Doing a Curve - Weird Result, What to Do?

Discussion in 'Feline Health - (The Main Forum)' started by PamJV, May 17, 2018.

  1. PamJV

    PamJV Member

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    Feb 2, 2017
    I normally have not been testing Ricky's blood glucose. It was decided to try putting him on 6 units twice a day of Lantus back in January and I did one curve then. Since it has been so hard to test him, my vet and I discussed it and decided as long as he looked stable and ate the same thing all the time that this was fine. Especially since I was not attempting to bring his BG down so low that I'd have to worry about it getting too low then close monitoring wasn't necessary.

    Well things began to change when they discontinued EVO and even when I still had some left he started to not like it, and was having some urination out of the box issues. So I've been dealing with trying out new foods, plus he needed a big dentistry and some teeth removed in March. All in all though Ricky has looked good and his plantigrade gait went away completely. His weight looks perfect and his fur is nice and silky.

    Now a couple of weeks ago my vet suggested trying RC Glycobalance dry food for Ricky. This was because we thought he was developing crystals. It turns out he didn't have crystals but had a UTI. That aside he really liked the RC Glycobalance which IMO is fine as long as he looks good etc. It is such a struggle to get him to eat anything like YAZ.

    My vet asked me to do a glucose curve now to check how his status is on this food. I began today and discovered I was going to run out of test strips because of the fact that it's so hard to test Ricky and get a nice blood drop, I was foolishly trying to test when there was just a trace of blood. So I wasted some strips today. You can look at his chart and see the spreadsheet for today. It's very odd. It started at 372 at 9:00 am and has been going down all day and at 7:00pm (9+ hours) his BS was 138. I only have one test strip left and am planning to test him at 9:00pm when I would normally give him his insulin again.

    I am wondering what to do based on the reading I will get at 9:00pm. If it's still going down, I would not give any insulin, and call the vet in the morning. But what do I do if it's raised just a bit, say back up to 200? Normally I'd expect his BG to have a bell curve and raise back to the same reading he got in the morning at the 12+ hour mark. I'm afraid if I give him 6 units when he's only at BG 200 or so that would make a drop too low in the night time.

    UPDATED .... Waited until 10:00 PM and his BG was 40 ! So did not give insulin. He looks OK but I gave him some Caro Syrup since this is a scary low reading. I wonder if it's even accurate.

    Will definitely show this to the vet tomorrow, or go to ER if he becomes ill looking.

    Thanks, Pam
     
    Last edited: May 17, 2018
    Reason for edit: Update results
  2. Idjit's mom

    Idjit's mom Well-Known Member

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    I can't advise on dosing, sorry. But I'm wondering if you have tried transistion to wet/canned food diet, low carb. We put Idjit on low carb wet food and he now does not need insulin.It's my understanding that it's best to always test before injecting insulin, especially if you change the diet.We also used the Alphatrak, but the cost and immediate unavailability of more strips prompted us to get a human meter, Relion Confirm, so we always have strips. There's information on diet, testing etc in the yellow tags on the top of the forums. Good luck with Ricky he's a handsome dude.
     
    Last edited: May 17, 2018
    Reason for edit: Correction and additions.
  3. PamJV

    PamJV Member

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    Ricky was on dry EVO which is low carb. But that was discontinued. He had also been on what the vet recommended Purina DM. RC Glycobalance is formulated for diabetics also. No he's never eaten wet food he's always refused that. I can't stress him now with trying that transition. Recently I have been trying some of the low or zero carb dry foods but he wouldn't eat those. For me success is just stability.....if he stays on insulin for the rest of his life that's fine with me as long as he looks good and acts happy. He can't handle daily testing.

    The thing right now his BG is lower than usual while on this glycobalance. That's what is strange. I've never seen his BG as low as 138 before

    AND just now at 10:00 his BG is 40 ! Definitely never saw that before. Obviously did not give any insulin tonight.
     
    Last edited: May 17, 2018
    Reason for edit: Update results
  4. Idjit's mom

    Idjit's mom Well-Known Member

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    Pam, editing your post does not bump it to the top of the forums, and get noticed. 40 is hypo! And needs to be monitored. Make another post, let you them know you need help!
     
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  5. PamJV

    PamJV Member

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    RICKY GOT A READING OF 40 TONIGHT AT 10:00 PM ! NO INSULIN GIVEN

    Gave him Caro Syrup.

    It's pretty late so I don't think I'll get answers now. I'm all out of test strips. The reason I use Alpha Trak is my vet told me the Relion meter was giving me readings over 100 points too low in error. We tested both meters comparing them to the vet office machine before.

    Ricky looks calm, but he's been sleeping a lot so it's harder to tell. He's not drooling or wobbly or any of that. But normally he'd be getting up walking around more than what he's doing. I will be trying to decide if he needs to go to ER. ER is an hour's drive so that's not something I do lightly at this time of night. If he were yowling in distress I'd go right away.
     
  6. Idjit's mom

    Idjit's mom Well-Known Member

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    Been trying g to get you help please stay on!
     
  7. Chris & China

    Chris & China Well-Known Member

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    Do you still have the Relion? Got any strips for it??

    It's not unusual for a human meter to be that much different at high numbers....it's the low ones that are most important and the human meter is usually pretty close to the pet meter at the lower numbers
     
  8. Noah & me (GA)

    Noah & me (GA) Well-Known Member

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    Dec 3, 2016
    Forget the test strips right now, it's better to be high than low.
    Caro syrup is good, if you don't have any you can use honey or corn syrup (basically the same as Caro).
    Don't over do it though, just rub small amounts with your finger on his gums.
    He won't yowl like it's pain if hypo is the case. Watch for a glazed/stoned look, do not let him fall into a deep sleep. Anything he eats is good.
    Call emergency and see if they'll at least give you some advice. An hours drive can be a nightmare, speeding, flat tire etc.
    STAY WITH US.
     
  9. PamJV

    PamJV Member

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    Thanks. Gave him a little more Caro Syrup and he looks more awake now.
     
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  10. Idjit's mom

    Idjit's mom Well-Known Member

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    Thank goodness, I was very worried. Please stay on, let us know.
     
  11. PamJV

    PamJV Member

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    OK, I wasn't sure how much Caro Syrup to give, so it might have been too much. The ER always tells us to bring the cat in, they never give advice over the phone. He is resting with his head upright right now.
     
  12. Idjit's mom

    Idjit's mom Well-Known Member

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    All I know is 68 on Alphatrak is hypo, and dangerous. Idjit hit a 60, and I was scared. It you can, dig out that relion meter if you have strips. It will at least let you know something.
     
  13. PamJV

    PamJV Member

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    No don't still have it.
     
  14. PamJV

    PamJV Member

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    We have another meter called True that belongs to my husband but all the strips are old, expired ones.
     
  15. Idjit's mom

    Idjit's mom Well-Known Member

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    Might be worth a try to see what True sez?
     
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  16. Noah & me (GA)

    Noah & me (GA) Well-Known Member

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    Where is the sticky for hypos? Could someone post the link please.
    Pam, where are you? I'm on Eastern time so it's midnight here and when I get tired it's lights out. I don't want to just bail out on you.
    Idjits mom is in Washington so she's got 3 hours on me. My "well known member" thing doesn't mean anything medically.
     
  17. Chris & Lucy

    Chris & Lucy Member

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    I don't know the specifics, but I've heard strips are good long after their expiration date.

    Any food with some carbs in it that you could get him to eat would be helpful.

    Since your riding this out, just keep an eye on him. Maybe engage in some play or luvins. Watch for a glazed look or any confusion.

    Once it passes its probably time for a curve and possibly an adjustment in his dose.
     
  18. Noah & me (GA)

    Noah & me (GA) Well-Known Member

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    Play is a good idea. See if he'll make a usual jump like onto the sofa and watch to see if his feet clear by 1/100 inch like a typical cat. Is his tail in the air like a happy cat?
     
  19. Idjit's mom

    Idjit's mom Well-Known Member

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    Chris, can you post link to hypos? I can't do it on my kindle
     
  20. Tracey&Jones

    Tracey&Jones Well-Known Member

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  21. Idjit's mom

    Idjit's mom Well-Known Member

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    Tracey linked the hypo post. Thanks again for jumping in. I'm staying on, it's only 9 here. Sleep well!
     
  22. PamJV

    PamJV Member

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    We are about to take him to ER. Just waiting for my husband to drive me.
     
  23. Idjit's mom

    Idjit's mom Well-Known Member

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    Drive safely, we want all three of you alive and well. :bighug: Take your caro with, you said it was a long drive.
     
  24. Noah & me (GA)

    Noah & me (GA) Well-Known Member

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    This is the text from the HYPO sticky. Now you won't have to keep going back and forth. Sorry about the length but it's not my place to edit something so important.
    I'm falling asleep, will see you BOTH tomorrow and the sun will be shining.

    Hypoglycemia or low blood sugar is a dangerous condition that must be treated immediately. Also known as insulin shock or insulin reaction, hypoglycemia occurs when there is too much insulin in the body potentially leading to neurological damage and/or death.
    Knowing how to respond to a hypoglycemic event whether or not symptoms are present can save the life of your diabetic cat. The following general guidelines are intended for those who home test the blood glucose levels in their cats. These guidelines are not intended to replace the advice given by your Veterinarian. It is very important that you discuss any and all treatment options with your cat’s physician BEFORE an event has occurred.
    SYMPTOMS
    Some cats may have NO symptoms whatsoever, but here are the most common ones:
    MILD HYPOGLYCEMIA
    Sudden ravenous hunger
    Shivering
    Weak or lethargic
    MODERATE HYPOGLYCEMIA
    Disorientation
    Trouble with vision... bumps into furniture
    Poor coordination, such as staggering, walking in circles or acting drunk
    Changes in head or neck movements
    Restlessness
    Urgent meowing
    Behavioral changes, such as aggressiveness
    SEVERE HYPOGLYCEMIA
    Convulsions or seizures
    Unconsciousness
    TREATMENT
    During treatment for hypoglycemia, try to test every 15 - 20 minutes until you see the bgs begin to rise. Then continue to test until you are satisfied that the cat is out of danger.
    VERY LOW NUMBERS – WITHOUT SYMPTOMS
    Retest glucose using a large blood sample to make certain you have enough blood, and if you still get a very low number (under 40 mg/dL or 1.9 – 2.2 mmol/L) administer a teaspoon of corn syrup, liquid glucose, pancake syrup or honey, or INSTA-GLUCOSE and follow with food until the blood glucose numbers rise to acceptable levels. The syrup can be mixed with wet food or poured over dry if the cat will eat the mixture. If using liquid glucose, dilute with water for a thinner consistency.
    LOW NUMBERS – WITHOUT SYMPTOMS
    Retest glucose using a large blood sample to make certain you have enough blood, and if you still get a low number (40 – 60mg/dL or 2.2 – 3.3mmol/L) give food or treats until the blood glucose numbers rise to an acceptable level. If the cat refuses to eat even his/her favorite foods, you can syringe feed or administer a small amount of syrup.
    LOW NUMBERS – MILD SYMPTOMS
    Try feeding first or give a little syrup or honey followed by food until the blood glucose numbers rise to an acceptable level and the symptoms disappear. The syrup can be mixed with wet food or poured over dry if the cat will eat the mixture. If the cat will not eat, syringe feed. If your cat will eat dry food. the high carbs will help to increase his/her bgs quickly, but remember the effects of dry food usually takes longer to clear kitty's system once the crisis has passed. Feeding a high carb canned food is preferable to feeding a high carb dry food because the effects will clear kitty's system faster. You can then follow with his/her favorite canned food. Keep in mind that giving syrup (Karo, etc.) or honey is not enough because the effects wear off quickly. You need to follow with food.
    IF IN ANY DOUBT, TELEPHONE YOUR VETERINARIAN.
    LOW NUMBERS – MODERATE SYMPTOMS
    Give a tablespoon of syrup, a teaspoon of liquid glucose, a tablespoon of honey or a tablespoon of sugar syrup followed by food and continue doing so until you see the blood glucose numbers rise to an acceptable level and all symptoms disappear. The syrup, honey, or glucose can be rubbed against the inside of the cat’s cheeks or on the gums for quick absorption. You can also mix the syrup with wet food or pour over dry if the cat will eat it. Continue to give syrup and food as needed and observe your cat for signs of recurring hypoglycemia. Keep in mind that giving syrup (Karo, etc.) or honey is not enough because the effects wear off quickly. You need to follow with food.
    IF IN ANY DOUBT, TELEPHONE YOUR VETERINARIAN.
    LOW NUMBERS – SEVERE SYMPTOMS
    Rub syrup, honey, or glucose on the gums and cheeks if your cat will allow it. Another option for administering syrup, diluted liquid glucose, honey or sugar syrup to a cat who is seizing is to fill a needleless syringe with the mixture and insert via the rectum.
    NEVER TRY TO SQUIRT SYRUP, HONEY, OR GLUCOSE TO A CAT WHO IS SEIZING AS THE CAT COULD CHOKE ON IT! RUSH TO EMERGENCY.
    AGAIN! ANYTIME YOU CAT IS SEIZING OR LIMP, RUB KARO, GLUCOSE OR HONEY ONLY ON GUMS OR ADMINISTER RECTALLY AND GET TO EMERGENCY OR YOUR NEAREST CLINIC IMMEDIATELY!!!
    Remember that syrup or any other sugared syrup/preparation will spike the blood glucose ONLY for a short period of time, so food is really important with mild and moderate symptoms. Dry food (high carbohydrates) will keep the blood glucose numbers elevated longer.
    After a hypoglycemic episode cats may be more sensitive to insulin, so a reduction in dosage is generally required, especially considering too much insulin – whether due to dosage, inadequate food intake, or the cat’s changing insulin requirements – caused the hypoglycemic event in the first place. With moderate to severe episodes, your Vet may have you skip the next injection altogether.
    IT IS VERY IMPORTANT THAT YOU DISCUSS YOUR CAT’S HYPOGLYCEMIC EVENT WITH YOUR VET, SO TOGETHER YOU CAN DECIDE UPON THE NEXT COURSE OF ACTION.
    Always keep in mind that with low blood glucose and no symptoms, the BG you get is not as important as where it is headed. In other words, if you get a BG of 100 mg/dL or 5.6 mmol/L or less and there are still several hours or more before the insulin peaks, your need to watch your cat (and the numbers) carefully and take appropriate steps. With very low numbers and NO SYMPTOMS, a cat can be fine one moment and seizing the next.
     
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  25. Tracey&Jones

    Tracey&Jones Well-Known Member

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    Good luck and drive safely!
     
  26. krazy4kritters

    krazy4kritters Member

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    I hope all goes well. Keep us updated!
     
  27. Chris & China

    Chris & China Well-Known Member

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    Just FYI....exercise can actually lower the blood glucose...it makes the insulin more "available" to the cells.

    Luvin' on the other hand is always a good idea;)
     
  28. Chris & China

    Chris & China Well-Known Member

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    May 10, 2013
    @PamJV Prayers going out for Ricky and both you and DH

    I seriously think he may be on way too high a dose. 6 units is a HUGE dose for a cat....even a big one!

    I understand your concern about using a human meter, but I assure you that there have been tens of thousands of cats through here that have been managed with human meters that have done just fine. Remember, the existence of pet meters is relatively new to the picture....before they were invented, everybody used a human meter because it's all anybody had!

    It may not tell you the same exact number, but it will show you "trends"....how Ricky is responding to his insulin dose....and it'll keep him safe.

    The "time for action" on human meters is 50....On pet meters it's 68, so as you can see, at the really important numbers (the low ones), they are quite close.

    Please update us when you can. We all care!!
     
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  29. Gill & George

    Gill & George Well-Known Member

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    sending prayers all goes well.
     
  30. PamJV

    PamJV Member

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    Thanks. Just got back home at 3:30 am. By the time he got to the ER his BG was 400 with their testing, and then they used my meter to check and it tested at 404. The ER vet said it would be unusual that Caro syrup would raise the BG that much in a couple hours time going from 40 to 400. But then again some of that 400 could have been nervousness going to ER ! She instructed me to test him in the morning (she gave me some AlphaTrak Strips) and if he eats and his BG is not low to then give him his insulin and to check with my vet about doing another Fructosamine test.

    I agree that his dosage could be too high now. Back in January he was testing in the 300's and 200's, which was normal for him. I never expected him to have low numbers like this. And on top of that it's very odd to have a this kind of a curve where it just keeps going lower over 12 hours.
     
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  31. PamJV

    PamJV Member

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    Feb 2, 2017
    Thanks ! We made it home.
     
  32. Gill & George

    Gill & George Well-Known Member

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    Hi Pam I am so happy that all is well with Ricky, that must have been very scary for you.:bighug::bighug::bighug:

    I think it is most likely the rise in BG could be attributed to a number of things/ or rather a combination.
    1. Stress (ER visit)
    2. Karo
    3. Bounce (his liver dumped glucose into his bloodstream because of the fast drop/his BG was lower than usual/or he dropped to low, he may bounce for up to 3 days, this might mean that you see high numbers for a while, or, and this could be fairly likely, since it looks like he may be on too much of a dose, he clears the bounce quickly)
    From the sticky in the lantus forum
    • Bouncing - Bouncing is simply a natural reaction to what the cat's system perceives as a BG value that is "too low". "Too low" is relative. If a cat is used to BGs in the 200's, 300's, or higher for a long time, then even a BG that drops to 150 can trigger a "bounce". Bouncing can also be triggered if the blood glucose drops too low and/or too fast.The pancreas, then the liver, release glucogon, glycogen and counter-regulatory hormones. The end result is a dumping of "sugar" into the bloodstream to save the cat from going hypoglycemic from a perceived low. The action is often referred to as "liver panic" or "panicky liver". *Usually*, a bounce will clear kitty's system within 3 days (6 cycles).


    I know you have said that he is really difficult to test,

    You cannot base an insulin dose on a fructosamine test because of the bouncing, you may get a high fructosamine result which indicates poor control, but it doesn't give you the reason for that poor control. The isuslin dose for lantus needs to be based on the nadir, on how low a particular dose is getting Ricky, the fructosamine test will not give you that.

    Taken from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3440050/

    Serum fructosamine concentrations provide a quantitative indirect assessment of diabetic regulation in both dogs and cats.7,8 The fructosamines are a group of serum proteins, primarily albumin, which have undergone glycation/glycosylation while in the circulation. An elevated fructosamine concentration indicates persistent hyper-glycemia over the previous 2 weeks. There are published target levels for canine and feline diabetics, although alterations in serum protein levels or increased protein turnover can impact the accuracy of this test.9 For example, serum fructosamine concentrations in cats with hyper-thyroidism are often lower than expected due to their catabolic state and may not appropriately reflect glycemic status.10 If stress hyperglycemia prevents accurate BG measurement in a cat, serum fructosamine concentrations can be a useful monitoring tool. A low concentration suggests insulin overdose, probably due to the onset of diabetic remission. Elevated levels in either species indicate poor diabetic regulation but do not indicate the cause. In fact, some patients receiving too much insulin have high fructosamine levels due to the Somogyi effect.
    (lets ignore the fact that they are talking about somogyi, we know that has been disproved, but bouncing gives rise to the same problem making it an unreliable way to determine a good insulin dose)

    As it seems that something has changed with Ricky I would strongly encourage you to over the next week to monitor his BG, you don't need to run curves every day, but amps and pmps and at least one other test in each cycle (maybe more if you catch him dropping like he did today), that would help you and your vet determine a safe dose for Ricky, something the Fructosamine test will not do.
     
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  33. Dyana

    Dyana Well-Known Member

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    Dec 28, 2009
    I have seen many cats go down the dosing ladder after a dental. He may only need half that insulin dose now, or even less. I also want to encourage you to test more often, and to keep posting here.
     
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  34. Noah & me (GA)

    Noah & me (GA) Well-Known Member

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    See! Like I said last night "will see you BOTH tomorrow and the sun will be shining". It's nice having friends isn't it? I know you're not completely in the clear but now you can make up for the lost sleep. Have a good weekend and take good care of yourselves. :bighug: :)
     
  35. Olive & Paula

    Olive & Paula Well-Known Member

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    Sep 6, 2015
    Well definitely earned a reduction for sure. I always have 200+ strips in house and extra battery. Sometimes the strips are bad themselves. So if you get an unusual number, take another test.

    Just the other day, Olive had a 63 amps, no way. Retested and it came out HI, again no way. Waited 10 minutes and got a normal for reading.

    Glad it all worked out for you.
     
  36. Noah & me (GA)

    Noah & me (GA) Well-Known Member

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    I'm happy we even have meters but the amount they can legally be off by is shocking. In Canada meters are free, you just fill out a short form and don't need a doctors note. I had a Bayer meter pushed on me, just an absolute piece of junk that I didn't even want to donate to a shelter.
    This is what people used in the 70's. Nice AC adapter too, what did you do if the power went out?
    meter02.JPG
     
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  37. Bronx's dad

    Bronx's dad Well-Known Member

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    I want one of those!
     
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  38. PamJV

    PamJV Member

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    Feb 2, 2017
    His BG of 40 came about at the 13+ hour. Would that be a sharp drop then. Of course it was abnormally low. My vet just instructed to take the insulin down to 5 units, and then do another curve next week. Right Ricky is hard to test. I find it so hard to get a blood drop. He flicks his ear as soon at the lancet needle gets near. Even when I do think I'm poking often there is no blood and I have to poke many times. So it's not a good experience at all. Yesterday I even tried the foot pad but got no blood with that either.
     
  39. PamJV

    PamJV Member

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    Feb 2, 2017
    His dental was April 13th. Would that still be affecting him? He's also had Convenia injections....one in April and one in May.
     
  40. PamJV

    PamJV Member

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    Thanks so much. If only I could be better at the BG testing !
     
  41. PamJV

    PamJV Member

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    Yes, thanks to all of you so much. Exhausted today !
     
  42. Chris & Lucy

    Chris & Lucy Member

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    Glad and relieved everything turned out well and everyone is OK.

    I've had similar experiences with Lucy when her dose was too high and the insulin would last well over 12 hours. It's always a possibility of a cumulative effect of shooting low numbers that you could be unaware of. The overlap throws off the relatively flat curve of the Lantus and by coming up from such low numbers at shot time and at the peak that a PS number can be surprisingly low. I've skipped low PS numbers just to find that in the 4 hours or so it takes the Lantus to start to take effect on Lucy, she has risen to a shootable number.
     
  43. PamJV

    PamJV Member

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    Feb 2, 2017
    In the US I believe Medicare gives free meters to humans with diabetes. That's all I know. My husband has been sent a couple of them, but only used them a handful of times. He's just borderline and doesn't take insulin.
     
  44. PamJV

    PamJV Member

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    That sounds very possible. My head is spinning. My vet said to go down one unit dropping the dosage to 5 units. He said maybe we could go down to 4 units after a week. Will have to try curves each week to see what is happening.
     
  45. JeffJ

    JeffJ Well-Known Member

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    Jul 7, 2016
    Hi Pam - probably a lot of us watching the thread, there were already enough helpers. Glad to see that you got Ricky through the hypo episode.

    Some cats have late nadirs. Leo is an example. Sometimes his nadir is +8. But often his nadir is AMPS+10 or +12.

    Many of us know the anxiety of a hypo. Leo's last hypo was in February while I was on travel. Both Theresa and I were up on the phone until about 2:30am. But we were prepared, so we were able to avoid the emergency vet trip. Anyhow, I bet you will sleep real good tonight!
     
  46. Tracey&Jones

    Tracey&Jones Well-Known Member

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    Dec 12, 2016
    Glad to see that Ricky is ok after your wild adventures last night.

    Testing is your friend and it may take awhile for Ricky's ears to learn to bleed with consistent testing. What size lancet are you using?
     
  47. PamJV

    PamJV Member

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    Feb 2, 2017
    I just switched to a 33 gauge lancet.
     
  48. PamJV

    PamJV Member

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    Feb 2, 2017
    If the nadir is +12 then how can one give the 2nd dose at night?
     
  49. Tracey&Jones

    Tracey&Jones Well-Known Member

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    Have tried a 28 for a bit...gets you a bigger hole. I started with the 28 and now use the 31 as Jones bleeds pretty good as long as his ears are warm.
     
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  50. PamJV

    PamJV Member

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    Feb 2, 2017
    I was using the lower gauge lancet before but they were not resulting in blood drops. I'd have to poke and poke as mulch as 8 times just to get a tiny bit of blood, I was thinking the 33 gauge might be sharper and poke better. Keep in mind I'm not using a lancet device, I just hole the lancet myself
     
  51. Noah & me (GA)

    Noah & me (GA) Well-Known Member

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    Dec 3, 2016
    I had no luck with 33 lancets like the hole was just not big enough. The 28's or 30's might look like you're pounding a nail in but usually one poke and you're done. I hold a piece of folded over paper towel behind Noah's ear to keep him from flicking it off. Even after years of doing this Noah will sometimes flinch and his ear gets shredded. It happens to all of us.
     
  52. Tracey&Jones

    Tracey&Jones Well-Known Member

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    Dec 12, 2016
    I hand hold the lancets, never used the pen thingy. To start...it takes a few pokes. I did 2 really close together and then stroked his ear to get the blood to bead up.

    A warm ear helps...I always rub Jones' ear before poking to get the blood flowing.
     
    Gill & George likes this.
  53. JeffJ

    JeffJ Well-Known Member

    Joined:
    Jul 7, 2016
    "If the nadir is +12 then how can one give the 2nd dose at night?"

    It makes for a challenging patient indeed. The answer is carefully. With these "mood" swings in Leo's blood sugar, I established a minimum insulin dose of 2.0. He always gets that unless there is a crisis mode of not eating.

    Plus I monitor his intake. If he has eaten well during the day but ends up at PMPS = 200, then I give him 2.5. If his BG goes a bit high while he is sleeping at night, it is better than a hypo. In general, for Leo he gets
    4.0 in the A.M.
    3.0 in the P.M.

    This keeps him safe, yet allows him to retain his energy and weight.
     
    Kris & Teasel likes this.
  54. PamJV

    PamJV Member

    Joined:
    Feb 2, 2017
    I think before I was using 30 ga lancets, and I'd have to poke some times 8 times before getting any blood. I can't say that a hole even occurred most of the time because of the way he'd be flinching so quickly. Sometimes there'd be teeny tiny spec of blood but I couldn't get a blood drop. I have 3 different lancets of different colors, can't tell what the gauges are. I can only see that the dark blue ones are 30 ga. I have light blue, and a teal.

    Over all it's unpleasant. I have to pick him up and put him on my counter so I can see what I'm doing and that of course makes him tense because he knows he'll get poked a bunch of times. If I was able to make it a quick one poke he'd probably tolerate it better.
     
  55. PamJV

    PamJV Member

    Joined:
    Feb 2, 2017
    I never have luck stroking his ear to get the blood to come out. I wonder if the fact that he's on a blood pressure med affects his blood flow slowing it down making it harder to get a blood drop.
     
    Tracey&Jones likes this.
  56. Idjit's mom

    Idjit's mom Well-Known Member

    Joined:
    Apr 3, 2018
    We have to warm Idjit's ear with a rice sock. I draw it over his head, under his chin, as well as warm both ears. Takes a bit longer, but he likes it. He even has started to purr a few times. I think it got easier when I started to relax, then he could relax. Just takes time. Be patient with yourself. :bighug:
     
    Kris & Teasel likes this.
  57. PamJV

    PamJV Member

    Joined:
    Feb 2, 2017
    That sounds very smart. I don't think Ricky is eating well lately. My difficulty with testing makes it hard to study what is going on well enough to figure out a good plan. I'm going to test him tonight and see if he's dropped again. Today I gave 5 units per my vet's suggestion. But that's still a high dose. He's a big cat but he hasn't been eating well, so it could be another low one tonight. My vet said dropping to 5 units should be maintained for a week before any change to a lower dose. But if his BG is quite low again then I think we might need to try going down to 4.0 or even 3.0 Just wish he'd eat.
     
  58. PamJV

    PamJV Member

    Joined:
    Feb 2, 2017
    I will try that
     
  59. Idjit's mom

    Idjit's mom Well-Known Member

    Joined:
    Apr 3, 2018
    Also, he gets a treat every time we poke, successful or not. Freeze dried chicken treats, cooked chicken bites. He usually gets to have his meal after a test also. He's food motivated, so it works.
     
  60. PamJV

    PamJV Member

    Joined:
    Feb 2, 2017
    Tonight I used a light blue lancet that came with the Alpha Track. The bag is not marked as to the gauge but it looked bigger than what I was using before. I got a blood drop on the first poke, so that was a shock ! Maybe the larger is better as you say. Many of the ones I have aren't marked for size. Tonight PS was 355. So that's not so scary. Still don't notice him eating.
     
    Tracey&Jones likes this.
  61. PamJV

    PamJV Member

    Joined:
    Feb 2, 2017
    Ricky isn't food motivated, and he doesn't like any treat. Also he's free feeding and only eats dry food. Usually he always ate around the time of the shot any way, but currently he seems off his food. Seems like it's not appealing
     
  62. Noah & me (GA)

    Noah & me (GA) Well-Known Member

    Joined:
    Dec 3, 2016
    Are there other cats or dogs in the house that could be eating his food. We have six and Noah is really private about eating. Some people here have baby scales, a good investment if you think you're going to have cats around your feet for the next 40 years.
    Eventually Ricky is going to have to start eating a diet of some wet food. I've had a lot of cats that just would not do it and we cheat a bit because we leave kibble out. Keep trying.
     
    Kris & Teasel likes this.
  63. PamJV

    PamJV Member

    Joined:
    Feb 2, 2017
    I did a PS test and the 28 gauge lancet did work better. So you are right about that. His reading was 350. So I will keep the 5 unit dose and try a glucose curve again next week.
    I leave the free feeding RC Glycobalance dry food out for Ricky on a coffee table where the dog can't get to it. I have 5 cats in total so any of the cats could eat the same food I leave out for Ricky. Right now I'm just trying to get him stable on the right dose so he can get back in the groove of feeling good. I don't think Ricky would ever eat wet food, even as a 6 wk old kitten he refused. He's very picky. I tried to get him to like YAZ or Epigen but he doesn't like those. All vets say the most important thing for a diabetic is to eat. It's better to eat something, no matter what it is than to eat nothing.

    This morning Ricky looked more upbeat and alert. All the Glycobalance dry food was gone from the bowl. I assume Ricky ate his portion. He was asking for more food this morning. Will see how it goes.
     
    Last edited: May 19, 2018
    Reason for edit: update
  64. Noah & me (GA)

    Noah & me (GA) Well-Known Member

    Joined:
    Dec 3, 2016
    I really did not ever want to see a can of Fancy Feast in our house, ever! I thought it was pig slop but it gets Noah to eat and he needs to eat wet food. Our cats are all nuts anyways. They don't want fresh salmon, tuna, sardines etc. They just want a Big Mac everyday.
    If you're interested in a scale ask about it in Feline Health. Weight loss can be a scary issue but it might not always be what you thought it was. Life is a mystery.
     
  65. PamJV

    PamJV Member

    Joined:
    Feb 2, 2017
    I already have a baby scale. Have had that to keep check on my chubby Yorkie ! Most of my cats are older and it has become a struggle just to find foods they will eat. All but Ricky eat wet food, but I give them what ever works. Ricky's weight looks good right now.
     
  66. Noah & me (GA)

    Noah & me (GA) Well-Known Member

    Joined:
    Dec 3, 2016
    All you need now is a baby!
    boohoo_08.jpg I read somewhere they poop a lot and need special food. No thanks.:(
     
  67. Noah & me (GA)

    Noah & me (GA) Well-Known Member

    Joined:
    Dec 3, 2016
    Wanted to thank you for that Chris. I mumbled something Thursday night about activity but did not suggest playing. Nonetheless that line should be a part of the Hypo protocol. I had also suggested not letting him fall into a deep sleep but that's from my neurological knowledge. Do you think that's a good idea? It applies to humans after concussions.
     
  68. PamJV

    PamJV Member

    Joined:
    Feb 2, 2017
    My chubby Yorkie is demanding enough !
     

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