BG results (first time)

Hopefully this will be my last noob thread, but I started her monitoring today.

She was 188mg at 10:43am, about two hours after she had eaten. (she got treats with the test so I can get her used to it)[treats were Purina Pro Plan hairball remedy (26%carb)]
She was 287mg at 3:33pm, about 3 1/2 hours after eating.

I have her insulin but not sure if I should even bother with dosing until I get a clearer picture of her curves. She's still in the 'normal' range. She's been on wet since last Sat. with less than 1/8 cup for the week (what she picks from the boy's food and it's usually crumbs). She gets fed at 2:3am, 8am, noon, and 5pm (coincides with when I leave for work, when the bf comes home and before he goes to bed, and when I come home). We started her on the diet last Saturday.

I'm going to do another week of curves to get a better picture of what her levels are, but what should I be looking at? Does she have to follow a normal curve cycle or is each cat different? I'm not seeing a reduction in her urine output, but the frequency has greatly reduced. I am also seeing her water intake drop, which may be a good or bad thing, I'm not sure. She's 12 pounds, down from 14.1 (at her highest weight in April when she had pyometra, which the uterus was a pound when removed), and she's about 12 years old. Her levels were normal before and after the surgery and has only developed this in the last three weeks. I want to be very sure before I start injecting her with insulin that this is in fact, diabetes.

Any and all advice is welcome.

 

Sorry, but I'm confused. What do you mean "She's still in the 'normal' range"? Her glucose? If that is what you mean, 287 is not normal. It is over the renal threshold (point at which glucose dumps into the urine) regardless of whether you are using an animal meter or human one.

 

It's fine to wait a few more days while you are getting her off the high carb food.... The high carb treats need to be eliminated. Just so you know, normal on a human meter is 50-120.

 

So are we following human rates or are we using feline rates because varied sources are giving a wide array of ranges. 80-120 on some, 120-300 on others, even 60-150 on one of the sites. I can't dose her if there isn't a concrete range for her to be in. She hasn't gone over 400+ and her intake is down (thirst and hunger have dropped since I started the wet, urine volume about the same but frequency is down).

 

The renal threshold on a pet meter is supposed to be about 250 (so a little lower on a human meter). So regardless of your target range, anything over that is too high. (I would disregard any range that tells you up to 300 is ok.) I have seen the 'normal' range of two major labs - one is 70-130, and the other is 72-175. Keep in mind that, if you use a human meter, your numbers are always going to look a little lower than they really are. Also, no matter what meter you use, there is a % of variance, so you cannot get too hung up on EXACT numbers. That is why you want to look more at ranges.

 

In that case, I should start dosing @1u 2x a day. A thought occurred to me....I work 12 hour shifts. How am I going to be able to make her doses 12h apart? I read I only have an hour window. So I work @4 a to 4p and her first dose is 3a, how am I going to get her 2nd dose?

 

I think I saw in your other thread that you have Lantus. If that is the case, you may want to post on that forum and ask about the scheduling/dosing. http://www.felinediabetes.com/FDMB/forums/lantus-basaglar-glargine-and-levemir-detemir.9/

If you could set up a spreadsheet to put your test results in, it would be helpful to anyone who tries to help you out with dosing questions. (You will also find that it will be very helpful to you.) http://www.felinediabetes.com/FDMB/threads/fdmb-spreadsheet-instructions.130337/

Janet mentioned getting her off the high carb food. If you are actively transitioning to low-carb wet food you could see how that goes first. You should be able to tell within a couple/few days whether her glucose still stays too high or not.

 

Lets try to clarify what the previous posters have said. You need to know that a lot, if not most, fdmb members use a glucose meter designed for humans. Human meters work well and are cheaper, but they read lower than pet meters. Those using them just get used to a slightly lower normal range.

This means that the normal range is different depending on which meter you are using - human meter or pet meter. Which are you using? Also what insulin and dose?

As far as having absolute numbers, it doesn’t work that way. You are working to keep the glucose below the renal threshold and above a hypo incident. But we have a saying here that “every cat is different” (ECID). Some cats feel better at the high end of “normal” while others are still having symptoms and need to be lower. But mostly you are working to make your cat feel better.

Start testing before meals and track the numbers. Changing to low carb food, and hopefully low carb snacks is a great start!

 

Alright, so instead of starting a new thread, I'll just update here. I'm using the Relion Prime. Her results from Sat. through today were 228m/ 1:44am -300m/4:21p [sunday] 200/ 4:31p before she fed.

I took her in today because I believe she wasn't drinking enough water. Her urine output dropped dramatically over the course of a couple days, and though she is eating normally (yes, I am mixing water in her food), she was also having tail twitching and constipation to the point she was vomiting after because she was struggling so hard to get the poop out. The vet did a BG test there with AlphaTrak 2, and she was 226 after being fed a half hour earlier. She was a little bit dehydrated but because she was in a range that was close to the 175m, he wanted to hold off on giving her insulin. I now have her blood test from July 5th to give a bit more perspective to those that are more in the know. He isn't completely confident that she has feline diabetes now and that we may be looking at kidney disease (or pancreas/liver issues). Her panel prior to her April surgery was completely normal as well as the testing right after.

These were the key points of her 7/5/18 test:
Monocytes: 1.032 [.04-.53k/uL]
Glucose: 537 [72-175mg/dL]
Creatine: 1.9 [.9-2.5mg/dL *normal]
BUN: 42 [16-37mg/dL]

Phosphorus: 6.4 [2.9-6.3 mg/dL *only a hair abnormal but for a feline with potential kidney issues, it is concerning]

TCO2: 23 [12-22mmo/L]

ALP: 112 12-59U/L]

Free-catch urine sample
Glucose: 3+
All else clear and negative

Rare Cocci was present but <9/HPF

Thyroid was normal at 1.3

So ultimately, the BG was the most pressing at the time, but given that her diet has kind of regulated the glucose a bit, I'm not sure what we're looking at. She is a special case due to the pyometra that we saw back in April but the AT2 and my Relion Prime seem to be giving relatively consistent and close numbers. He also quoted the 120-300m range for felines so I am not sure what the 'normal' range is. She was treated today with fluids for dehydration, given a 14 day antibiotic just to cover any potential uti or bacterial infection, and sent home with miralax to ease the constipation. Any insight from anyone who has dealt with this type of situation would be greatly appreciated. Could she be normal? Could she have kidney disorder that could elevate her glucose like that?

 

Yes, that high of phosphorous level is concerning. One want to keep it below the middle of the acceptable range.
Do you know the level of urine specific gravity (USG)? That is a good indicator of kidney condition before it degrades enough to be seen in the kidney blood values.

 

USG was 1.019, a hair under min. normal but this panel was before her diet and regulation. I won't know where she sits at until we do another one. Right now, her bg sits between 90-160m comfortably, and her output is starting to come down to more normal levels. I'm not going to stress her out by taking her in for another panel for at least a month unless she has a massive decline.

 

A USG of 1.019 indicates significant kidney degradation