2/23 First time testing number need advise

I have finally gotten to the point where I can test Simone's BG without sticking my own finger nor making it stressful for her. Today I started recording numbers every 2 hrs after her 7AM injection and would like some advise before I give her the 7PM injection. The vet would like to see her around 7 mmol/L (126) on a regular basis.

Simone was originally given 1 unit twice a day until Feb 15, then the vet increased that to 2 units twice a day after her BG Curve showed high numbers all day. With her BG levels not going below 17 (306) when spot tested through out the day since Feb 15 I increased it to the 3 units on Feb 21. Also I have just started introducing the wet food into her diet for only a couple days now.

Insulin: SoloSTAR Lantus Pen - currently at 3 units (#3 on pen dial) twice a day (7AM & 7PM)
Meals: Royal Canin Diabetic Dry mixed with a little Fancy Feast twice a day (6AM & 6PM for 1 hr)

Please forgive the crude info but I'm still learning the numbers thing.

6AM: Meal time
7AM: AMPS - 20.8 (374.4)
9AM: (+2 I take it) - 16.7 (300.6)
11AM: (+4) - 15.2 (273.6)
1PM: (+6) - 13.4 (241.2)
3PM: (+8) - 7.3 (131.4) Quite a drop from the 1PM (+6) reading
4PM: (+9) - 5.8 (104.4) Gave a few treats as the levels were dropping fast
5PM: (+10) - 6.1 (109.8)
6PM: Meal time - ?
7PM: Next shot (+12) - 13.8 (248.4)

I'm going to check every 20 - 30 minutes or so after that +9 result as it seems she dropped really fast since her +6 reading. I'm thinking of skipping the next dose and then checking to see when her BG levels rise again and go from there. This is the first time since Feb 6 that shes had close to normal levels since being diagnosed.

 

Congrats on getting those first test. Great job on the curve today.

Are you using the pen itself for injections? You can only make changes by whole units and that's too big a dose change for kitties. Usually we change by 0.25 units ata abtime. We do that by using syringes to remove the insulin from the pen. I'm thinking three units might be too high a dose and maybe trying somewhere between two and three would be better.

 

Vets for some reason all seem to do dose adjustments in whole units, I guess it's what they were taught in their one day? of instruction on diabetes in school. We advise doing dose adjustment in quarter units (0.25) at a time and find that is the safest way to zero in on a good dose for the kitties.
I'm not sure you know this, but you don't really want to feed the last 2 hours before it's shot time. The BG spike from the food eaten could make you think it is safe to shoot when the food spike is just temporary and she could actually be heading down. Also, I see that you feed her for 1 hour at 6am and 6pm. Um, you really want to feed the main meals at shot times, and then feed her smaller meals as needed throughout the day, especially if she is going lower or pretty low at her nadir. Giving food during the middle of the cycle helps to flatten out the cycle.
I'm sure others will be on to help you.

 

I meant to add that going to an all low carb wet or raw diet can greatly reduce the insulin needs.

What type of meter are you using?

 

Thanks. I started yesterday but had to quit at the +4 mark, so I was determined to do at least a 12hr curve today. With Simone going into lower single digit numbers I'm a little scarred. Heck I was happy this afternoon when I seen the +6 - 13.4 (241.2) reading.

Guilty as charged, I'm using the Pen "as is" Wendy. I've been told by a few members to get syringes and will do so hopefully tomorrow. I have no problem going down to 2 or even 1 if need be and under dosing until I get some syringes and can fine tune her dosage.

 

Thanks Dyana. I can easily change the injection time. It was my vet that suggested I let her eat first, then give her the injection. Thing is Simone is a nibbler. She will eat a little, come for her AM treat when I'm at the computer, lay on the computer desk for a little while, then go and get more to eat. That's why I give her the 1 hr to eat most of her food.

Wendy, I use a GE200 human monitor (http://www.gediabetes.ca/#product). It was the one with the most economically priced test strips that I could find. Since Saturday I've gone through 26 strips on both Simone and testing myself to get a feel for the glucose testing process.

What is considered too low a BG value where hypoglycemia can occur ?

 

Hi Scott,

I just wanted to drop in and offer a word of encouragement. You're doing a great job (and it looks like you have the numbers thing down ). Wendy and Dyana, who responded to you here, were two of the wonderful individuals who helped me get my cat, Jersey, into remission. And @Wendy&Neko is also from Canada, as I see you are.

Here's the link to your first post for those who would like to read more about Simone's background.

 

Thanks Shelly. I've learned more from this forum then my vet ever told me. I went into this blind and the members here have not just helped with links and info but in relieving the stress and frustration through their kind words. +10 time so off to test.

 

Welcome!

I'm not sure about the price of your strips, Many people use the Walmart meter and strips -- Relion. You can also use Arkray strips (and meter) in the Relion meter and those strips are available through ADW which is an online diabetes warehouse.

Where hypoglycemia is a factor varies by cat as well as many other factors. As a rule of thumb, we use the guidelines with Tight Regulation and intervene with high carb food if numbers drop below 50. Most cats do not exhibit symptoms of hypoglycemia unless their numbers are much lower -- a situation we all want to avoid. With TR, the does is reduced if numbers drop below 50 so this is safe but there is no margin for error. That said, some cats will have symptoms at this range. A big factor in learning how to manage your cat's diabetes is knowing your cat. Each cat's cycle can be different. Some cats have early onset and nadir whereas others have a later onset and nadir. It's all about knowing your cat.

At some point, you'll want to read through the two dosing strategies we use -- Tight Regulation and Start Low Go Slow -- and decide which approach you want to use. There are sticky notes describing the strategies.

 

Hi and welcome. It would also help some of us help you if you start a spreadsheet. I'm not used to world numbers and need the visual.Here are the directions.

http://www.felinediabetes.com/FDMB/threads/fdmb-spreadsheet-instructions.130337/

 

Unfortunately the ReliOn brand is not available in the Canadian Walmart. They don't carry a generic brand from what I've seen either. I'll check out ADW and see if they will be cost effective on Canadian orders and shipping (plus duties and taxes).

I just started reading the Lantus stickies so I'll be sure to check those threads out.

Ahhh thank you. All these numbers I'm reading are a little overwhelming.

 

The Relion and Arkray meters and strips are only available in the US. ADW doesn't ship to Canada. I am in BC near the border and have a post box in Washington so got my strips that way. In Canada, the cheapest strips I have seen are the Bravo, though a lot of people use some of the common ones like Aviva or Bayer and buy strips on eBay. Getting a meter whose strips need just the smallest drop of blood helps,save strips.

You will want the BD Ultrafine II syringes, in the purple and yellow box. I don't know where you live, but near me Safeway pharmacy, of all places, had the cheapest prices. Costco and Real Canadian Superstore are the next cheapest.

 

We don't want our cats on insulin to go below 50 or 2.8 on a human meter. Below that we give high carb food to bring the numbers up. Hypo symptoms may not appear until lower. I once caught my kitty in the 20's and she was hungry, but that was it, no other symptoms. I was lucky. I never liked seeing her below 50 for any length of time.

 

Thanks Wendy. No Safeway were I live so I will check SuperStore tomorrow.

Simone's +12 reading was 13.8 (248.4) I think I'll just give her a 1u dose tonight and see what her reading is in the AM again. I don't want to overdose her and have her go Hypo especially throughout the night.

 

With Lantus, in general, you do not want to adjust your dose based on the pre-shot number. This is one of the ways that Lantus differs from the non-depot, shorter acting types of insulin. Instead, dosing is based on the nadir (lowest point in the cycle), I can appreciate being apprehensive about low numbers at night. I would encourage you to get a "before bed" test every night. Many cats do experience lower numbers at night so getting at least one test, in addition to your PMPS, is very helpful with respect to having an idea where your kitty's numbers are heading.

If you give differing amounts of insulin at each shot time, the depot doesn't have a chance to stabilize. As a result, you end up with wonky numbers.