BG Home Testing & Vetsulin

My 18 lb cat was recently diagnosed with Diabetes and he has been on Vetsulin for a few days now. I have been able to draw enough blood to home test him once so far. When should I be testing his blood in relation to when he is fed and given insulin and what should his BG be each time I test him? What would be considered an alarming number? Also where can I get a 10mL bottle of Vetsulin and 0.3mL, 29G, 1/2" syringes for the lowest price? My vet is charging $70 for a bottle of Vetsulin and $36 for 100 syringes.

 

I get my insulin from Allivet and syringes from ADW diabetes. The best thing to do is to Google Vetsulin. You will find several pharmacies that will have it. Be sure that you order U-40 syringes. I buy Viewpoint syringes with 1/2 unit markings. The markings are easy to read and they cost less then $12.

 

Thank you!!

 

Test a half hour prior to shoot time. So if you shoot 8 am, test at 7:30, then feed, then shoot. What is your prescribed dosage?

What is his bg when you tested? What meter are you using?

Hypo numbers are below 50 on a human meter and below 68 on a pet meter. Hypoglycemia can be deadly if it's sever so that's why home testing is so important.

The no shoot number is typically around 200 until you have more info on how your cat reacts to the insulin. This is why you see everyone here with a link to a Google spreadsheet. You can download our spreadsheet template to use.... It would make dosing advice much easier to give.

 

He's prescribed 4 units. I've only tested once and that was 4 hours after giving him insulin and it was 96. I'm using the Relion Confirm from Wal-Mart. It read 40 points lower than what my vet got when we tested at the same time. Where can I download a blank copy of that spreadsheet?

 

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

 

4 units is a REALLY high dose. Most cats start at just 1 unit. and being that he dropped down below 100, I'm inclined to think you should lower that... I'd probably go to 2 units instead and see what the numbers are like. What was the number just before preshot time? My cat doesn't reach her lowest until hour 5-6, so your cat may have dropped quite a bit lower after that... Possibly into a dangerously low range.

I see you downloaded the spreadsheet.... Start plugging in the numbers that you have. Human meters always read lower because they aren't calibrated for human blood. Typically the higher the number, the greater the difference between human and pet meters.

 

I only have 1 reading so far which is the 96 but it was probably more around 136 since apparently it reads about 40 points lower. How do you know how much to lower the dosage based on the BG numbers? My vet wants to do another BG curve in a week (2 weeks after diagnosis) to determine if dose needs to be adjusted. I have not measured his BG preshot but when my vet did a BG curve the first day he was given insulin it was 418.

 

118 is Not a high number. My cat who is in remission is sometimes about that. The high dose of 4 u is concerning to me. Very concerning actually. @Critter Mom @Elizabeth and Bertie @Squalliesmom @Alexi

can you guys weigh in on this with me?


Make sure you are prepared for a hypo should it happen. Have you read the sticky we have about them? You can't assume it's always 40 lower than the vet. Please be aware that at 50 and lower on a human meter is considered a hypo number. Have honey on hand and some high carb gravy foods to keep on hand. If you are home tomorrow please consider doing your own curve, and for sure get a preshot number, then one at +4 if it's on the low side like it was today I would test every hour until the numbers start going up... You don't know how your cat is responding to the insulin yet so I don't think it's a good idea to let her get so low already. Things can go wrong pretty quickly.

I do want to compliment you on testing at home! I didn't stay home testing the first two months and now wish I had.

 

I'm trying my best. I pricked him at least 10 times before finally getting some blood. Hopefully it will get easier and faster. I edited my post. I mis-typed. It was 418 not 118. A few days before that when they drew the blood that lead to his diagnosis his BG was 530. I do have honey and syrup on hand and have been monitoring for hypoglycemia. My vet said not to do another curve until 2 weeks after being on insulin because it will take a while to level out but I will try to do a curve tomorrow.

 

Oh thank goodness. I thought you shoot him at 118! I was having a little heart attack here. Lol

 

I found the first week it was really hard to get a sample. By the second week it was soooooooooo much easier. Don't give up.

 

If you absolutely must.get.blood, aim for the vein directly. If you successfully poke it, it may bleed profusely, which is why we don't normally aim for it directly. If it does bleed a lot, get your sample on a clean fingernail and blot firmly for a minute or too.
In an urgent situation, do what you need to do.

 

I just tested him right before feeding him and giving him his insulin and his BG was 110. Is that considered low prior to giving insulin?

 

Smoky has very sensitive ears so I use his back paws, the bigger pads to test him. He doesn't seem to mind that as much. Are you using a lancing device or doing it freehand? I use a warm cloth on his paw pad before testing. I have heard if the pre shot number is under 200 not to give insulin. My vet started smoky on 2 units of vetsulin, smoky hits his lowest numbers about 5 hours after his shot.

 

Thanks for the advice! I'm afraid to give him 4 units right now if his pre-shot BG is 110. Should I just not give him any insulin or should I give him a reduced dose? He's only been on insulin for a week now.

 

I would not give him any insulin if his number is that low at pre shot. If you did give insulin at that low of a BG number watch him carefully for signs of hypoglycemia and treat accordingly. Also, you may want to test him every hour or two to see how his BG numbers are. I have found out its better to be high for a day than too low for a moment

 

My vet did the same thing with smoky when he was diagnosed. He started him on two units of vetsulin which was far too much for him. His BG would be 400 to 500 and drop down to very low numbers, 100 or less at times in 2 or 3 hours after shot. The vet then dropped him back down to one unit and raised it up to two over time.
I've only been giving insulin to my kitty since Sept 6 of this year so still am a newbie and really find this site extremely helpful.

 

Have to get to bed soon, need to get up in 6 hours to go to work. There is usually always someone on the forum to chat with, hang in there.

 

Thanks for your help! I decided not to give him any insulin and I'm going to check his blood again in 2 hours.

 

I am SO glad you decided not to give Simon any insulin tonight! 110 is way too low to shoot without more data on how he is handling the insulin. Also, 4 units is awfully high. I would start over with just 1U or less, in Simon's case.

Vetsulin is a fast acting insulin that usually hits its peak around 3-5 hours after administration (what would be the nadir-lowest point in the cycle-for your cat). Blood glucose will then start to rise again, slowly, and will frequently drop a little bit again around +7 hours. This is because Vetsulin is actually comprised of two different components that have different actions. Vetsulin dosing is largely based on the pre-shot values. Since it is a fast-acting insulin it is best to wait 20-30 minutes after kitty eats to give the shot. This assures there is some food in the system when the insulin hits.

Blood glucose will almost always measure higher at the vet's office than at home because of stress. It is not unheard of for it to be 100-200 points higher at the vet's. This is one of the reasons home testing is so important. You also cannot compare your vet's reading, taken on a pet-specific meter, to yours, taken on a human meter. There is no comparison between them. Many of us here use human meters, and we just use a different scale than the pet meters do. Tests should be taken before every shot, and at least one other time during the cycle, ideally more than once, so you can determine your cat's nadir and see how he reacts to the insulin.

I see you are feeding Purina DM dry. This is very high in carbohydrates, well over 20%. We recommend diabetic kitties eat a canned/wet diet low in carbs, 10% or less. The Tiki Cat you mentioned is a very low/no carb food. Any food transition should be done slowly over a period of time to help avoid a hypo or any tummy issues, and you MUST be home testing for safety. I am surprised that Simon tested so low tonight when his AM shot should have been out of his system, and while he is eating hi-carb, dry food. Please do not give him any insulin in the morning without testing first and posting for help if BG is under 200. It looks to me like there may be a small chance that Simon's diabetes might be able to be controlled by diet alone. I don't want to get your hopes up in case it turns out he can't, but it is a possibility. I have to caution you against changing his diet, though, until you are testing full time and can monitor him closely for hypos. You will probably need to do a dose reduction when you transition him. In Simon's case, I would not switch foods at all until you work out his proper dose (I think 4 units is much too high for him), I would be too afraid he would drop dangerously low.

It would be very helpful to you, and to us, if you could set up a spreadsheet for Simon. These links will help you:

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

http://www.felinediabetes.com/FDMB/threads/understanding-the-spreadsheet-grid.156606/

If you need assistance setting it up just sing out, someone will help you!

I will be up for a little while longer, when you test Simon again please post the results, I'd like to see where his BG is now.

 

Thanks so much!! I just tested him again and got 102. There was still some blood on his ear after touching the first test strip to his ear so I put another one in the meter and touched his ear again (only pricked once) and got 126. Is that much variation normal from the same blood drop at the same time? It also seems very low considering he ate 2 hours ago and did not get any insulin. Makes me wonder if the meter is not reliable. The meter is brand new. I've only used it twice so far.

 

Simon is vey handsome - I love siamese cats. Well done for starting home testing and getting your spreadsheet up and running. 4 units is a big start dose and I agree the dose needs to come down. Dry DM is a high carb food - in fact I keep it in reserve as the high carb if needed for very low numbers. Don't change his food until you are confident with home testing and have a lot more numbers. Even then any food transition needs to be done slowly as it will drop his numbers. I transitioned over a week gradually adding more of the new to the old whilst monitoring the numbers.

Did the vet give you an ideal weight for Simon?

With vetsulin the blood sugar tends to drop quite quickly after the shot so it should be given after feeding, the lowest point comes in 4-6 hours after the shot before rising again. He got a big drop on that first day and may well have dropped lower today.

For people starting out we recommend 200 as the 'no shot' number, good call to skip tonight. He is likely to be high again by the morning so can you post the morning pre shot number and we can suggest a dose to take account of that. It is much better at this stage to let the cats numbers run a little high than to have to deal with a hypo, (actually its better not to have to deal with a hypo at all but our kittys like to surprise us). Cats can tolerate high numbers remarkably well. Once he is settled on a dose you will need to do a curve to determine when his lowest point is and what the number is.

126 is a safe number and the difference allows for meter variance.

Can you tell us a bit more of how the diagnosis was made - what did you notice and what tests were done at the vet?

 

I noticed him drinking excessively and urinating very frequently. That was going on for at least a month before I realized that meant he could have diabetes and took him to a vet to check. He would sit in front on his water bowl for sometimes up to 5 minutes and just drink. I was cleaning out his litter box 4 or 5 times a day and there was often multiple urine piles. The vet did a full "senior blood work panel" as she called it. I know it included a urinalysis. She said his kidney levels, thyroid levels, and everything else that was tested came back normal except for high glucose levels. She also said he did not have a UTI. His glucose was 530. That was done on 10/19/16. I got the results back on 10/21/16 which is when the vet told me he had diabetes. She had me come in 10/24/16 to give him his first dose of insulin and calculate his dose/do an insulin curve. She gave him 4 units that day and after doing the curve said that looked like an appropriate dose for him. She didn't recommend home testing. I took the initiative and decided to do that myself after reading a few things on this website. I'm supposed to take him back to the vet on 11/4/16 for the vet to do another insulin curve. She did not give me an ideal weight for him, just said he needed to loose weight. I haven't tested him the past few days because my vet said not to until his levels become consistent (she said that would be about 3 days after starting him on insulin) but now I'm wondering if his levels have been low like they are today and I've still been giving him 4 units. I may have gotten really lucky he didn't go into hypo.

 

Yes, you may have been lucky, indeed! I think there's a good chance that he will need little to no insulin once he is no longer eating the high carb food.

I don't think there is anything wrong with your meter, a variance of up to about 20% is normal.

He really is a handsome fellow, your Simon!

 

I doubt very much that she would inject herself with a powerful hormone without first checking to see if it was safe and if she needed it, so I don't know why she thinks you shouldn't check Simon for the same thing!

 

Thank goodness you are testing. Please don't give him 4 units at shot time, even if he is above 200. It's really much too high of a dose. Almost all cats are started at 1 unit and more rarely 2 units, but not more than that. I sincerely feel you are putting his life at risk with 4 units. Thank you to the others that have given the same advice.

 

Really good call not shooting at such a low number. If you had, esp that amount you would have had him in a life of death situation.

 

I agree completely! I would not give more than 1 unit, and maybe even less than that, depending on his AM BG.

 

Agree - please don't give 4u, it is too much. Always best to err on the side of caution. It's better to be high for a little longer if necessary than dangerously low due to too much insulin.

 

BTW, the numbers may be a bit elevated in the morning. That's called a bounce from going so low today and skipping a dose. Don't let it freak you out, and please even if it's 400+.... Don't give more than 1 unit and let's see what happens. Please post your morning reading before giving the shot so we can advise.

 

Probably best to post for advice, and reference/link to this post for the history.

 

That's good to hear! And thank you!! We love his dreamy blue eyes!

 

Thank you to everyone that has offered advice! It is much appreciated! I will post his AM BG before giving him any insulin.

 

Welcome to the forum.

Thank goodness you are home testing and so many people were able to give you some good, safe advice about the dosing. As was already said the 4 unit dose is FAR too high especially for a kitty just starting insulin. The normal starting dose is 1 to 2 units every 12 hours, but some kitties may even need less than that. Since Vetsulin is faster acting and can drop numbers very quickly in the first 3-4 hours after a shot, home-testing is so important so as not to risk glucose numbers falling too low. With you planning on switching to a low carb wet food, the insulin requirements can also change drastically, so careful monitoring of the numbers is even more important. There have been some kitties that have managed to go off insulin in a very short period of time, largely with changing to the proper diet for a diabetic kitty.

Please do test before the next shot time and post before giving the shot to get some feedback on whether it is safe to give the insulin.

 

Hey everyone! So I just tested his blood and got 170 with a human meter. Should I give him any insulin?

 

Hiya ,
For those new to diabetes we suggest that no shot is given if the blood glucose is below 200.
Another option is to 'stall'; ie. wait a little while - without feeding - to see if the blood glucose comes up to a shootable level.

Even if it does come up to a shootable level you may still want to be cautious with the dose if you've not shot at this number before. And your ability to test during the cycle afterwards may also factor into your decision of whether to shoot, and how much to shoot.

Eliz

 

II am not a proponent of skipping shots especially for a non-depot insulin like vetsulin. I give a reduce dose. Based on yo r recent BG I would give 1/2 unit.

 

I agree with the half unit suggestion

 

Hi, just now seeing your post. What did you decide about Simon's insulin this morning? Did you shoot the 1/2 unit? I think that was a good suggestion. Have you been monitoring his BG? I'd be curious to know what it's been running, if you wouldn't mind posting any numbers you may have gotten today!

 

I decided not to give him any insulin because I wasn't able to monitor him. I will be testing him again around his PM shot time shortly. I wasn't able to test his BG any today either so I don't have any numbers. He really does not like being pricked in the ear and I usually have to prick him multiple times to get blood. Any suggestions on how to make testing quicker and less painful for him? It would help me test him more often.

 

If you read through this link:

http://www.felinediabetes.com/FDMB/threads/hometesting-links-and-tips.287/

It has excellent suggestions to help with home testing. For myself I have one spot I test my two kitties at with all the supplies ready before I start with the ear pokes. I do a bit of a cuddle before I test and with one a treat after (he is VERY food motivated) and with the other a cuddles and a brushing (she loves her brushings) Find something that your kitty enjoys and give it as a "reward" after testing. I also use a round cotton cosmetic pad behind the ear when I am poking to give some stability to the ear and then to fold over and hold and apply pressure after the poke to keep the ear from bruising or scabbing. It really does get easier as you go along. The first week I started testing with my first one I was in tears and he was howling...now he comes to the test mat on his own and sits and waits very nicely for the "pokey" Staying calm and relaxed helps the kitty to also stay calm and relaxed

 

I follow the same procedure as Tuxedo Mom. I use Squallie's favorite treat for his testing reward, and that is the only time he gets that particular one. He is also fairly food-motivated, or at least, treat-motivated, lol!

What size lancet are you using? Sometimes starting out with a slightly bigger lancet can help, until the ears "learn" to bleed. If you are having difficulty finding the right spot you can shine a light behind his ear and you will be able to see the vein running down the outside; you want to poke between this vein and the edge of his ear. Do you use the lancing device or freehand it? I freehand it because I think I have better control, and the device also tends to block what I'm trying to see. I apply a very thin layer of Neosporin with Pain Relief ointment (not cream) before I poke, too.

It really does get easier as you and Simon both become accustomed to it and fall into a routine. I can practically test Squallie in my sleep now, lol. Keep at it, you will get there!

 

Before her ears bled relatively easily, I used a 28 guage lancet and poked twice in the same spot one after the other. Don't be afraid to poke all the way through.

 

I can't test smokys ears so have to use his back paw pads instead. He doesn't seem to mind it too much. Is your vet open to you home testing? I would let his vet know about his low pre shot numbers.

 

Wow! Where do you live? I bought that same size bottle of insulin from my vet for $40 and 100 syringes for $20.

 

His PM pre shot was 160. My vet is closed on the weekends so I plan on talking to her about it Monday. I'm in Garner, NC. It's right outside Raleigh, NC. I thought it was a little high.

 

That's a really low preshot. And that's after skipping in the morning? Did you skip again? I'm thinking your cat will soon be just diet controlled.

 

Try to keep the spreadsheet updated with the newest data. If your morning preshot is over 180 but under 250 and you can monitor I would give only half a unit. If you can't monitor don't shoot under 200. Over 250 give 1 unit. 150-180 give less than a half.

 

That's after skipping 2 doses and I did skip a third time. It would be wonderful if he could just be diet controlled. I will definitely be talking to my vet tomorrow to see what she thinks. She will probably want me to bring him back in to check his blood using their meters. I will continue to update the spreadsheet. Thanks for the helpful guidelines for the morning pre shot! I will do that!

 

I live about 50 miles from Philadelphia. I thought vet costs were less than that in the south. I lived in Miami for several years and meds were a lot less then they are in Pennsylvania. Sending hugs that Simon might be able to have his diabetes controlled by diet alone.

 

Hey everyone! I have an interesting update on the situation. I took him to the vet today about 3 hours after he ate and they tested his blood using the Alphatrak and got 295. They also tested it using mine and it read 250. He was pretty stressed out when they drew his blood (he was shaking). I showed her his spreadsheet and she said 4 units may have been a little aggressive but only reduced his dose to 3 units. She also said I shouldn't have stopped giving him insulin and that a pre shot number in the 100s is normal. She said I should always give him 3 units unless his pre shot number is 60 or below (20 or below on my meter). She also tried convincing me again not to home test for at least 2 straight weeks of being on insulin and then bring him in for another curve to see if 3 units is still appropriate. Any thoughts on that? I called my old vet earlier and they are going to look at his spreadsheet tomorrow and recommend a dose they think is correct. It will be interesting to see if it's the same. 3 units still seems high to me.

 

[QUOTE="alana_danielle94, post: 1813823, member: 16584"]pre shot number in the 100s is normal. She said I should always give him 3 units unless his pre shot number is 60 or below (20 or below on my meter). She also tried convincing me again not to home test for at least 2 straight weeks of being on insulin and then bring him in for another curve to see if 3 units is still appropriate.[/QUOTE]


LOTS of bad advice there. First off the usual starting dose for Vetsulin for a newly diagnosed kitty is 1-2 units. A preshot of 60 is FAR too low to be giving an insulin, especially Vetsulin which can act very quickly and drop numbers fast. I am not sure where you get the difference in meter readings...60 on your vets VS 20 on yours. 20 would be a serious hypo and a kitty should be taken to the ER if the numbers drop that low. As far as not testing, the new vet standards are to encourage people to do home testing, since the numbers at home are not stress influenced the way they would be at a vets office AND home testing keeps a kitty safe,by knowing if the number is too low to shoot.

I agree that 3 units is too high with the lower numbers Simon has been hitting, The safest approach is to start at a low dose and gradually work up as needed. I certainly hope your old vet has more sense than this one.


ETA On a pet meter a reading of 100 is in the normal range and it would be very bad advice to suggest giving a shot of Vetsulin at that level, especially when your kitty has only been on insulin for less than 2 weeks

 

Oh my God. I think your vet is insane. Three units is still too high. A preshot number in the 100s may be normal but you need to have enough data and experience to know if your cat will be safe if you give insulin; I can tell you that three units would NOT be safe. As for numbers on her meter vs numbers on yours...if Simon's BG is 20 on your meter it is a life-threatening medical emergency and he needs to be seen by a vet immediately! What is your vet thinking!?!?!

 

I'm sorry I reacted so strongly but honestly, that vet's advice could very easily be the death of your cat. Please do not give him three units of insulin! I really hope you old vet has some better guidance for you. And please DO keep home testing!

 

That's exactly how I feel! I think she was a little mad that I wasn't following her instructions exactly. She said it seemed like I didn't trust her yet. It's a little hard to trust her though when everyone is telling me she's wrong.

 

The problem is that vets know a little bit about a lot of diseases but they are NOT specialists. I have seen too many times where the advice a vet has given could very well have killed the kitty if the pet parents had blindly followed it. The people on here eat, live and breathe FD 24 hours a day 365 days a year and have documentation to back anything that is discussed. Some vets are familiar with diabetes with dogs, but not kitties, and some vets are JUST not familiar with diabetes at all.

 

I don't normally give dosing advice, and I try very hard to NOT say bad things about vets, but that's just crazy. Her advice is not just bad, it's deadly! She simply cannot have any familiarity with feline diabetes, that's the only thing I can think.

If your old vet has any experience with the disease I'm sure he will be able to give you better advice. You might want to ask him if he thinks Simon's diabetes could possibly be diet-controlled if he is switched to a low-carb, canned/wet diet.

 

I had to leave my old vet over a similar situation. She told me to give my cat 7U of Vetsulin 2x daily and, of course, he had a hypo! I reduced his dose and changed his diet from the hi-carb dry she had me feeding him (I was also home testing, which she told me not to do!) and when he next went in to see her she read me the riot act and told me if I didn't follow her instructions I was killing my cat. Well, I walked out and never went back. I got really lucky and found a wonderful new vet who understands FD!

 

She seems like one of those that just knows a little although she claims she knows how to manage it. She told me to go see a specialist if I don't trust her. Another thing the bothers me about her is she's convinced that the Purina Pro Plan DM dry food is hands down the best food to feed a diabetic cat. I told her I was starting to give him a little of the Tiki Cat canned food and she was like that's not going to be as effective because the Purina Pro Plan was made by vets specifically for diabetic cats. I tried to explain the whole lower carb thing to her but she wasn't buying it. I will definitely be asking my old vet about the food situation and whether or not he can be diet controlled. If he was 295 at the vet earlier today, what should I give him for his PM dose if not 3?

 

Wow! 7 units?! I might have to do the same. Sounds very familiar. It's so scary to think about how little some of these vets know and that they are out there treating animals and the owners can be so easily fooled.

 

Right there that shows that she has no idea about FD. Informed vets will suggest ONLY wet canned food. They may suggest a prescription wet food (which is not necessary) since they have been "taught" by the pet food companies to sell their products, but a good vet would never suggest a dry food. That would be like a human doctor telling their diabetic patient that it is okay to eat potato chips and donuts.


ETA The pet food companies are the ones that do the nutritional classes when a future vet is taking their training

 

Yeah, my old vet wouldn't listen to me about the carbs, either, kept saying the same thing your vet told you. That "prescription" cat food they push is just like any other dry cat food, it just has a jumped-up label!

Please test Simon tonight before you feed him and post for dosing advice. I do not like to give dosing advice so I hope someone else will hop on here and help out, lol, but I'll try to help you as much as possible!

 

Ok! Will do! Thank you!

 

It might be a good idea to do a post for dosing advice on the Vetsulin forum. There are a lot more people using Vetsulin/Caninsulin now and the forum is much more active than it used to be. You could post your test numbers with a topic of "Need dosing advice for shot" and include a link to this post for background information. That way you would get information and advice from experienced Vetsulin users.

The link for the Vetsulin forum is:

http://www.felinediabetes.com/FDMB/forums/vetsulin-caninsulin-humulin-n.19/

 

Ok! Good thought! I will do that!

 

Yeah time for a new vet. This one has no clue about dosing vetsulin.