Hi Everyone! I am looking for some advice. My Gizmo was diagnosed with diabetes on 12/21/18 with a BG reading of 519. I took him off the dry food and tried controlling with just the diet. I finally started given Gizmo Prozinc last night. I do home testing. Can someone look at the following numbers and tell me if this is normal for a beginner on Prozinc? He hasn't had much of an appetite the last couple of days. He will eat if I hand feed him and add just a few pieces of his old dry food that I have left. 6:30 P.M. BG 376 Ate a little more than a couple of tbsps. gave 1 unit prozinc 7:30 P.M. BG 422 12:30 a.m. BG 397 This morning 6:30 A.M BG 386 Ate a little more than a couple of tbsp. Gave 1 unit of prozinc 8:30 A.M BG 415 FYI... The BG readings above are the numbers I get from an Alphtrak 2. According to my vet the glucometer reads about 70 points lower than a blood test they sent to the lab. This was based upon a blood sample that they used to test both my and the vets Alphatrak 2 glucometer. They both came back with 374. That same blood sample was sent to the lab and it came back at 445. So the numbers above are on the low side. The 7:30 pm BG is really 492 as an example. Is it normal for the BG readings to go up after the first couple of injections. Does his body have to get used to the Prozinc? I am panicked since I am new to this and I started the Prozinc because I wanted to get his BG numbers down not increase them. Am I doing something wrong? Please any advice you can give me would be appreciated.
You can't make much of just one day on it. Give his body a few days to adjust. Keep tracking, and it would be helpful if you enter the numbers into a spreadsheet that we can see. Here's how to do that. http://www.felinediabetes.com/FDMB/threads/fdmb-spreadsheet-instructions.130337/
Thank you Janet. I wasn't sure how his body was supposed to respond. I will have to learn to be more patient. I just want him to start feeling better. I notice that you use an alphatrak meter as well. Do you have such a big discrepancy in the BG readings as mine does? How do you account for it when the numbers get to the 200's or lower. Do you think I should try another type of meter? Will this vary with each new vial of test strips? And thank you for posting your video on testing the cat's blood sugar it really helps out us newbies.
Deep Breathes! You are not doing anything wrong. Those number increases you saw at 1 hour and 2 hours post shot and a meal are likely just from the food he consumed. A meal will increase BG levels to some degree and the amount of increase you are seeing is not unusual at all. On the meter front, I beg to differ with your vet. The AT2 meter should read relatively the same as the pet lab test would. Are you and the vet sure you have your meters set on the correct cat code for the vial of strips you are using? Using the wrong code could produce the difference in readings you experienced. I used an AT2 meter for ages and anytime lab values were checked, the meter was within a few points of the lab value. Was the testing of the 2 meters done on the same blood sample that was sent to the lab as using a different sample could cause a difference in the results.
Don’t freak out. Expect the unexpected in the beginning while kitty gets used to having insulin on board...
thank you for making me feel better about the high numbers. The testing of both Alphatrak 2 machines and the lab testing was all done off the same sample. The vet said that this is the only way we can get an accurate result. I have checked my cat code several times, because I was worried that i did not change it when i received the new vial, but it is set correctly.
Was the lab result from an in clinic machine or did the sample get sent out to a lab? All lab machines need to calibrated periodically and failure to do so would be another the reason for such a difference in readings. Also assuming the vet did the testing, are you sure the strip used in your meter came from your vial of strips and that his meter had a strip from the vet's vial of strips? Mixing up the strips could cause an off reading too. No glucometer is going to be as precise as lab work 100% of the time, but the whole point of having a pet meter is to get as close to lab equivalent results as possible and that is why the AT2 strips are batch tested to provide a code for most accurate results. 70 points difference even on a very high readings just doesn't sound right to me and kind of defeats the purpose of having a pet meter.
The sample was sent out to a lab. We used test strips from our own vials at the same time in the room. Both of our glucometers gave the same BG reading of 374. I agree that it defeats the purpose, so i have been considering buying a different glucometer, but maybe i will ask my vet if we can repeat the test to see if it is any closer the second time. If i were to switch to a different glucometer does anyone have an suggestions?
That is indeed interesting. I'd change the battery in both meters and run a control solution test to make sure both are reading within range before doing another side by side test. I assume you have a new meter so it should be in good working order. The vet's is anyone's guess. Frustrating to say the least. If you do decide to get another meter, then a human meter will do just fine and be far less expensive. We know the normal range for the use of human meters and most folks here use them due to the high cost and lack of immediate availability of the strips for the pet meters. If your vet gives you any grief, then use the human meter for day to day testing and if you run curves for the vet, use your AT2 meter for those. Human meters do read lower than pet meters (and obviously pet lab results) but knowing that the warning of low BG reading on a human meter is 50 and top of normal range is 120, gives you enough info to safely monitor. There is no way to convert human meter readings to pet meter readings or vice versa. Typically, the pet meter will read higher and the difference will be greater the higher the BG. Any human meter will do just fine but it is much easier if you get one that requires the smallest blood sample (like the AT2 meter) of 0.3microliters. The Freestyle Lite meters and Glucocard from ADWdiabetes online store are frequent choices.
The numbers are supposed to fluctuate. They don't stay steady. Alpha is very accurate and the one most vets use. The reason many on here don't use it is because the strips are pricy. I cut the cost by using Freestyle Insulinx strips with it. That's great if you are getting to readings under 200! It took my cat almost 3 months before I saw a number under 300.
It's not an exact number. You could take a reading with the same meter on the same drop and get a number 10-20% different. small difference at low numbers, but could be more of a difference at higher numbers. Alphatrak is a good meter and very reliable and accurate. I've been using it for two and a half years.
you aren't going to get a meter that is closer. Human meters run lower than pet meters. It's the reason I've stuck with alpha ... I like having the same readings as my vet.
i have tested the machine using the control solution about three different times. it is always in the normal range which confuses me about the lab testing that was done. When Gizmo's reading are running high, the control solution seems to be on the higher end. When his readings are on the lower end the control solution seems to be in the lower range. All of this just makes me nervous for when his numbers get lower. I just don't know which numbers to trust. The alphatrak test strips are pretty pricey. i pay about $55, a vial of 50. Is this pretty standard. Does anyone know where to get them cheaper? Janet, you mentioned that you use the Freestyle insulinx test strips. Are they pretty accurate? What code do you have to use with them?
Any suggestions on how to help Gizmo get his appetite back. He was eating just fine a couple of days ago. Then yesterday morning he would not eat much of his favorite wet food. I had to resort to putting a little of his hard food on top to get him to eat and that was only when i hand fed him. The rest of the day he had no interest in food. He made no trips to the food dish on his own. I have Ketone strips to check for ketones. I check about once a week. It has been about five days since i checked last. Should I check it again. Could his pancreas be inflamed?
I use code 38 with them. They cost about $35 for 100. I've gotten them much cheaper even on eBay. Recently won an auction of 300 for $25ish. Score. Here's my comparison.
Could be ketones... Yes id check.... Could be pancreas. Could be he's just feeling yucky from high numbers. Try sprinkling a little parm cheese on top... Or FortiFlora... Or tuna juice.
i was not able to get your comparison to come up yet, but i will keep checking it. I definitely will be looking into them. Any advice on how to get a urine sample from him when have not been able to catch him in the act. I can usually catch a sample with my Gizmo measuring cup, but I have not been able to catch him while he is going. He only uses the litter box about two or three times a day now that i have taken him off the dry food. He doesn't drink much out of his bowl or fountain now either. Do you happen to know how long it takes for a cat to become dehydrated if he isn't eating much? That is where he gets most of his water these days.
Thank you for putting the comparison chart up so i could view it. Those are really close in numbers. I definitely will look into them for the price difference. I happen to notice the big fluctuations in the BG readings. Is this what I can anticipate Gizmo's to look like. I know each cat is different. Do you notice that C.C. won't want to eat when the numbers are high? How long did it take you to really learn what C.C's numbers would look like? Do you do a curve every weekend?
Cc has fortunately never turned down a meal. She's actually about 4 lbs overweight. Lol. When her numbers are high (over 400) she's much more Lethargic and shorter tempered with the other cats. Her eating actually increases and she drinks like crazy. Every cat is different. I'm still figuring out CC'S numbers day to day. She's in Flux. Lol. She was diagnosed in May 2016. After about 3 months her numbers started coming way down and she was very predictable... after 4 months she was in remission. She stayed in remission (no shots) for a year until the numbers crept up again. I thought it was her teeth and I had a dental done, but it didn't help her numbers. This past June she went from numbers in the 200's into crazy high 4-500's. No real explanation why. In August I switched from vetsulin to ProZinc hoping it would help, but no... She was in some kind of insulin resistance mode until I finally got to a breakthrough dose of crazy high 12 units. Since then in the past few weeks the preshots are finally coming down... Thank goodness... And the dose is down from that crazy high 12 units to still crazy high 9 units.... But we are making progress. During the week I test preshots and a before bed reading. On the weekend and days off I get a bunch of extra readings.
oes it ever get easier or will it always be a roller coaster ride? The vet couldn't give you any reason why CC's numbers went up so high? Was it due to a steroid shot? An illness? I am someone that likes to have answers. It appears that this disease is always going to leave me with alot of questions without a lot of answers. Gizmo is still overweight. He was 19.2 lbs. when I had him at the vets for his dry skin and respiratory infection in November. That is when he was given the Depol Medrol shot. I think that is what pushed him over the edge. When i took him to the vet on 12/21/18 he was down to 16.8. He is currently averaging around 16.5 lbs since then. Everything else has been stable except for the BG readings. I was hoping that once the steroid left his system his BG would return to normal. Obviously that is not going to happen. you don't know how much I appreciate all that you have shared with me. This forum is such a blessing. I have been able to find out so much information and help from people on here. I was a stalker for a while before i finally joined. I am glad i finally did. I pray that CC and all the other precious felines with this disease will all go into remission and stay in remission. I have to leave for today. Thanks again for all of your advice and insight.
Believe me it does get easier and we are all control freaks to some extent so you'll fit right in. Unfortunately, diabetes is a bit of a roller coaster but as you get to know your cat's reactions better, you'll become proficient at understanding what is going on and making decisions about how to deal with it. Don't give up hope. If Gizmo developed diabetes as a result of a steroid shot, the chances of getting him regulated and possibly off insulin are good. Steroids can take a while to completely clear the system. Don't ever give up hope. I like Janet, have a cat who was gulping down copious amounts of insulin due to a secondary high dose condition and recently got her into remission. So anything is possible.
Hi Heather and welcome! (and don't worry about needing to logout for awhile - we are used to conversations spanning over long periods of time ) I would recommend picking up some ketone strips at any local pharmacy. You get a test by sticking a strip in Gizmo's pee - either while he's going, or catching a little (we can share some tricks with you on how to do that) and testing from there. Not eating is very concerning for a diabetic cat as ketones can progress quickly. So please get a test today. Pancreatitis is also a frequent cause of a cat going off his food. My guy is down with it right now too. Cerenia or Odansetron (for nausea) and bupe (for pain) are the most common and effective treatments. For those of us with cats who have chronic pancreatitis, we often use CBD as well to help with nausea, appetite, and pain all at the same time - although not quite as powerful as the bupe. Please don't worry about the accuracy of the meter. I know that's strange to say, but all you really need to know is "too high", "too low", and "just right", and any meter - human or pet - will give you enough information to know that. Personally I am a fan of using a human meter. The protocol we use here was written based on human meter numbers, and they are just easier to deal with than the pet meters. Not to mention the expense which really adds up with the amount of testing we do here. Having a meter that reads in line with our dosing approach makes dosing decisions easier. I would recommend getting a human meter and just use the AT2 when you need to give numbers to the vet, then use the human meter for regular monitoring. Linda had some great ideas about why the meter was off, and I would add one more: is there any chance the vet is comparing it to the fructosamine number instead of the "instant" number from the lab? Fructosamine is measured on a different scale, but given the numbers you're seeing, they could be around the same range. Or it could just be one of those things. Sometimes any meter will get a wonky reading. It's possible the lab meter was just off. Again though, I really wouldn't worry about it. It makes no difference at all if the number is 374 or 455. Both numbers tell you the same thing: his BG is too high. And that's really all you need to know.
While her numbers now are unpredictable it's not a big stresser to me. The only stressful part is planning for an out of state trip. I hate boarding her. I'm hoping her dose will be down further before July when it's time to travel. I'll have her medically boarded at the vet office. I can only control what I can and the rest I just have to take as it comes. Just take my best guess and sometimes ask the opinions of folks on here. I love the collective knowledge and experience I can tap into. CC had No real reason for the sudden change in her numbers that made them so high for so long .... She did have a second dental in July, three teeth pulled, and we hoped that would resolve it, but it didn't. It is what it is. Could have been the discomfort of her teeth, arthritis pain, or no particular reason at all. No, never had a steroid shot. I will say this week is the first week since MAY that her average preshots were under 300, so I'm pretty excited. She is a bit of a roller coaster but she's a happy girl, sweet, cooperative, and loves attention. One of the sweetest cats I have ever known.
Are you able to get any other mid cycle tests? +1, +2 and +6 are good, but it is entirely possible that Gizmo went lower than his usual between +2 and +6, and if that's the case, he may be bouncing.
Hi @majandra - Gizmo only has two cycles on insulin so far. So he doesn't have a "usual" yet. Heather and Gizmo are just getting started.
Hi Everyone! Thank you so much for all of the advise you have given. Janet, CC is gorgeous. Reminds me of my Gizmo. He loves sleeping on his back. So, I have been doing a lot of testing while I was gone. I still am working on getting my spreadsheet up. I am not technically savvy, but I have someone coming to help me tomorrow. Gizmo's numbers are still high. I did have one day this week that his BG reading was 185 at +6. I was so excited to see such a low number, but that was short lived when I did the PMPS shot it was 414. It is so frustrating to see the numbers go up and down so much. I have looked at a couple of your spreadsheets and it looks like this is pretty normal. I guess I was expecting his numbers to be more consistent. Does that ever happen? Does that come with regulation? Does it help to feed the same kind of wet food at every meal? I have been able to get Gizmo to eat more since I started buying the freeze dried chicken and crumbling it on top of the food. I have never seen him eat so well. i am super happy that all of you are so supportive. I couldn't imagine doing this alone. We have not been to see the vet in a couple of weeks. When i was last there, they helped me order the insulin and supplies that i needed, showed me how to give the injections, but didn't ask to see Gizmo in a week, two weeks, etc. Is this normal?
It's normal to bounce up after a lower number that their body isn't used to. Hopefully with time he will get more used to the lower numbers and do less large bounces
Thank you Janet. How long does it take to start seeing lower numbers on a regular bases. I have been giving the insulin for two weeks and 185 is the lowest. I had one other low number of 203 at +6 about a week and a half ago. Otherwise the +6 numbers have been 250 to 397. I hope that I will be able to get my spreadsheet up tomorrow so i can share Gizmo's numbers. This past Sunday I increased his insulin to 1.25 units twice a day without consulting the vet. AMPS and PMPS numbers have been a little lower but not by much. How long should i stay at a certain dose before it is increased or decreased?
i took your advice on the test strips and bought some insulinx test strips. What a cost savings! And thank you for the suggestion of FortiFlora. I was going to buy it but I found some freeze dried chicken at the pet store and tried it. As i mentioned before it worked wonders. I am wondering though if the FortiFlora is the better option since it is a probiotic. What are your thoughts?
Great he's enjoying the chicken. A few of my cats love it too. As long as it's doing the trick keep doing what you're doing. I buy the purebites packaged for dogs on amazon or chewy.com. It's less expensive per ounce than the tiny ones for cats.
Fortiflora is a probiotic, but I didn't find it very effective for my cat's IBD. It does however seem to taste amazing because Sam will eat anything if I sprinkle some on top. For an effective probiotic I use/used different ones, so if you're looking for that I'd be happy to share some suggestions. I just use fortiflora when Sam doesn't want to eat.
It really depends on the numbers you're seeing. When you get your spreadsheet up, we'll be better able to respond to this one. If you aren't able to get it going today, just let us know. There is someone here who can help, so we can get you connected.
I am not able to get my spreadsheet up because I don't have Microsoft office on my computer. Is there another way to do this? I did a curve yesterday and the results are below 2/2/19 AMPS @ 6 am 342/382 1.25 u at 6:45 am +5 321 +9. 365/355 PMPS @ 6 pm. 449. 1.25 units at 6:30 pm +4. 306. +7. 310/317 +10. 408 2/3/19 AMPS @ 7 am 439. 1.25 units at 7:30 am
You don't need microsoft office. The spreadsheet we use is in google docs which is free and online. You just need a google account. Go to google, and in the top right corner there should be a way to open/sign-up for a google account. Once you've done that, follow the directions here: http://www.felinediabetes.com/FDMB/threads/fdmb-spreadsheet-instructions.130337/ If that doesn't work, let me know and we'll get someone to help you.
i have updated Gizmo's spreadsheet with all the data, but it doesn't show up when i click on his spreadsheet in my signature.
Hooray! I got it figured out. Somehow I added 48 rows so all of my numbers were way down the spreadsheet. Thank you to all of you that helped me with this. Janet had sent me the information a couple of weeks ago, but i had to have my niece help me get it going. Any advice you can give me on Gizmo's numbers and whether i should increase or decrease his insulin dose. I am not sure when to contact his vet and get them involved again. They did not give me much to go on the last time i saw them. They showed me how to administer the insulin, but didn't tell me how long he needed to be on the 1 unit before they would consider an increase in the dose. I was told that if he didn't respond to the 1 unit that they would increase to 2 units, but from what I have read here is that is to much of an increase all at once. As you will see on his spreadsheet, I did increase his dose to 1.25 units about a week ago. I am just wondering if i should increase to 1.5 units yet or wait another week. Again, any advice you could give would be appreciated. Should I start a new thread when i have new questions, or just continue on this one? I am sorry for my ignorance. This is my first time ever joining a group of any kind, so I don't know how this all works.
You’re doing just fine! It’s up to you if you want a new thread. We usually suggest starting a new one before you get to a second page. Otherwise it’s up to you either way. Sorry for the slow replies - it’s Super Bowl Sunday . I think you should increase to 1.5u. And I don’t think you should wait a whole week for the next increase, but let’s see what the 1.5u does and go from there. PS great job getting the spreadsheet going!
Thank you Djamila! No worries about the response time. As you can tell, I get on when I can, even at 1:45 am. I am a little fearful to increase his dose when I will be at work. I am so afraid he will go hypo and I will not be here to help him through it. Our vet tech told me that I should not be afraid that it is unlikely to happen and it would be gradual. I am not sure since I am new to this. What has been everyone's experience with this? Hopefully you have not had many. By they way, Djamila, I love Sam's story. He is lucky to have you. It takes a special person to take care of any person or animal with a touch aversion. We all just want to love on our loyal companions. My way is touch. I couldn't imagine not being able to hold Gizmo.
Good morning, Heather! Logging in whenever you can works. We're usually able to just answer next time we log on as well. Well first I will tell you that hypos can happen and they can happen suddenly. HOWEVER, at the high numbers you're at, the small increase of 0.25 is unlikely to cause it. Think of it this way...you're in pinks and reds pretty consistently. For example, he was at 439 yesterday morning. This means he has over 350 points to drop before he gets to numbers that you'd want to take action at. He doesn't drop anywhere near that on a normal day, so such a small increase should be more than safe, and hopefully help him get into slightly lower numbers. I can say that over the time that I had Gypsy, I never had a hypo. And while I've seen them here, they are actually pretty rare. High numbers worry me more than low numbers in all honesty! Do you leave food out for Gizmo? Sorry if you've answered this....I'm not the greatest at memory!
I absolutely agree with everything Rachel said. While hypos happen, given the numbers you're seeing and the very small dose increase, I feel comfortable that Gizmo will be safe. If you look through my spreadsheet you'll see that my cat has had a number of lime greens, and he's still doing just fine. They aren't something to be complacent about by any means, but at this point, Gizmo's high numbers are the greater risk. And thanks for reading our story! After I wrote it, Sam ended up with chronic pancreatitis. The rounds of pain and illness have mellowed him considerably, and he's now turned into a snuggler whenever he doesn't feel well. He still doesn't want me to pet him, but he very much wants to sit in my lap and have me scratch his head, and curls up right next to me when I sleep. He's still got a wild streak and gave me a nice bite behind my knee the other day when he got a little too playful (I think he mistook me for a gazelle ), but overall he's turned into a sweet little old man.
Thank you to both of you. You made me feel so much better about increasing the dose. It all made so much sense. I do leave wet food out to graze on all day. I struggle with taking the food away from him two hours before the next testing. I try to give him his insulin between 6-7 every day, which means I test him at 6-6:30 every day. I work until 5 pm. My husband usually will be home by 4:30 and will take his food away, but that is not always the case. Sometimes he won't get home until 5 pm. This then pushes his dose back further, leaving only 11 hours between doses. Those are the days that you will see no testing before the AMPS/PMPS. I read that it is best to be consistent with the testing/feeding/shooting time but this part has tripped me up some. Then there are times that I come home and Gizmo is hungry because even though we took his plate away from him at 4:30, he may not have eaten anything from it since 3pm as an example. I hope all of this is making sense. Any advice on how to work this out with an 8-5 job schedule? I don't want to to the test/feed/shoot to late in the morning so I have time before I go to work to stall if his numbers ever get down to 200 or below. Thanks again for all of your help.
Do you have an auto feeder? If you get one that moves to a new compartment (most like the petsafe 5) you can set it to auto move to an empty compartment 2 hours before shot time. You could set that for overnight and during the day so you don't have to worry about getting up early just to take food away. That might be easiest for you both since you can not worry about getting home/remembering to take up food. As for the "starving kitty" routine (oh how well I know that one!) you just have to find a way to get through it sometimes. I find taking a long shower or a walk helps. If you can't hear them, you won't feel as bad! Gizmo should get used to the routine over time. It's always hard when they act like they're starved but remember that he had access to food and he will have some more soon. It's hard to listen to them cry, which is why I like removing myself from the situation if possible.
Rachel, thank you for suggesting the auto feeder. It would be so wonderful not to have to wake up at 4 am to take his food away. I will look into one this weekend. Gizmo is a silent beggar. He applies the sad eyes that just wants to make you cave in. He has even begun to go lay down in the spot that we check his BG and just lays there staring at me. I do my best to distract him with playtime during the last half hour. Sometimes that works, sometimes it doesn't. He doesn't always feel up to playing much. I will be so happy when I can get his numbers lower. We are heading in the right direction. I am wondering when I should increase his dose again. He has been on 1.5 for a couple of days now. Any advice from anyone would be appreciated.
Depending on the cat, you can increase every 3-6 cycles or so. Most folks will increase after four cycles so they can always increase either in the morning, or at night (whichever cycle they can monitor the best). When you reach a dose that starts to cause some bouncing, you'll slow down a little bit. We can help you figure that out.
Thank you. I will increase him to 1.75 u tomorrow evening since I am not here during the day. I do work close enough that I can come home at lunch every day which is at 12:30 pm, which is why you see the consistent testing at the +6 and not the others. I think this is his nadir, but I haven't done enough testing at the other intervals to know for sure. Can any of you determine his nadir from the testing that I have done or do you need more testing at the other intervals?
I think we'd need more data for nadir, Heather. You usually get a test at +6, which is great, but it's hard to be sure without some further data points. Maybe try a curve this weekend? Or just try to grab tests at different times on days when you are home?
Alas, Rachel is right. It's hard to say at this point. Plus, the nadir can change. In the PM cycle, my cat has an early nadir. Usually around +3. During the day he is all over the place: sometimes at +3, sometime at +6, and sometimes late in the cycle. I think grabbing some other times when you can be home (maybe on weekends?) will help, but it's dynamic and can move...because cats.
Thanks again. I thought that the data I had was not enough to determine this yet. I will try to get additional testing this weekend at the other intervals.
