How to understand my cat's blood glucose curve?

My cat Linus was diagnosed 3 years ago and it has been a bumpy ride. He started out weighing 11-12 lbs, he now weighs 7 lbs and needs to gain some weight. I did a blood glucose curve yesterday in hopes of finding someone who can help me understand this. I took his blood sugar in the morning like we always do and administered his injection after him eating, I then took his blood sugar every hour for 12 hours. He is on Novolin N. I fear if we do not get some weight on him we will lose him, can someone help? Thank you

 

Hi Susan, welcome to you and Linus. To really see what's going on, it would help for you to set up a spreadsheet.
http://www.felinediabetes.com/FDMB/threads/fdmb-spreadsheet-instructions.130337/
If you need help, let us know and we'll be glad to help you.

 

Until you get your spreadsheet setup you can present you data like this:
PMPS = X PMPS is the morning BG before shot.
+1 = Y (the + number indicates the time since the shot)
+2 = Z
.....
+11 +
PMPS

 

That spreadsheet is far too complicated. This is my numbers and times:
@ 10 20 AM His Blood sugar was 368, we fed him ( Fancy feast) and gave him 2.5 U Of Novolin
@ 11 20 AM BS was 319
@ 12 20 PM BS was 181
@ 1 20 PM BS was 86
@ 2 20 PM BS was 55
@ 3 20 PM BS was 65
@ 4 20 PM BS was 143
@ 5 20 PM BS was 248
@ 6 20 PM BS was 285
@ 7 20 PM BS was 362
@ 8 20 PM BS was 359
@ 9 20 PM BS was 354
@ 10 20 PM BS was 374
At the 1 20 PM check I fed 2 spoons of fancy feast ( classic liver and chicken) It's his favorite
At the 2 20 PM check I again fed him the same amount of the same food
And again at the 3 20 PM check. I am trying to figure up to know how low the BS goes down per U and 1/2 U of insulin.

I hope this helps. My thoughts are we are giving too much insulin, he does not gain any weight and he looks horrible, I can feel his back bones and his ribs. I hope someone can help me please.

 

@ 10 20 AM PS 368, we fed him ( Fancy feast) and gave him 2.5 U Of Novolin
@ 1+1 319
@ +2 181
@ +3 86 Fed 2 spoons of fancy feast ( classic liver and chicken)
@ +4 55 Fed as above
@ +5 65 Fed as above I think?
@ +6 143
@+7 248
@ +8 285
@ +9 362
@ +10 359
@ + 11 354
@ PMPS 374

I redid your info to get rid of the times and just replaced it with time after shot. It makes it easier to read.

Your curve is typical of N/NPH insulin. It only last 8-10 hours. Based on your cure I would reduce dose to not more than 2 units and I would go to 1 1/2 units to help ensure that Linus does not go too low without having to feed.
I would talk to your vet about changing to a longer lasting insulin like the Human Lantus and Levemir or the pet insulin ProZinc.
Note that they are more expensive than N/NPY. Many here in the USA order Lantus and levemir from a Canadian pharmacy, a lot less expensive than USA
http://www.rxcanada4less.com/search.php
A prescription is requires for all three insulins

 

There isn't really a pattern in BG you can find.
The numbers can keep a little bit of a pattern if you've given insulin for a while and when your cat is regulated but everyday will still be different.
It depends on what the cat does, is it an active day or a lazy day, and the food amount that the cat gets, and if he eats it all or not. There are so many things that increase/decrease the BG.

 

I do not understand what you mean. The curve is typical of one using a festing-acting insulin like N/NPH.

 

He use to be so easy to read, in that I could tell if he was a little low BS or high by the way he was acting. After having diabetes for a little over 3 years so much has changed, I think he is use to it and therefore he is not giving me clues like he first did.He is eating every hour and a half to 2 hours, I go through at least 3 to 5 cans of fancy feast per day and he is still losing weight. I personally don't care how much he eats, I would love to see him put some weight on. It's horrible to see, breaks my heart.

 

I wonder if I could introduce some other kind/brand of wet food to his diet that would help him gain some weight as well. Any suggestions?

 

Hi Susan, I thought the spreadsheet was difficult when I first started too, but it's really very easy to fill out. If you're interested in starting one, just ask and someone will set it up for you, like they did for me!
If you've been using Novolin for three years, it may be time for a change. Ask your vet about ProZinc or Lantus. They both last longer and will help get Linus' glucose under control. When that happens, Linus will be able to use the food efficiently and gain weight. In the meantime you could try to use a food with higher quality ingredients such as Wellness or Natures Variety Instinct. Have you seen this chart
http://www.catinfo.org/docs/FoodChartPublic9-22-12.pdf
Look for foods with low carbs and higher calories

 

Understanding the Spreadsheet/Grid

 

Our vet finally switched Linus to Pro Zinc today!!! Yay! Problem is they were out of the special U 40 syringes for administration. I have looked this up online and what they say is U 40 insulin can be administered with a U 100 syringe, it is 40 mg of insulin per Unit instead of the 100 mg if insulin per Unit with the Novolin N. So we are going to try 2 Units of the ProZinc in a 100 Unit syringe, this should be 80 mg insulin as the 1 unit was a little too much with the Novolin.

 

Glad you've switched to ProZinc! What dose did your vet tell you to give? Here is a conversion chart for using a u40 insulin with u100 syringes
http://www.felinediabetes.com/insulin-conversions.htm
@Sue and Oliver (GA) And @Rachel will help you with dosing if you'll come post in the ProZinc forum.

 

Please use the conversion chart. Or, memorize that each tick mark on the U-100 syringe is measuring only 40% of what it indicates (ex. a 0.5 unit tick mark on a U-100 syringe measures 0.2 units of a U-40 insulin).

 

Hi Susan! Glad to hear you were able to switch insulins. I see Sharon gave you the conversion chart and BJ explained it further. We'd be happy to help with any questions you have and any dosing advice you need!

 

He started the ProZinc On thursday and it seems to be worse to get the proper dosage than the Novolin was. Here is the info I have compiled thus far:

BS was 381 we gave him 1.5 units ProZinc:
1 hr later 329BS
3 hrs 215 BS
6 hrs 190BS

376 BS we gave him 1 unit because we were told his BS should be lower than 170 or sugar spills out into the urine, and higher than 120, is this correct info?
1 hr later: 313 bs
2 hrs 343 bs
3 hrs 285 bs
4 hrs 297 bs
6 hrs 252 bs

BS was 349, gave him 1.5, still trying to pin point the correct dosage, he is still losing a lot of weight.
2 hrs later 247BS
4 hrs 136 BS
6 hrs 98BS- we gave him some wet food with a few drops of karo because we thought he was dropping too low and he was acting odd, pacing around and sniffing the floor all over the house.
Checked him 15 minutes after the karo/food BS was 113
7 hrs BS 200

BS 308, gave him 3/4 of 1 unit, this was evening so we checked him 4 hrs later in the middle of the night BS was 190

BS 363, we gave 1 unit
3 hrs BS 150
4 hrs BS 98 again, so a little more food and syrup
5 hrs BS 116
6 hrs BS 120

Bs 329, gave him 1/2 Unit
2hrs BS 313
4 hrs BS 300
6 hrs BS 347
8 hrs BS 382.
This is todays readings, the last one. I need to know the target BS numbers for him to gain weight as I fear he will not pull through this and I am so scared and heartbroken. He is not a huge eater at one time, he grazes all day , every couple hours, usually fancy feast, chicken or turkey and giblets, and chicken and liver. He will also eat a little Friskies wet Turkey and giblets.He eats very little dry food, we keep dry out all the time as we have 6 other cats as well, we have Cat Naturals and Kitten Chow as they are the 2 I found with the most protein. The vet gave us dry food called W/D Digestive/Weight Management, and canned as well, would this not make him lose more weight? I am anxiously awaiting a reply. Signed scared and sad, I don't know what to do. Our cats are our lives, our kids are all grown, and our cats, Linus 14, Abbey ( His mom, she is 17) Garfield 6 , who was found in the back of a delivery truck and we took him as a 3 week old kitten, he has been through pneumonia, had his colon removed due to mega colon, Blondie who is 11, Frank Sinatra who is 11, Molly 11, Cleopatra 11. We use to live in the country and many people dropped off cats , so we took them in, got them fixed and in good health at the vet office and adopted them out. We are use to giving meds and special cares, but this diabetes has me beside myself with worry.Please help.

 

Hi Susan you do have your hands full! @Sue and Oliver (GA) and @Rachel are the ProZinc dosing gurus and they will be glad to help you get to the right dose for Linus.
I know you say he doesn't eat much dry, but even a few pieces can skyrocket blood sugar- I found that out the hard way! If you must feed dry, try to find a low carb one such as Evo or Young Again. Can you set up the spreadsheet? It will make it much easier to see what's going on. If you need help, like I did, just ask and someone will do it for you.

 

We can have someone set you up with a spreadsheet. We really need to be able to see his history and doses when you want dosing advice. @Marje and Gracie can you help?

A couple ideas. Are you using a human meter or a pet meter? With a human meter, the hypo range starts at 50. With a pet at 68. Your nadirs (lowest point of the cycle, usually 5-7 hours after the shot) of 98 are good numbers and no karo is necessary. Karo will raise the levels and influence your next preshot number, artificially. I would also stop switching the doses each cycle. As he is a new diabetic, it makes more sense to find a dose that gets him into good ranges and stay with that awhile.

The 1.5 was not a bad dose. If the 98 makes you nervous, how about trying 1.25 and staying with it a few cycles (unless he drops too low)

For reference, your first goal is regulation with preshots in the mid 200s and high 100s or double digits for nadir, but above that hypo range. Then you can fine tune.

If you would post on the PZI forum, we could help you with dosing.

http://www.felinediabetes.com/FDMB/forums/prozinc-pzi.24/

Please let Marji fix you up with a spreadsheet and come over to the PZI forum where everyone uses or has used your insulin.

 

He has had diabetes for 3 years, its that the Novolin was not very good with getting him regulated and staying regulated, it was great for the first 2 years , then it has been horrible. If someone can do a speadsheet for me I would appreciate it. Do I start a new topic in the ProZinc forum link or how do I do this? Copy/paste all I have written into a post there? Thank you

 

Yes, just copy the URL for this thread and paste it on the other forum.

 

Thank you

 

I'll send you a private message about the spreadsheet. Just check your inbox....upper right corner of this page.