my diabetic cat registered High on glucometer

Discussion in 'Feline Health - (The Main Forum)' started by Theresatramondo, Jun 5, 2013.

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  1. BJM

    BJM Well-Known Member

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    Oct 6, 2010
    Check state law on 'sharps' disposal.
    In Ohio, I was able to use an empty laundry detergent jug to collect my sharps and dispose of them. Some pharmacies have programs for sharps.

    After a furshot, you want to be safe - if she weren't running high right now, ie if she were closely controlled, adding 3 more units of insulin to an unknown amout that may have been injected could send her into hypo. Those can be fatal, so "better too high for a day than too low for a moment".

    Our shopping partner ADW carries the Arkray Glucocard 01 and 01 mini; it is the exact same thing as the WalMart ReliOn Confirm and Confirm Mini. The test strips are interchangeable. It uses a very small blood drop and are some of the least expensive meters members use here.
     
  2. Deb & Wink

    Deb & Wink Well-Known Member

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    Jan 31, 2013
    Theresa, Got your email but it had your sheets/notes of BG's and such from 6/17 through 6/19. I have already put those numbers in your SS.

    How many cans of food a day would you say Tiffy is eating now?

    I want you to spread out the food, over at least 4 meals a day, 6 if you can. Split it into equal portions and feed her over the course of 24 hours. For instance, that 1.25 cans you fed her at one meal tonight. Split that into at least 2 meals and feed her a couple of hours apart. That way, her body doesn't have so much food to process all at once and that will help to keep her BG numbers more even by spreading out the food.

    I'd rather see you feeding her some food in the morning, some food before you go to work, more food midday, food at PM preshot, more food before you go to bed. Ok, that is 5 meals a day, but smaller portions at one time. Would you try that?

    I have a Relion Confirm that I use with Wink now. Test strips are $0.36 a piece. Much lower price than the Alpahtrak test strips. The meter itself runs about $16-17. You can go to Walmart.com and look at it online and order it online also. To see the Glucocard 01 at our shopping partner, ADW (American Diabetes Wholesale) from the link at the top of the screen. Also available by mail order.

    The Arkray Glucocard 01 that BJM mentioned is the equivalent of the Relion Confirm. Looks a bit different externally, but made by the same manufacturer and the test strips are interchangeable between the Confirm and the Glucocard 01.


    I think Tiffy may need an increase in insulin also. I need to see the latest numbers to tell that for sure.
     
  3. Theresatramondo

    Theresatramondo Member

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    May 29, 2013
    The Only Thing is that she is going through a lot, like Carl said, so it is so hard to tell, but we can always move it down. I fed her like 1 1/4 can for dinner and I just gave her another quarter. Her +3 number was 375. Hi, but I had to feed her. I can't feed midday. I can do breakfast and before work, depending when I leave betw 8:30 and 9.
    BJK ( think I have it right now ), I never reshoot the amount she is supposed to get, I only reshoot the most a unit. Please look at the new numbers and tell me what you guys think. She is going through a lot with the meds, etc.
     
  4. Theresatramondo

    Theresatramondo Member

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    One more thing, Maybe I can do 1 can at dinner and 1/4 for the second meal. I can do that. It is just that she licks it down so fast.
     
  5. Deb & Wink

    Deb & Wink Well-Known Member

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    Theresa, got your new email and had the right sheets for updating your SS. Tiffy's SS is updated now.

    I wonder what was different last night to have her be so low this morning, in the 200's. Did she drop really low overnight? Did she eat less? Any thoughts?

    Some cats do eat really fast. Hoovers. My two civies (civilians, non-diabetic) are hoovers. Food is gone in less than 2 minutes. I have to guard Winks food so the other cats don't steal it. Tiffy may be used to grabbing what she can get as fast as possible after life on the streets.

    How about 3/4 of a can at pre-shot and 1/2 a can a few hours later?

    You can't feed mid-day during the day when you are at work but how about the weekends? So 4 meals a day during the week, more on weekends?

    I'm afraid to suggest a dose increase because of that low 200 this morning. I think we need a sliding scale and I've never done one.

    Carl? BJM? I know Robin & Harley do sliding scales but not sure if there is enough data.
     
  6. BJM

    BJM Well-Known Member

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    Oct 6, 2010
    Google not playing well with my phone; I'll have to look later.
     
  7. Today's AM cycle is confusing. Beautiful yellow preshot this morning though. I don't understand where that 400 at +3 came from. That's right about the time the insulin should have been kicking in. The 276 after that makes sense, as that would be the insulin pushing it back down.

    I think the 2u dose might be too much on yellow preshot number. Looking at the spreadsheet, the last time you gave 2u on a yellow number, (6/18 AM cycle) it looks like she may have dipped low and then bounced later in the cycle.

    If you see another yellow preshot number, maybe try reducing to 1.5u or even 1u for that shot?

    Tonight's PMPS numbers don't seem logical. Not when you tested 3 times in the space of a few minutes. The food wouldn't have shown up on the meter that quickly.

    I'd be hesitant to advise an increase in dose until you can be sure the antibiotic is working, because that should clear the UTI and also drop the numbers down. How many days left until the AB is done?
     
  8. Theresatramondo

    Theresatramondo Member

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    May 29, 2013
    I think it is the reshot. So it may be giving her what she needs which is prob another half unit.
    Let's see next week's numbers. This morning on 2 units she was 475. I will post numbers later. I'm sorry ~ I reshoot her when I shoot thru. I won't do it once we regulate her but she's so high all the time, I feel if I reshoot a unit, it won't hurt her. I never reshoot the whole dose. I reshoot 1 unit. So that may have been the morning low. Bjk picked it up but u guys didn't see it in the notes. It shows in the notes for a shot or 2 before the low number. I see if ball on her coat and estimate it @ unit. I'm a good judge. She is really skinny. It is hard to shoot her. You think u tent her but she has no skin. She needs 3 more lbs on her.
     
  9. Theresatramondo

    Theresatramondo Member

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    May 29, 2013
    Her numbers:
    fri, 6/21 6:40 +12 - 217
    +3 - 400
    +5 -276
    6:30 pm - +12 - 742 - fed and admin'd 2 units
    6:32 - 519
    6:35 654
    (that was the disparity)
    9:15 +3 - 372
    Saturday:
    6-22 7:08 am - +12.5 (amps) (half hour late for shot and food) - 475
    9:15 - +2 - 457
    6:34pm (pmps) +12 568
    6:36 (did a test shot to compare to last night) -555 (not a big disparity)
    Fed at 6:36 3/4 can
    Shot at 6:44
    8:04 starving to the point that she is jumping all over.
    If she is high tomorrow morning, I am raising her to 2.5 units. she is so hungry. it is 8:05. It should be kicking in. Going to give the 1/4 can. (3/4 can doesn't work) Need to give her at least 1 can with each meal.
     
  10. Theresatramondo

    Theresatramondo Member

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    May 29, 2013
    Read my previous note and this one in conjunction. It give the numbers.
    The Azrythro is 6 days 1x 1 ml per day and then every other day 1 ml 1x a day for 8 days.
    Help with the high numbers and the starvation. I am feeding her that 1/4 can. She is crying ohmygod_smile
     
  11. Deb & Wink

    Deb & Wink Well-Known Member

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    Tiffy is not starving. But the part of her brain that controls appetite isn't getting the correct messages. Please read this discussion from several years back for details. http://felinediabetes.com/FDMB/viewtopic.php?f=9&t=31942

    Here is a small excerpt that explains why feeding too much is counter productive. The bold text is mine.

    Until you can get a better control on the food intake, Tiffy will be in a cycle of demanding more food and not having enough insulin to process it, thus spiking the BG numbers over and over again. Too much food is contributing to those high numbers.

    We can't raise the insulin dose too high to compensate for the increased food intake because Tiffy is already dropping low sometimes on the dose she is on. Catch-22. Between a rock and a hard place.
     
  12. Theresatramondo

    Theresatramondo Member

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    May 29, 2013
    Deb, I agree, her +4 number was 147. I did a second test to confirm it and it was 149. Now this scared me. I never saw it this low at +4. I gave her 1/2 can of food, she still has another hour and I feared a 100 pt drop. I wanted to secure her until we stabilize the numbers a little, not knowing where she is going with the numbers. So in total for dinner and after dinner snack, she had 1 1/2 cans and some dried turkey treats. Let's see the next few days. I will send you her sheets tomorrow am, but are we talking tomorrow night to do the instructions on how I fill in?
     
  13. Deb & Wink

    Deb & Wink Well-Known Member

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    Wow! 147

    I don't think you've gotten a number that low, especially not that early.

    With that number, raising the dose of the PZI would be uncertain. Let's see what number you get at her +5 and +6, which is her usual nadir or low point.


    Yes, tomorrow 6pm for the lesson on how to update the SS. You want to call me? Or did you want me to call you? (I have to warn you, my voice is a bit rough, been battling laryngitis most of this year).

    I'll try to get the updates done from what you send me in the AM. Then we can mostly review and have you enter any new data since then.

    ETA: For next time, give her less food at one time. We need her to be a little bit hungry so she will eat if her numbers drop too low. We usually only advise giving a tablespoon or so of food at a time.
     
  14. Theresatramondo

    Theresatramondo Member

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    May 29, 2013
    My cat is looking a lot better with the numbers. I think we should keep the 2 units until we see. I can curve her today. Her ears are too beat up And being a stray, I can hold her paw too long to get blood from it. We will have to grin and bear a few days of rest on her ears.
    so +12 amps was appr 337. Lowest I've seen her was the last 2 days. +5.5 right now and I don't want to hit her ears. She is resting. At 11 I fed her half a can. I am sure she is low. I will try to get a reading, but am hesitant. Sending number over to deb now. :D
     
  15. Wendy&Tiggy(GA)

    Wendy&Tiggy(GA) Well-Known Member

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    Nov 15, 2011
    I still think she is way too high. Sure we are seeing less blacks but you really are aiming for greens and blues. I would even be happy with her to have pinks and yellows only at this point. The reds and blacks are bad.

    Does she paw at her ears and act in any way like they hurt? If not, I would just continue to test but try and find a spot you haven't hit yet ;) and remember the neosporin with pain relief.
     
  16. Wendy&Tiggy(GA)

    Wendy&Tiggy(GA) Well-Known Member

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    I don't see this 147 on the SS?
     
  17. Deb & Wink

    Deb & Wink Well-Known Member

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    Jan 31, 2013
    That would be because for now, Deb is updating the SS and she missed it due to exhaustion last night.

    I'll be teaching Theresa how to navigate her way around the SS this evening. Then, it will be up to her to take her notes and get them into the SS.
     
  18. Deb & Wink

    Deb & Wink Well-Known Member

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    Jan 31, 2013
    Theresa had a lesson on how to get into her SS on google and how to do the updates. If she has any questions, she will post here.

    She said that Tiffy is acting so much better now. Still hungry, but Theresa can tell when Tiffy's numbers are lower and she is feeling good.

    Any other PZI users that could look at the SS and advise on the dose would be appreciated.

    Tiffy has just been fully switched to the lower carb EVO canned food. Not receiving any more W/d canned at this point. Hoping this helps to bring down the numbers more.
     
  19. BJM

    BJM Well-Known Member

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    Oct 6, 2010
    Antibiotic notes:

    If an antibiotic is given, it will take out certain bacteria, but not all of them. Thus, the first antibiotic may not be successful, nor the second, if its not attacking the right bacteria.

    Some bacteria are becoming resistant to common antibiotics and may need a longer course, a complementary antibiotic, or a seldom used antibiotic to manage it.

    And finally, if the infection is not bacterial, all the antibiotics in the world won't help. Virus treatment is generally supportive care, sometimes with an antibiotic to prevent a secondary bacterial infection.
     
  20. Theresatramondo

    Theresatramondo Member

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    May 29, 2013
    Hi, Wendy, I am using pain relief antibiotic. she is much better today. I will take 4 readings until we can stabilize her. She was low this morning and high at nadir. Help
    Also she is still sneezing. This is like the 4th or 5th round of antibiotics. Calling vet in a few. She stopped the panting so I suspect it was the nose being stuffed and not breathing. She is resting now even though her nadir number was high - 545. See SS. I am cutting out the freeze dried treats in am or doing one or the other, but they seem to spike her in am when I give them with evo. maybe too much.
     
  21. Wendy&Tiggy(GA)

    Wendy&Tiggy(GA) Well-Known Member

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    Nov 15, 2011
    What kind of freeze dried treats are they? are they 100% pure meat? if so they are zero carb and should not spike her BG. Are you sure the increase in BG isnt a result of her bouncing off the blue last night? Although i dont see any numbers on the blue readings last night? just a coloured box?

    Hopefully the antibiotics will kick in soon and bring her down more.
     
  22. Theresatramondo

    Theresatramondo Member

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    She has been on them since Thursday. they kicked in already. and they are 100 percent meat. just think maybe too much food in am. I hate it because she seems like she is suffering starving.
     
  23. Theresatramondo

    Theresatramondo Member

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    May 29, 2013
    there is no blue for 6-23. that is just a carryover. there would be a number in it. I only did 3 reading yesterday due to her ears. :?: I hate it when she is searching for food. kills me
     
  24. Theresatramondo

    Theresatramondo Member

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    May 29, 2013
    Tiffy's Bloodwork came out primo. She is in good shape, but that she is still underweight at 8.5 and needs to gain more weight. she should be 11, 11.5, 12 lbs. The doctor said to try L-Lysine and try nose drops for children. It is just a matter of regulating her insulin. please see sheets. she is high in am and pm. I am going to give her a can in am and a can in pm. I am going to let her drop and not feed in between. I don't think she will hypo. The few times she has dropped in the 100s, she was still high 100s, and most usually she is in the mid to high 200s or low 300s to high 300s.
    Let's see if it works. Doctor feels she needs more insulin and if that doesn't work, he said try lantus? does anyone have any idea or input
     
  25. Deb & Wink

    Deb & Wink Well-Known Member

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    Jan 31, 2013
    Glad to hear all the blood work was good and the vet made a couple of suggestions with the l-lysine and the children's nose drops.

    I'm not surprised the vet said Tiffy needed to gain more weight. Take it easy on the food. You don't want to feed her so much at one time that she vomits. Being a speed eater like she is makes that more likely with too much food at one sitting.

    What did the vet suggest for a dose increase with the PZI insulin?


    Lantus is a good insulin. Different management techniques. Dose changes are made off the nadir not the pre-shot number. That is one big difference. Longer lasting, with overlap from dose to dose. There is a Lantus Savings Card program from the manufacturer on the Solostar pens which could save you money. Dosing best if done on a 12/12 schedule. Not as much flexibility in changing shot times from day to day.
     
  26. Theresatramondo

    Theresatramondo Member

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    May 29, 2013
    He said he thinks she is too high and even though she drops, she doesn't drop enuf. He suggested an increase and if we can't get it working another insulin. Now I'm wondering if carl can help me. I'm wondering if I can hit her w 2.5 in pm ~ I can monitor her drops and 2in am??? :id :?: ea:
     
  27. Theresatramondo

    Theresatramondo Member

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    May 29, 2013
    Carl ~ tiffy had a uri not uti. Anyway, her bloods r gr8. My question is this: can I increase insulin in pm to 2.5 and then keep it @ 2 in am? Did u ever hear of that? She's too high on just the 2. I'm only feeding 1 can in am and 1 can in pm. Look @ ss.
    I think I did until pmps. So if I didn't her +12 pmps was high 500s. In am +12 amps she was 580 appr. Fed 3/4 can evo and @ +2 she 437. Left 1/4 can for her. She's not dropping enuf. Now those low #s we saw were my reshooting her when I shot thru her. So she would get extra insulin possibly at a shot or 2 during week. I didn't have the technique down. Just got it right this week. Every cat is different. I feel that gave her #s in low 200s and 100s. I think if we hit her w 2.5 in pm when I'm home and could monitor and the 2 in am and leave food we should get her lower? Ur feedback pls? Copying this to thread
     
  28. Theresatramondo

    Theresatramondo Member

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    May 29, 2013
    Hi can u look @ ss and last couple of posts. Tell me what u think. I know u hate when I reshoot her after a fur shot but it showed us that maybe she needs more insulin at certain shot time either am or pm to get good :?: #s :idea:
     
  29. Theresa,
    With Prozinc, there is no rule that says the dose needs to be the same AM and PM. So yes, you could shoot a bit more on the cycles where you can be there to test. As long as you are comfortable as far as what to do when her numbers drop just in case nobody here is around to assist.
    And you can split up her meals and feed her during the middle of a cycle to try to manage those numbers. Just don't feed in the two or three hours before each shot.

    I would keep the shots 12 hours apart, but I would not shoot small doses at ant other time even if you suspecta ur shot. All that will do is confuse things and cause overlap of doses.

    Is she still showing symptoms of the uri?
     
  30. BJM

    BJM Well-Known Member

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    Oct 6, 2010
    It does look like you can increase 0.25 units. Syringes don't have that marking on them so you have to eyeball it.

    As far as food goes - she needs about 50% more food than a non-diabetic cat right now because she is not regulated. See Cat Info for details. How much does she weigh and how much should she weigh?

    Feeding in mini-meals across the day reduces food spikes; a pet feeder such as PetSafe 5 may be used when you are not home.

    If you spread canned food thinly across a plate, it'll take her longer to eat.

    You might also try freezing part of the canned food and putting it out to thaw and be nibbled.
     
  31. Theresatramondo

    Theresatramondo Member

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    May 29, 2013
    She is still sneezing. She is on antibiotic now every other day for 8 more days and l~lysine.
    I only gave a can of food each meal and so 3/4 and then 1/4 2 hrs later. I was giving her 1 1/2 but tried for 2 days less food thinking the numbers would decrease, but no luck. I'm going to give her 1 and 1/4 to 1 1/2 tonight. Tiffy is 8.5 lbs. She needs to be 11.5~12 lbs. Deb said she will maintain on 1/2 can each meal and 1 can spread she will put on weight but she's skinny and the numbers r high so 1 1/2 is ok.
    Raising .25 is hard. I was going to raise .50 so 2.5 in pm and 2. In am
    Feedback pls?? I will chk her bg. And leave food for tom. She won't hypo. She's hasn't gone under 300 at nadir so... feedback?
     
  32. Deb & Wink

    Deb & Wink Well-Known Member

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    Jan 31, 2013
    We are trying to balance food intake some with the insulin. I do think that 2 cans of EVO, spread out over the day, will be enough.

    You were going to get me the exact name of the EVO you are feeding so I can check the calories and such. Still waiting for that.

    Carl thought you could give a higher dose in the PM.

    Your vet thought Tiffy needed an increased.
    BJM thought you could give 0.25U increase.

    You want to give 0.5U increase and can monitor tonight.

    We often tell people, "You know your cat better than we do. You hold the needle, your choice. "
     
  33. BJM

    BJM Well-Known Member

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    Oct 6, 2010
    With nadirs over 300, an increase of 0.5 units is probably safe. I'd suggest you be monitoring hunger behavior, just in case. Maybe test around +3 and +5ish?
     
  34. Theresatramondo

    Theresatramondo Member

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    May 29, 2013
    Can you check my numbers with the increase, pls. I think I can raise her in am too. I need feedback. I will give it 3 days. Her amps and pmps are high. Her nadir last night was good, below 300, but in +am it was betw 300 and 400, so... Let's she how she does by like Sunday.
    Deb, I remember saying what she is eating Evo 95 percent protein. It is brown label and the only Evo I know. Beef and Chix/Turk 95 perc. Brown label. :lol:
    I don't know. I still don't like the numbers. I am going to leave her exactly 1/4 and at 1.5 tonight, nothing else. Her ears are shot.
    ANOTHER THING: :YMSIGH: I JUST NOTICED AN ABRASION-ISH SORE-ISH REDDISH THING ON SIDE OF MOUTH. I AM APPLYING BABY ORAL GEL AND MIGHT TAKE HER TO VET SATURDAY IF IT DOESN'T GET BETTER. :YMSIGH: :sad:
    MY LITTLE BABY I THINK HAS THAT HERPES VIRUS.
     
  35. Theresatramondo

    Theresatramondo Member

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    May 29, 2013
    WHEN I SAID LEAVING IT AT 1/4, I MEANT CAN OF EVO, NO TREATS AT 3 AM. I WANT TO SEE HOW SHE DOES. SHE IS SKINNY TOO BUT MUCH BETTER. DYING WITH THE SORE THING. :roll:
     
  36. Deb & Wink

    Deb & Wink Well-Known Member

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    Ok, looked at the ss. See room to change the dose but need someone else to make those suggestions.

    You'll be home this weekend. Better chance to raise the dose for AM also?
     
  37. Deb & Wink

    Deb & Wink Well-Known Member

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    Jan 31, 2013
    Ok, EVO 95% Chicken & Turkey flavor and Beef flavor are both 210 calories.

    10 pounds ideal weight ( a gain from current 8.5)

    (10 * 15 calories per pound ) +70 = 220 calories minimum

    220 calories + 50% more because she is still unregulated. 220 + 50% = 330

    210 calories divided by 4 (1/4 can) = 52.5 calories

    330 /52.5 calories per 1/4 = 6.25 quarters

    so a little over 1 1/2 cans a day. Lets call it 1 3/4 being really generous.

    I know, I know, she's going to tell you she is STARVING on only 1 3/4 cans a day. 1/2 am before shot, 1/4 before you leave for work, 1/2 pm before each shot, 1/4 a couple of hours later, 1/4 bedtime snack?
     
  38. BJM

    BJM Well-Known Member

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    Oct 6, 2010
    ProZinc may be shot on a sliding scale, so let's look at your spreadsheet, see what dose with what starting glucose has what effect.

    Ex.
    With 300s preshot levels, 2 units got you to blue

    With 400s pre-shot levels, 3 units may be good - you'd need to monitor the first time to see how low it took her.
     
  39. Theresatramondo

    Theresatramondo Member

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    May 29, 2013
    Hi. I don't understand what a sliding scale is. She was in the mid 200s at pre this morning. I fed her 3/4 w water and LL aand 2 units and at + 1.5 she was 437. Thought the insulin didn't kick in. I left vher 1/4 can for safety and left. She's much better and less hungry. Let's get her down. She is less aggressive too. She slept all night. No pawing @ cage
    CAN SOMEONE EXPLAIN SLIDING SCALE AND HOW IT WORKS? I'M ADMIN'G 2 UNITS IN AM AND 2.5 IN PM W APPROX 1 CAN OF FOOD EA HALF SESSION meaning 1/4 @ 1.5 to 3 hrs after shot for safety. W TREATS ie fresh vchix or freeze dried treats
     
  40. Deb & Wink

    Deb & Wink Well-Known Member

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    Jan 31, 2013
    Theresa, Please start a new post. This one is getting too long and cumbersome. I'll link this one in for reference if you don't know how to do it.

    Sliding scales will be explained in the new thread. :mrgreen:
     
  41. BJM

    BJM Well-Known Member

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    Oct 6, 2010
    Sliding scale means you get the pre-shot test and based on the number, you select a dose.
    Low pre-shot, lower dose.
    High pre-shot, higher dose.
     
  42. Theresatramondo

    Theresatramondo Member

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    May 29, 2013
    Thanks everyone for seeing me through this rough time. I don't know how to thank you. I am starting a new thread. it is need help adjusting Tiffy's insulin or something like that.
    I guess we are onto a new stage with Tiffy. Tiffy is making leaps. Look for the new link and new numbers. All yellows and pinks - some red. :coffee:
     
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