When to test?

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Herman's Mom

Herman's Mom

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Hi, I'm new to this group. My cat, Herman, was just diagnosed with feline diabetes last week when I brought him to the vet for weight loss. At the vet's office, his glucose level was 500. He stayed in the hospital for a couple of days and was 300 when I brought him home. The vet prescribed 3 units of PZI in the morning and 3 at night. However, from reading one of the diabetes web sites, I knew that if I was going to change his diet (which I did - Fancy Feast classic, no more dry food), then I would need to adjust his insulin levels as well. I am unable to test his blood myself (yet), so I arranged for a vet tech to come to my home once a week to test it until I get brave enough to try it. In the meantime, I stopped giving him insulin to see how he would do on just the food. He was tested last night and his level was 250. That was from diet alone. He was stressed at the time of the test, so I'm thinking the actual level might be a little lower than that. The vet reduced his insulin dose to 2 units twice a day, but I'm thinking maybe I should go a little lower even, like to 1-1/2, and see how he does. My question is, if he's only going to be tested once a week initially, should the test be administered before or after he eats in order to determine how much insulin he should be getting?

Thank you for your help.
 
You want to test before eating to see if he’s high enough to shoot. We advise newbies not to shoot if the blood glucose is under 200 on ProZinc. Not only do we want to know that Herman is high enough to shoot, we want to know how lose a dose is taking him. Any way you could have the tech come back 5-7 hours after the shot for a test? You are right to be concerned giving 2 units when he tested 250 being stressed. If he were mine, I would definitely lower the dose. How much? Hard to say, but I would probably say 1 unit or even less.

Good luck on home testing. It was really stressful for me (and my Bud) in the beginning but it’s nothing now. It really is key to keeping kitty safe. I didn’t regularly home test at first either. I had Bud on 1.6 units of ProZinc and I was testing him every other night. On an off night, something told me to test before his shot. So glad I did as he was 98! I really think I might have killed him had I gave him 1.6 units with a preshot of 98. That was the moment I decided to test before every shot.



Is Herman not a laid back kitty and that’s why you’re nervous to test, or is it the process itself you’re not comfortable with?
 
Thank you for your reply. I think I will go down to 1 unit twice a day and see how he responds. The vet tech can't come back in 5-7 hours because I don't even get home from work until 7pm. She comes at 8pm. Then I leave for work at 7:50am in the morning. So time is very limited for me, except on weekends, and the vet tech isn't available then. I'm trying to find someone else, but in the meantime, I'm limited to once a week testing. :(

Herman is pretty laid back, but his mama isn't! I am very nervous and he senses my nerves and reacts accordingly. I can't even watch my own blood tests without nearly passing out. I wish I knew of another mom of a diabetic kitty who could sort of mentor me.
 
Herman's Mom said:
Herman is pretty laid back, but his mama isn't! I am very nervous and he senses my nerves and reacts accordingly. I can't even watch my own blood tests without nearly passing out. I wish I knew of another mom of a diabetic kitty who could sort of mentor me.
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I understand this; I was a nervous wreck at first too and felt like Bud could sense that. And I have no fear of needles! Any chance you live close to St. Louis? Herman is gorgeous, by the way!
 
I live in Oceanside, Long Island, New York. That's not Herman, that's Annie. Annie is my little disabled rescue. She was born without full use of her back legs. I have 18 rescued cats altogether (inside) and take care of another 15 or so ferals outside! I'll upload a pic of Herman soon.
 
Well then, Annie is gorgeous! That's quite a brood you've got there! I thought I had a lot with my little "herd" of 6. Lol!

Well shoot, wish I lived closer. But there's some wonderful people on here that might be able help you desensitize enough to get up the nerve to test.
 
Have you tried posting on the health forum with your location? Someone out there might be closer to you and be able to come help you learn to test. It really is important since we dose based on preshots and nadir (mid cycle).

Have you seen the protocol for ProZinc? http://www.felinediabetes.com/FDMB/threads/protocol-for-prozinc-pzi.109077/ This might help you get a better idea of how we work with this insulin. :)

I'd suggest watching some videos on testing a cat's BG. It really doesn't hurt them, and most are just chill about it all. My Gypsy came running to me at test time!!

You can do this! I know it's tough at first, and quite a steep learning curve, but we've all been there and made it through!
 
Herman's Mom said:
I will find the strength to do anything I have to do to keep my boy healthy. :)
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That's the spirit, Herman's Mom!

I totally understand how nervous you are about testing Herman yourself, but trust me: You WILL be able to do this! Bat is so intolerant of other people that she needs to go in the gas box at the vet's just to be examined (!!!) ... so of course I was scared to death about testing her myself. But she actually allows me to pin-prick her ear multiple times a day with NO fuss, and even ended up going into "meatloaf" position for her insulin shots. (I think our cats actually realize that we're doing something to heal them.)

What type of meter is your tech using? If it's an AlphaTrak2, those require only the tiniest droplet of blood. And I'm sure there are some human meters (others here who use them could tell you which ones) that require a tiny droplet, too.

Anyway, I am sending best wishes your way, and just remember what you said earlier: Yes, you can find the strength to keep your boy healthy! Best of luck to you & keep us posted on how it's going for you & Herman. :bighug:
 
Isn't the best time to test before an injection is 30 minutes after eating?I'm new to all this too so I'm just curious.
 
Hi Dana,

The answer depends on your insulin. If you are using one of the shorter lasting insulin so that tend to cause harsh fast drops early in the cycle, then you want to feed, test and shoot so you sure have food in their tummy. If they suddenly drop. With ProZinc, which is less harsh, you want to test before the shot (and 2 hours after the last feeding so there the number will not be food influenced). That way, you have a true test number to base your dose on. So, it is test, shoot and feed with ProZinc. The other reason it is important to test first is to be sure you have a number high enough to shoot.

Are you using ProZinc? If so, have you see the protocol we put together? It is in blue in my signature.
 
Sue and Oliver (GA) said:
Hi Dana,

The answer depends on your insulin. If you are using one of the shorter lasting insulin so that tend to cause harsh fast drops early in the cycle, then you want to feed, test and shoot so you sure have food in their tummy. If they suddenly drop. With ProZinc, which is less harsh, you want to test before the shot (and 2 hours after the last feeding so there the number will not be food influenced). That way, you have a true test number to base your dose on. So, it is test, shoot and feed with ProZinc. The other reason it is important to test first is to be sure you have a number high enough to shoot.

Are you using ProZinc? If so, have you see the protocol we put together? It is in blue in my signature.
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thank you so much for your information yes I am using prozinc. Some of diabetic language confuses me.What does shoot mean? I will read protocol now. My vet didn't tell me any of this info. Frustrating.
 
dana moore said:
thank you so much for your information yes I am using prozinc. Some of diabetic language confuses me.What does shoot mean? I will read protocol now. My vet didn't tell me any of this info. Frustrating.
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Also what is a cycle and midpoint? The vet said to test 5 hours after injection. what happens if my cat eats between then is that going to make it go up again?
 
dana moore said:
Also what is a cycle and midpoint? The vet said to test 5 hours after injection. what happens if my cat eats between then is that going to make it go up again?
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His am # before food was 54. Then 215 after so I gave him 1.5. Vet was telling me 2.5. Then I did bg hour later and it's 245. but the vet did tell me if his numbers are below 250 after eating to give half a dose if it's over 250 to get the full dose of 2.5 units.
 
Shoot, means giving the insulin shot. A cycle is the time between shots. Midpoint would be 1/2 in between the shots, so if you shoot at 6am and 6pm (for example), the midpoint would be noon. And nadir, which will probably be your next question, is the lowest point that the insulin takes the cat, or the lowest BG number during the cycle.
 
And just my opinion, as I don't use Prozinc, @dana moore , I would check again in an hour, as the food should wear off within two hours. With a 54 before the food, you probably need to keep a close eye on him today.

You might want to start another thread in the Prozinc or the main health forum, just so you can be sure that the answers you are getting are specifically direct at you.
 
So the 54 is a low number. How long after the last shot was this? It could be that he bounced up after that low number. That and the food could have gotten him up to the 215. (A bounce is when their body perceives a number lower than it is used to and releases extra sugar so they bounce up to a higher number.)

It is great you are testing so you can really see how the insulin is working and adjust the dose accordingly. If I were you, I would get some tests today, especially in the 3/4 hour range after the shot and in the 5/7 hour range to see how low the insulin takes him.

For reference, we suggest a new diabetic start at one unit and slowly raise the dose, based on their home testing numbers. That's much easier than trying to decide how much to safely reduce a dose. We also suggest that you not give a shot under 200 until you have more data. Instead, don't feed and retest in 20 minutes or so, to be sure the number is rising, not falling. You don't want to shoot a falling number, thus adding more insulin when the last shot is still working.

We consider a cat regulated if they are in the mid to lower 200s at preshot and in double digits at nadir. But not below 50, which is nearing hypo territory. His 54 is concerning if it happened late in the cycle. Not only does it suggest he might have been lower earlier but also that the insulin is lasting longer than usual - an indication that the dose may be too high.

What kind of food are you feeding? I am interested in that fast jump right after the shot.
 
Testing:
1) Always test before giving insulin to make sure it is safe.
For now, your no shot level is 200 mg/dL on a human glucometer (230 for pet-specific meters); this will lower as you collect data around the middle of the cycle to know how low he is going.

2) Mid-cycle tests between shots - whenever possible, test around the nadir (lowest glucose level between shots) for your insulin, to see how low he's going. For Lantus, this often falls between +5 to +7 hours after the shot. For ProZinc this is around +5 to +6. (Nadirs can and do fluctuate.) Some folks do this on weekends or set a clock for the middle of the night to get this test done as it helps determine dose adjustments. This number should be at or above 50 mg/dL on a human glucometer (68 mg/dL for pet-specific).

3) A before bed test is helpful in determining if you need to break out some higher carb food and steer the glucose level or go to bed with some peace of mind. Steering means giving 1-2 teaspoons of high carb gravy, waiting 30 minutes, and re-testing (repeating as needed) to make sure the glucose stays above 50 mg/dL on a human glucometer.
 
Sue and Oliver (GA) said:
So the 54 is a low number. How long after the last shot was this? It could be that he bounced up after that low number. That and the food could have gotten him up to the 215. (A bounce is when their body perceives a number lower than it is used to and releases extra sugar so they bounce up to a higher number.)

It is great you are testing so you can really see how the insulin is working and adjust the dose accordingly. If I were you, I would get some tests today, especially in the 3/4 hour range after the shot and in the 5/7 hour range to see how low the insulin takes him.

For reference, we suggest a new diabetic start at one unit and slowly raise the dose, based on their home testing numbers. That's much easier than trying to decide how much to safely reduce a dose. We also suggest that you not give a shot under 200 until you have more data. Instead, don't feed and retest in 20 minutes or so, to be sure the number is rising, not falling. You don't want to shoot a falling number, thus adding more insulin when the last shot is still working.

We consider a cat regulated if they are in the mid to lower 200s at preshot and in double digits at nadir. But not below 50, which is nearing hypo territory. His 54 is concerning if it happened late in the cycle. Not only does it suggest he might have been lower earlier but also that the insulin is lasting longer than usual - an indication that the dose may be too high.

What kind of food are you feeding? I am interested in that fast jump right after the shot.
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Shiloh & Rhonda said:
@Sue and Oliver (GA) , the way I read it, was the fast jump was right after the food, but before the shot. @dana moore is that right?
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Yes
 
dana moore said:
54 was at the end of the 12 hour cycle. right before I was getting ready to give him his breakfast and then after he ate it went up to 215 and the vet told me to wait until he eats before I give him a shot always wait until he eats.
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my husband just took a blood glucose reading at midpoint and it was 134 which this is the lowest its been yet after 7 hours. I haven't been giving him much carbohydrates. Trying to stay with wet food.he has lost a little bit of weight not much.thank you so much everyone for your help I really appreciate it
 
You can certainly make sure he has something in his tummy before you give the shot. But it is best to test before feeding. In his case, food made his number rise 150 points. You want to give a dose based on his actual number ( not food influenced as food causes the levels to rise). You would not give any insulin for a 54. You could for a 200+ But not if it was solely because he ate. Does that make any sense? What are his numbers now?
 
Oops. We posted at the same time. 137 is fine. I would watch that he doesn't continue to drop.

You want a smile shaped cycle with ProZinc with the higher numbers at each end and the lowest number in the middle
 
This is Dana's husband. I have a question. For the smile shaped graph, is the first reading pre-food, pre-shot post-food, or post shot post-food. Then when is the last reading on the graph.
 
Hi! Generally the first number is called AMPS. That means morning pre shot. This reading is pre food and pre shot for ProZinc. Last reading (or PMPS, evening preshot) is also pre food pre shot. We like to get numbers before they eat and get insulin so we can see what the number is without being influenced by anything.
 
What Rachel said. We try to take food away for the 2 hours preceding the morning and evening shots, so that number is "true" and you can feel safe basing a dose on it. Food after each shot is fine. Many people like to feel mini meals during the cycle; the thought is that it supports the pancreas.
 
if the reading is over 250 what would you all suggest I gave him one and a half units this morning and he seemed to ddo pretty good. he was first diagnosed at over 600 at the veterinarian's office so I know that this diet change has been a big part of the numbers going down
 
I would probably stick with that as well. With such a drop and little data, I'd hesitate to go more.

Has he been on this same dose the whole time?

I think if you could set up a spreadsheet that would help. We can see patterns with that and help you dose better if we have that. :)
 
Night before was 2.5. My vet wanted 3 until I told him he had signs of hypoglycemia. I just took pre shot pre food it was 60 and then I took it again and it was 204 so I just don't think I'm getting enough blood. he's not eating very well he's very picky with his new food so I think I'm just going to stick to the 1.5 again like this morning. he doesn't like to eat until after I give him the insulin which drives me crazy.My husband is going to start a chart tomorrow I am just really intimidated by taking blood from his ear and I know that he can tell
 
Yes, getting another test to just be sure is a good idea. If he is in the 200s, then I definitely would stick with the lower dose (1.5) and get a before bed test just to be sure he is in safe numbers. My thinking is that the earlier dose gave you a late low number which is not safe.

The spreadsheet is a great tool for you, your vet and for us, when you want quick dose advice. It will let us see his history at a glance. Here are the directions. If you need help, just ask.

http://www.felinediabetes.com/FDMB/...te-a-ss-and-link-it-in-your-signature.130337/
 
I just took another reading and it said 134 I'm not going to give him any medication I'm freaking out at this pointthis is after he ate a few bites of food
 
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