MURPHY'S HOME FROM HER GLUCOSE CURVE TONIGHT

We weren't very successful unfortunately, it was still in the high 300s, but we did increase the Lantus, which we expected, so she will get 2 units twice per day. She is also starting B12 injections to see if it makes her feel any better, and I hope so. So many things with her. This d. cati mite situation is really frustrating how it works. She is talking to a research vet at Cornell on Monday to see what the deal is with this particular mite. It can cause secondary infections, which would make sense that she ended up with MRSA 3 times within one year, but the d. cati mite is actually very rare, and caused by FIV, feline leukemia and guess what -- feline diabetes. Cats who aren't treated for diabetes, which of course, we didn't know becuase her old vet didn't Dx her, their immune system becomes suppressed and this is what some come up with. The mite is really really difficult to get rid of - obviously, since she's had it for over one year. It requires lime dips, and frankly, I'm not certain she could handle the smell - it's truly violent to me, because of her asthma. Murphy and I went to the grocery store shopping tonight - I had to get Karo in case she gets a little odd this weekend adjusting to the new dose of insulin. My vet said to look for spaciness, glassy eyes, and a drunk wobbling affect. Anything else? I do have my meter and strips to check her.

 

Have you ever tested before? If not are you at checking the urine to see if sugar is spilling in? If you cannot test then that is something you should do

The problem here is that the bg's at the vets can be off by more then 100 -200- 300 points due to stress and other factors
Also infections can raise the bg and I would be hesitant at this time to raise the insulin without testing cause you do not know what would happen to the blood glucose once the ear mites are cleared. I also do not know what dose you were giving before but if you were giving 1 unit 2x a day the most a dose should be raised is to 1 1/2 units 2x a day. Realize that at this time that is a 50% increase inb the dose

 

Murphy doesn't have ear mites. It is called "d. cati," or demodex cati, super uncommon, which is a mite that comes from a suppression in immunity from untreated diabetes, which was not of my doing, her vet didn't Dx her over a year ago after 5-6 lab panels, clearly showing she was diabetic. And, the year before that, she wasn't not diabetic. The d. cati is really a tough booger, because it's one of the hardest mites to get rid of, it thrives on immune problems like FIV, feline leukemia and diabete, and what sucks is that it causes secondary infections, which we found from talking to Cornell that this is what happens. Start off with d. cati, turns into mange, and right on to MRSA/MRSI. This totally sucks. What I am using is from Purina Veterinary Diets right now. It is a glucose urine monitor for the litter box, sprinkled in the litter box, it is like tiny newspaper pellets, takes about one hour to get the achieved result from the sugar in the urine after the kitty pees. But, it's prescription only, so it is ordered by my vet's office. I have used it before with Oscie, my struvite boy, and it really is very accurate and works well. As with Murphy's diet, we are not changing a thing until she is stabilized on the insulin. We don't want to add fuel to the fire, and the possibility of a hepatic situation. So far, so good. She's been home since 7:00 last night, it's 3:00 a.m., now, and she appears to be fine, but I've the entire weekend to check on her. I'll be home the entire weekend.

 

are you home testing her BG's? You can save yourself lots of money and avoid doing curves if you learn to home test.

Not to mention the added stress on the cat, being at the vet all day. It's also the best way to know what's going on, home testing, otherwise you are shooting insulin blindly and no human would do that to themselves - it's not different for an animal.

just a thought.

hope you get answers on the mite thing - can't say I ever heard of this. scary indeed.

 

Another important reason to home test is that you want to know what her BG is before giving the shot; testing in the urine tells you what the BG was many hours in the past, not what it is right now.

If you have the meter and strips, it may be a very good idea to start testing now, then you have time to ask any help or advice or tips before the next shot. Shooting blind and not knowing how to test will be upsetting if you have a cat go low and there are no signs.

My Oliver gives me no signs at all that he is low, none. If I did not test, I would not be able to have caught his low numbers. Also, there were a couple times when he was too low to even give insulin!

Curves at the vet can be very misleading. My Shadoe often tests very high at the vet office - I test her before going to the vet and when getting home. My Oliver goes very low! One time I had to feed him before leaving the vet office - I tested him when I went to pick him up and he was dangerously low.
Once you get the hang of testing, you will see it's pretty easy. Mine literally sleep through the testing; the poke of the lancing device is so fast that they just don't react anymore. Try it on yourself on your fingertip, just to see how it feels and to adjust the depth.

Then instead of a scary trip to a vet and being dumped for a curve that results in numbers totally artificial, you can test her in the comfort of her own home. She will thank you for it.

 

Fortunately, I have my One Touch Ultra, and had just rec'd my new lancets and new strips. Boy, those are strips are expensive. But, we are starting, and you are correct, especially with my little girl since she's asthmatic. She does get nervous when going to the vet, although she seems to calm down some (she loves her vet tech, David). Anyways, I've got a reading this a.m., it's our 2nd dose of 2 units, first was last night, and I think it would be a good idea for me to be around the entire weekend to see how she does. From what my vet stated, that she will probably need adjustment in the future, so, like with her asthma, I chart EVERYTHING on her, and this will be no different. Cross all fingers that she has a good day. But, I'll tell you - that B12 shot gave her tons of life back. We're doing it once a week for now.

You know, I am over the shock and awe of my previous vet and all the labs staring him right in the face, that Murphy was diabetic. Am I upset, absolutely, but such a negligent thing - a standard of care that he took oversight with, and vets are so protected by law, there's nothing more I can do than take him to small claims court. But, I think it's more stress than it's worth. I did report him to the state board though. After 5-6 lab panels with all coming back abnormal and each progressing, my new vet told me there's no way she would have passed this up.

Bummer, but we move on!

 

Have you checked ebay for your strips? We got ours there at less than half the drug store price. Just be sure to check expiration dates and the reputation of the seller.

 

Reputation is VERY important, so there is nothing stopping you from 'rating and reviewing' the other vet online. I check the listings for vet offices local to me all the time; I need to know who is horrible so that I know where NOT to go.

You can provide that vet with some free advertising that he will wish he never got.

If you could set up a google spreadsheet to track the BG numbers, you can add it to a signature here and others will be able to help if you need some guidance.

You can click on my spreadsheet links in my signature to see what I record.
Google is something that everyone can access - not everyone has the applications to view any other types like Excel.
It will come in handy in the future.

As for testing, there are 3 tests that you should get each day: once before each shot, and the third test is just before you go to bed. Some cats go low in the eve, so you want to know your cat was in a safe number before going to sleep.
Later on, once you have an idea of where nadir is, you really won't need to test all that often because you will have a good idea of how your cat reacts to the insulin.
For example, I would be wasting my strips to test Oliver much before +4 because he reacts slowly. I also know his nadir is very late, so his lowest number is usually just before his shots. I know that Shadoe is much more sensitive, so I test her earlier, plus her nadir is close to mid cycle.

Once you know this info about your cat, you know when to test and when will just be a wast of strips.

Up front, it's alot of knowledge and some expense, but later on, you will know how to do changes and alot cheaper.

 

Thanks for the information. I'm assuming "nadir" means the peak time, but please clarify for me. Great news, Murphy's PLI went from 25 down to 5.7 in 9 days!!! Hopefully, it was acute and not chronic! I'm pleased as could be. So far, she seems totally fine today, glucose is a little over 250, so 6 hours after her 1st shot of 2 units this a.m., so good.

Is there a video on testing on the ear vein. I did it last night and this a.m., but I want to be certain I'm not doing it blindly and am doing it correctly. It's almost as if I need someone to show me personally! Just the way I process things.

I'm so happy about her PLI this a.m.!!!

 

Yes, nadir is the lowest point in the cycle.

Here's the video: http://www.youtube.com/watch?v=_zE12-4fVn8

 

Great news, Murphy's PLI test came back this morning, and it went from 25 last week when I took her in critical, down to 5.7, so hopefully, this isn't a chronic situation. And, I just tested and her glucose is 161, versus 387, 331 and 304 yesterday when they did the curve. But, that was only because she had 1 unit of Lantus in the morning. So, headway? I sure hope so.

She does not like the ear prick thing I tell you that much. Do I swab her ear with an alcohol swab after?

 

You can use Neosporin on her ear - the kind with pain reliever is fine. And if you just hold on to her ear for a few seconds after poking, it will help with any bruising.

 

at what point was murphy 250, pre shot or in the middle of shots, like +6?
2U is alot of insulin to pump with no testing, especially that mid cycle test.
you must have said but i don't remember...which insulin?

 

That was mid-morning towards noon. I think she's doing good so far. And the PLI - well, that's fabulous to me. She's on 2 units a.m. and p.m., but that did not start until last night, and prior to that she was on 1 unit twice per day, every 12 hours, but we couldn't get her under the 300s. So, she's adjusting to the Lantus, and I think my vet wouldn't head me in the wrong direction. I just hate pricking her little ear though.

 

Hi there!
Im glad to see you are making an attempt at home testing! This is great!!! I think you will find it gets easier both for you and Murphy. You may be able to start a seperate post asking for anyone in your area for a live tutorial. That is how I learned to test (from another FDMB member), and in turn I have gone out to help others just learning. Worth a shot, if you feel it would be helpful to have someone 'hold your hand', so to speak, for a few hours.

I have to admit, after looking through some posts Im a little hesitant to say anything. BUT, I would feel worse if I didnt. Jumping from 1 to 2u of Lantus sounds dangerous. I understand Murphy was in the 300's at the vet, and its possible she may need that much insulin. The protocol with the most success, which we use here is increasing by .25 units. And, of course monitoring. The reason we do this is to keep the cat safe. 1 unit is A LOT of insulin. For some cats, .25u is a lot. Even less than .25u can make a difference in a cat going into a hypo or not. If you go to the lantus support group on this site and look at other's spreadsheets, you will see this is true. You can look at this sticky for info on dosing:
http://www.felinediabetes.com/FDMB/viewtopic.php?f=9&t=1581

Just like you, our main priority when offering words of caution like this is to keep Murphy safe, happy, and healthy. Please read through the info in "lantus land". Post to the group. And please, please, PLEASE keep testing A LOT, if you are going to continue this huge increase. Make sure to read the sticky on hypo's at the top of the page. Learn to recognize possible symptoms of a hypo. Get karo and/or honey in your house ASAP. Make sure you always (starting now) have high carb cat food. Usually the fancy feast versions with gravy will be sufficient. Feed the gravy in small bits with a spoon of food, if you are suspecting a hypo. Avoid the kibble. It will not help you at the moment...maybe hours later. Ask for help.

Another thing you may want to factor in, other than vet stress, when the curve was done is the pancreatitis attack. If Murphy was having an attack while there (Im unclear if that is the case), than her BG's would likely be increased. If she is better now, than her BG's will start going lower...naturally.

I wish you the best.

 

I also wanted to mention that you may see some high numbers with your pre shot tests. Its possible Murphy could go lower than her liver is used to (not necessarily hypo range), the liver will panic, dump sugar, and suddenly you will see #'s in the 2, 3, 400+ for a while (up to 72hrs). Just wanted to give you a heads up, in case you were not familiar with this process. This is why mid cycle (nadir) checks are so important. You can see if this is happening OR if she is just not getting enough insulin.

 

That was Murphy's first run with insulin on 8/24/10 when she was in crisis. So, we started her on 1 unit Lantus 2x per day. Then, earlier this week, she started showing signs of being hyper again, frosty paws, ravenous, drinking a ton, and pee'g like there's no tomorrow. So, that's why we took her in yesterday to do the curve. Her vet said for a while, we may have to do this. At least her pancreas is getting a rest, her belly is not tight, she isn't vomiting and doesn't look dazed/confused/drunk/wobbly. I've been home all day and so far, so good.

All day long yesterday, she was almost close to 400 and then dropped to 304 or something like that around 3:30/4:00 p.m. I really trust my vet quite a lot; she's got a diabetic cat who is hyper-g as well and runs about the same #s as Ms. Murphy. At least for right now, after the curve yesterday, I am comfortable monitoring her at home. But, I think I will have my sitter come on Monday around 12:00 to make sure she's okay. She knows how to test as well. Murphy and I went to the store last night after I took her from the vet and we shopped for Karo, so I'm good with that. As far as high carb, are you talking interim when they are hypo? Because we are going to eventually start migrating to a low carb, high fiber, high protein diet, but we don't want to start that until she's somewhat regulated. Can't do it yet, because she's compromised and we don't want a hepatic situation coming up.

I think today was a super good day for her, and the B12 injections I think are going to help her alot.

L/M

 

it's just that regulation is perhaps not impossible but highly unlikely without the low carb wet food.
i know your cat has problems that make change difficult.
i guess it's up to you to prioritise what you can and cannot do at this time.

and i do understand your fears, you will just have to trust us on some things..carolyn really knows what she is talking about. she had mulitple problems with latte.. terrible problems.
but i agree with her notion of not raising 1 whole U at a time. doubling the dose...is extreme.
testing at this point would become imperitive. she is very experienced with the use of lantus.
we are really rooting FOR you

 

I checked Murphy's glucose at 4:00 or so, and it was 161, then checked at 10:15 tonight, and it was 141 (almost 3 hours after she ate). But, this is a human meter, and I read that you need to increase the # by 30 - 50 in order to get a somewhat accurate number. So, it may be 191 and 171 if that's the case.

I'm telling you, right now, I'm almost thinking I don't to prick her ears until she goes on Tuesday. I can't seem to get it right. And, she's not tolerant of this right now, and it affects her breathing. I cannot seem to penetrate the vein and I don't want her getting upset, it's just going to bring on an asthma attack and I can't have that right now. She might get an infection or something in her ear. She's just going through too much right now, antibiotics, injections, asthma treatment twice daily, it's too much. I don't want to bruise her ears if I'm not getting it right. I get upset when she's upset and with the asthma, I have to stop somewhere to keep that at bay, or I'm in trouble. She's a severe asthmatic -- very severe. Keep in mind, we are still dealing with the MRSI infection as well. It's very complicated.

I've been looking at her all day and all last night, and I'm still up and have set my alarm for 2:00 a.m. to make sure she's still doing okay.

I'm not sure I'm getting the increase in the Lantus by 1 unit twice per day. If my vet thought it would harm Murphy, she wouldn't have decided to do this. And, with the pancreatitis right now, she also wanted to give the little pancreas a break, use the Panazyme, and give Murphy relief. I'm using U-100 syringes, perhaps you are thinking about U-40 syringes. And, she's been active today, no glazy eyes, nothing like that. Eating, drinking, etc. Seems very happy, grooming, but the ear pricking, although it may take some time, it's adding fuel to her asthma.

 

Increasing from 1u to 2u is actually doubling the dose, and that is quite alot!
The protocol followed by many here for Lantus/Levemir does not call for a large increase because you very likely could jump right over your ideal dose. What if the perfect dose is really 1.5u? You have already past that and won't know without hometesting to see BG reactions.

Below is a bit from the protocol that truly does work when followed:


"General" Guidelines:

--- Hold the initial starting dose for 5 - 7 days (10 - 14 cycles) unless the numbers tell you otherwise. Kitties experiencing high flat curves or prone to ketones may want to increase the starting dose after 3 days (6 cycles).

--- Each subsequent dose is held for a minimum of 3 days (6 cycles) unless kitty earns a reduction (See: Reducing the dose...).

--- Adjustments to dose are based on nadirs with only some consideration given to preshot numbers.

Increasing the dose...
--- Hold the dose for 3 - 5 days (6 - 10 cycles) if nadirs are less than 200 before increasing the dose.

--- After 3 consecutive days (6 cycles)... if nadirs are greater than 200, but less than 300 increase the dose by 0.25 unit.

--- After 3 consecutive days (6 cycles)... if nadirs are greater than 300 increase the dose by 0.5 unit.


Reducing the dose...
--- If kitty drops below 40 (long term diabetic) or 50 (newly diagnosed diabetic) reduce the dose by 0.25 unit. If kitty has a history of not holding reductions well or if reductions are close together... sneak the dose down by shaving the dose rather than reducing by a full quarter unit. Alternatively, at each newly reduced dose... try to make sure kitty maintains numbers in the normal range for seven days before reducing the dose further.

--- If an attempted reduction fails, go right back up to the last good dose.

--- Try to go from 0.25u to 0.1u before stopping insulin completely.


Random Notes...
Because of the cumulative nature of Lantus and Levemir:
An early shot = a dose increase.
A late shot = a dose reduction.

A "cycle" refers to the period of time between shots. There are 2 cycles in one day when shooting twice a day.

Sometimes a dose will need to be "fine tuned" by adding some "fat" or "skinny-ing up" the dose.


As for the testing, my two actually sleep through the ear pokes, and you really don't need to be aiming for a tiny vein in the ear tip to get blood for testing. My eyes are not good enough to see the veins, but pokes with the lancet device in the general area gets me enough of a drop to test.
Just poke your own fingertip with the device and you are able to get a drop for testing; the same goes for your cat. Just be sure to hold firmly on the poked spot just as you would when testing yourself to stop the bleed and reduce any bruising.

There are TWO tests you really need to get and that would be just before each insulin shot. They are important because your goal is to no longer need insulin, right? So you are hoping for numbers to go lower and lower, and testing will show you that progress. There have been many days when I had to delay shots because numbers were too low, and some days, I even skipped shots because of low numbers. Those 2 tests are very good to do.
Another test you will hear many say is important is the before-bed test. Many cats go low at night, so it's good to know where your cat's BG is before you head off to sleep.

With Lantus/Lev, dosing is based on nadir or the lowest point, and NOT on the numbers you get a pre-shot. You could have a 300 at pre-shot, but in mid-cycle, you get a number that is 150, and then the next pre-shot is 300 again. You base your dose on the 150, and not those other numbers.
See below for a general guideline of what you may see when testing along a cycle:
How to do a Curve
Example of a typical curve:
+0 - PreShot number.
+1 – Usually higher than PreShot number because of the last shot wearing off. May see a food spike in this number.
+2 - Often similar to the PreShot number.
+3 - Lower than the PreShot number, onset has started.
+4 - Lower.
+5 - Lower.
+6 – Nadir/Peak (the lowest number of cycle).
+7 - Surf (hang around the nadir number).
+8 - Slight rise.
+9 - Slight rise.
+10 - Rising.
+11 - Rising (may dip around +10 or +11).
+12 - PreShot number.

Try to remove food in the 2hours before each shot because food will give you a false reading as the food will raise the BG. If you test at 6am/6pm, lift up the food at 4am/4pm.

Dry food is bad. It makes a BIG difference in the numbers, and many cats have turned out to be diet controlled - remove the dry, feed under 10% carb, no need for insulin. The vet can say whatever, it's still bad. I tell my vet office all the time ... hey, I hope you are not selling that dry kitty crack to your diabetic clients as you are killing them! It may not do any good, but I feel better for mentioning it to them.

Just be careful when switching to be testing BG as the numbers should drop nicely with food changes.

What would be very helpful to you and others wanting to help you, is to make a profile with info about other health conditions, like the asthma and any meds given so that others will take them all into consideration.

Also setting up a spreadsheet will make it clear what BG numbers you got and at what times.
You can click on the links in my signature to see how I record my test numbers for my two.

I am sure that you will start to see good changes now that you have started the insulin and are switching to wet low carb foods.

 

This just totally sucks. I just can't get a drop from her. Her fur is dark on her ears and I cannot see or feel the vein. I tried 6 times this a.m. at 3:30 and nothing. She started wheezing again and I can't go there, it's a combination of really bad things that set her up. But, she appears to be just fine, is drinking, is attentive, purring, eating normally, no dazed and confused look, no wobbling or acting drunk. I'm going to Dr. Renee this a.m., and because of the asthma and the MRSA right now, I am lucky to just get the insulin in her. It's too stressful right now since she's such a severe asthmatic, so I'm holding off until I talk to her vet. It's discouraging but I can't have her upset for 15 minutes while I try to find a vein and in the midst of trying to get a drop of blood, I have to run for the albuterol while she's having an asthmatic event. I couldn't get a drop of blood. I am not giving up, but it is a sticky situation with her, I'm walking a fine line with the entire picture. Honestly, I could never see trying to prick her while she sleeps.

 

Oliver had very dark ears. We found if we poked on the inside, it was much easier. Have you looked at her ears with a flashlight and then put a drop of vaseline where you see the little capillaries coming off the vein? Also, be sure to go in at a slant, not straight on. Didn't you have a member who was willing to come help? Maybe Cindy and Mousie? It is so much easier if someone helps out at first.

It is hard in the beginning - it took us a weekend of poking before we got a drop. But she is throwing some pretty low numbers. Better a few pokes than a hypo?

 

I am really sorry it was such a struggle this a.m. :sad: Does not sound like fun. I was lucky in the sense that I had a cat already used to being poked and prodded. So she was very good about testing (even when she thought I was doing too much :roll: ). BUT, when I first had to start doing other things...fluids, other injections, oral meds, etc...she was not so easy. It took time and lots of trial/error. One of the most important things was for me to be calm and gentle. They catch those anxiety vibes more than we know.

Maybe you could have the albuteral, or other asthma meds handy where you are testing? That way you dont have to add to any commotion or anxiety by getting up, running for it, panicking, etc. Possibly even give it to her before you test ...as a preventative. I have asthma, and often times if I know its going to be a hot/humid day and I will be outside, I use my inhaler before I leave the house. I dont know about treating asthma in cats, so cant say its wise to do this. Just a thought for you to ask your vet about.

I would really encourage you to start another post asking if there is anyone in your area who would be willing to come over and help you. For all I know, we could be neighbors and I could be there in a flash! :mrgreen: There are so many good people here, willing to reach out and help each other. There are numerous testing tips folks could give you. Another thread could be started for that as well!

A lot of folks on here have unique situations, with cats who have multiple health issues. Treating the diabetes is not as black and white for all. You are not alone when it comes to having to take other things into consideration. But it can be manageable - the testing, shooting, feeding, etc.

Im glad to see you have a good relationship with your vet. I had a wonderful one with mine. He was a gem. My girl had acute renal failure from a pain medication many years ago. I became very distrustful of vets from that experience, and turned to the internet. I had to learn to balance the info from my vet and the internet to come to the decisions I felt were right for Latte. There certainly were some 'crazies' on the internet, but not too many actually. Often times I was educating my vet with what I learned. He couldnt possibly know everything, right? He learned a lot from us....and us from him. Guess I just wanted to share, because I know you are hesitant to take advice or suggestions from strangers online. Never just take advice for face value...from internet OR vet. Research thoughts, ideas, and work WITH your vet to provide the best care. Always be an informed care giver.

I hope your day goes better, and Murphy is feeling okay.

 

Okay, so Murphy and I don't give up too easily. I decided I would try it with my One Touch Ultra lancet device, and bingo!!! I was just using the lancet alone, and it was quick and painless for her. I think I was poking around too much and she was getting anxious and upset. So, 4:00 p.m. yesterday 141, 10:00 last night, 161, and 7:00 a.m., she was at 167, so we are making progress. Although I cannot guestimate, but I would figure somewhere in the middle of the night, she would have been around 200 or a little lower.

Wfhewww!!

 

No, no one has offered to come help me, but it really isn't any trickier than when I started her on inhaled meds, just a different thing. By using the lancet device and now that I know where to head, I think we'll have a few setbacks, but we should be okay. I thought I had someone from here who was going to try to help me, but she was always too busy to even talk to me, so I gave up.

Her numbers are really good now. I'm pleased with that.

 

Well, Im glad you found something that worked easier.

When giving BG #'s, it is helpful to give it in a format of +hrs from shot time. We are all in different time zones, and have no idea when you shot. So 10pm could be a +3 (3hrs after shot), or +6(6hrs after shot). We dont know. A 141 at +3, after doubling your dose would likely warrant a lot more testing to make sure Murphy stays safe. A 141 @ +8 *may* not be as crucial. But again, some cats nadir (go lowest) later, so who knows. Thats why its important to test.

If I were posting #'s, it would look like this, so others could help me *if* I needed/asked for it:
AMPS: 162
+2- 144
+4- 107
+6- 82
+8- 112
+10- 137
PMPS: 178

So did you give her 2u of lantus @ 7am with a BG of 167?
If you have not read about the 'shed' concept with lantus and levemir, you may want to do so (I think the link I provided yesterday did that, and maybe in the stuff gayle posted this a.m.). You may not see drastic results in the first few days, but as the insulin builds up in the shed suddenly you may get MUCH lower numbers.

If you shot the 167 this a.m., I would highly recommend getting a few tests beginning to mid cycle at least.

You have a lot of posts, but nothing specifically asking for help that I have seen. Did you need, or want help? If at any point you do, start a DIFFERENT post with the subject line reading: Help with testing in (where ever you are).

You are always welcome to the Lantus forum for feedback, as well.

 

One of the members of the Lantus forum asked me to stop by.

A couple of thoughts that I don't think anyone has mentioned. First, it's great that you started home testing and that you're successful. As an FYI, you don't want to actually poke the vein in Murphy's ear. You want to try to poke between the vein and the rim of his ear. If you poke the vein directly, you'll get a lot more blood than you need. It also takes a while for an ear to "learn" to bleed. I'm guessing that the more you poke, the more capillaries develop and the easier it is to get blood.

I would NOT rely on the urine glucose monitoring method. It is notoriously unreliable. The following quote is from the 2005 Position Statement from the International Diabetes Federation.

Further, if you are concerned that numbers are even lower than 180, you have no way of ascertaining "real time" glucose levels using urine monitoring. By the time urine is processed, which takes several hours, your cat could be severely hypoglycemic. Similarly, urine testing does not give accurate readings at the upper ranges of BG levels.

As others have said, glucose curves done at the vet's office may be effected by stress. I would test before you take your cat to the vet for a curve and then see what the results are at the vet's office. My cat's numbers run much higher. Also, because I home test, my vet does not ask that I bring Gabby in for curves. I have much better data from home testing AND I'm saving a great deal of money by doing this myself.

Also a note about your meter. I would not assume your meter is any less accurate than your vet's. If your vet uses an AlphaTrack meter in the office, the calibrations are a bit different. However, the Lantus dosing protocol based on the research conducted by Jacqui Rand, DVM at University of Queensland, is the what the dosing protocol used on the Lantus board is based on, has parameters for both human meters and the AlphaTrack meter. Use the numbers your meter is giving you.

As Carolyn has pointed out, testing is essential for the safety of your cat. Big jumps in dose can create big problems in resulting BG numbers. Unless you are carefully monitoring, you could have a very difficult situation on your hands. An overdose of Lantus can easily take 16 hours of aggressive monitoring (i.e., testing every 15 - 30 min) to keep your cat safe. It is an exceptionally difficult situation for someone new to feline diabetes as well as those of us who will not leave you to handle this on your own for those 16 hours. We are committed to helping you to keep your cat safe. The dosing protocol that I linked is based on published research and is well recognized in the veterinary community for its ability to facilitate remission and for keeping cats safe in the process. At minimum, you should be getting a pre-shot test and at LEAST one test during each 12-hour cycle. With numbers in the 100s, given the large dose increase, if this were my cat, I would be testing aggressively -- at least every 2 hours -- so you have a clear picture of what's happening.

As far at the demodicosis, while Gabby didn't have mange, she did have ringworm. I spent more weeks than I can accurately remember using the sulfur lime dip to get rid of the fungal infection. Unless it exacerbates Murphy's asthma, it's not as bad as it seems. Do you know whether you need to disinfect your home, as well?

 

I am so glad you found a testing method that works for you. It will give you more peace of mind knowing what Murphy's BG levels are, and she will feel better when her BG isn't fluctuating as much. With the guidance of your vet and the many experienced people here, I am hopeful that you will be able to balance all of Murphy's issues. Bless you for doing all of this for her.

MJ&Donovan

 

Okay, so this a.m, before Murphy ate, I think she was at 167. At 1:45, she was at 304. I need to get some information to figure out the timeframe.

 

I am not sure what you are asking. If you need the formula for recording the info, it would be like this:

8/11
amps (Not sure what your number was before the morning shot yesterday)
+9 141 ( I am assuming you gave insulin yesterday at 7am so the 141 at 4pm would be 9 hours later?)
pmps ( I assume you gave a shot at 7pm but I am not sure?)
+3 161 (this is your 10:00 number)

8/12
amps 167 2 units Lantus
+ 7 304
pmps (this will be what your number is tonight before the shot)

I know it is hard to get your mind around this, but we are all in different time zones, so when you say 4pm, we have no idea what that means. When you say 9 hours since the shot, we can understand where she is in the cycle.

If this is not what you need, just disregard.......

 

Okay, I'm on PST.

So this a.m, she was at 167 before eating. 1:30 this afternoon (1/2 hour ago), she was at 308, but she did have a little kibbles and my vet said right now it's okay to leave a little out because we aren't pushing changing the diet immediately because she has some other things going on. I'm going to take the 308 as not accurate because she started breathing heavier and she was getting nervous with me poking and prodding. It's going to take me some time to get this right. Her poor little ears. I hate this.

 

Are you putting a little neosporin every once in a while? And holding the ear for a few seconds to minimize bruising? And giving her a treat each time? It really isn't that bad. With her health issues, if I were you, I would be thrilled to have a tool to be sure she doesn't hypo. That would be a real problem. A little poke with a treat attached - nothing!

 

I am still not clear on the times of your shots and tests, so I will use my Shadoe's shot and numbers as an example for you.

amps - 6am EST - BG 194 - I gave her insulin shot right after testing.
+3 - 9am(3 hrs after shot) - BG 112 -
+6.5 - 1230pm (6.5 hrs after shot) - BG 94 -
+9 - 3pm (9 hrs after shot) - BG 195 -
no food given after 4pm - no food to be given for 2 hours before shots
pmps - will be at 6pm EST - I will test her BG then give her shot

 

What a dummy I am. My One Touch Ultra meter -- I forgot to recalibrate for my new test strip vial, which I am assuming causes either a reduction or increase in readings.

 

What time do you give your shots?

 

7:30 a.m. and 7:30 p.m.

 

can you test her right before you shoot tonight?
So, test...shoot/feed...or feed/shoot (however you do it). But test first.
It would be great to hear where she will be at that point!

Hope she is feeling well today.

 

1/2 hour before din-din, 274. Went down some. Vet called, it's going to take some adjusting. I think today, I must have got a spot on her upper back where it may not have been absorbed well or something. She was wanting to eat all day. Murphy is now asleep and happy.

Is it possible I gave her injection at a bad spot?