Don't Know if I Need to be Concerned

We just did Victor's mid-cycle test and the message " Hi " came up on the display, which in the manual for the meter says it means the blood glucose level is more than 600 and to repeat the test with a new strip, which we did, and the result was 376. So does that mean we can disregard that initial message?

 

Sounds like it may have been a bad strip and you can probably disregard that message, but I would test again in about 30 minutes or so with another strip just to be certain. Hopefully it's not an issue with the meter bugging out!

 

I will do that, thanks.

I hope not too, we definitely don't need that.

 

So we retested a half hour after the second test and the result is 530 now. I don't know if maybe the second reading of 376 was faulty or if this one is or exactly what is going on, but I'm worried, so could I please get some responses about what we should do, if anything?

 

@H.M. Victor if it were me I would do one more test to see what you get. If its another really high number like in the 500s then I would go with that one vs the 376 that you got. If its been at least 20 minutes since you got the 530, then test again now and see what you get.

 

Okay, will test again and post back here.

 

Just tested again and the reading is 382.

 

@H.M. Victor well that's not making things easy, lol. Two higher numbers and two 300 numbers. I guess your PMPS will give you an idea of which one was the right one?

 

No, it's not making things easy. And just when I thought I was getting less stressed.

 

I think I'd raise it to 2.5 tomorrow. Doesn't matter which is right. They are both too high.

 

I agree with Janet. You need to increase the dose tomorrow. We normally recommend increases of 0.25 u but Victor's numbers are high enough that a 0.5 u increase will be fine. You can go to smaller increases once you're seeing lots of yellow and some blue on his SS.

 

So that would be 2 and a half units then? Which would be between the second and third line on the syringe? (The syringes we use don't have half-unit measurements on them)

Sorry if these are newb-type questions, but since we've never dealt with dosages other than 2 or 1 units, I just want to be sure I get it right.

 

You're using U100 syringes because Humulin is a U100 insulin. You can buy these syringes with half unit marks. For now, though, if yours only have full unit marks, 2.5 u would be half way between the 3rd and 4th marks. The first mark nearest the needle is zero, the second is one unit and so on.

Never feel shy about asking questions like this. Always better safe than sorry!

 

I agree with Janet, it doesn't affect your dosing decision which reading was correct. However, I understand it could be disconcerting and feels like just one unnecessary variable!

I'd suggest calling the number for ReliOn support (look in the manual for your meter) to see if they can send you some "control solution". It is just a red liquid of a known sugar content. You will put a drop on a strip and the control solution bottle itself will tell you the range in which it should read. They are only good for a few months after opening, but if this were to happen again, you could test your meter against the control. And of course test one once the solution arrives just to validate your meter. But that won't prevent you from getting a wonky strip once in a while.

Btw, I've heard that you shouldn't tell ReliOn that you use the meter for your cat. Tell them it is for your "10 year old brother, Victor". That's basically not a lie, right?

 

Could you possibly post a picture showing exactly where that is, just so I have it for reference?

 

I found this elsewhere on FDMB:

 

So it would be where I have it highlighted yellow, right? Between 2 and 3 units?

 

Yes, that’s correct. Your syringes are like the right hand diagram though - no half unit marks.

 

I know, I only highlighted the one on the left because it shows the 2.5 marking, and it would be in the same place on the right hand diagram, between the 2 and 3 units.

We just did Victor's PMPS test and his number is 489, so...I guess all it comes down to is making sure to increase his dose tomorrow.

And just one other question, my mom accidentally pricked her thumb with the same lancet we had used on Victor, should we be concerned about that?

 

No, plenty of us have nicked ourselves after sticking the cat (with either the Lancet or syringe). Wash the finger good and just keep an eye on it, but I wouldnt be concerned.

 

OK. Thanks

 

She may have a sudden craving for raw tuna and may think that curling up on the floor in a sunny spot is a fantastic idea, but she'll be fine

 

Feeling pretty stressed/worried right now, with the results we were getting during Victor's mid-cycle test, and now he hasn't eaten much of his PM meal, so I don't think we can give him his shot tonight, but this made me smile, thanks.

 

Why are you worried? He's too high....he needs his insulin (and I agree on the increase too)

He has a LONG way to fall before you need to be even slightly concerned

 

How much of his food should he have eaten for us to be able to give him his shot? Because he barely ate half of it.

 

With him running in the 400's, I'd go ahead and give his scheduled dose.

You can continue to urge him to eat too. It's actually better for our sugarcats to have frequent smaller meals anyway

As long as you have the ability to test and enough supplies (strips, high carb gravy food, Karo/honey/syrup) you're almost always going to be able to handle anything that happens

 

So we should go ahead and give him the 2 units? And it would be okay to let him eat some more afterwards? You don't think his numbers would go low enough to be dangerous? We do have Karo syrup, but don't have any gravy food, just his dry food.

 

Yes, I think that's a good idea

Also, the next time you get out, pick up some canned high carb food like Fancy Feast Gravy Lovers to have around just in case.

Dry food works, but it takes longer to break down and get into the bloodstream and then takes longer to work it's way back out. Using just the "gravy" part of canned food is a faster and better way to get their blood glucose numbers up IF they need it

 

It's been over a half hour since he ate what he did of his food, so is that still within the time frame that it would be okay to give his shot? And we can let him eat some more afterwards? You don't think his numbers would go low enough to be dangerous?
And it would be better to give him the 2 units rather than just 1 unit?

 

Sorry....lost my internet connection (living in the middle of nowhere, it happens)

I would have gone ahead with the 2U dose, but if it's been an hour, I wouldn't shoot again.

 

@H.M. Victor I agree he is still in the high enough range of numbers to give him his full dose of insulin. Have you tried putting some canned Tuna on top of his food as a topper? Usually the cats go wild for this. You can buy just regular tuna in water, the kind us humans eat and sprinkle some pieces all over the top of his wet food. You can even pour a little juice in it. When you open the can let him smell it first, then add it to his food. Tuna is super cheap to buy and it usually helps a ton.

 

Just make sure the tuna "water" hasn't been flavored with garlic and/or onion. I was stunned to find out they do that! Now I look at the label before I buy tuna, because my guys always get the tuna water!

 

As long as my cat eats even a few bites I shoot.... She's a grazer and usually only eats about an ounce at a time over the course of a few hours. You don't want to leave her in the 300's-400's with no insulin.

I think you should do 2.5 this morning

 

I pricked my thumb with Oreo's lancet yesterday. Went ahead and checked my own blood sugar while checking hers .

 

I agree with Janet about the 2.5 u dose this AM.

 

Lol I've done that.

 

OK guys, will increase Victor's dose to 2.5 this morning.

He threw up again this morning, so I guess it would be the same as yesterday? As long as he eats his usual meal he still gets his shot?

 

Yes, that's correct. Is he a kitty that vomits often? I believe you said that his usual routine was to be fed his daily ration in two meals a day. Splitting that into several smaller meals can help the vomiting issue so I'd give that a try.

 

Crossing fingers you see a blue today

 

Why are there blanks for the units every other evening? Are you not shooting twice a day? He really needs two shots every day.

 

Not always often. This morning it looked more like a hairball, which he does get more often. We could try your suggestion about splitting into several smaller meals if you think it might be better.

 

I'd certainly try splitting his ration into smaller meals. If he's a kitty who loves his grub he'll be happier, it can help to stabilize blood glucose and it might reduce the vomiting. There's no down side. Just be sure to remove all food at least two hours before a pre shot test so you see a non food influenced number.

 

In the SS notes, Victor's owner said PM shot wasn't given because he didn't eat enough.

 

I would love to see a blue.

We're not always sure if he's eaten enough of his food to give his shot, or at least from what the vet told us. The instructions they gave us were this:

If he eats
1/4 food = 1/4 insulin
1/2 food = 1/2 insulin
3/4 food = 3/4 insulin
all food = all insulin

We've never been sure what that translates to in units though, especially since the syringes we have right now don't have half unit markings.

 

How much of his ration do you think we should give him at each smaller meal? Our vet told us to give him half a cup morning and night. How many meals should we split it into, and when should they be given to him?

 

I believe what your vet means is that if the dose is 2 u (for example) you give 1/4 x 2 u = 0.5 u OR 1/2 x 2 u = 1 u OR 3/4 x 2 u = 1.5 u if he eats those fractions of his food. You'd have to eyeball the 0.5 u and 1.5 u on your syringes.

 

Is it dry food? I ask because you mention "half a cup". I'd try 4 meals with the larger two being breakfast and supper and the smaller being lunch and before bed. This doesn't have to be measured exactly. Is he a grazer or will he eat it all in one go?

Yes, I know I'm a broken record. I strongly encourage you to switch him to Friskies or Fancy Feast pates ASAP. The Prescription W/D is expensive and far too high in carbs. I'm sure you'd see a significant positive effect on Victor's BGs with a switch to low carb wet food.

 

Yes, it is dry food. And he is definitely more of a grazer, he doesn't eat it all in one go but will usually eat all of it within an hour so, and he does like to eat at random times throughout the day. Should we start the smaller meals this morning as well?

Believe me, I have a broken record in my head about getting him switched to wet food. I guess we would keep the 4 meal routine with the wet food too? How would we ration out the wet food when we do get it?

 

You want to phase in the wet food gradually to avoid tummy upset. Does Victor ever eat wet food? Does he like it? Kitties are often "addicted" to kibble but can make the switch over time if the owner is committed to the process.

Here's what I'd try if it was my kitty:

• buy a couple of cans of Friskies pates (avoid the green lidded "indoor" variety - too high carb) if that's what will fit your budget
• measure out Victor's usual daily half cup of kibble and remove maybe a quarter of it
• at each meal give some of the kibble but add in a teaspoon or so of the wet food
• keep that mixture going for a couple of days
• maybe on day 3 remove a slightly larger portion of kibble from the daily ration and increase the amount of wet to two teaspoons
• feed that mixture for about two days
• continue this day by day, gradually reducing the kibble and increasing the wet until he's eating only the wet food
• the slower this transition, the better.

He might or might not cooperate. Here's a great article with tips to help you: https://catinfo.org/docs/TipsForTransitioning1-14-11.pdf

 

He has eaten wet food before (a different prescription brand from our vet) and he did like it, so I don't think we'd have much of a problem with trying to transition him.

I edited a couple of extra questions into my last reply, if you could take a look at it again.

 

I'm glad he's willing to eat wet food. It'll help you a lot. It'll take some experimenting over time to learn what the proper amount of wet food is for Victor but I'd start with the goal of one 5.5 oz. can of Friskies pate per day - after the switch is complete of course. The proper amount is what allows a very slow weight loss over many, many months and then then maintains him at a good weight for his size. Teasel's brother is a big boy and one can of low carb wet food a day works for him. That's where weighing the kitty comes in. I gave you a link yesterday to a pretty economical digital baby scale on Amazon. That would be ideal if you can possibly afford it. If not, try holding him with you on a human scale or maybe you might find a used baby scale online.

Let's say you're going to give him one can of wet food a day. If you'll be feeding in distinct meals, try 4 times a day as I described above with breakfast and supper being about 1/3 can and lunch/bedtime 1/6 can. You might have to fiddle with this plan over time to suit Victor and/or your schedule but it's a starting point. Some people leave wet food out for kitty to graze on but pick it up for the two hours prior to the pre shot BG test.

 

Okay, I'll be sure to make a note of this.

And just so I'm absolutely clear about the 2.5 dose, since the syringes we have don't have half unit markings, 2.5 would be where I've highlighted yellow on this diagram, between the 2 and 3 units, correct?

 

Yes, that's correct.

I'm going out now for several hours. If you have other questions, post them on this forum and someone will be able to help.

 

Alright Again, thank you so much for all the time you've spent answering my questions and all the advice you've given. I can't even tell you how grateful I am for it.

 

@H.M. Victor you really really really should start getting Victor off that prescription hard food. I can't express that enough. First of all the hard good alone is going to cause his numbers to be high. They say no cats should eat hard food, but especially diabetic cats. I know it's scary at first but trust me it is going to make a world of difference. My boy was on Hills Prescription C/D hard food and wet. When I finally made that change to friskies and fancy feast I finally started to notice a difference. Your also going to save money by switching. The prescription food is so expensive. Another thing you have mentioned quite a few times about Victor throwing up. Guess what? I will put money on it that its the prescription hard food causing it. I say this because my boy was one that threw up a lot. I just thought it was apart of him, never thought any differently. Well after we got him off the hard food he never threw up. My husband and I even said it's so crazy that he hasn't thrown up in so long. So fast forward a couple weeks in we got our first scary low number where we needed to introduce a little high carb wet food. So I put a little wet food down and I put 6 pieces (6 PIECES) of his prescription hard food on top to help his numbers come up, guess what? He threw up that night. ITS THE HARD FOOD CAUSING IT!!! I seriously can't believe all that time a never knew it was because of it. Seriously go get some friskies pate and start him on it. You can look at my notes on my spreadsheet of how I slowly introduced the new wet with his old hard. It was the best decision.

 

I know, believe me, I'm not putting it off on purpose, it's just that pretty much all of our money that my mom gets at the beginning of every month (which honestly isn't much to begin with) goes to rent, other bills, and non-food items from the store (we are on food stamps), which leaves next to nothing for the rest of the month.

I promise I will see what I can do to start the switch to wet food ASAP.

 

Good data gathering today!!

Looks like he's on the way back up again (which is one of the bad things about Humulin ...it just doesn't last long enough)

I'd plan on shooting the 2.5 again at PMPS unless he does something really weird

 

Yeah, makes me wonder why our vet put him on it to start with. Just did the PMPS test about 20 minutes ago and his number is 398, so I assume we should go ahead with the 2.5 units?

 

Yes. Stick with the 2.5u.

 

Yes from me too

 

Okay. So if he doesn't eat all of his food, should we still give him the 2.5 units and then see if he will eat some more afterwards? That's always where it makes me really nervous because I want to be sure he has enough food in him before giving his shot.

 

Yes....as long as he seems "willing" to eat (not sick and refusing food completely)

 

Alright. He very rarely actually refuses food. He just tends to eat less of his meal at night than he does in the morning.

 

As long as he takes even a few bites, yes. We want that number down as he is still far too high even at his lowest.

 

Just wanted to let you know that I showed this to my mom and it gave her a good laugh. She wants to print it out and hang it up on our pinboard

 

I recommend increasing to 3 u tonight. He still has a lot of room to drop. If that makes you nervous, eyeball 2.75 u the best you can but only hold that dose 3 cycles or so if you don't see blue on your SS.

 

I would skip 2.75 and go right to 3.

 

@Kris & Teasel @JanetNJ Victor's AMPS number this morning was 388 and we just did a +4 hour test and it's barely gone down at all at 332. I don't know if it's just that the dose needs to be increased or if we're not giving the injection right or if there's a problem with the meter or what. You guys think that increasing to 3 units would still be safe for him?

 

I wouldn't worry about it. I agree that going to 3 u is the better option. You won't see a consistent decent BG drop until you're closer to his "good dose" range.

 

And we don't need to change how much food we give him, do we?

 

No, you don't. When you're able to make the switch to low carb wet food, more vigilance will be needed. That's because your current dosing is based on his BGs eating the high carb prescription food.

 

I know this was a while ago but we're going to try your suggestion of topping his food with tuna since he still doesn't eat much of his nighttime meal, but I was wondering if it would be okay if we mix it in with his food instead of just putting it on top? He might just eat the tuna from the top and ignore the rest.

 

Yes, it's fine but you don't want to feed too much plain tuna either. It can be "addictive" to a lot of cats and it's not a complete meal