About to give PM shot but level at 64

Hi, I'm new here. My vet wasn't helpful in explaining testing in relation to giving shots at our consult so I'm hoping you all can guide me a bit here. In fact, the vet just blindly wanted us to give 2units lantus BID with no home testing to our 10 pound cat so I'm clueless here. However, after a discussion yesterday here and some research, I decided to start her at only 1unit this morning at 8:30am and she seemed to do okay all day today. But I finally mustered up the ability to test her blood sugar (successfully, thank god) for the first time just a few minutes ago, around 7:30pm. She has not eaten in a while, but I was surprised to see the reading come back at only 64.

I needed to clarify a few things. I've read on here that if her BG is under 200, not to shoot. This obviously is way below 200, but she hasn't eaten yet. So am I supposed to be taking her blood after eating?

Should I skip tonight? So I be reacting to this level? Should I feed her and do another test again after she eats to see if it goes over 200? I really wish my vet had given us more info, I feel incredibly frustrated and overwhelmed on my first day doing this. Please help!

 

Skip the shot.

We suggest new members do not shoot under 200. You need more test data to know how low your cat will drop.

No, the pre-shot tests should be taken with no food for 2 hours prior to the test.

The dose you are giving is likely too high. Glad you dropped it to 1U from the 2U your vet suggested.

 

Yep skip tonite and let's see where she is tomorrow morning. Do your syringes have half unit markings? We might drop to 0.5 tomorrow.

 

Liz,

You switched to low carb foods. That may have been enough to bring Nadia's BG (blood glucose) levels down.

This is your very first dose of Lantus insulin today. Lantus is a depot type insulin. Only part of it goes to work now, the rest goes into storage in the tissues for slow release later. We usually have people stay at the initial dose for 5-7 days but that 1u looks like too much.

It's very possible that your cat Nadia dropped even lower today than that 64 you got with this PM test.

I'm thinking 0.5U could be too much for Nadia.

Please, get a test in the morning to see what the BG is before you shoot the insulin. Take the test before you feed your cat.

We always test before every insulin shot.

 

My husband and I had a looooooong emotional discussion about this tonight. We are really frustrated with the direction (or lack thereof) we have received from our vet on treatment. I am really concerned about what might have happened if we had blindly given Nadia 2u and not tested at all as she had directed us to. That being said, we'd feel more comfortable shopping for a new vet right away using the interview questions posted on this board. I just feel like we were thrown to the wolves by our current vet.

That being said, since we have changed her food to low carb food, do you think the dietary change alone might be enough to regular? And do you think it would be harmful to not give her another shot at all until we get her in to see a new vet? I imagine it would be in the the next week or so. I can continue to test her blood glucose now that I know I can successfully do it and I will still track it. I just don't feel comfortable continuing to do this with a vet we don't trust.

My husband wants to join the board too because we are so grateful for your knowledge.

 

A change in diet can be more than enough to bring her into remission. I would skip the dose tonite as discussed and keep testing while you find a new vet. Maybe start a new post on here and see if anyone can recommend one in your area.

If she starts to be consistently over 200, we can restart the insulin at a low dose.but you should continue to test her pee for ketones to be safe,

Wendy

 

If glucose tests (am, +6, pm, bedtime) show her between 40-130 mg/dL without insulin for 14 days, she is officially off the juice (OTJ).

If you get am or pm tests over 200 mg/dL, you might consider a token dose of 0.25 (you eyeball it on the syringe) to 0.5 units, depending on if you'll be around to monitor.

And to challenge your finger dexterity, we have the drop method for dosing.
To practice: Fill a syringe with 0.5 units of colored water (to make it easier to see). Twist the plunger down and squeeze out equal sized drops until you can get the same number of equal sized drops reliably. Now you're ready to dose by drops. Draw up the insulin and squeeze excess drops into the trash.

 

That is certainly one option, to find another vet. We call it voting with your feet. You may want to have a discussion with your vet about how you think the 2u starting dose was too much and the home testing and lowering the dose to what you felt comfortable with, was what saved your cat from a hypoglycemic episode.

The dietary change could be enough to regulate your cat. We want to see numbers in the 40-130 range. That is with a human glucometer.

Harmful to not give another shot? No, I do not think it would be harmful unless her numbers start to go high, over 200. I would suggest testing her every day. If you can test twice a day, that would be better. Test in the AM and then about 12 hours later in the PM. If she stays in that range of 40-130, she should be just fine without insulin. If she goes too high, you may want to give a tiny dose.

Do you have 3/10 cc insulin syringes with 1/2 unit markings on the barrel?

Your DH is certainly welcome to join. He can either use the same logon id as you do or create his own.

What is your husband's name?

 

Thank you so much for all your information!!! I have already received 10 times as much clear info here as I have at the vet. I am definitely going to look for a new one tomorrow.

I plan to continue to test and make sure it doesn't go over 200 as you all say. As I test, should I withhold her food for 2 amount of hours before the test to be consistent? Is that the right amount of time relative to eating to ensure it's an accurate test result?

I don't have the insulin syringes that are 3/10cc, but I will buy some to have on hand. Is there a link online you can send me to?

My husband's name is Kevin. He will be joining tomorrow. He is eager to learn about Nadia's condition and we already feel like you all have been our lifesaver tonight. Point blank, do you all think that the vets direction for 2u this morning and 2 u tonight (no home testing necessary) would have put her into hypo? I know there's now way to know for sure, but it sounds like it's very likely, right?

 

Possibly, no way to know... Check this out.. http://www.felinediabetes.com/FDMB/viewtopic.php?f=28&t=99179

 

I am one of those people who did not follow my vet's advice. He wanted 3 units 2 x a day after only one week and when I came here, everyone pretty much said it was too much too soon. I went to 2.25 units and have gradually gone up and now back down to 2.5 from 2.75 2 x a day. The people here see diabetic cats on average of 4-5 new ones a week and study spread sheets until their eyes cross. I read somewhere that a vet may see 4 diabetic cats in a year. They just don't have the expertise the people here do if you ask me. My vet never told me to home test. Since I had a meter for my dad, I just jumped right in and did it myself. I am so happy that I did.

I would never give my cat insulin with a reading of 64, but I know my kitty and how he reacts to his insulin now that I have been testing him for 8 weeks, several times a day. I would most definitely give your vet a chance to explain the dose and why he did not tell you to test at home before firing him/her. They may not have known the implications. Perhaps you have a chance to teach them a thing or two with this lesson. Either way, best to you and Welcome! These folks are lifesavers...literally!

 

Yes, 2 hours without food for pre-shot tests

Welcome to Kevin.

Have we shared the http://www.aahanet.org/PublicDocuments/AAHADiabetesGuidelines.pdf] AAHA Diabetes Management Guidelines for Dogs and Cats[/url] with you? It's a vet journal published article from June 2010 that is very helpful with more current diabetes management ideas. I like to recommend that people print off 2 copies, one for themselves, one to share with their vet.

As part of the introductory statement in this article, it says.

It's that combination of art and science that makes your hypo question difficult to answer. Treatment has already been modified based on your cats response to the low carb food and the the lower amount of insulin.

I think at this point, it is time to stop the 'what if scenarios' and look forward to the future with your cat. We know you love and cherish Nadia and will do your best to help her in this new journey you have started on together. We call it the sugardance.

 

I don't know if your state requires a prescription for insulin syringes or not. You want the 3/10 cc, 5/16" or 1/2" needle, 29-31 gauge, 1/2 unit markings on the barrel. People like the Terumo, Some like the BD. Walmart has the Relion line and their 3/10cc syringes do have the 1/2U markings, even if the pharmacy people say they don't. Have them open a box to double check.

If you go to the top of the screen, over towards the right side is a box labeled ADW (American Diabetes Wholesale). By using that link to buy diabetic supplies, a tiny amount of money goes to this site to help keep it going.

I try to do most of my online shopping, Walmart, Amazon, other shopping partners through the links on this site. I consider it the least I can do for all the help it has provided to me and the other folks here.

 

Hi,

I've recently been in your shoes with my boy Kitten. My vet didn't encourage home testing, and wanted me to blindly give him the Lantus as well. After changing his food from the dry junk to an all wet food (low carb), he self regulated and no longer needs any insulin.

You will find better information and advice on this board than most vets. The folks here have an incredible wealth of knowledge.

That being said, if I were in your shoes, I'd find a different vet, one who encourages home tsting and views you as an "ally". Perhaps some vets feel "threatened" by those of us that love our furbabies enough to give them the special care and attention they need. I couldn't care less about a vet's ego. I do what's best for my baby.

One thing to remember: Better to have their blood glucose high for a day than low for a minute.

 

Hi Liz-

Just now seeing this but replied in your other post from this morning a little while ago. I am in Austin also and would be glad to help if I can or try to answer any questions. It's all overwhelming when you are just starting out, but we have all been there. PM me with your number if you want to visit, discuss resources, etc...
And definitely keep posting here, you will get tons of amazing information, support and guidance.

betty