? Confused about BG numbers on spreadsheet

OK, I'm a little bit confused here. I started home testing with Smoky in mid September. What I don't understand is why his AM and PM pre-shot numbers were all in the yellows when I started. He was on much lower doses of vetsulin then. Now his numbers are in the purple,red, and even black a few times on my spreadsheet. I have not been able to test as often as I would like due to my work schedule. His vet said to raise it from 2 to 2.5 units but I'm not comfortable with that. I think giving him 2.25 might be better. Anyone have any advice for me?

Also, I have been using the same vial of vetsulin since Sept 6 and don't know if it is still any good. How can I tell as that type of insulin is naturally cloudy when mixed? I am wondering if his recent higher numbers even at higher doses are due to his insulin getting weak? Smoky had an ultrasound done two weeks ago and they found inflammation in his pancreas, liver, and bowels. Should I just ask the vet for a new vial of vetsulin? I am worried about the damage being done to his organs between the inflammation and his higher BG numbers.

 

Lisa, I'm sorry but there's just not enough information on your spreadsheet to give me a clue to help. I suspect your insulin is driving him down way too hard during the cycle causing his liver to dump more sugar to try to save itself. With your insulin, giving a shot without knowing what their reading is is playing russian roulette. Whoever gives those shots PLEASE must learn to test before giving it. How do you know that any one of those untested days was a number that was too low to even give insulin. I'm even MORE concerned with your shooting untested and great potential of unattended hypos that go totally unseen than the damage being done due to the high BG numbers.

I'm not trying to be mean or nasty but this approach just terrifies me all the way down to my toes...

 

I have tested smoky a few hours after his shots quite a few times. I don't need someone coming down on me. I have to work all different hours at random times and days. I don't have anyone else who is willing to test my cat for me. I am very thankful that my roommate is able to feed smoky and give him his shots when I can't make it home on time. I stayed up half the night with him to make sure he was OK during those times I could not test him. That comment about playing Russian roulette with him was extremely hurtful.
There was a time when I wanted to give up on living and he saved my life. I kept going because I knew I had to take care of him and no one else was there to help me do that. I have to work a lot of hours to care for his needs so you might want to think about how you answer a post the next time around. You might not know someone's situation and what they are going through.

 

Lisa, I didn't say any of that to be hurtful. Let me share a story that will explain why I said that. My first diabetic was diagnosed June 8th. I started testing the July 24th when I finally got a working computer and learned to test. On August 12th, 3 weeks later, if I hadn't been testing, I would have giving a full dose into an already hypo number and went about my day...until I found him.

I've cried with too many that haven't found them in time - I don't want to cry for you and yours because I didn't say something. A human wouldn't give insulin without checking to be sure it's safe, our kitties need to be just as safe and they can't tell us when their sugar suddenly bombed.

PLEASE - whoever shoots needs to take an extra 2 whole minutes and test. Your insulin can cause numbers to dive quicker than others.

 

Lisa, I am a vetsulin user as well and ur insulin has gone bad . I went thru the same thing back in September and when I read the fine print with the packaging saw I was supposed to throw it out 28 days after first puncture!!!! I was way past that. My vet was not even aware of that fact. Go to the forum for Insulin Support Group for Vetsulin/Caninsulin/HumulinN here on the Message Board and click on 3rd Sticky titled Vetsulin/Caninsulin User Guide...explains "following withdrawl of first dose use product within 28 days" and when in doubt and numbers start to climb think about replacing it. Dont feel bad that this ...it is a fact our vets should know and point out when prescribing it...hope this helps

 

Not that this is the only reason for ur numbers but it sure isa part of it

 

I thought the insulin had gone bad too. The package says to discard in 42 days, it has been 55 days. I called smokys vet and have to go up after work today to get a new vial. I might ask him about trying a new insulin out, a friend of mine suggested prozinc.

 

I saw that 42 day statement too...what they don't point out is that it needs to be pitched 28 days after " first puncture"..... once I started opening a new bottle on/ before the 28th day, things evened out...I think u will see an improvement with new bottle...I write the date I need to pitch it on the box and my calendar so I don't slip up and forget ...I'll be interested to hear how things go with Smokey .

 

Yes, Vetsulin seems to loose effectiveness after about a month. I have used Lantus, Levemir, N, Prozinc and BCP PZI for many months and it was OK until the vial/pen was empty

 

ProZinc, unfortunately, is quite expensive even in the US I think. If your finances are tight you might want to stick with Vetsulin and explore its potential for a longer time. Smoky was diagnosed only 2 months ago so it's still early days.

 

The insulin may have gone bad too but what I'm concerned with even more is the possibility that sweet boy is diving into really low numbers when a dose hits. The liver then dumps counterregulatory hormones to keep the body safe, the numbers zoom up high. I'm concerned that you're seeing the 'high' side and missing the dangerous lows.

HUGS Lisa - I'm really not an ole meanie...I'm just really concerned about you and your kitty....

 

In total agreement with Squeaky ab testing before feeding...she and others skilled at reading your spreadsheet will be able to spot problems and help u to help Smokey ,which I know u want to do. The more info the better the help .

 

I picked up a new vial of vetsulin for smoky tonight. Going to give him a shot soon and then check him around +3 to see how he is doing. I have an appt for smoky to see his vet on Monday. He wants me to bring in a urine sample to check for infections, especially UTI and bladder. Smoky has urinary issues so vet will be checking for crystals too. I have also been testing him for ketones which so far have come back negative.
I started my new position so should be much easier to test him in am and pm before shot.

 

Oh yeah , yeah, yeah !!!! Can't imagine the stress you've been under . To be able to test before feed and shoot is going to be so wonderful for Smokey!!

 

I'm glad for you. I'm sure you'll feel much better now that you have a more stable routine. Treating an FD kitty is hard enough without having to fit it in around an erratic work schedule.

 

I got a new vital after two months just to be sure.

 

WOOHOO! I LIKE seeing your tests at shot time every time!!! GOOD WORK!

Glad you started your new position too - nice! Wet food with lots of water will help keep crystals washing through and not clumping, hopefully you'll have much less issues with them.

HUGS!

 

Smoky had surgery in April of 2014, he has not had any crystals in his urine over the past year. I do have to get urinalysis done every six months. He had become blocked in 2014 and had to have most of his " boy parts" removed.
He has severe allergies and lost over half of his hair, my poor baby boy. He has grown a lot of it back. He just needs to gain the weight back he lost . I have to check my fur baby to see how he is doing on the new vial of vetsulin.

 

Smoky dropped from 464 to 351 in +3 hours. Will see if new vial of vetsulin works out for him.

 

Getting the blood glucose under control will help get that weight back on Smoky!!

Click on pictures to expand:

China at diagnoses...less than 8lbs

China after about 4 months Lantus and help from the great people here!!..about 13lbs

They can really come a long way back......and now she's uhh....."too fluffy" and on a diet!!

 

Are you home over the weekend so you could get a curve in?

 

I am home on Sunday and Monday each week. I'm wondering if smogyi effect is going on with smoky. I just tested him and his BG went up from 452 on the outdated insulin yesterday morning to 550 this morning on the new vial I started last night. Should I give him a reduced dose for am? His numbers seem to continue to climb while on the same dose.

 

It's really hard to know. It's possible he needs a reduced dose. It's also possible he needs a higher dose... That's where a curve could be helpful in figuring it out. With it so high right now I'd say keep your dose steady for the time being.

 

I called my vet who said to reduce his dose to two units for 3 days

 

For

Forgot to post this earlier

 

I gave him two units this morning and will check him later to see how he is doing. My vet asked if I could monitor him until his appt on Monday morning.
My roommate is home to watch him for signs of hypo, she knows what to do foe that.

 

Getting ready to test smoky soon. I'm not sure if I should give him a reduced dose for a few days or not. I guess I can decide on that after I test him tonight and see what his BG is. My vet thought it was a good idea but he has given that choice over to me.

 

I tested smoky tonight and his BG is slightly higher than in the am. I gave him a reduced dose of 2 units last night at the vets suggestion down from the 2.5 he had been receiving for the past three days. Should I test him for ketones with his BG being so high the last few days. He also has a ravenous appetite the last three days. I need to give his shot soon and don't know if I should go back to the 2.5 units, stay at reduced dose of 2, or increase to 3 units? I'm inclined to go back to the 2.5 units myself.

 

I would do the 2.5 or 3. I don't think 2 is cutting it. You said you can curve on Sunday. Why not stick with 2.5, then I'd it's still high Sunday try 3 when you can test all day.

 

I gave him 2 units, didn't see your post until later. I can do a curve on Sunday, it would be good to be able to show it to the vet on Monday. I'll go back to the 2.5 tomorrow morning, I agree with you about the 2 units not cutting it.

 

I did a bit of a curve on smoky today, gave him 2.5 units of vetsulin. He only went down to 233 by +4 and by +6 had gone back up to 296, 367@ +9 and 483: PMPS. I have to give him his shot soon, am trying to decide between 2.5 and 2.75. Is three too big of an increase at one time?

 

Maybe try 2.75 u? I wouldn't jump up 0.5 u in one step.

 

He is going to see his vet tomorrow and having his urine checked for any infections he might have. He still has the inflammation going on with his pancreas,liver, and bowels.

 

OK thanks for your help. I will give him the 2.75 tonight and can at least do a before bed test. I'm so glad someone on here told me about the U 40 syringes with half markings on them.

 

It's a 170 point drop.... It was just a really high start number. I would increase the dose a bit.

 

I can give smoky a before bed test if I can find him that is he is hiding from me right now. Guess he got tired of all the extra pokes today.

 

I goofed up last night, forgot to pick up his bowl when I got in the shower. Smoky was munching away when I came out so could not get a before bed test in.
He is going to vet this morning, should I ask about him getting steroids for a short time? I know they bring BG up but he has a lot of inflammation over the last three weeks. How is the inflammation going to go away without meds? I think this is a big reason for his higher readings lately.

Also, if it turns out he has any kind of infection will the antibiotics affect his BG at all? I feel that I am giving him insulin injections for nothing since the inflammation is not being treated. All this is driving me crazy.

 

We all make mistakes, Lisa. Don't worry about missing last night's dose. You'll have to ask your vet about the inflammation issue. As for the antibiotics, it's my understanding that an infection can affect BG values. Not sure about the antibiotic itself though. Makes sense to me that the main thing would be to get rid of an infection if there is one. Heads up, though - antibiotics can upset some kitties' digestive system.

 

Oh, I gave him his shot last night. I wanted to get in an additional test before bedtime, sorry about the mix up. I'll ask about ways to treat the inflammation. I'm just concerned since the ultrasound showed that his pancreas, liver, and bowels were affected.

 

Update for Smoky: I took him to his vet and they ran a urine sample. They found a lot of white blood cells in his bladder and urinary tract. He has a UTI and his sugar (urine) was at 1000. He was negative for ketones. His vet said he probably needs to see an internist. He was given a shot of Convenia and a prescription of Metronidazole. He has a combo of liver, pancreas, and bowel inflammation, forgot what he called it.

Smokys vet wanted me to increase his insulin from 2.5 to 3 all at once. I have heard from other members to only increase the dose by 0.25 at one time. I gave him 2.75 last night and this morning. What should I do? keep giving him that same dose for a few cycles or just go straight to 3 units of vetsulin?

 

Lisa, I wouldn't raise it to 3 - when this infection is gone, his numbers will come down. I don't want to see it cause a hypo when that happens.

Just so you'll know for future reference, Convenia has a 'black box' warning about giving it to cats. It's truly for things like skin infections, not internal infections like he has.

Was it 'Triadis' that he called it?

HUGS! At least you know there's an infection now...

 

I believe it was called "Triadis". He was on 2.5 units for about 5 days then I raised it to 2.75 last night and this morning. Do you think I should keep it at 2.75 or go back to the 2.5 again? The vet said the Convenia was more for his food allergies, he is scratching at his head and neck.
I'm guessing the metronidazole is some type of antibiotic or anti bacterial med?
I have to test smoky in about 30 minutes and of course feed him and give his shot after that.

 

Triaditis?

 

Yep that's it, I'm a terrible speller sometimes

 

No problem. I believe there are other people on here who have kitties with triaditis. @Carol & Murphy is one person who might be able to give advice.

 

I'd leave the dose at 2.75 u for at least one more cycle. If he's in red or pink tomorrow AM you could try 3 u if you can monitor. Metronidazole is an antibiotic that I believe has some anti-inflammatory effects as well.

 

OK thanks. getting ready to do smokys pre-shot test. I'm trying to decide if I should continue with the 2.75 units or go back to 2.5? I just found out he has a UTI.

 

OK I can't monitor him during the day tomorrow but can keep an eye on him tomorrow after his pm shot

 

I will give him the 2.75 units tonight, I might be able to run home tomorrow at lunch to check him if I give him 3 units.
It would be about a +5 reading, his PMPS was 511.

 

Sorry we weren't around when you were asking this. I think you choose right for tonight's shot, I'd wait and see what tomorrow's AMPS is before deciding how much to give.

 

I gave Smoky 2.75 units in AM, he was at 445. He was 538 @ pm test, not sure why his numbers jumped. I gave him 3 units tonight and his BG at +2 was 309. I can check him again at +4 but have to get some sleep after that. I feel so bad for him right now, he has to take allergy drops once a day, antibiotics twice a day, and insulin shots every 12 hours. plus testing his BG.

 

BG was 309 at +2 and 311 at +4 after pm shot. I have to get up in 6 hours so need to get some sleep. I don't understand how his BG could go up at +4 already. Should I go back to the 2.75 dose. I gave him three units but think I should have waited until Sunday when I could monitor all day.

 

With that big a drop at +2, I wouldn't be surprised if he's really high again in the morning

That's one of the bad things about Vetsulin.....some cats it just doesn't work very well on and you get those fast drops that set them up to bounce again .....it can also wear off too soon on a lot of cats (not all of them, but a lot of them)

Hang in there....We're all here to help you any way we can but you might want to consider using a different insulin if your vet will go for it.....Lantus is a great insulin for cats and we've seen a lot of cats go from Vetsulin to Lantus and were really pleased with the results.

It's expensive, but most of us are buying it from Canada so it ends up breaking down to about $15/month (Info here on Lantus from Canada)

 

You are right about his higher numbers this morning. The relion meter read hi symbol which means he is over 600. Unfortunately, I can't afford to use Lantus, my vet suggested I try prozinc. There are 3 possibilities for the high BG: I gave him Pure Bites tuna with water, it's used as a supplemental feeding. We forgot to pick up dry food that my roommates cats eat. Smoky will not normally eat it but can't say he didn't for sure. I think it might be that the 3 units was too much for him. I can run home at lunch and do a +4 or +5 check on him later.
I am worried about what dose to give him this morning.