fits my day and my work hours.

What time was the shot of 7units?
 
7 units at 7:30PM....
I have already switched to twice a day because once just didn't feel right. He had 7 units at 7:30 this morning which apparently wore off by this evening!
I am going to get a fresh bottle tomorrow but I don't want to cut him back too quickly, can't that have a bad effect?
Do I need a new prescription to get cartridges instead of a vial?

Thank you to everyone for linking me up with the Lantis board, I never would have found that on my own!
 
ok so 7u twice a day?
every 12 hours.

I'm with Gayle on the dose, I worry about this too, but would like more members experienced with Lantus to chime in on this too.

Did the vet check for ketones at all?
Can you pick up a box at your pharmacy? They're not pricey - about $10 - $12 or so.

You'll want to be checking for ketones with high numbers, however, again, I would suggest a curve.
If he is dropping very low you need to catch those numbers.
Any wet food with gravy would be higher carb, you'll need a selection of high carb foods, and karo if in case you have a hypo situation.
Please follow the links Gayle gave you about that.

Dry food is the highest of course, but does take longer to get in the system and longer to clear out.


If you are going to start fresh insulin, again, I highly suggest monitoring numbers, fresh Lantus can pack a punch.
 
ok, I don't use Lantus on Spot, we use Lev, but they kind of work the same way.

I have to agree with Ronnie and Gayle...7 units is way to much! I also suggest that you cut it back to 1 unit twice a day, and go with a change in diet. I feed Spot Petsmarts brand of Sophisticat and they have several flavors that are low or no carb. Believe me...the change in food will help a lot! Just make sure, if you change food, that you also lower the insulin amount.

Good Luck!
 
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