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Dosing - Should I delay shot tonight?

Discussion in 'Feline Health - (The Main Forum)' started by whiskysmom, Nov 9, 2019 at 9:29 PM.

  1. whiskysmom

    whiskysmom Member

    Joined:
    Oct 21, 2019
    Hi there,

    We've just started testing Whisky at home a few days ago. Now that it's the weekend we're trying to get some mid-day readings too. He's on 1.5 U Prozinc twice/day and Purina DM food.

    When I tested him at AM +4 he was 13.9 (250) and then at AM +7 he was 15 (270) and now at PMPS he is 10.4 (187). Spreadsheet is up to date. I'm curious why he would've dropped lower this long after his AM dose, and if I should still shoot as usual this evening?

    Any advice is greatly appreciated. We're fairly new to diabetes (late-Sept) and really new to home testing.

    Thanks!
     
    Last edited: Nov 9, 2019 at 9:35 PM
  2. MrWorfMen's Mom

    MrWorfMen's Mom Well-Known Member

    Joined:
    Feb 18, 2015
    Since he has dropped so late in the cycle, if you haven't fed him, I'd stall, don't feed him and check again in 30 minutes to see if his BG is rising on its own.
     
  3. whiskysmom

    whiskysmom Member

    Joined:
    Oct 21, 2019
    Thanks! I've already started feeding him unfortunately. Since we're so new to testing we're trying to teach him that test = dinner so once the test was done I put his food bowl down as I didn't realize the number was possibly too low.
     
  4. MrWorfMen's Mom

    MrWorfMen's Mom Well-Known Member

    Joined:
    Feb 18, 2015
    :)If he just finished eating, retest him now if he will co-operate.
    I know it's early days for you and testing may still be a bit of a hit or miss proposition.
     
    whiskysmom likes this.
  5. MrWorfMen's Mom

    MrWorfMen's Mom Well-Known Member

    Joined:
    Feb 18, 2015
    Do try to get a test before EVERY shot to ensure Whisky's BG is high enough to safely give insulin. Also make it a habit to try to get some night tests. Making it a habit to at minimum get a test before bed every night, will help fill in the picture of how Whisky is doing. A lot if not most cats drop lower at night than they do during the day so it's important to get some night data in order to see how low the dose of insulin is dropping BG.

    Does Whisky have any history of ketones or DKA?
     
  6. whiskysmom

    whiskysmom Member

    Joined:
    Oct 21, 2019
    Ok I will give it a shot! I feel bad for his ears since testing is new and we've poked him so much in the past couple of days (sometimes it takes an extra poke to get him right now) but we will give it a try. If we aren't successful, should we give him a reduced dose or possibly skip? It's weird since his numbers were higher earlier on in the cycle.

    Yes - Whisky did have ketones in September which led to his diagnosis. We believe he had DKA and Pancreatitis. We've been testing his urine regularly and no evidence of ketones.
     
  7. MrWorfMen's Mom

    MrWorfMen's Mom Well-Known Member

    Joined:
    Feb 18, 2015
    Those higher numbers could have been from what we call a bounce. A bounce occurs when BG drops and lot, drops quickly or drops to levels kitty now thinks are too low due to the elevated BG from the diabetes. They are a normal but frustrating part of this that we have no control over. Since you have just started testing, it's possible Whisky has been in lower numbers in the past few days and that lower BG tonight is a bounce clearing.

    If BG is up a bit (food shouldn't have clicked in too much yet), then you are probably safe to shoot. If BG is still about the same, and there is no history of ketones or DKA, then you could reduce to 1u for tonight just to be safe.
     
  8. whiskysmom

    whiskysmom Member

    Joined:
    Oct 21, 2019
    Thanks so much! We're up to 12.8 now (230) so I think we'll shoot and keep a close eye on him tonight.

    I really appreciate your speedy help and advice!
     
    MrWorfMen's Mom likes this.
  9. MrWorfMen's Mom

    MrWorfMen's Mom Well-Known Member

    Joined:
    Feb 18, 2015
    You're quite welcome. Leave a little food out for Whisky overnight because there may be a little food influence in that 2nd test. That way if he is dropping lower at night, he has something to munch on to boost his BG and keep him safe.
     
    whiskysmom likes this.
  10. whiskysmom

    whiskysmom Member

    Joined:
    Oct 21, 2019
    For sure will leave some food out for him tonight. He also has us well trained to get up around 3-4am to give him a snack of his wet food (oy!) so I'll be able to check on him then too. Thanks so much!
     
    MrWorfMen's Mom likes this.
  11. whiskysmom

    whiskysmom Member

    Joined:
    Oct 21, 2019
    @MrWorfMen's Mom - Whisky did well overnight! He woke me up for his nighttime snack at 2:30am and all signs seemed good.

    For his AMPS this morning he was up to 18.7 (337), I'm thinking likely because I reduced his shot last night to 1.25U. But we're back to 1.5U this morning so I'm sure he will come back down. I just didn't want to risk a hypo, especially overnight.

    We're getting the hang of testing, but right now it's still a team effort. I hold Whisky and distract him with a treat while my husband does the poke and encourages the droplet to form. Then I get the strip fully inserted and soak up the blood. I'm hopeful that I'll be able to do it solo at some point. Whisky is a REALLY good kitty and pretty cooperative - he just doesn't like his ears touched so he tries to escape. We poked him about 6 times yesterday to get 4 tests during the daytime cycle, and then we tested pre-shot this morning. So I think we're going to give his ears a break and just do the pre-shot test, and maybe one mid-cycle if we can. I will try to keep doing the ketone urine tests though, especially since he was higher this morning.

    Someone in another thread mentioned that they sometimes notice that the FreeStyle Lite meter will sometimes read low if the blood droplet is small, even though it beeps that it collected enough blood. She said she sometimes tests twice in a row and it will read higher with a larger blood sample. I'm wondering if that may have been a culprit last night for us too as the lower reading was definitely a very small drop and the higher reading a bit later was definitely a larger drop. I'll keep an eye on it and try to get a decent drop moving forward. And it could also be the bouncing like you mentioned. I guess we'll know more as we get more test results :)

    Thanks again for your help last night!
     
  12. MrWorfMen's Mom

    MrWorfMen's Mom Well-Known Member

    Joined:
    Feb 18, 2015
    Stephanie, I used the Freestyle Lite and FS Freedom Lite meters as well as a pet meter. While I did have the odd occasion where I know the FS meter was reading low (usually in very low potentially dangerous range) I didn't generally have any issues with the meter. The size of blood drop needed is tiny and really shouldn't matter because the meter won't beep or start to read unless there is sufficient blood. That said, the meter was designed to read human blood and it's quite possible that because of the different composition of cat blood, that the sample size could have an effect on results but that could effect any human meter. A number of human meters require a larger sample of blood to test so until you get Whisky more used to testing you'll probably be happier with the FS than some of the alternatives. Just something to keep in mind. And keep playing with his ears as much as possible every time you give him a pet or cuddle so he gets used to having his ears handled.

    It's always a good idea to have a back up meter so if you are concerned, try out another meter and then decide which you prefer. The important thing is to pick a meter and stick with it because no two human meters are always going to read the same. They all have their idiosyncrasies and all meters in Canada have a 15% variance allowance meaning could conceivably be 15% higher or lower than the display.

    I think the important thing to remember here is that high is high no matter what meter you are using and even in low range, I personally prefer a meter that is reading low to one that reads high so I can take action in plenty of time to avoid any seriously low readings. If you get a reading that seems odd, it's always a good idea to retest. It may be a bad strip or insufficient blood or whatever.

    One thing I did note with the FS is that when the battery was running down but before I got any notification, I got some weird readings. You never know how long a meter has been sitting on the shelf in the store so never hurts to change out the battery if you think your readings are off in some way.

    As for last night, I'd take the meter readings at face value and act accordingly. You did just fine.
     
    whiskysmom likes this.
  13. whiskysmom

    whiskysmom Member

    Joined:
    Oct 21, 2019
    Thanks @MrWorfMen's Mom - that makes a lot of sense. I guess consistency is key no matter which meter we choose. I really do like that the FreeStyle Lite only uses a tiny amount of blood, and that makes sense about being better if the reading is a bit low than a bit high.

    We're giving Whisky ear rubs often and trying to get him used to them being touched. He's been pretty darn good on all accounts. If it was our other cat Brutus, I think we'd be in for some hissing and grumpy behaviour but Whisky tolerates us pretty well. He's a gentle giant. I think he actually enjoys his shot time now because he gets a ton of cuddles and a treat. So hopefully we'll get him there with the testing as well!

    So nice having support and experience from others who have been there! Thanks
     
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  14. whiskysmom

    whiskysmom Member

    Joined:
    Oct 21, 2019
    Whisky is back in the blue PMPS tonight. 10.3 (185). We couldn't stall, so we fed and did the shot as usual with 1.5 units, but we will test him again at +3 and ensure he has access to food overnight. And I know he'll wake me up (by way of intense purring and licking my arms...) for his 3am snack, haha :facepalm:

    I'm curious if he's just a bouncy kitty right now. Or maybe if we're not administering the shots consistently. Or maybe his pancreas is inconsistently producing some insulin. Or if the batteries need changing. Who knows?! But we'll keep testing and see if any patterns become clear over the next little while. We have a vet check up on Friday so I'll take the spreadsheet in with me too. I'm also really hopeful we can figure out his nadir and ensure it's not going too low.

    It's a bit tough because I want to know the facts, but right now we can only make observations and educated guesses. I know more answers will become clear with time. I might have a touch of impatience! :smuggrin:
     
  15. Red & Rover (GA)

    Red & Rover (GA) Well-Known Member

    Joined:
    May 18, 2016
    While FD is a steep learning curve, the treatment of is a marathon, not a sprint. The picture will become clearer as you get more tests in.
     
    whiskysmom likes this.
  16. whiskysmom

    whiskysmom Member

    Joined:
    Oct 21, 2019
    Great metaphor for me to keep in mind - thank you!
     

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