Home testing and Food

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How often do you all test at home? Does the amount of times ever change for any reason?

And could you please tell me which kind of food each of your cats eat?

thank you!! xox

 

Fancy feast classic morning and night and Young Again Zero carb food free fed whenever.

Before remission I generally tested 4-8 times a day. Depended on what I was doing that day.... I'd I was home or not.

 

My cats all eat Wellness canned. We used to eat Friskies but had to switch when they discontinued what we liked!

As for testing at home: I always tested preshot of course. I got a nadir whenever I could (usually on the weekends or days off). I tested +2 or +3 after PM shot (before bed test) most nights so I could see where she was going. Then I did a curve every few weeks or if I just felt I needed one because the numbers got wonky. I would also grab a test at night if I..ahem...woke up for any reason . It was just as easy to run downstairs and grab a quick test while up!

Pretty much, at first especially, you want to grab tests when you can so we can see what's going on. As you figure out your kitty's patterns, you usually can test at key points during that pattern, changing the test times as needed.

 

Thanks. Is the Young again dry food? Can I leave that out for Theodore when I am at work since it is zero carbs? He stopped eating all dry food so I don't know if he would even eat it - but I like the thought of having food available in case he is hungry? Or should I just try to feed only at the two shot times and snacks if needed?

 

Thank you!! Is your cat laid back about being tested? Theodore is starting to really growl and hiss when he even thinks I'm going to do it. Not good!! I hope I didn't mess up somehow. It can't be hurting him that bad? I think he has other pain real bad so he might just be getting irritated with me. I don't know but I hope this all gets better!

 

I leave it out all the time. You can get a free sample if you ask them.... Youngagainpetfood.com

I honestly credit this food with helping get my cat into remission.

 

Gypsy was pretty laid back about it. She sometimes growled a little at me, but never ran or anything. Usually she just chilled while I was testing her.

 

The food thing is a battle with Freya, as she's proving very sensitive to carbs. So we're still trying to find her holy grail. For now, she's on UK Whiskas 7+ Selections in Jelly (poultry and fish types). Not ideal, but the UK cat food situation isn't great either, and I'm okay with feeding her this until we find something better. It's 3.87% carbs. There's some great stuff in places like Germany though, so a lot of UK folks order from the internet, which is what I've been doing. I haven't lived in the US for five years now, so not sure what the food situation in stores is like over there, but you may be able to find more options online than locally anyway if he doesn't take to Fancy Feast for whatever reason. Freya's got some MAC's brand to try soon, which is between 1% and 2.5% carbs. As you try different foods, you'll figure out what works for Teddy or what doesn't. It just might take a bit of trial and error, if he turns out to be a carb-sensitive guy like some of them or has any other issues. I wish there was something like Young Again that I could get in the UK at a decent price. Would love to have some dry to stick in an automatic feeder sometimes.

I always test her before each shot. Sometimes there's the odd low number where you can't safely inject at all, so this is important. I do my best to always get one at nadir, or as close to it as possible, and try to get at least one before bed each night. If she's having a lower night, I'll wake up and check her at nadir time. If there's anything out of the ordinary, or anything changed, I will test as often as possible. My biggest concerns are from +4 to +6 hours since that's when she tends to be lowest. I guess the simplest way to put it is I do it as much as I can, but if she's having a higher day, I'll give her ears a break.

Here's a very handy link to a carb calculator. I also downloaded the CarbCalc app for iPhone, which is basically the same deal -- a carb calculator specifically for cat food. It's great for making notes of stuff in stores or from websites, and you can save the info to your food library.

 

Hi Shawna! Great job getting started with Theodore's spreadsheet! I'm so sorry to hear he's having such a hard time with walking and pain. He's seen the vet recently, hasn't he? That is concerning that he isn't walking at all now, so if it's possible, I would at least call and talk to the vet about what's happening with his legs.

As far as your questions on this thread: I usually tests Sam 3-5 times/day. Always before the two shot times, and as often as possible near the two nadirs. Sam has a pretty consistent nadir around +4 or +5, so he makes it easy for me. The fifth test is either because something is concerning me (he's acting funny, the cycle seems active, the cycle is flat, etc.) or because I'm checking to make sure his nadir is still in about the same place. As Rachel said, it does move around. Typically on prozinc it's between +5-7, but many cats hit their low point earlier than that. As you collect data, it will start to become clear.

I rotate what I feed my cats because they'll get bored with a food and then refuse to eat it. So it's like a kitty restaurant at my house. The good part of that is that they aren't all that picky. The bad part is that I have to keep mixing it up for them. So they eat some variety of: fancy feast classics, friskies pates, Primal freeze-dried, Primal frozen, Nature's Instinct Raw (frozen: chicken or rabbit), and then there is usually some rotating variety of food off of the food list.

I do not feed them dry food. There are many health problems that can be caused by dry food for cats, so even if it's low carb, I think it's just too risky.

Here is a link to the food list: http://www.felinediabetes.com/FDMB/threads/dr-pierson-new-food-chart.174147/

And here is a link to a thread where Dr. Lisa talks about dry food in pets: http://www.felinediabetes.com/FDMB/...ust-carbohydrate-content.175004/#post-1943357

 

Thank you so much for your reply!!!!
I hope you get the food situation sorted for your kitty. Thank you so much for sharing what you do with her. Xoxoxoxox

 

Awesome information, thank you!!
I smiled when you wrote it's like a kitty restaurant at your house!
Theodore is so picky so before when all this first started and I had to switch from dry food (which I wish I had known his whole life not to give him only dry food!) but anyways when I was transitioning I'd open like three or four different cans until he chose one LOL. He is spoiled and picky
Yes I need to talk to my vet. I called yesterday but they want me to bring him in Thursday for another curve - and we could talk the the receptionist said. but since he freaked out so bad last time and his bs spiked to crazy high levels from stress I just don't want to bring him in. I want to do it at home. So I'll call to talk to the vet tomorrow to see what she says.
I'm really worried about his legs but I am hoping so badly they will get better with more stable blood sugar? That's what I was told might happen and I know it might not either, but I'm praying it does get better! And I'm going to do the b12 supplements too.

Today I noticed he was a little better on his feet but he will not get up ever unless I pick him up and put him down to use the bathroom. Then he will slowly make his way back to the couch. I just get worried that he will fall climbing up the three little stairs to get to his spot on the couch. I think he will be ok but I always worry about my fur baby!

 

I test before each shot and at least 1 day time test (usually nadir) and if I'm feeling extra paranoid I'll have my bf who's a night owl test her at night before he heads to bed. Of course this changes if she decides to do something crazy lol

For food we feed EVO dry because we have a non diabetic cat in the house who will not touch wet food no matter what we have tried. So we needed something that won't hurt Angel and is acceptable for Miyu to eat as well. With angel we feed her wet food that is not patè and 10% or less. I've found a lot of gravy foods that are 10% or less and those are her fave. A lot of purina pro plan. Only bad thing is is that the foods I given her are way more expensive than just buying a case of pate. I'm spending between $1.50-$1.75 a day to give her wet food.

 

Question - ok when a preshot is 89, which Theodore's was tonight - I did not give any insulin (Janet thank you for helping me!!!)

But my question is - does that mean I don't give any insulin until morning if the preshot determines I need it? What if his blood sugar gets high tonight? Do I just leave it alone until morning?? That's the only part I'm worried about ?
And in the morning I have to go to work....so if his blood sugar is low will it be safe not to give insulin again for the second time in a row????

Thanks in advance if anyone can help! xoxoxo

 

Thank you so much for sharing with me!! I'm going to have to check out the purina gravy because Theodore does love gravy! He ate dry food his whole life so this whole ordeal had been an expensive chance, but I am more than happy to do anything it takes for him of course. Although I do wish he would get a job though, haha, just kidding Lol

 

You don't have enough date to see how he reacts to shooting at low levels, so until you do, don't shoot anything under 200. So no, don't give him anything tonight and if he is low in the morning, don't give him anything again. not giving insulin is a good thing.

 

Same.

 

If you give insulin later, you'd need to move your morning cycle back so it would be 12 hours later. Since you have to work, that probably won't be a good option for you, so I would just wait until morning. If he's still too low in the AM, you can skip the shot again. More than likely, he'll be high (but don't let that upset you...it's natural after a NS).

 

No shot at all until tomorrow... Even if it goes higher later. If it's still under 140 or so then no shot tomorrow. Let's see what happens. If it's low then it's a lot safer to not give a shot than to give him one that will cause him to go too low.

 

Try not to let the thought of him being temporarily higher worry you too much. It's way more preferable for his BG to be higher for a time than too low from too much insulin.

 

Oh yeah true, that makes sense about the 12 hours and thanks for the heads up about it may being high, thank you!

 

Thank you all SO MUCH!

the one thing I don't understand is that his am preshot was 158 and then +9 hours it was 117 (I had given one unit of insulin in morning)

But then three hours later at his pre pm shot, it was down to 89.

Does that mean his nsdir(?) lowest point would be at 12 hours since his preshot was lower than his 9 plus test?

(And if I'm not making sense please just tell me and I'll just keep observing data instead of trying to figure this out ? Lol)

 

From my experience, it's an indicator the AM dose is too high. Maury's last curve 14 April resulted in a dose decrease.

 

Oh that's interesting to me. Do you have to do a bunch of curves before you can really switch the dosage? Because some days are not like today was. I know I've only observed data for a short while but it seems like a couple curves would be needed?
And I need to figure out if it's ok to ever give him a small snack because tonight he didn't eat all his normal amount (he had no insulin because his test was low) so I gave him food at 3+ because he looked hungry....it was just a little bit, but I don't want that getting in the way of accurately figuring out his dosage. But I don't want him to be hungry either. I wait at least two hours to test him if I give him a Little more food - and I don't usually do that but tonight I did. just need to see if that's ok or not. I don't want him to be hungry.

 

I don't always need a curve to tell me if Maury needs a reduction, if he has a drastically lower PMPS I do, what I think are called, a micro dose reduction. It's what I'm fiddling with right now. I'd like to see some blues and dark greens in his AM cycle again

 

If the morning PS is high enough you should give insulin. It might actually be a little higher because of the no shot tonight. The dose you give tomorrow AM will depend on what the BG is so post here is you're unsure.

 

Personally I think it's not that the nadir is at 12 hours but that the pancreas is waking up! But I do agree that at that level 1 unit is too much.

 

Under 135 no shoot

135-150 0.25..... Just a drop basically
150-185 0.5

185 and up do 1

 

That's totally up to you. I have 6 cats so leaving dry is what I do but they all also get wet twice a day.

They will send you a free sample of the Young Again Zero carb food if you call or email. Youngagainpetfood.com

 

She loves the Friskies, and for testing i did at least twice daily. You can use carb calculator for idea

 

Shawna, I disagree with the advice you were given to shoot below 150. You have very little data at this point, you're away from the house most of the day, and Teddy's responses to the insulin would all make me very cautious about dosing right now. If it was my cat, I don't think I would be shooting below 170 at this point, and maybe not even that low.

Our first rule here is to keep our kitties safe, and shooting on low numbers when you can't be home to monitor just isn't safe until you have enough data to know that he isn't going to drop too low.

As for the snack question: yes, definitely okay to give snacks! Most/many of us either free feed (leave food out all the time), or feed several small meals during the 12 hour cycle (either b/c we're home, or by using a timed feeder that opens during the day). One strategy is to get mid-cycle numbers is to test, and then give the snack so it isn't food influenced. Because I free feed, I just test whenever I want to and don't worry about if they've just had something to eat. The only time I worry about the two-hour rule is before the AM and PM dose times.

Thinking ahead to the weekend: will you be around a lot on Saturday or Sunday to do a curve? And what is Teddy eating right now? If I'm remembering right (and forgive me if I'm not!), he's been eating the glycobalance, and you were going to start transitioning him to FF, is that right?

 

Take a look at your 4/28 PM and your 4/29 AM numbers. Your +5 readings seem to be a better reflection of the nadir.

I'd agree that your 5/2 PM number is probably due to bounce. The 1.o U dosage at a BS of 158 would appear to be too much based on your data set.

Now that Teddy's glucose levels are in a 'reasonable' range, you'd probably be better served by partial unit dosing below a level of 250 mg/dl or so.

I'd suggest doing a mini-curve if you are comfortable with the nadir time. Get the AM and PM numbers and bracket the +5 presumed nadir time by maybe an hour or so on both sides. If the BS on the first bracket number is lower than the value of the second bracketed number, then the actual nadir would be in between those two times where the glucose curve changed direction (think of the bottom part of a U). After you are confident and get a consistent nadir time you can move to a 3 point curve. But getting the nadir number (or close to it) is critical, so make sure you have a high level of confidence in it.

Good luck...it looks like Teddy's making progress!

 

His morning ps was 256 so I gave him 1 unit.
I checked him as soon as I got home from work at 4pm and that was 10+ hours and it is 117.

Should I still text him again at 6pm, which is two hours later then when I tested when I got home ....it will be at 12+ hours.....and I'm assuming I won't be giving him insulin tonight then

 

Thank you!

 

I will be home both Saturday and Sunday and I can do curves both days if needed!
Yes you are right about his food. I have been feeding him like half of each....I want to switch just to fancy feast but sometimes he won't eat enough of it and he will eat more of the royal canon. But I'm trying to do more fancy feast and ween off the royal canon completely. I'm going to look into the friskies and purina pro too, I think is what I read. Gotta double check.
When I tested him at 4pm, when I got home from work, he was 117 (I'm using the human meter , I hope people just know this or was I suppose to specify??) but, I probably won't be giving insulin tonight right???? I don't see it going up before I feed him right?
Is it healthy for a cat to be between 200-300 bs?
I am just asking because I worry about what if after he eats his blood sugar gets really high? I'd have to wait until morning. See that's where I'm still confused.

 

The 4/28 numbers are not accurate because the vet had told me to give Theodore 4 units of insulin....because he got too stressed at the vet and his blood sugar was through the roof... so I can't really take 4/28 and 4/29 into consideration for his "normal" right, since it was due to excessive insulin?

 

Thanks for this information! I am not fully understanding what you are saying, but I pretty much get it....I am rereading...are you saying to test him every hour until I find his lowest point? To find the nadir?
Doesn't the nadir time change based on insulin given and how much/when food is given??
I do understand the U concept....
I really appreciate you explaining this to me. I get it but a part of me is still a little confused.

 

Or maybe I am wrong! But I do know that 4 units was too high so that's why he got so low - but now I'm thinking maybe it doesn't matter what the actual numbers are, but just the time it makes the U curve ??????

 

For tonight: You should test at +12, because cats sometimes go up as much as 100 points in the last hour. Cats who are trying to go OTJ may not, but we aren't sure what Teddy is doing just yet, so do the test (I know, I hate doing extra tests too, so you have my sympathy!)

If he isn't high enough at +12, you can try to stall without feeding for another 20 minutes and then test one more time to see if he's rising. If he's rising, you can consider a dose, but if he's flat and still too low, you skip. You can post your +12 and someone can chime in at that time to walk you through that.

 

You're right that the 4/28 cycle doesn't count. But the reason it doesn't count is that you intervened in the cycle with high carb food. So the numbers, and the rise that you see there, aren't a reflection of his nadir, they are a reflection of the food you were giving him to intentionally make them rise at that point.

Getting a curve this weekend will be great! On Saturday morning, start a new thread that is titled something like "Curve Day" and we can help you with it. More directions on that in a minute....(I want to try to get to all the questions!)

 

His pre pm test is 161


Oh now I understand that it is normal to go back up.....I couldn't understand what was making it go up but it's time. Sorry it too me a bit to understand...now it is making more sense! Thank you.......

 

You don't need to keep saying which meter because you're using the spreadsheet for human meters, however, you might add it into your signature to help people out.

A non-diabetic cat's BG is usually between 50-120. A cat on insulin will ideally have pre-shot numbers in the lower 200's, and nadirs close to 100. We always love seeing the greens (50-99), but those require a bit more monitoring. It can sometimes take awhile to get to those ideal numbers, but Teddy looks like he may be headed that way already.

If you skip a shot and his BG goes really high, you do need to wait until morning. That's why we try really hard to get the doses right so you don't have to skip. That's also why the stalling technique is used. Skipping shots has to happen sometimes, but we do our best to get two shootable numbers a day.

 

Since it looks like he is rising, can you hold him off from eating for 20 minutes to see if he gets a bit higher?

 

What does OTJ mean?

Great, excellent! I will do that Saturday morning. Thank you for all your help!

 

Oh this is all starting to make sense now!!!!!! I'm so thankful!!!!!!!!

 

Well he chowed down before I read this.... uh oh.... ??

 

"Off the juice", as in remission, no more need for insulin.

 

My gut right now is thinking to go with either a 0.75u or a 0.5u dose. I'm leaning toward the smaller dose.

One really important thing we believe around here is the idea that "you hold the syringe" We can give our opinions, but none of us know you, your cat, or your circumstances, so the decision about what you think is right, is always up to you. And it's always okay to disagree with someone's opinion. I say that because the dose right now is going to come down to what you think is best.

So what do you think?

 

Off the juice lol, that's cute
Thanks!

 

Yes Janet had given me some good advice yesterday saying 0.5 when it's around this number also.

Well to be honest with you, I still don't feel confident enough to know what I think is best. That is why I thank you all from the very bottom of my heart. i am going to use your recommendation because at this point I feel you guys know what is best. But I totally understand what you mean with what you are saying.
Thank you....I hope you know you really are a life saver....you and everyone on this site. I would have never been able to do all this without you all. I would have been in the dark fumbling around and poor Teddy would have suffered more. So when I say thank you a million times it's because words just can't explain how thankful I really am. You are saving my best friends life with this help you are giving me. Theodore is my heart (as I know your kitties are to each of you) -- so thank you and I'm going to give him the 0.5 dose - and I can check as many times tonight as needed.

Xoxoxoxoxo

 

I still ask for advice on my kitty too! It's just nice to know if I'm in the ballpark of what other people are thinking and I appreciate the peer-review aspect that we check one another's advice.

I want to clarify that my suggestion of lowering the dose wasn't because of the PS number. It was based on the long cycles that you're seeing. One unit seems a little too high for Teddy right now. Figuring out whether to go to 0.75 or 0.5 is because of the overall numbers, not just the 161 that you have right now. Does that make sense?

I would recommend that you lower both doses - AM and PM since your PM numbers are a little too low right now. So as we consider the .5 vs .75 question, do you think you would be comfortable with drawing up a 0.75u dose (in the morning)? It's a little tricky because there isn't a line for it.

 

I'm not sure what a long cycle means? You mean it takes a long time for teddy to go down and then back up, does it go by 12 hour cycles?

And yes I can make it be .75.
Isn't the goal to be in the green though, so is teddys too low if he isn't always in the green?

(Sorry If I am asking too many questions...I can't believe how much I'm learning, this is really so great)

 

Lol...no such thing as too many questions around here! Remember most of us are/were teachers, so we love sharing information!

Teddy most likely spend a good portion of the day today in green numbers -- but you were with your firsties and didn't see it. And even if he wasn't (though I bet he was), there are two considerations: one is getting into the green numbers, the second is getting two shootable numbers. So first we have to balance it enough for you to get two safe shots, and then we'll hopefully work him down and off the insulin (anti-jinx!).

Long cycle means two different things: either that the nadir is later than the +5-7 range that is typical on prozinc, or that the cycle is over (you're reached +12) but he still hasn't risen enough yet. When you get one long cycle, it's no big deal - sometimes it just happens. But you've had two in a row, which probably means your dose is a smidge too high right now.

 

I believe what Djamila is saying is that your cycle seems to be lasting longer than 12 hours. Looking at yesterday's cycle, you can see Teddy was going down still at PMPS time...so the cycle which usually lasts 12 hours was going longer than that.

 

Ahhhh ok I get it now!! You are so good at explaining things!!!!
So I'm going to start doing .75 I think then??
And on the spreadsheet do I write .75?
And if I wake up tomorrow morning and let's say it's over 250, I mm just saying hypothetically, then should I go back to 1 unit??

 

Ok yes that makes sense now!!! Thank you and djamila!!!

 

I'm glad it's making sense! I always wonder when I'm typing things out if they make sense to anyone else, or just in my own head!

Yes, on your spreadsheet you just type .75 and it should auto-format to 0.75 And my suggestion would be to give that dose on anything over 170. I would like to see if some of the other prozinc folks agree with that idea before you commit to it though. @Yong @Rachel @Kris & Teasel @StephG

 

Yes very excellent way of explaining!!
So does that mean you would say if it's below 170 no insulin at all? Or .5, etc...

 

I would say no insulin right now just because you aren't home to monitor and don't have enough data on Teddy to be sure he's safe.

It's not that you'll never shoot lower numbers (take a peek at my spreadsheet), it's just a matter of safety until you know how Teddy responds. Right now his numbers are all over the place (normal at the beginning), so I prefer to err on the side of caution.

 

I agree, I think I would go down to 0.75 and see what that does.

ETA: and I would agree no insulin below 170 too. If you're home to monitor and are comfortable with steering, we can revisit that, but I wouldn't give below that until you can monitor so you can keep him safe AND get data for next time.

 

I like 0.75 u for now. Long cycles can happen because that's the duration a particular kitty gets or they can happen when the dose is a little high. Yes, no insulin under 170 until you have a lot more data.

 

*raises hand* with the others . One extra note, if you get a PS of 170 or less where you do a NS try to get a test a few hours later to see how he's doing without it. Will help figure out what to do if it happens again. Oh Rachel said that too

 

I think 0.75 might be a little high for that preshot. It's probably fine but I would monitor it. I stick by my original of 0.5. I'll actually tweak that scale just a little more and say

135-150. 0.25
150-185 0.5
185-225 0.75
225+ 1


Of course you hold the needle so you go with your gut and make your best decision.

 

I think there's some confusion happening. We were recommending NO shot this evening because the PS was under 170. The recommendation to lower the dose to 0.75 u was for tomorrow AM IF the PS is over 170. However, on the SS I see a PMPS of 161 and a dose of 0.75 u. Please let us know if this is correct.

 

Oops...that's my bad. I thought it would be okay if she gave a small dose tonight since she knew he was rising and would be around to monitor.

 

Maybe I'm the person who isn't understanding?

 

No, you're right. That does confuse things to have encouraged her to shoot tonight, but then say not to shoot tomorrow (if he's below 170). Shawna, I'm so sorry for confusing you. I think Teddy will be okay tonight (although do get a test, of course), but I should have been more consistent in my opinion about that!

 

Shawna, I apologize if I've created a lot of confusion. We'll get this sorted out.

 

No way, no apologies ever!!! You guys have saved my kitty and my sanity!!!
I gave a little less than .75 tonight and I'm here to check him all night.
I appreciate you all SO much and I understand so much more about cycles now hay you've described it!!! Smile! Thank you!

 

No apologies needed ever! There was no confusion! You guys are literally life savers and I am so thankful!!!!! I don't know what I would have done without you all! I'm forever thankful!

 

Can you imagine if you weren't testing and still blindly shooting 3 units? Yikes.

 

Or blindly shooting the 4 units the other vet told me to do!!!!!

 

Theodore is purring and snug as a bug in a rug... or snug as a kitty in a blankie LOL.... and he sends all his kitty kisses!!! xoxoxo

 

Here is Teddy as a baby!!! He was zero pounds and fit in my hand!! Awww sorry to put it on this thread, but I just had to share! awww xoxoxo

 

Oh, he's adorable!!! And thank you for being so gracious!

 

Great photos!

 

The white / lighter fur for his "eye liner" is cute!

 

I just love his light eyeliner!

 

Is he getting around any better? Or still struggling?

 

Well, there are three primary blood sugar components that the insulin needs to counteract for control. The first is the background blood sugar level (that is primarily checked at the pre-shot readings; i.e. How much is this reading above 120?). The second is to counter the anticipated rise in blood sugar from the food, and a large part of that is the carbohydrates in the food. These first two are sometimes called the bolus. The third requirement is the constant background demand for insulin that the body needs (basal rate). The difficulty in dosing a cat (or a person) with a single type of intermediate to long acting insulin is that it must cover all of these three requirements in a single shot. That is why some human insulins come premixed with a combination of short and long acting insulin.

So the prime thing that a diabetic (person or cat) that is taking insulin shots requires for the basis of good control is a regular schedule. This would include injection time, level of activity and diet (quantity and time). So yes, the irregularities on 4/28 could probably skew the readings for a cycle.

Yes and no. To me the three key measurements are the two 12 hour readings and a single nadir value. This is because I'd want to keep a regular insulin schedule at 12 hour intervals with Prozinc (2x/day dosing) . If I were using NPH, I'd probably want to use two 8 hour readings and a nadir value since it would most likely be dosed 3x/day in a cat. Again, regularity is a key.

My objective would be to get reasonable blood glucose numbers at the 12 hour periods without risking an hypoglycemic event at the nadir. The more data that I could correlate among these three values would help determine how much of an initial insulin dose could be given with a level of comfort.

Earlier you seemed to look for a less burdensome way to do a curve. I am certainly not against testing every hour and it does paint a more complete picture, but I feel that it does not add that much more to it. I feel, and this is just my opinion, that each person needs to get a better understanding and feel for dosing their cat and the way to do that is to collect data and use it as a reference for future decisions. Once things have stabilized you could build a sliding scale from your data. So I'm basically saying I would not do testing every hour but I would do testing more frequently where the nadir is likely to occur and bracket test around the anticipated nadir time. Initially, I would try to establish the time to the nadir so that I'd know with some confidence that it would occur 'around' that same time in the future if regularity were maintained and I'd be able to more efficiently test (three point curve). NOW THIS IS IMPORTANT: That is how I would do a curve or a mini-curve. I am very comfortable with this approach and I am used to working with and isolating data and I also have an understanding of diabetes...in humans/me, anyway. On the other hand, the curve generated from hourly testing is foolproof and easy to understand and implement. I guess I'm just trying to say that there is more than one way to get a blood sugar curve and get usable results.

The 'nadir' is the lowest blood glucose value and should correspond with the 'peak' level of activity for the insulin. The time of the 'nadir' should remain fairly consistent providing that a regular injection/feeding/activity schedule is maintained. The 'peak' (height of activity for the insulin) should remain fairly constant for a specific insulin type in the same person/cat. Think of 'nadir' and 'peak' in terms of time after injection and not absolute blood sugar numbers.

I actually try not to be confusing, but sometimes I just don't know when to shut up and I make things worse.

 

Still struggling....he actually won't get off his spot on the couch unless I lift him down. I mean he does have a hundred super soft (pink) blankets to cuddle with lol... but really though, it is sad to me but I just keep feeling hopeful that he will start to get better. I left him down to get him to use the bathroom and he is very wobbly on his feet...but he is taking a few slow steps to come back to the couch. This weekend after all that happened he couldn't walk at all, so he can walk now...very shaky and won't do it willingly though.
I'm going to take to his vet tomorrow and I'll update with what she says.
And he'll be starting the b12 soon too.

 

Oh no, you are not confusing...you are so intelligent and prior to this I had no knowledge on diabetes, so that's why it took me a bit longer to understand. I appreciate you so much for sharing this information and explaining it to me!!!!!!

This is really great information you just explained! Thank you!! I'm going to save this so I can refer back to it. Oh I didn't mean to imply I wanted a less burdensome way to do a curve...I actaully didn't really know what a curve was lol!! But what you wrote makes sense!

In your opinion - should I give my cat a third meal? I know everyone does it differently - but what do you think? I feed him at 5-6am and 5-6pm. I never want him to be hungry, so do you think if I give him a small third meal as long as I keep it at the same time every day?? Sometimes I can't get him to eat a lot at his meal time.....he was used to eating anytime he wanted before. So I'm interested to see what you think about that since you have so much knowledge.

And thanks again for your help and kindness!!!

 

Jbfrank,
I just looked at Buddy's spreadsheet....wow! Did he get better in just less than a month???
And he is so cute! Awww love your picture of him!

 

Sorry to reply AGAIN but I just reread again and saved it in my email - and I just have to say again this is really such valuable information!!! Thank you a million......so appreciated!!!!!!

 

When doing a curve, we generally suggest testing every 2 hours. That way, you can get an overall feel of what the day is like without having to poke every single hour all day.

On a regular day, we suggest testing at both AMPS and PMPS, nadir if you can get it, and then a before bed test at +2 or +3...gives you an idea of where they'll go at night.

 

First, please don't consider me an expert on feline diabetes. Although I am in somewhat of a unique position in that I myself am I diabetic, I don't have the base of experience treating cats that so many of the regulars here have under their belt. Their experience is a valuable commodity that they are sharing to help me and you.

As far as Teddy's feeding schedule, I would think that you primarily want to be consistent with it whether it's 2 or 4 meals a day or whether it's more of a grazing pattern. If Teddy is eating all of the food that you've been feeding him, then I'd add another meal and/or just leave some food out. Buddy's feeding schedule (and the other two ferals are on the same schedule) is to get about 1/2 of Friskies Pate (remember, that is the larger size can) every 12 hours. I also mix in a little Young Again Zero Mature with it. Then whatever they don't eat initially is just left out for whenever they want it. Typically, a little bit of the food is still in their bowls so I just dump it and start over.

But these guys used to eat one of the highest carbo rich cat foods that I've come across. Their diet now is maxed at 5% carbs, and probably a percentage or two under that. I have noticed that with the new diet they are eating less (maybe much less) in volume and I believe that is a characteristic of switching from a high carb to high protein/fat diet. Remember, it is primarily the carbohydrates in the cat food that screws up their blood sugars. Same thing in humans. When I eat something, I pretty much balance the carb count against an insulin dose. I don't look at proteins at all. In humans, some fats are problematic in raising blood sugars and some aren't at all, but there is a delay as the 'bad' fats are converted to 'something' else that causes the blood sugar rise. From what I understand, the cat's system/metabolism is developed or has adapted to a high fat diet and fat is processed fairly well by them, so I would assume that blood sugar elevation in a cat is minimal...but that's just a supposition on my part based on piecing other bits of information together. So basically, I would just work out a feeding schedule that you can maintain and that makes Teddy happy. Just minimize the carbohydrate content of his food.

Yea, it surprised the hell out of me how quickly Buddy turned around. He was on NPH for a week preceding the Prozinc spreadsheet, but it was full of havoc as the NPH had too short of an activity curve and Buddy's diet was being changed. I was not at all comfortable with things until his 12 hour numbers were getting out of the reds. But I would not say that he is better, because he's probably still classified as a diabetic. One of my preferred adjectives for a diabetic is 'maintained', meaning that their blood sugars are under reasonably good control. Currently I think of Buddy as a well maintained, non-insulin dependent diabetic.

And Buddy is one cool cat. We've got five cats in the house (and a dog). Three of the cats are ferals and the two 'regular' house cats were adopted from rescue shelters. It is very interesting to observe the unique personality of each of the cats and compare and contrast them. The other cool cat that we've got is Ozzie (also a male), but he's more of a 'Dennis The Menace' type and the dog loves playing with him. When the dog won't come to me when I call her, I just start calling for Ozzie and she comes running looking for him.

 

It's very interesting to read about a human diabetic's experience because kitties can't talk. It's true that cats have much lower carb requirements than we do and and their unique biochemistry allows them to convert protein to glucose much more efficiently than we can. Makes sense given that they're obligate carnivores and we're omnivores. I like the information @jbfrank gave about the need for consistency when dealing with diabetes.

 

Great pmps! Stall, recheck the numbers, and if still low, no shoot.

 

Yep, we tend to feel consistency is key! The fewer variables changed at a time, the best so you can isolate what works and what doesn't!

 

Thank you for this excellent information. I really appreciate it and it all makes sense.

Aw I love that you have five cats and a dog....and that's cute about Ozzie!!! Lol