Also newly diagnosed

Also newly diagnosed
Discussion in 'Feline Health - (The Main Forum)' started by Debbie Gregory, Yesterday at 9:32 PM.

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1. 
   Debbie GregoryNew Member
   Joined:
   Sunday
   Hi, I'm new to this disease and am about to have a nervous breakdown at this rate. My cat is having a hard time stabilizing. Dirty Butt didn't look good and ended up with a low test today of 77 and I rushed her to the vet just before closing. Just in that time the vet tested her and she had dropped to 39. They gave her something and I waited there for another hour until they tested again at 285 and sent her home. She looks OK now. Of course no insulin tonight. They want her in for a curve tomorrow.
   
   A little history. She was diagnosed with the beginning of kidney failure about six months ago, but with low numbers. She was diagnosed last Thursday with diabetes and had a curve done all day Friday. The vet put her on 2 units AM and PM. I brought her in Thursday because she was refusing to eat, which is a repeat of an infection she had a few months ago. At that time (a few months ago), her glucose was slightly above normal, nothing to worry about, no diabetes that we knew about. Clavamox took care of the infection, although we never knew what was infected. Now she is fighting an infection that seems identical. initial blood tests showed glucose at 468. I have been giving insulin on schedule until she wasn't feeling right on Sunday night. I had no home test kit, so I took her to emergency. They tested her at 344 and gave her fluids and anti nausea drug. I continued the insulin Monday and Tuesday and got a home test kit. She has been feeling much better and eating better. Tuesday night I tested her at 193 before giving her insulin. I was concerned because it was so much lower than before. It was 9:00 PM so I called the emergency vet and they said skip the insulin and call my regular vet in the morning. I tested her at 353 this morning and called my vet, she said give her 1.5 units. So I did. I came home from the grocery store and found her hiding and not looking good. I tested her at 77, then rushed to the vet. The vet is concerned because this isn't making sense.
   
   Has anyone else had this type of fluctuation in numbers?
   
   FYI - She was already on Fancy Feast and Friskies canned food. I switched all my cats a few years ago as I've been dealing with kidney failure in several cats for several years. They don't like the gravy or sliced versions, so I've always gotten the pate. I was kind of heavy handed with the Temptation Treats and letting her eat some of Dusty's Hill's J/D canned food, both of which have high carbohydrate content (cut her off from both last week), but it doesn't seem like cutting that out of her diet would be enough to cause much lower numbers.
   
   Debbie Gregory, Yesterday at 9:32 PM Edit Report
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2. 
   AlexiMember
   Joined:
   Apr 10, 2016
   Hi Debbie - can you tell us a little more about your kitty? Is she on antibiotics currently and what insulin are you using? Diet changes and treatment of infections can drop the blood glucose numbers. Are you able to get any mid cycle numbers to see how she responds to the insulin - it may be that the dose is a little high for her. If you can add a signature it will help people stop asking the same questions. We will help you work this out and get you back on track, numbers often read higher at the vets so good you have started home testing. There are users on the forum experienced with cats with renal disease and diabetes so any questions ask away.
   
   How to take blood from the paws
   Cappuccino's Spreadsheet Alpha Trak 2 meter
   Alexi, Yesterday at 11:30 PM Report
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3. 
   JanetNJMember
   Joined:
   Jun 8, 2016
   Temptations are really high in carbs. I gave my cat a few when she was too low... Maybe 5-6 pieces and her numbers rose from 59 to 354. Makes me cringe when I think about the handfuls I've given her over the years. I'm positive it's what set of her diabetes.
   
   Folks here will help you set up your spreadsheet and give good advice.
   
   Make sure the wet food is the classic variety NO GRAVY.
   
   https://docs.google.com/spreadsheets/d/1nAInqkndqDxpngGFgmTAoSwldtpCsmWLE1GTq6iFylE/pubhtml
   JanetNJ, Today at 4:47 AM Report
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4. 
   Shelly & JerseyWell-Known Member
   Joined:
   Feb 1, 2014
   (((Debbie))) Lots of hugs to you.
   
   Here is the link to your post on the welcome forum so others can go back and read the additional info you provided.
   
   ↑
   The vet is concerned because this isn't making sense.....Has anyone else had this type of fluctuation in numbers?
   Click to expand...
   It's actually quite common for numbers to fluctuate widely, especially when a kitty is first starting out on insulin and unregulated. Just to give you an example: Not long after we started using Lantus, Jersey's numbers went from 355 at AMPS (morning shot time) down to 77 and up to 553 in less than 12 hours.
   
   I know you had some initial questions about testing. How are you doing with it now? Do you still need some tips and suggestions?
   
   Are you using a human meter or an AlphaTrak? That's an important question because it tells us how to interpret the numbers. Most of us here use inexpensive human meters (e.g., Relion Micro or Confirm from Walmart). If you are using a human meter, you don't want your kitty's numbers to drop below 50. If you are using the AlphaTrak, you don't want your kitty's numbers to drop below 68.
   
   What do we need to help you with first? I know you're dealing with a ton of issues right now, so tell us what we need to focus on right now. We'll just take it one step at a time.
   
   
   
   Shelly
   
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   Shelly & Jersey, Today at 5:15 AM Report
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5. 
   Debbie GregoryNew Member
   Joined:
   Sunday
   I am getting ready to take her to the vet this morning so they can do another curve on her. I wanted to do the curve at home, because she is so scared there, but frankly, I'm scared of the drastic drop in her numbers that happened yesterday. It takes too long to drive to the vet and my testing skills are not very good yet.
   
   The good news is that she is feeling good as far as the infection is concerned. She is acting normal again, she is eating good, and .... sadly sitting up and pawing the air begging for Temptations. I was giving her waaay too much and wish I could explain to her why she can't have them any more.
   
   Debbie Gregory, Today at 7:53 AM Edit Delete Report
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6. 
   JanetNJMember
   Joined:
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   Have a little honey and high carb treats/food on hand if her numbers get too low.
   
   https://docs.google.com/spreadsheets/d/1nAInqkndqDxpngGFgmTAoSwldtpCsmWLE1GTq6iFylE/pubhtml
   JanetNJ, Today at 8:01 AM Report
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7. 
   MrWorfMen's MomWell-Known Member
   Joined:
   Feb 18, 2015
   Boy you really have had a time of it but I guarantee this does get easier and with the help from this board, you'll have Dirty Butt (love the name!) and you feeling better very soon.
   
   Unfortunately, BG tests done at the vet's office are often elevated because of the stress of a strange environment and that can lead the vet to prescribe more insulin than is needed. While you are learning to get tests consistently, it's sometimes necessary to do a curve at the vet but I would encourage you to post here for opinions about the recommended dose before dosing her again. The other problem with diabetes is that BG is constantly fluctuating. Sometimes kitty has a bad day with higher numbers and if that's when a curve is done, even at home, they don't always reflect kitty's "normal".
   
   Most folks here test before each shot and then at least once during each day and night cycles for a total of 4 tests daily. After a short period of time, one starts to get a picture of how kitty is doing and that data is far more reliable for making dosing decisions than curves. Starting off with conservative dosing is the best way to ensure kitty doesn't go too low. Slow and steady wins this race!
   
   Menace 2016 Human Meter SS |Menace 2016 AT2 Meter SS|Menace's 2015 FS/AT Meters SS |Canadian|ALPHATRAK2 METER|IAA|DO NOT COPY DOSING
   MrWorfMen's Mom, Today at 8:18 AM Report
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8. 
   Shelly & JerseyWell-Known Member
   Joined:
   Feb 1, 2014
   ↑
   my testing skills are not very good yet.
   Click to expand...
   It will get easier. I promise. Whether you are ear or paw testing, try warming the spot first. I filled a sock with rice and put it in the microwave for about 20 to 30 seconds. I held the sock on Jersey's paw for about 10 seconds. Then I put just a touch of Neosporin with pain relief on the testing spot. The Neosporin helped the blood well up. If you're testing on the ear, try to hold something (maybe a cotton ball) behind the ear when you poke. After getting the blood sample, I held a cotton ball on the site for a few seconds and then put another dab of Neosporin on the site to help it heal.
   
   In terms of treats, you can always give Dirty Butt some pieces of plain chicken as a treat.
   
   Hang in there!
   
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   Shelly & Jersey, Today at 8:20 AM Report
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9. 
   Debbie GregoryNew Member
   Joined:
   Sunday
   Back from the vet. Another problem. I brought in my new test kit (Alpha Trak purchased from the vet) and the tech and I both took a sample at the same time, I got 250 and theirs was 306, they are two identical meters from the same manufacturer. So they are going to do a control test on both meters and test again with a third meter that is a different brand.
   
   Since this is the second infection, I asked the vet to look up the numbers on the first infection from May, before we were even thinking of insulin. It was 250, that was at the worst point of the infection before antibiotics, and there was no glucose in the urine, so the vet attributed it to the vet visit and the infection. Now, at this point, depending on what her real numbers are today, I'm wondering if maybe we should leave her off insulin for several days and see what happens -- her diet is different, no more Temptations, no sneaking bits of dry food, and no Hills J/D?
   
   All four of my cats are being fed 4 times a day (1/4 of a can of Fancy Feast pate each), which is a pattern I started with Dusty, my oldest and more than 3 years into kidney failure -- 8:30 am, 1:00 pm, 7:00 pm, 11:30 pm. He is slowly failing and it is hard to get him to eat, so several smaller meals a day works for him and the other cats are real happy with it. Dirty Butt is still on Clavamox, we are following the same pattern as last time, and will keep her on it another week. Last time it took until the 4th day before she was feeling and eating better, same this time. So this is probably a repeated UTI due to the kidney failure, although I never saw any problems with the litter box. The insulin is Prozinc. Now the 2 units AM and PM is obviously too high, as well as the 1.5. The vet wanted to go with 1 unit this morning, but I'm guessing that may be too high as well, especially after she calms down at home. I will need some advice for sure tonight.
   
   I'm getting better at testing, but it is a skill. Dirty Butt is 14. I may not have mentioned but she is also blind, a genetic problem, 3 of the 4 kittens in the litter were blind. It doesn't hold her back much, but it makes a visit to the vet even worse because she feels so vulnerable, on the other hand, it makes her really easy to work with, she just tries to make herself small and doesn't fight.
   
   I'll post again when I get her home and some more results.
   
   Debbie Gregory, Today at 11:01 AM Edit Delete Report
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10. 
    Shelly & JerseyWell-Known Member
    Joined:
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    ↑
    I will need some advice for sure tonight.
    Click to expand...
    I don't have any personal experience with Prozinc, but I've put a call out for some dosing help for you.
    
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11. 
    MrWorfMen's MomWell-Known Member
    Joined:
    Feb 18, 2015
    ↑
    Another problem. I brought in my new test kit (Alpha Trak purchased from the vet) and the tech and I both took a sample at the same time, I got 250 and theirs was 306, they are two identical meters from the same manufacturer. So they are going to do a control test on both meters and test again with a third meter that is a different brand.
    Click to expand...
    I sincerely hope that the issues are not meter related. Just a few points to clarify before you or the vet start thinking the worst.
    The meter must be coded to match the strips being used in it. When you were at the vet, did you both use strips from your own vials so your respective meters were set to the right code for the strip being used? If either of the meters was tested with a strip from the wrong vial, this would explain the problem. I'd check this out before assuming the meters are faulty. Control solution won't shed any light on this problem for either of you when using your own strips.
    
    Last edited: Today at 11:57 AM
    Menace 2016 Human Meter SS |Menace 2016 AT2 Meter SS|Menace's 2015 FS/AT Meters SS |Canadian|ALPHATRAK2 METER|IAA|DO NOT COPY DOSING
    MrWorfMen's Mom, Today at 11:33 AM Report
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12. 
    Sharon14Well-Known Member
    Joined:
    Aug 16, 2015
    Since you have two kitties with kidney problems, you may want to consider switching to a low carb, low phosphorus food, such as Wellness Grain Free Turkey, or Wellness Core Beef, Venison & Lamb. Here's a list of a few others
    https://docs.google.com/spreadsheets/d/1E_HZnTcJdsr20Gpivo2ID1KQ9wlZAe1Xy3LDTDVRofU/htmlview?pli=1
    
    Colin's SS
    Sharon14, Today at 11:51 AM Report
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13. 
    RachelWell-Known Member
    Joined:
    Aug 25, 2013
    Hi Debbie! We'd love to help you out with dosing advice. It definitely sounds like Dirty Butt needs less insulin. Especially since her numbers will probably be higher at the vet, like you said. Why don't you come over and post on the ProZinc forum? We have several folks there who have used your insulin and we tend to see those posts first...plus it's h arder to find them on the main forum since ProZinc isn't the most frequently used insulin. If you post the number you get before shots, we can definitely help you.
    
    Gypsy's SS Dosing specific to Gypsy. Do not copy without advice!!
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    Rachel, Today at 5:03 PM Report
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14. 
    Shelly & JerseyWell-Known Member
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    Feb 1, 2014
    Thank you @@Rachel for helping with dosing.
    
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    Shelly & Jersey, Today at 5:25 PM Report
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15. 
    Debbie GregoryNew Member
    Joined:
    Sunday
    OK, back from the vet, she is good, but unfortunately, the vet tech was harsh on her and had her growling, just sitting in her carrier, when they brought her into the room. I've had her since she was 8 months old and never heard growl in 14 years, she is normally a sweet heart. She didn't stop until she realized I was there, then calmed down. She had only had a quarter of a can of Fancy Feast this morning, and just now wolfed down a half can of it. So she is definitely eating well, so not worrying about the infection any more.
    
    The coded number was fine. They came to the conclusion that my meter is reading too low and suggested several doses of the control fluid before doing the next test. So I guess I will have to trust my meter, I have no other choice. This shows the last two days and the curve from today:
    
    Tuesday
    
    10:00 am = 2 units insulin (didn't get my meter until that night)
    9:30 pm = 193 (under 200 so vet said to skip the insulin)
    
    Wednesday
    
    no insulin for 24 hours at this point
    10:00 am = 353 (vet said to give insulin but lower to 1.5)
    10:00 am = 1.5 insulin
    3:40 pm = 77 (vet said come in immediately)
    4:15 pm = 39 (at the vet's office, vet gave dextrose)
    5:15 pm = 285 (vet said to skip PM insulin because of the dextrose)
    
    Thursday - curve at vet
    
    9:00 am = 306
    9:20 am = 442
    vet gave 1 unit insulin at 10:00 am
    11:00 pm = 332
    1:00 pm = 314
    3:00 pm = 471
    
    Vet wants me to give her 1 unit. I know the high numbers are affected by being at the vet, so should I give the 1 unit tonight? I asked the vet for the number where I should not give any insulin, she said anything below 200. Since she crashed with 1.5 at 353 yesterday, should I maybe give a .5 tonight if the number is above 200? Is .5 even a viable dose?
    
    I noticed that on Tuesday at home, she crashed 5 hours after the 1.5 insulin. Today at the vet, her number went up 5 hours after the insulin.
    Looking for the differences in the two days:
    
    She was fed at home both days in the morning before insulin.
    She had another meal at 1:00 at home on Tuesday, but no food this afternoon at the vet.
    She was home and relaxed all day Tuesday, but at the vet all day today.
    
    Can being at the vet make that much difference?
    
    Since I need help with dosing I probably should copy this to the ProZinc forum, but I'm not sure how to copy it over.
    
    My mind is spinning so , thank you so much for your help!
    
    Debbie Gregory, 44 minutes ago Edit Delete Report

 

Copying over from the main forum was easy, I was expecting it to be complicated.

 

You have definitely been on a journey, Debbie. Where are you now'? Have you gotten an evening number?

 

The vet gave her insulin at 10:00 am, so I have been letting her settle down, feeding her, and getting into her routine. I'm dreading testing her after the growling and upset they caused at the vet, I'm hoping that doesn't transfer to me. I've got another two hours, so I was going to work on the meter and try control testing like the vet suggested after the mismatch of test numbers between their meter and mine...and maybe eat dinner.

 

I think I'd give .5 tonight, assuming she is 200+. .5 might not be enough, but it's overnight and it sounds like you both need a break. We can get back on track tomorrow - set you up with a spreadsheet so her patterns are easier to see, figure out whether .5 will be too little or whether you should try it awhile. Post tomorrow with your am number and we'll go from there?

 

Happy to do that! See you tomorrow.

 

The great news is that bad time at the vet didn't transfer to me. The little sweet heart let me give the antibiotic pill, and put up with my 5 attempts at pricking her ear to finally get some blood tonight.

I'm kind of worried about her, she is too quiet and her test came out at 113 at 10:00 PM, so I didn't even give the .5 unit tonight. I hate to test her again, but I'm worried she may be crashing again. The vet gave her 1 unit at 10:00 AM, it has been over 12 hours since she had insulin. I'm beginning to think maybe she shouldn't be getting any at all.

 

It's midnight and I was starting to panic because she was so quiet and she was restless and kept lying down with her feet up in the air, but her feet were definitely shivering, and I read those are two of the symptoms of hypo. I tested her and it was 130, so going up again, not down. I can breathe again and maybe get some sleep.

 

Good you skipped the shot last night. Her numbers may be coming down as the infection clears, so keep testing! Since this is her second UTI, you may want to try adding D mannose powder to her food. It helps with E. coli infections and seems to soothe the urinary tract. I use this one https://www.amazon.com/gp/product/B000HCMK90/ref=ox_sc_sfl_title_3?ie=UTF8&psc=1&smid=A367YBEX25WJNQ
Please post your AM number and let us know how she's doing.

 

Hey Debbie. I hope you got some rest! I know you must be exhausted with the worry of the day.

Since it's been so long since Dirty Butt got insulin, she won't be hypo. Those numbers you got at midnight are perfectly fine even if insulin is on board...without any insulin on board, they are DEFINITELY fine. She's probably quiet because she's exhausted too! After a day at the vet, my cats look for a quiet spot to curl up and sleep for the rest of the day!

You did exactly right giving no insulin.

Debbie, you are doing GREAT. I know the beginning of this journey is scary and overwhelming but you're doing a wonderful job! And we're here for you.

 

Debbie

You have got a lot of good information from everyone. Just wanted to also add in that you are doing a great job!

BTW I just LOVE the name Dirty Butt!!

 

This is why home testing is so wonderful! No worrying about whether she is too high or too low. A poke and you know!

 

I tested her at 7:30 AM and got 335, before feeding -- so 7.5 hours since she ate and about 20 hours since the last insulin. It was a tiny amount of blood, but it triggered the meter. She seems to be acting normal. I did feed shortly after that and she didn't eat as much as I would like, although she was wolfing down the roast turkey I gave as a reward for the prick in the ear.

 

Deb, look at your private conversations (upper right hand corner) if you want help with your spreadsheet.

So it looks like she needs some insulin. What are you thinking?

 

Sorry to not get back to you right away, I'm not feeling so hot this morning. The spreadsheet will have to wait a while.

Do you think .5 insulin would work?

 

As long as you can test a couple times - maybe 2/3 hours after the shot and then in that +5/7 hour time, I think .5 should be fine.

 

OK, will do.

 

I just tested her at 3:15 PM and it was 335, a disappointment. The .5 unit is so tiny, I wondered at the time if I got it in her since I'm still not very skilled with the needle. Anyway, the insulin was at 9:30 AM and the test was at 3:15 PM, so 5 hours. She has eaten almost a whole Fancy Feast can of food today in 2 meals (the last at 1:00 PM) as well as roast turkey each time I test her, so I don't know how that affects the numbers. She seems happy and normal today.

 

I am glad she is feeling more like herself. I think staying with .5 is not a bad idea for a couple cycles. If she doesn't start to give you lower numbers, you can increase by .25 in a few days.

 

I like that advice. Starting smaller and going up slowly makes more sense to me.

Thank you!

 

You seem to be doing the right method, following slow increases. Big kudos to you for taking care of a blind, diabetic kitty. What a great cat Mom you are!

 

Evening shot of .5. She tested at 338. This morning it was 335. So I guess it is good the number is not spiking up but staying steady. What would be a good target number for her?

 

Jeff, thanks for the kudos. I used to be involved with cat rescue and colonies. When I moved from CA to WA, I packed up all the kitties from two colonies, my own house cats, and my deceased mother's cats -- 16 in all, almost all of them were born feral. Road trip from hell. They all became house kitties because of the predators around here. That was 10 years ago. I've cried over slowly losing so many over that time. I have four elderly kitties left. I was always taught that when you take an animal in, it was for life. I have unwanted experience with all types of diseases and conditions, but this is my first with diabetes. Makes me look in my own pantry and put down that 2nd piece of candy!

 

Wow. That is a lot of dedication. I can't imagine a road trip with just one cat. So many lives you have raised. It's tough losing one, and must have been hard thru the years losing some of the others. I hope you are able to lift up the life of Dirty Butt a bit. General target is 80-200 for diabetic cats. The wikipedia article shows a target range of 100-180. There will be high points during pre-shot on the 12 hour points.

I know what you mean about awareness. I am a better eater now too. Diabetes in humans in America is an all time high - matching some huge waistlines. I was raised in San Jose but was born in WA. I miss the northwest, and the cooler temps.

We rescued Little Dude a month ago. He is a stray who came to our neighborhood house. He had one very expensive vet visit, including surgical removal of two broken upper canines. And he got snipped (ouch)! Tried to catch him again today for the followup visit since his ear mites came back. He is one smart kitty, a no go. So we'll try again on Monday.

 

Patience always wins out with cats ... and bribery. He will eventually figure out you're the best thing that ever happened to him.

Thank you for the target information. Dirty Butt is a sweet heart. Being blind from birth she and her sister do just fine -- as long as I don't move furniture around or leave something in the middle of the floor, they seem to have a map in their head. When they get scared though they run into walls. You would think they would walk everywhere, but they run and trot along beside me around the house, climb the cat trees, sit in windows, and fall asleep on the back of the couch.

I can't imagine living any where else, it is just gorgeous here.

 

That is so cool that both sisters follow you around everywhere. They are so lucky to have you as a cat mom.

 

Since you use an AlphaTrak, your regulated ranges will be a little higher than the human meter. So mid 200s at preshot and lower 100s at nadir, but above 68 which is approaching hypo range. Once in regulated ranges, you start fine tuning the dose. But with her recent low numbers, we are being cautious. If she doesn't drop for nadir into the 100s and is still in the 300s for preshot, you might try for something between 0.5 and one unit tonight. Maybe what we call a fat 0.5

 

So excited, out of the 300's, it was 269 this AM.

 

How any hours after shot is nadir?

 

Usually 5-7

 

My kitty is not eating her canned food meals very well today, but is very interested in baked chicken. So I gave her the baked chicken thinking she needed to eat. Is that a good idea?

 

Baked chicken is a good food for her. High in protein, low in carbs. Our kitties think it is the equivalent of high cuisine.

 

Is it enough to keep her numbers up and not go hypo -- in other words, better than not eating if she is having an off day on the canned food?

 

You always want her in safe numbers. All the other stuff you can work on for another cycle.

 

She was 269 this AM, and I just tested her at 6 hours after insulin and got 139. Yea!

If this continues, should I stay with .5 insulin for a while?

She is now relaxed at home instead of at the vet, the infection seems to be gone although she will be on antibiotics another week, and her diet has changed to wet food or cooked meat. The only thing left that could be a good influence would be losing some weight. She is pudgy, but not obese. It's hard to get a blind cat to play.

 

Yes, I would stay with 0.5. As the infection clears, and as she eats more low carb, she may come down.

 

"It's hard to get a blind cat to play." So funny, but true. You could always rub her so much that her purrs eat up the calories. I have tried this technique with Leo. It doesn't use many calories but seems to make both of us happy

You never want to have her hypoglycemic. A single hypo event could be fatal since it is hard to control in that range.

 

Sounds like things are going well! I think the wet food will probably help with the weight.

 

She was already on canned food before this happened because of the renal failure, every bit of moisture helps. The ban on Temptation snacks will probably have the most effect, all those carbs were probably adding to her weight. She is still sitting up and pawing the air begging for them, she was getting a lot. I am amazed that she still follows me around and jumps in my lap after the last week of shoving pills down her throat and poking her with needles. I guess the roast turkey helps....bribery is good.

 

Yes, those high carb treats are not good for her since she is diabetic. There are good protein treats around. And well turkey is just about the ultimate great treat.

 

Sue -- My meter is making me nervous. I still worry about it being off by 50 points from the vet's. Saturday she tested AM with 269, nadir 139, PM 413 which didn't seem right, so I retested 2 minutes later and got 248 which did make sense. This morning I got 200 so I didn't give her any insulin. I didn't retest that 200 this morning because I only have 2 test strips left until I can get more at the vet Monday (never realized I would go through them so fast). So I don't dare even use 1 for a control test. The vet insists their meter is correct, although mine is new. What could cause the meter to throw a 413 and 2 minutes later 248?

The only thing I can think to do is see if I can borrow my neighbor's meter from maybe two years ago and test using the same blood and the same test strips on both meters at the same time. I need more test strips before I can do it. Come to think of it, the vet tech was using her test strips and I was using mine....hmm.

I'm having some trouble copying the spreadsheet to my computer, but that can wait until you get back.

 

Some use freestyle lite strips in their AT meters. You can pick them up at many pharmacies. @MrWorfMen's Mom or @Carol & Murphy can tell you about it.

 

First of all, make absolutely sure the meter is set to the right code for the vial of you are currently using. If you have an AT strip left, check your meter with the control solution to ensure the results are within the range on the vial (100-185mg/dL). If you get a reading outside that range then it's possible the meter is faulty. If it reads within that range, then you can assume the meter is working.

Before testing make sure you wash our hands because the tiniest touch of something on the strip could cause a wonky reading.

The Freestyle Lite strips will work in the AT2 meter. Only do this if the control solution test shows the meter to be working correctly. Below is a note I put together about using them as safely as possible. Given you are running out of AT2 strips and using the FS strips as an interim solution, use the control solution to check if you get any suspect readings and retest without feeding.

"Having thoroughly investigated the FS vs. AT strips (checking patents, manufacturing location, assay used in the strips, calling both human and animal divisions of Abbott etc.) I am 99.9% sure the FS strips and AT strips are identical in their physical composition. The AT strips however have been batch tested to determine what code on the AT meter will produce a reading closest to animal lab values. Without the AT code for each vial of FS strips, your results will not be as accurate as those using AT strips with the meter set to the appropriate code. My own cross checking elicited results within 10% of the AT strips. Others have indicated their results were within 5%. The difference may depend on how high or low the reading being compared is.​

I am not advocating use of the FS strips in the AT meter, but they are an alternative. If you choose to do so, it is imperative that you have your AT meter set on one of the cat codes (known codes are 08, 37, 38, and 93) to get a reasonably accurate result. Do NOT use the code on the FS strip vial as that is for use only with older FS human meters.

It is also imperative that you keep some AT strips on hand to do baseline checks of your results with the same drop of blood, each time you open a new vial of FS strips or alternately, use AT meter control solution to ensure the strips are readings within the expected range. Also double check any unexpected or low FS strip readings using an AT strip.

All meters have an allowed variance in their results of up to +/- 20% and using the FS strips in the AT meter adds another variance into the picture so your results, while in the ballpark, may not be as accurate as is possible."
​

Hope that helps. Holler if you have any questions.

 

I always make sure the code matches the container for the strips. I only have two strips left to test tonight and tomorrow morning, so I don't I can't do a control now. The last time I did a control (3 days ago) the range on the container was 100 to 185, and I got 159 twice.

Since her reading was 200 this morning, I am hoping desperately that it is correct, because her numbers have been coming down.

I'm too new at this (1 week) to feel comfortable using anything other than the meter's own test strips for now.

 

Debbie, I understand completely and quite honestly I don't use the FS strips in my AT meter either because I like to know exactly what I am dealing with even though I'm not new at this anymore. I do however like knowing that should I ever run out of AT2 strips for any reason, there is a close alternative I can get my hands on easily if need be.

 

Debbie

I am one of the people who use the FS Lite strips in my AT2 meter. It took me a long time and many, many, many side by side comparisons from the same drop of blood before I became comfortable with trusting the results. If you aren't comfortable doing it this way then don't worry about it right now. Maybe down the line you can do some comparisons. Right now you need to feel comfortable with what you are doing.

 

Debbie I understand how you feel too. I only suggested it because you were down to two strips and couldn't get any more until tomorrow. I thought that knowing there was an alternative, if needed, would be good for you to know.

 

It really is good to know there is an alternative. I suspect the AlphaTrak strips are going to be expensive, but it is what it is, for now.

 

What should the average feeding/test/shot schedule be through the day? Do you:

test first thing in the morning, give insulin, then feed
-- or
feed first and test later, then insulin?

 

The routine should be to test/feed/shoot and the test should be done at least two hours post food to avoid any food influence on the numbers.

ETA Then we try to get a test in around the expected nadir which would be between +4 and +7 I believe with ProZinc (others may correct me on that time frame!)

 

Well, the pressure was on with only two test strips left, but I finally got a reading -- 203. Yea!

I need some advice. My vet gave me a no shoot number of 200, that's why I didn't give insulin this morning. She is only on .5 unit AM and PM, which is pretty tiny.

So with no insulin this morning, Dirty Butt hasn't had any for almost 24 hours and is staying at 200 and 203. I'm inclined to go no insulin tonight. What do you guys think?

 

Sorry for the late reply. At that number, I would not shoot. That is almost in the normal healthy range. You sure don't want to give a dose and risk a hypoglycemia event.

Also I've done that trick with only 2 or 3 strips left. Now I'm stocked up.

 

FWIW, I think not shooting last night was the right decision however, the normal range for BG using the AT2 meter would be 72 to 175 (based on IDEXX lab values) so she seems to still be a bit high depending on when those readings were taken. Were the tests you did taken with no food influence (no food for prior 2 hours at least) or after food? If those tests were after food, then I'd try to get a couple of tests at times when there is no food influence and see if she falls into the normal range.

Is she still on the Clavamox? If so, I would suggest testing her for ketones just to be safe! I don't see anything about a history of ketones but if there is, then skipping insulin isn't necessarily the right decision and you might have to consider a reduced dose. I'm wondering if the infection is still at play and keeping her BG just slightly out of normal range.

 

The next time, I would try stalling when you get a number near 200. Wait 20 minutes without feeding and retest. If she is over 200 then maybe try a tiny bit of insulin. With your U40 syringes, the easiest way to give less than 0.5 would be to draw up 0.5 and let out a few drops.

Re the meter. You can continue with your AT after you get some strips or use the Free Style or get the human meter (it will be different ranges than the AT but as long as you know the levels you want to shoot, lots of people here use human meters. ) If your AT meter is a little off your vet's, it isn't a huge issue. You are looking for trends and patterns during the cycle. The important thing is that you had a no shoot number that you are comfortable with. With an ATmeter, and with her changing infection and good changes, I'd say maybe 220 or so for now. Does that sound reasonable?

 

The 200 was 6 hours after food and 12 hours from last insulin .5. The 203 was 7 hours after food and 24 hours from last insulin. I ran out of strips so I couldn't test this morning. I have an appointment at the vet in an hour, so I will get more strips and lancets and test again. Crossing my fingers and toes that it is under 200 next time.

 

Debbie I hope I caught you. DON'T buy lancets at the vet. The AT lancets are very expensive (money grab eith different packaging! ) and the lancets for the Freestyle Lite human meters are exactly the same and half the cost!

 

Help! OK, new meter strips. I set the meter with the new code, ran a control test, worked fine. I tested Dirty Butt 5 hours after she ate and got 409, was shocked so I tested again and got 364. What happened to 200? I tried to get my neighbor's AT2 meter, but he couldn't find it, so I have to wait until morning when Rene gets home. If I give Dirty Butt insulin and the numbers are not true, the nadir would be at 3:00 AM. Should I wait until morning and test again and decide the dose?

 

If you are ever unsure, do NOT give insulin. DB might be on a sugar rush. Or may be fluctuating.

With diabetes it is possible to have a spontaneous remission. So if you are not sure of the reading, it is bad practice to dose. A cat can live with high numbers for awhile. But they can't live thru a full hypoglycemia.

 

If you have time, you may want to type some recent numbers into the spreadsheet. It makes it real handy for you and others here to review history. From the view I see, the spreadsheet looks empty.

 

I haven't had time to figure out how to copy over the spreadsheet to my computer in order to update it.

I gave her a little piece of cheese this morning, but I can't see that making a difference. Maybe she found a Temptation under a chair or a few old bits of dry food on the floor of the pantry. I did see her in the pantry this afternoon. I thought I had everything picked up.

I guess I will test her in the morning, then feed her, then give her maybe the .5 of insulin like before, depending on the test number. Then watch and test later. By that time I should have Rene's meter (identical to mine) and use the same blood for both meters and see what happens. After going hypo once before, I am really scared to just jump back to 2 units.

Does that sound like a good plan?

 

Debbie, the spreadsheet is already on Google drive, so you don't need to copy it over to the computer. You can access it from the computer by signing into Google Sheets on the computer. You have to sign in on each device you are using.

The readings you got from the meter are most likely fine. Any reading can be +/- 20% of actual BG as would be measured in a lab.
409 +/- 20% would be 327 to 491
364 +/- 20% would be 291 to 436

While they may look to be miles apart and I understand why you retested after the 409 reading because it seemed unusual, the BG is constantly going up and down. and even on the same drop of blood the BG reading might be a little different. Taking the meter variance allowed into account, those readings are a lot closer to one another than you think they are.

It's possible Dirty Butt got into some contraband but if I am following correctly, she hasn't had insulin for over 24 hours. If that is correct, that's more likely the cause of the higher BG.

 

Yeah, I think your meter is okay, Debbie. I know it's worrisome, but really, the variance can cause the numbers you are seeing. In the end, we're looking more for patterns than individual numbers. If you see a weird number, it's good to retest like you did...but then assume for those random higher numbers that it could be a hairball, could be the heat, could be she saw a squirrel!

I know hypo is scary. Do you have a hypo kit put together? Having everything you need ready and in one place might help you since then you know you're ready IF it happens.

 

Debbie

Changes in numbers can occur for many different reasons without it being a meter error. Without seeing the patterns on what is happening when you test it is very hard to judge what might be happening. If you are able to put some of the data into the spreadsheet you already have set up it would be most useful to see for people to offer advice. You would just have to manually enter the preshot test you have done...put the number of units given, and enter any additional tests between shots

 

Thank you -- you guys always calm me down out of panic. Her number this morning was 347. She was down to .5 when I was getting the 200, she hypo'd on 1.5 units. So to be really conservative, I will go with just over .5 unit and see how much affect that has on her over 24 hours, then tomorrow move it up depending on her numbers. Does that sound OK?

How do I log into Google Sheets? I've kept my own records on her ever since this started 12 days ago, so all I have to do is update the sheet.

 

A conservative dosing is always best especially when you are not able to monitor a lot between cycles.

This is the link for setting up a spreadsheet:

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

Everyone on here uses the same format so that if dosing advice or emergency advice is ever needed the information is in a format that everyone is used to. I waited a few months when I started before setting up mine and I wish I had started it right from the beginning. I had some low numbers before I had my S/S set up and trying to give all the right information and updated information was very difficult when I needed help with the lows.

If you have any problems with setting up the S/S just ask. There are a few "spreadsheet gurus" on here that can certainly help you out.

 

I was sent this link last week, but I've been so stressed out about this kitty and my other sick kitty, and some other stuff. I need to get organized.

 

You have to log into your Google account first, then go to Google docs and click on Sheets in the left hand menu. Your spreadsheet should be there.

 

If you want I can tag Marje and get her to set it up for you, Then all you would need to do is fill in the numbers. It is hard to do extra things when there is so much else going on. I am sorry about your other kitty being sick, at the same time as you are having to deal with Dirty Butt's new problems.

 

@Tuxedo Mom - there is a spreadsheet link in Debbie's signature and I can see it. It looks like it should be working and just needs data.

 

Thanks Linda. I was also talking with another gal who hadn't set up her spreadsheet and I guess I mixed up the two people

So when Debbie gets a few minutes she can add in the information she has.

 

Sue was originally helping me with the spreadsheet and set it up for me in my signature. She sent me a link (different from the one above) and said I should copy it to my computer and then fill out the spreadsheet. I was never able to copy it to my computer. When I click on the spreadsheet in my signature, it is blocked, there is no access. This morning I was able to make changes to the one Sue sent to me by email -- I hope I am not making changes to the real template that everyone uses. Sue was unavailable for a day or so and we haven't reconnected.

What do AMP, PMPS, and the + numbers mean?

 

OK, I was frazzled when Sue originally sent me the email with the spreadsheet. She did explain the AMP and + numbers. What does PMPS mean?

 

Maybe this will help
http://www.felinediabetes.com/FDMB/threads/understanding-the-spreadsheet-grid.156606/
PMPS is the PM preshot

 

AMPS is the AM Pre-shot reading, PMPS is the PM pre-shot reading.
The next column is for entering how many units of insulin were given.
Each of the 11 columns marked +1, +2 etc. are for any other readings taken during each cycle and the +1 would be a test at 1 hour after the shot, +5 would be 5 hours post shot. We stick to the number of hours post shot rather than times because we are all over the planet and this way everyone knows what's up with kitty.

I'm not sure why Sue told you to copy it to your computer other than to have a backup or be able to sync it online if you are using a copy on your PC to enter data. Have you tried signing into Google and going to Google sheets because I can see the spreadsheet there and if you are signed in you should be able to see the editable copy. You can't edit from the link in your signature because that has view only privileges because you don't want anyone else messing with your data.

 

The only access I could get was through the link in the email Sue sent me. I've tried to copy that link to somewhere safe on my computer, but no luck.

 

What I did when Sue set mine up was I opened up in the link from her email, then I saved it to my favorites and put it on my favorites bar. Did you try that?

 

OK, I'm all set up.

Thank you everyone.

 

Looking good. Did saving to the favorites bar help you?

 

When I tried to do it a few days ago, don't know why but it wouldn't work. If you hadn't mentioned it, I probably wouldn't have tried again.

 

I have honey in the pantry. What would I need in a hypo kit?

 

Here are two links you should find helpful.

This link outlines what to put into the Hypo Kit.
http://www.felinediabetes.com/FDMB/threads/jojo-and-bunnys-hypo-tool-box.2354/

This is how to handle a hypo should low numbers occur.
http://www.felinediabetes.com/FDMB/threads/how-to-treat-hypos-they-can-kill-print-this-out.15887/

 

I just got a little cheap toolbox and put all the stuff in it. You could do that in a shoebox or anything really...just to have it all in one place. Linda gave you the link. It's good to have so that you are ready just in case...and for me, it always makes me feel better to know that I've done what I can to prepare. It might help you worry a bit less.

 

Do you ever see kitties that need just a little insulin, such as giving it once a day in the morning?

 

WOOHOO!! I can see your spreadsheet with the numbers filled it

Since a kitty's metabolism is much faster than a human or a dog, there is no insulin that will last 24 hours in a kitty. When the doses seem too high it is best to lower the dose so that you have two shootable preshot numbers. Otherwise the insulin wears off if only doing once a day and the kitty spends a good portion of the day with no extra insulin on board.

 

Debbie, here is another tip for you for the Hypo tool kit that I found helpful. Keep your MC and HC food separate from your LC food so you do not get them mixed up. My MC and HC were is a whole another area than the LC in my kitchen.

 

Excellent advice Bobbie. I actually use a felt pen and write the carb % on the side AND top of each can in case I mix them up. That way I don;t have to "remember" when I am in a panic.

 

I'm asking about the once a day because my kitty seems to be very sensitive to insulin. She was 347 this morning. I gave her .6 this morning, her nadir was 101 and 10 hours after insulin she is 140, so no shot tonight. I'm guessing she will be low 200's tomorrow AM, what kind of a dose would I dare give her? I guess I should talk to the vet and see if her kidney issues are messing with things.

 

That is a pretty low dose, but you could see what your vet thinks about shooting .3 morning and evening. With two shots a day it would cover the whole 24 hour period rather than only a portion of the day

 

Yep, as Mary Ann said, it's best to reduce the dose in this kind of situation. If you think about it, the insulin isn't lasting the whole 24 hours in your kitty. If it was, you'd have more regulated numbers. While it does give you an unshootable preshot, then you get a higher number for the next preshot.

 

I'm getting suspicious that the Clavamox for the UTI has been bumping her numbers up. In the last couple of days Dirty Butt has been hiding the pill in her cheek, that I thought went down, then I it find hours later. She didn't get one last night. Look at her spreadsheet. She started the Clavamox 7/28 and the vet wanted 2 weeks instead of the usual 1 week, there are 4 days of pills left. I'm going to skip the pill this morning and see what her numbers are tonight...and call the vet.

 

The UTI can be causing the bump in numbers. And if he has been hiding the pill in his cheek and not getting the dose, it could be that the AB has not had time to do it's job . It 's my understanding the Clavomox liquid has sugar and can cause higher BG's but I think the pills are okay.

 

Best not to skip the antibiotic. It's very important to finish the full course to ensure all the offending bacteria are killed off. If it has been messing with her numbers, you simply compensate with insulin. The infection itself will cause elevated BG so if she doesn't get the antibiotic you could end up creating a vicious circle.

 

The vet agreed, skip the pill and watch her numbers. She would like a urine sample to see if the infection has cleared, that will be a challenge. If she goes to the vet for it, her numbers will sky rocket. Time to start looking for a soup ladle, I guess.

 

A urine sample at this time will not show a proper result as far as the infection. When redoing a culture you need about 10 days to pass after the antibiotics are finished or the results will not be accurate. I too would agree with finishing the antibiotics. One of my kitties had a UTI and was put on 10 days at a lower dose than he should have. The UTI "seemed" to clear up but came back with a vengence and he had to be put on 3 weeks at the higher dose to finish clearing it up/

 

Wow, i'm late to the party you guys!!! Hi Debby and welcome! See you are new here
I see you've got already a lot of great advise on how to handle this sugardance! I will keep reading your posts!

 

Yeah, you can't get an accurate idea of if the infection cleared until she's been off ABs for 10 days. I'd wait until then to get a sample.

 

Thanks guys.

 

Curious, where does Sheba fall in the food category? I bought some for my old cat and he really loved it and Dirty Butt left her dish to try and sneak some off of his dish. I looked at the food chart and I didn't see Sheba on it, but I have heard it mentioned by others on this forum.

 

I feed Colin the Sheba Chicken Pate and it's fine, very similar to Fancy Feast I think, although I'm not sure of the exact carbs.

 

Not sure what's happening (believe me, I'm not complaining), but I haven't given insulin to Dirty Butt since Tuesday. I talked with the vet and she wants me to get a urine sample to make sure the UTI has cleared, but that is not going to be easy. If I walk in the room with her, she gets scared and jumps out of the box (feral kitty to the bone), so the ladle isn't going to work. The plastic beads from the vet don't seem to be realistic. I may have to bring her in to the vet and hope her bladder is full, so I don't have to leave her for them to get a sample.