Going in for our first BG Curve today.

Pan has been fed, given his shot, and his Xanax. We leave in 45 minutes. His favorite LVT is working and will be the one doing his tests. Considering he was over 500 last time when he got diagnosed, and he's had 1u 2x a day for the past week with zero fur shots (which I am super proud of myself for getting a handle on), what numbers should I be happy with?

In my head I feel like I would be thrilled if he was between 200 and 300, and pretty comfortable not to change anything if I account for vet stress despite the Xanax. He's so much more himself this past week, bright eyed and alert with zero visible signs of hypo or high BG. Plus he's gained some weight back. Poor Pan was 12.6lb down from 18 in mid June, and is back up to 13.2 last I checked. My brother dropped off some old human meters he had and I'm going to price test strips later so I can try home testing.

 

Well, I think what numbers you are happy with depends on your goal. If you are just looking to control clinical symptoms and that is success to you, then you will tolerate higher numbers than someone whose goal is remission or at least the tightest possible regulation. I strive for keeping Mia's numbers in the normal range as much of the time as possible. Normal range on a pet meter (AlphaTrak2) is approximately 75 to 150. You mentioned 200 to 300; keep in mind that the renal threshold (on a pet meter) is approximately 250, so even if you don't want to aim for 'normal', I would suggest aiming to stay below that. Getting strips and beginning to home test is a great idea. Really, that is the best way to manage this. Going to the vet for occasional curves is not going to give you the full picture, and it subjects Pan to the stress of the vet visit/stay (and you to paying for it).

Could you please set up a signature? It would be helpful to have info like date of diagnosis, type of insulin being used, etc. when you post as those things impact our responses. http://www.felinediabetes.com/FDMB/threads/editing-your-signature-profile-and-preferences.130340/

I believe Pan has only been on insulin a couple of weeks. Often, this is a marathon, not a sprint. Some cats quickly go into remission, sometimes just from a change to low-carb wet food, but many cats take awhile to regulate. So, it is possible that you will still see some higher numbers as part of the curve. Let us know how it goes!

 

Is this good?

My long term goal is remission, but right now it being managed is acceptable.

 

Yes! Thanks for adding the signature.

The greatest chance of remission is within the first six months. There are cats that go into remission much later, but those first six months are the best chance of it happening, if it is going to happen. I think there is a different mindset for someone who wants remission/tight regulation vs someone who is okay with just controlling clinical symptoms. It impacts how you handle dose increases. Someone who is only concerned with clinical symptoms will most likely stay at a dose once they see improvements vs someone who is aiming for remission/tight regulation who will methodically continue to adjust the dose working toward their goal.

Let us know how the curve goes.

 

Realistically, with his age, can I expect him to go back to normal? We have no idea how long he's been diabetic, but we're at minimum 2 months according to the fructosamine test he had.

Am I a bad cat mom if he's happy with it just under control and living a good life and we don't push it? Because his happiness and quality of life is my highest priority. But balancing that is so hard when you can't speak to him. Also it sucks with him not home. I need to get out of this house.

 

A lot of cats do go into remission so don't throw that hope out. Most of the cats that are diagnosed are a little older. He is not ancient! You are not a bad cat mom for whatever you choose. The fact that you are giving him treatment and making sure he seems happy shows that you are not 'bad' and that you love him. You are just at the very beginning of this, you will figure it out. Don't hesitate to ask questions here or even just to reach out when you are feeling overwhelmed, sad, whatever. We do understand. We live this, too. (If you home test and do your own curves, you won't have to miss him while he's at the vet.)

 

Thanks. ♥️

I intend on home testing if we can. I'm not sure I'll be able to get him to put up with it but I will do what I can to get him to accept it.

And if I can't, his LVT and I are friends, she might be willing to come do it at our house on one of her days off. Pan loves her so it shouldn't be stressful if that was how it was getting done.

 

as well as pricing the strips, check to see the amount of blood required for each, to get a result
the older OneTouch meters required 1.0 ul -- which can be a challenge to get, in a recently diagnosed cat
newer OneTouch Verio requires .4 ul --
Freestyle Lite seems to be the one human meter still in production requiring a .3 ul droplet -- the recently discontinued ReliOn Confirm or Micro take the same

for us, it made a difference ! I still occasionally get an error message of "not enough blood"

 

My Jack is 12 and was diagnosed in April 2019. I started home testing because taking him to the vet for testing was a disaster. He was so stressed and they couldn't even get his curve test complete, but you can be sure they charged me for it!

Home testing gave me the information I needed to understand where his numbers were every day, and sometimes every couple of hours of every day. And having that information allowed me to take control of the situation, which alleviated a lot of stress and allowed me to calm down and focus on reducing his stress during testing and dosing.

I followed the Start Low Go Slow dosing (SLGS) method and with the tremendous help and support from the folks on this forum, my Jack is now in remission for almost a month now. He's back to his happy, active self.

So to answer your question, yes a 12 year old cat can go in remission. Jack will always be diabetic and I will always be testing, but for now we are in a happy place.

So to echo @FurBabiesMama, don't give up hope.

 

So they called his curve early when his Xanax wore off because he spiked. His first test (+2) was 292, and then at +4 he was 409. They gave him 1u, and 2 hours later he was 415. Our LVT asked if I was comfortable with her coming to our house on one of her days off to do a curve at home. I cried. We both cried. She's a wonderful human.

The vet doesn't want to change his dose of food just yet, he thinks that if he wasn't so stressed he would have seen more of a drop in BG in the second test and is recommending home testing to get the numbers that way.

I also talked to the vet about skipping his shot tonight and just feeding him wet food instead of risking a hypo episode. He agreed with me on that after we talked. He was comfortable that it wouldn't happen but understood my concern and agreed he'd rather Pan go a bit high tonight than be rushed in later.

So I have a lot of emotions right now and have cried a bunch.

 

hurrah for home testing! had only one curve at the vet, soon after diagnosis, that's when he was on 2u Vetsulin (as you will see, that was too high a dose)

preshot 418 ... +2 132 ... +4 52 (!!!!) on a pet meter ! ... +6 87 ... +8 125 (at which time I picked him up, clinic about to close)

so glad we are not shooting Vetsulin any more ! the high highs, the low lows

another good thing, if he bottoms out, you can intervene, which the vet above ^ did NOT

 

Oh crap. I misread his chart somehow. He was 238 at +2. I.... I am very happy with that number just a week into this.

 

It sounds like you have a good vet. Hopefully doing the curve at home will give you good results.

 

I'm confused about the curve numbers. There should be a pre-insulin shot test result then a test result at +2 (2 hours after the shot), +4 (4 hours after the shot), and so on.

You said:
+2 = 238
+4 = 409
Then you mentioned them giving him 1u and him being 415 2 hours later.


Can you clarify?

 

Sorry if this comes off as short, I'm just stressed and have emotions so I want to answer you I just am out of manners or something at this point in my day. Please don't take it personally.

He eats at 6:30 and 6:30. The vet told me to feed him and give him his morning shot. They open at 8. He gets Xanax for vet visits already so he said to give him his Xanax to avoid as much stress affecting the numbers as possible.
His shot was close to 7 so they tested at 9, 11 (when his Xanax wore off and he started to stress was probably around 10 based on his dose and time given), and at 1. They gave him 1u to try and correct the spike, but it seemed to keep him fairly level instead of continuing to climb because he HATES the kennel room. They called it early because of his stress at that point.

I don't really have more to give you, I don't have a meter with strips yet, I wanted to make sure I could pay for this curve first and since they open after he eats we don't have a pre number. I assume this is how curves at a vet work since they have office hours and insulin needs to be given at relatively specific times?

 

Okay, so I think I got it:

7am - shot given (no pre-shot test)
+2 (9am) = 238
+4 (11am) = 409 - additional shot given
+6 from original shot / +2 from second shot (1pm) = 415

Well, I am glad to hear that you will have someone coming over to do a curve in your home next time. That should get you a lot better data. Try not to be too upset and stressed (I know, easier said than done). It will get better. It all becomes very routine quicker than you would think. I hope you can relax this evening and maybe get some cuddle time with Pan.

 

Yes. And thank you for the patience and understanding. It's been a day.

My LVT is a godsend. She fell in love with Pan the second she laid eyes on him and he loves her back so we've become friends and she's doing far more for us than is her job because she loves him. To be honest she will probably have me do some of it too so she can help me learn to poke him for tests.

 

that clears up a lot of it -- we TOTALLY understand being stressed -- you with a cat with FD -- and Pan with a vet visit --

you are on Vetsulin, so they might have given you slightly different instructions to remove some of that .. the curve I quoted was when we were on that too, and the more usual way of doing it, is to take the cat in before his breakfast -- they do a test as soon as clinic opens, feed him there, give him his dose, then test every two hours after that

Vetsulin, by its nature, allows you to be somewhat more flexible about shot times, since it often does not last the 12 hours between programmed shots

anyway, that now makes a lot more sense, since you aren't home testing, you couldn't do a pre-shot test, and with Vetsulin as your insulin, you MUST have food "on board" before the injection -- that 238 shows a nice response to the insulin

from Catcat's and my experience while he was on Vetsulin, I agree, that whole procedure you were caught up in, is stressful to the max --

once you get set up and more practiced with testing, yourself, you will find a MUCH different curve !

 

I didn't know that I had a bit more flexibility, which is nice to know, it makes my life a little easier. So if my husband wanted to take me on a date and we had a 6pm reservation, I could theoretically feed him an hour early and give a shot?

My understanding is it also takes between 4 and 6 hours to hit nadir so he should have gone even lower in normal conditions right? The vet said he is pretty sure that he's dropping close to the high end of normal on an average day and likes the dose, so as long as I can manage a minimum of +2 and +4 at home and give him at least 7 days of data, he doesn't have to go back for 6 months.

And of course he comes home smelling of a million animals, our other cat is hissing at the sight of him over it, won't eat, he wants her food, I am playing warden while she slowly finishes her dinner AN HOUR AND A HALF AFTER BEING FED and I am over today.

 

ah, Vetsulin -- you will hear this quoted a lot -- ECID -- Every Cat Is Different --
because it was initially developed for dogs, who have a somewhat different metabolism, some cats respond very sensitively to it

onset is usually fast, sometimes within the first hour after shot, usually quite a bit by +2, from there on, it's ECID --

Catcat usually hit nadir (insulin most effective) between +3.5 and +4.75 .. usually dropped 50-100 points by +3 and could drop another 50-75 or so by nadir; I did a lot of testing in the first half of most daytime cycles, if you are curious, check out his spreadsheet (link in my signature) -- up until we switched to Lantus

there are several people on the board who are WIZARD at helping you with questions, even occasionally mentoring, just ask, you will eventually get the answers you need (different time zones so no one person is here 24/7)

 

Vetsulin is usually the least recommended insulin for cats because it doesn’t typically last as long, but it’s also the cheapest, and because of the typically shorter action time you do have more leeway with giving shots earlier or later if you have to

My Sophie has done well on it but you definitely have to know how it works. It typically causes their blood sugar to drop very quickly and steeply so it’s really important to test! Trying to get Sophie’s blood sugar controlled before I was home testing was a nightmare

 

yes, I so agree! some cats do well -- Catcat was on the borderline, turns out Lantus is working better for him