First BG test at home

She had a shot yesterday about noon at the vet. 2 units. Her BG before the shot was 421. Just got back from picking up her insulin (Lantus) and test strips. She didn't like the test, but tolerated. Her BG was 232. Since I was late getting it picked up, my plan is to do a shot at noon today. Then start with the every 12 hours tomorrow. My question is at 232, does 2 units seem like too much?

 

2 units may be a little high, especially if she is a small cat.
The starting dose for Lantus is calculated as follows:
What is her ideal weight?
What is her current weight?
Take the lower weight.
Convert to kilos, if in pounds (pounds/2.2)
Multiply by 0.25
Round down to the nearest 0.25 (we eyeball 0.25 and 0.75 increments on the syringes)

If you're going to be home to monitor and test, you could give 2 units. Or do the math above and get what a starting dose should be.
Or be conservative and give 0.5-1.0 units.
You hold the syringe.

Stress from the vet's office may raise the glucose 100-180 mg/dL.
Food changes may lower the glucose 100-200 mg/dL and lower the insulin dose 1-2 units.

 

If you shoot at noon today, are you going to be able to shoot at midnight/noon going forward? If not, it's probably better for you to wait until this evening and choose a time that will work for you to be able to shoot every 12 hours

2 units is a pretty high starting dose....most cats are started at .5 to 1 unit, based on their weight and held for 5-7 days while testing to see how they do, then adjustments in dose are made in .25U increments

 

Thanks everyone. I may have gone about it the wrong way, but I did give her the shot. Closer to 1.5 just to be conservative. I figured since it had been 24 hours since the dose yesterday, better to get something in her rather than wait another 7 hours. Then in the morning, I will start with the 7 am/7 pm. Will try to test her again in an hour or so and see where we are at.

 

Currently she weighs 12.4. The vet said he would like to keep her at this weight. Last year, she about 16 pounds. So by my calculations, 1.4 units is what I came up with.

 

2 hours post shot, 207. She was much more accepting of the test this time.

 

Hello again!! We'd love to know your name and your "extra sweet" kitty too!

Yes, 1.4 would be a starting dose, but we usually start them a little lower than the "recommended" since we don't know anything about how they're going to react

It'll really help if you get our spreadsheet started so as you get tests in, you can enter them. The spreadsheet is every bit as valuable a tool as a low carb canned diet and a good insulin. Here are Instructions on How to create the spreadsheet

It's important to always test before each shot so you know if they're high enough to shoot at all. When first starting, we suggest an "ask for help before shooting' limit of 200. That means if you get a pre-shot under 200, you "stall", don't feed and post asking for help. Make sure your subject line says something like "Stalling, need help!!" so the people that scan the board know you're looking for help

As you get more tests in, that limit will come down......with enough data, most of us will shoot anything above 50

On the AM cycle, we'd like to see a test somewhere between +5 and +7 (5 to 7 hours after the morning shot)....that's usually in the neighborhood of when Lantus nadir's (the lowest point in the cycle is the "nadir"). Lantus is dosed based on how low it takes them, so that's important to catch. Of course any other tests you can get are welcome too! There's no such thing as too much data!

On the PM cycle, after the Pre-shot test, it's important to at least get a "before bed" test in to make sure they're going to be safe overnight or to decide if you might want to set an alarm to get up to get another test later. Most cats go lower at night

Here's some tips on ear testing:

It can be really helpful to establish a routine with testing. Pick one spot that you want your "testing spot" to be (I like the kitchen counter because it's got good light and it's at a good height....it also already blocked 2 escape routes due to the wall and the backsplash) It can be anywhere though...a rug on the floor, a table, a particular spot on the couch...wherever is good for you. Take him there as many times a day as you can and just give his ears a quick rub and then he gets a yummy (low carb) treat. Most cats aren't objecting so much with the poking..it's the fooling with their ears they don't like, but once they're desensitized to it and learn to associate a certain place with the treats, they usually start to come when they're called! Or even when they hear us opening the test kit!

You also have to remember...you're not poking him to hurt him...you're testing him to keep him safe and understand what's going on inside his body. There's just nothing better than truly understanding what's going on inside your kitty's body and with this disease, the more knowledge you have, the more power you have against it. The edges of the ears have very few pain receptors, so it really doesn't hurt them. Also, if you're nervous and tense, it's going to make your kitty nervous and tense too. As silly as it might seem, try singing! It forces you to use a different part of your brain!

It's also important to make sure his ear is warm. A small sock filled with a little rice and microwaved or a small pill bottle filled with warm water (check temp against your wrist like you would a baby bottle) works well

Keep asking questions!! The people here are great about helping out!

 

Thank you so much for all the information. My name is Rhonda, and my kitty is Shiloh. She is a 14 year old tortie bob-tail. She was definitely more receptive of the second test. She was already in my lap, as I was brushing her. The first test, I was on the floor and my two dogs were crowding around to see what I was doing.

I so worry that I am doing something wrong, or not enough, or too much!

The mid day test will be an issue. I'm an attorney and can't always make it home for lunch, and my husband works 30 miles from the house.

 

Nice to "meet" you Rhonda....and extra sweet Shiloh too! (What a pretty name!!)

Can you adjust your shooting schedule so you can get a +2 in the morning and still be home in time to shoot 12 hours after the morning shot? That +2 is what I call my "crystal ball" test since we've seen that a lot of times, it can give us early warning that our kitty might be making a move that cycle and we can make arrangements to keep them safe. Do you have a neighbor or friend who might be able to test when you can't?

The other thing that you might want to consider is an auto feeder. The PetSafe 5 is a favorite around here, and that way you can set it to open and offer her food later in the cycle

Here's what the +2 "rules" are:

If the +2 is about the same as the Pre-shot, then usually it's going to be a fairly normal Lantus cycle....where the number gradually goes down until nadir and then gradually goes up
If the +2 is higher than the Pre-shot, that usually means they're starting to "bounce" and those cycles are when you can usually get by with less tests (and less worry!)
If the +2 is lower than the Pre-shot, that's your early warning that she might be going low on that cycle, and you can do what you need to do to keep her safe..whether that's come home at lunch, or leave some higher carb food down for her ....depends on the situation that day

If you'd go ahead and fill in some information in your signature line it'll help....and will keep us from asking the same questions over and over again too. Just click on your name on the top right and choose "Signature". A new page will come up with the Signature Box and you can put information like your name/kitty's name, diagnosis date, type of insulin, type of meter, etc....and when you get your spreadsheet going, the link to that would go there too.

Also, since you haven't said yet, what food are you feeding Shiloh?

 

I'm trying to figure out how I can adjust my schedule. Since I just received the diagnosis yesterday, it's all very overwhelming.

As of now, she is eating Blue Buffalo Indoor Healthy Living. But after some of what I read here, I am switching both her and my boy to Evo.

 

If they'll eat wet, you'll help make them healthier to get them off of dry altogether. Cats get the majority of their water from prey (which is close to 80% water) Dry food just can't get them the water they need, no matter how much they drink on top of it.

With diabetes already involved, you want to get as much water into them as possible to help protect their kidneys.

Have you see the information at CatInfo.org? They also have a Food Chart that shows the carb percentage for most any food sold in the US. You want to get something under 10% carbs. Most of us feed Friskies pate's or Fancy Feast Classics, but there are lots of choices

We totally understand "overwhelming!" 2 years ago (on this date matter of fact) I joined the FDMB....it's been a crazy learning experience, but I'd do it all again in a minute. The difference in China's health has been nothing short of a miracle!

Just take one step at a time and keep asking questions as you think of them!

 

I also work all day, and so does my partner (with the exception of Mondays). So I test and shoot at 7am/7pm, set auto-feeders for the cats to eat at 1pm, and we get our mid-cycle numbers in the PM cycle. Usually at +3 (10pm) right before bed, and then again at +6 (1am). My partner and I take turns on who gets to set an alarm to get up and test & feed the cats at 1am. Then I test more frequently in the AM cycle on the weekends when I'm home, usually doing a full curve one day (every 2 hrs for a 12 hour cycle), and a mini-curve the next (every 3 hrs for a twelve hour cycle).

Staying up or setting the alarm to get the 1am test seems hard, but it will make your dosing so much safer and more accurate. The more quickly and effectively you can get her BG under control, the more likely she is to go into remission, and I speak from experience--it is far easier and more convenient to have a diabetic cat in remission than on insulin.

Are you thinking of switching to EVO dry or canned? EVO canned is a great food (just remember it's high calorie so you may have to play around with the right amount to feed), and you can get it in large, 12 oz cans at most places that sell it. A canned diet will give you more variety than a dry diet, and it will add the much-needed moisture to the diet that your cat needs. Also, many diabetic cats can't handle even lower carb dry foods because of the way the food is processed (it always has to have some form of starch as a binder). Bandit can eat canned foods at 8-9% carbs with no effect on his BG whatsover, but if I give him a handfull of EVO dry his BG goes up 100-200 points. So unless your cat absolutely has refused all attempts to feed canned, you may not want to go that route because it might make regulation harder. Not to mention cause other medical issues like Urinary Tract Disease or Kidney Disease which can make life even more difficult. There's a great website here that explains the basics of feline nutrition, and food chart that gives you the protein/fat/carb and phosphorus content of many commercial canned foods to shop for. Anything below 10% carbs is ok, and at 14 years you probably want to choose something below 250mg phosphorus (because most senior cats have lost some kidney function, even if it's not yet showing up in their bloodwork).

I feed Bandit a combination of different canned Wellness Core, Weruva, and Nature's Variety Instinct, and it works well! He went into remission eating Fancy Feast pates, but we switched to the higher quality, lower phosphorus foods when he turned 12. We feed the cats 4 times a day (7am/pm, 1am/pm), and freeze portions and set auto-feeders when we aren't home at lunch time to feed them.

I know all this can seem overwhelming just starting out! But after things settle down and become more routine, it will get better, I promise! I think I was a nervous wreck for the entire first month after Bandit's diagnosis. There's a lot of changes to make and information to process.