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Discussion in 'Feline Health - (The Main Forum)' started by Terrelle, Jul 23, 2015.

  1. Terrelle

    Terrelle Member

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    Jul 23, 2015
    Hi Guys, I'm new around here and it's been a rough week. My baby Terry who is 12 yrs old had enucleation surgery was diagnosed with type 1 diabetes. Apparently this is why her lens ruptured. Terry is finally home after a 4 day vet stay but now I have to adjust to giving her insulin, antibiotics and pain medication along with closely monitoring her glucose. At the moment her levels are about 11-14 in the mornings but fine in the evenings and she is getting 1 iu 2x a day. Any suggestions for a newbie?

    I am going on vacation next week and am afraid to leave her but I have a friend who is a vet assistant who has agreed to come and feed and take care of her. Do you guys think I should cancel my trip?
     
  2. Sue and Oliver (GA)

    Sue and Oliver (GA) Well-Known Member

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    Dec 28, 2009
    There you are!

    What kind of insulin are you using? Are you in Canada or Europe? (In the US, we use non metric numbers). What kind of numbers are you seeing? (It sounds like you are testing at home?). 11 would be 190 in US terms and would be a very pre shot number. (Multiply your number by 18 )We think a cat regulated if the kitty is in the lower 200s before the shot And double digits 5-7 hours after the shot, when they usually drop the lowest.

    What kind of food? We suggest feeding wet low carb food. A vet explains why here: www.catinfo.org. BUT you don't want to change the diet without being careful monitoring - our cat dropped 100 points overnight when we switched from dry to wet.
     
  3. BJM

    BJM Well-Known Member

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    Oct 6, 2010
    Are you testing in mmol/L? If yes, perhaps you are in Canada, Europe, or Australia?

    Generally, you want a dose that allows you to shoot every 12 hours, as no insulin lasts 24 hours in the cat.
     
  4. Terrelle

    Terrelle Member

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    Jul 23, 2015
    I'm in canada and she's on Caninsulin, it measures in mmol/l The vet switched her to prescription diet w/d :)
     
  5. Sue and Oliver (GA)

    Sue and Oliver (GA) Well-Known Member

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    Dec 28, 2009
    If it's Hill's WD, it's 25% carbs on our food chart. We suggest feeding under 8%. It might make a big difference if you'd switch to a lower carb. But you might want to lower the dose before you'd change as her levels could drop quite a bit.
     
  6. Chris & China

    Chris & China Well-Known Member

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    May 10, 2013
    You might want to strongly consider changing insulins too. Caninsulin is a harsh, fast acting insulin that's much better for dogs than it is for cats (that's where it got it's name after "canine")

    Since you're in Canada, you can buy insulin over the counter (and it's a lot cheaper than it is here in the US) Lantus and Levemir are both great insulins for cats that are milder and longer lasting than Caninsulin and you can get them at any human pharmacy.

    Lantus has a proven and published protocol that was shown to get up to 84% of newly diagnosed cats into remission within 6 months, so it's worth seriously considering the change
     
  7. granadilla

    granadilla Well-Known Member

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    Jun 13, 2015
    Can your friend check Terry's blood sugar and adjust the dose as needed?

    If not, I might postpone the trip if that's feasible. Terry has been through a lot in a short amount of time. She might be fine while you're gone but if you're going to be miserable and stressed then it might be worth postponing the trip if you can wait until she's further in the recovery process and when you know more about how she does on insulin.

    Right now I'm out of town myself but I'm having a friend take my cat to the vet tomorrow because she was dehydrated this morning before I left. I've been tense and worried all day. I couldn't cancel this trip but I kinda wish I could have.

    What were you feeding her before the switch? If she was on a high carb food, then even switching to W/D (which isn't as low carb as is preferable) might be enough to affect what her dose should be. If at all possible, I second the recommendation to switch insulins to one of the longer-acting ones (lantus or levemir), especially if you're going out of town.

    Shane
     
  8. Terrelle

    Terrelle Member

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    Jul 23, 2015
    Thanks guys, I wish I could postpone my trip but unfortunately it might be my last chance to go camping with my 95 year old grandfather so if possible I'd like to go... but I'm pretty sure my friend can monitor it as she does have experience and training working in a vet office.

    Right now in the mornings before food she's about 11-14, at lunch she's at 6 ish, by the evenings she's at 11 and 2hrs after her evening insulin she's at about 5.

    Any recommendations on how to ask my vet if I can change her insulin? I don't think in canada we can get the pork or beef based insulin over the counter.
     
  9. Robin&BB

    Robin&BB Well-Known Member

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    Sep 28, 2013
    Wow, sounds like Terry's been having a rough time; I'm sorry to hear that. If I were in your shoes, I'd postpone my trip. As big a drag as that may be to do, there are too many variables right now to leave that much responsibility in the hands of someone else, even a friend who is a vet assistant.
    We generally need to monitor our newly diagnosed kitties closely in the beginning of treatment, and with all that Terry has been experiencing already (4 day stay at the vet, surgery, antibiotics/pain meds and now the need for insulin), my vote would be: stay home until she's better stabilized.

    My cat went on Lantus when she was first diagnosed in 2013, and was off it and in remission within 8 weeks. If your vet is insistent on using a prescription diet, the Purina dm canned is very low carb (3%). No dry/kibble foods. Switching over to lower carbs makes it especially important to be closely monitoring blood glucose if Terry's already on insulin; as others have mentioned, it can drop her insulin dosage need considerably.

    My vet had Bat on the w/d canned to start, too (while on Lantus), but when I realized how high the carbs were, I gradually switched her over to low-carb canned (the dm at that time) by reducing the w/d to dm ratio incrementally: 75% wd/25% dm, then 50/50, then 25% wd/75% dm, etc.
    If the Purina Fancy Feast Classics (chicken or turkey with giblets) canned food is available in Canada, that's a good, much-less-expensive choice than the Purina dm canned; has only 4% carbs.
     
  10. Maggies Mom Debby

    Maggies Mom Debby Well-Known Member

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    Dec 28, 2009
    It's not ideal, but if it was me, I wouldn't miss seeing a 95 year-old grandfather. You may never get this opportunity again.

    Your numbers are really not too bad. US equivalent of 192 pre-shot and 90-100 mid-cycle. Your vet-tech friend will be checking Terry's glucose, even getting a couple of mid cycle tests? Is there a glucose number that she will not give insulin? A plan should be made about what to do if Terry goes too low. If you are at all worried about Terry's glucose going too low (hypoglycemia), you could cut the dose a little while you are away, especially if Terry doesn't eat as well while you are gone.

    If you are able to be in touch, I would have the pet sitter email, text or leave messages with Terry's condition and glucose readings. That will help you relax a bit on the trip.

    Don't change anything so close to leaving, but when you get back do a little research on www.catinfo.com. A food with a lower carb content may get Terry off insulin.
     
    Last edited: Jul 24, 2015
  11. Terrelle

    Terrelle Member

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    Jul 23, 2015
    Thanks, yes I will be having her check her levels before each shot but she does already seem to have gone into a stable cycle. She probably won't be able to catch any mid cycle tests and I'm sure she'd be texting me with updates.
    Are there any idea for help giving shots and taking tests from uncooperative cats? She's fine when I do them but she's a bit of a fraidy cat so I don't know how good she'll be for my friend

    Thanks again everyone, your really helping me be at ease :)
     
  12. Robin&BB

    Robin&BB Well-Known Member

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    Sep 28, 2013
    Whoa, didn't realize this was a visit to a 95-year-old granddad. Changes the landscape considerably! (How did I miss that?)
    When you say she's a 'fraidy cat/uncooperative ... how uncooperative is she? Can you paint us a clearer picture of how she behaves at test/shot time?
     
  13. Maggies Mom Debby

    Maggies Mom Debby Well-Known Member

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    Dec 28, 2009
    Treats are one way of ensuring cooperation. :) If you already have a testing routine, have the pet sitter try to follow it. Have the sitter come over a couple of times before you leave to get Terry used to her. Maybe have the sitter test her those times and give Terry treats. You may want to block hard to access hiding place, like under the bed, if you are afraid she might hide.

    Good luck!
     
  14. Terrelle

    Terrelle Member

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    Jul 23, 2015
    Well for me she behaves perfectly and puurs, when other people she doesn't know are around she hides and squrims to get away from them. She's never scratched or bit anyone on purpose, the only way i've ever gotten scratched is by her back paws pushing to get away from me if there is company or she is scared.

    And I should say, I see my grand father very frequently this camping trip has just been a yearly family tradition for 13 years and this is proabably the last year they'll be able to come with us.
     
  15. Critter Mom

    Critter Mom Well-Known Member

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    Jun 16, 2014
    Hi there,

    I agree with Debby - not a good idea to change anything before you go away. Hills' w/d is very carby - are you feeding dry or canned, btw? In spite of the carbs Terry's numbers aren't bad at all. (So sorry about his little eye. :( )

    It's great that you're home testing BG. It's vital to be doing so before even attempting a food change from high to low carbs so as to keep a cat safe.As mentioned above, Caninsulin's quite a harsh insulin for kitties and you're feeding a high-carb food. It's highly likely that as soon as you start to transition Terry to a lower carb food (gradually, of course) his need for insulin will drop a lot, and drop fast. For example, when I moved my cat, Saoirse, from w/d dry to low carb wet food I had to repeatedly drop her Caninsulin dose and in less than a week I had to stop giving it to her because her numbers had improved so much and the Caninsulin was threatening to take her too low. And her numbers weren't anything like as good as Terry's.

    I'd suggest getting as many pre-shot, +3, +6 and +9 readings as you can manage (daytime and evening cycles) before you go away. Knowing a bit more about Terry's BG pattern on Caninsulin will be a help to you and the vet assistant.
     
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  16. Elizabeth and Bertie

    Elizabeth and Bertie Well-Known Member

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    Sep 6, 2010
    Hello, and welcome to FDMB!

    A diagnosis of feline diabetes can be challenging, especially at first. But you will soon get the hang of things. Honestly! And we are here to support and help you in any way we can. :bighug:

    Regarding the blood glucose numbers that you've given above; are these 'typical'? If they are then I think you may want to consider reducing the evening dose of insulin. If Terry is at '5' just two hours after the shot then there's a chance she could drop too low by the peak (lowest point) of the insulin cycle (with Caninsulin/Vetsulin that is often (but not always) between 4 - 5 hours after the insulin shot).

    BTW, you are bound to see comments/info on the forum that say Caninsulin/Vetsulin isn't a great insulin for cats (and there are some sound reasons for those comments), but please don't be discouraged. Some cats do just fine on this insulin (and some have even gone into remission (ie become diet-controlled diabetics)). It's early days. And only 'time will tell' whether it's a good insulin for Terry.
    Here is the link to the FDMB user guide to Vetsulin/Caninsulin, which may have some helpful info for you. If you have any questions at all please just ask. Vetsulin/Caninsulin user guide

    Why did your vet think Terry has type 1 diabetes (type 2 is much more common) ...?

    Eliz
     
  17. Maggies Mom Debby

    Maggies Mom Debby Well-Known Member

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    Dec 28, 2009
    BTW, I'm in wonder at a 95-year old going camping!!
     
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  18. Critter Mom

    Critter Mom Well-Known Member

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    And I'm in awe of same!
     
  19. granadilla

    granadilla Well-Known Member

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    Jun 13, 2015
    For sure, if it's a trip with 95-year-old grandparents, that changes things! I totally agree with Debby and Aine, don't change plans and don't make changes to Terry's food before the trip (changing from W/D to something lower carb). And even though W/D ain't the best, my cat went OTJ while eating it. :) But now that I know more, I've switched her to other stuff.

    Have your sitter come over and do some tests while you're there. Maybe that way Terry will get comfortable with the sitter handling her. And barricade any hiding spots that will be hard for the sitter to reach her. My Marshmallow likes to sleep under the bed but I cut lengths of cardboard, taped them together to make a 6-foot-long piece of cardboard, and taped it to the bottom of the bed. That way she can't get under there while I'm away. :) It's far from gorgeous, but it did the trick!

    When do you leave for the trip? Try to get as many readings as possible before you go so you can feel confident about her dose before you go.

    Good luck, post questions if you have them, and breathe. Terry will be okay. It's hard to leave her right now, but she will be cared for while you're gone.:cat:
     
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  20. Robin&BB

    Robin&BB Well-Known Member

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    Sep 28, 2013
    Definitely agree about not trying to change from the w/d to another lower-carb formula before your trip. That's something you can do later on. And I looked closely at my old notes from when Bat was treated with Lantus while on w/d: She didn't get transitioned off the w/d canned until close to the end of her treatment (like, just 2 weeks before she went OTJ) so I wouldn't worry about that right now.

    Shane, those are some great suggestions re: getting Terry more comfortable with the sitter & barricading hiding spots! :)
     
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  21. Terrelle

    Terrelle Member

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    Jul 23, 2015
    Thanks for your support guys, it really is helping me stay calm about this. I was bullied a lot as a kid and terry was kind of my only friend who just turned up at my dad's school when I needed someone so I care about her so much it's verging on unhealthy (but I'm sure all you guys know what that feels like). I've been taking 4 readings a day and so far the highest her levels have gone is 14.7 which is 252 and that was only once, other than that it's ranged mostly from 4.7 (84.6) to 11.4 (205.2).

    Do you guys know at what level does it start to become concerningly high? is 14 an ok reading for right before administoring insulin?
     
  22. Critter Mom

    Critter Mom Well-Known Member

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    Jun 16, 2014
    Not unhealthy at all. I've been bullied by people, but never by any cat. Probably why I think more of cats than I do of a lot of humans. ;) I'm glad that you and Terry found each other and that she is such a good friend to you. :bighug: (I owe Terry an apology - I erroneously reassigned her gender in my earlier post. :oops:)

    You're doing great with the home testing. Has anyone here asked you to set up a spreadsheet to start recording Terry's test results? In case they haven't, here's a link to instructions on how to set one up:

    http://www.felinediabetes.com/FDMB/...te-a-ss-and-link-it-in-your-signature.130337/

    If you can get the doses and BG readings into a spreadsheet for Terry, it will help members better advise you on doses. What is the meter you're using? Is it a pet meter or a human meter?
     
  23. Terrelle

    Terrelle Member

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    Jul 23, 2015
    Thanks, I'll try to set that up, and we're using a human meter, does that make a difference, and also she's called a boy all the time. :p I don't think she takes it personally ;)
     
  24. Critter Mom

    Critter Mom Well-Known Member

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    Jun 16, 2014
    The spreadsheets are a great help for learning your kitty's pattern and trends.

    Human meters read a little lower than pet-calibrated ones. Because of that different reference ranges are used for the different meter types. The most important number to get your head around at the moment is the hypo threshold. It's 2.8mmol/L / 50mg/dL on a human meter (3.8 /80 on a pet meter). Members responding to your posts will need to know your meter type so that they can properly understand Terry's BG numbers. It'd be great if you could add the meter type and insulin type to your signature (I see you're already on the case with your spreadsheet - good stuff!).
     
  25. Terrelle

    Terrelle Member

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    Jul 23, 2015
    Thanks, I added it I think... If you guys don't mind can you look at her chart, I think I did it correctly...
     
  26. Maggies Mom Debby

    Maggies Mom Debby Well-Known Member

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    Dec 28, 2009
    That looks great! You see all the blue and some green numbers? A lot of people here would do the happy dance to see numbers like those. You are doing great!
     
  27. Shiloh & Rhonda (GA)

    Shiloh & Rhonda (GA) Well-Known Member

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    May 9, 2015
    Can I ask which of the cats in your picture is Terry? They are both gorgeous BTW.
     
  28. Terrelle

    Terrelle Member

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    Jul 23, 2015
    Thank you guys :) Terry is the tortie and winnifred is the ginger, She has one less eye now then she does in the pic but she's still pretty beautiful. I'll post a pirate pic when she's all healed up, right now she's still in the cone and stitches.

    Wow I didn't know that those numbers were pretty good, I'm surprised she had eye complications then if her glucose levels aren't so bad
     
  29. Terrelle

    Terrelle Member

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    Jul 23, 2015
    He still drives and cares for my grandmother who has alzheimers! He is sharp as a whip still but is having some health problems now.
     
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  30. Terrelle

    Terrelle Member

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    Jul 23, 2015
    Also it looks like our fur babies could be siblings
     
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  31. Robin&BB

    Robin&BB Well-Known Member

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    Sep 28, 2013
    Your two kitties are just beautiful! :cat: And so are Terry's numbers. That's truly amazing, considering how much she's been through just recently.
    Great job on getting that spreadsheet up & running! (P.S. Your grandfather sounds like a real pip - how great!)
     
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  32. Maggies Mom Debby

    Maggies Mom Debby Well-Known Member

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    Dec 28, 2009
    Well, Terry's getting insulin now and she wasn't before she lost her eye. At this point it's hard to know how high she was running before or how long her glucose was high.
     
  33. Critter Mom

    Critter Mom Well-Known Member

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    @Maggies Mom Debby -

    Debby, I was wondering about that. Also, do you think the resolution of the eye problem (sad as it is :( ) might have had a positive impact on Terry's BG?
     
  34. Terrelle

    Terrelle Member

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    Jul 23, 2015
    \
    It's defs had a positive effect on her behaviour, she was so lethargic and sad before and now she's behaving more like herself.

    Also, do you guys know if bloated abdomen is a symptom of diabetes?
    I've seen some cases online where it seems to be associated with it but I can't find a definative answer.

    Her abdomen has felt kind of bloated on the sides, I think it's getting better but it's still pretty solid feeling
     
  35. Critter Mom

    Critter Mom Well-Known Member

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    Jun 16, 2014
    Saoirse's abdomen was bloated at diagnosis. The abdominal bloating pretty much disappeared by the time she went into diet-controlled remission. Sadly since cessation of her Lantus therapy, the abdominal distension has returned with a vengeance.

    Saoirse has had low thyroid test results (not a complete panel - can't remember the specific value the test was for offhand, poss total T4??) and she's showing umpteen clinical signs of hypothyroidism (rusting fur, low mood, low energy, weight gain, alopecia/shedding). The specialist she saw said it was related to her pancreatitis, and I've been trying to find out a bit about Euthyroid Sick Syndrome. Apparently ascites can be a symptom of hypothyroidism. Don't know much about it at the moment.

    There are other conditions that have abdominal bloating as a symptom. Cushings is one, but apparently it's quite rare.

    Definitely something to ask your vetty bean about.


    EDITED TO ADD:

    Try to note whether there is any variation in the bloating. In particular, try to see if there's any reduction after a period of fasting, and also whether the bloating reduces after Terry has visited the litter box (Saoirse seems less bloated in the aforementioned circumstances). Let your vetty bean know about any variations.
     
  36. Terrelle

    Terrelle Member

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    Jul 23, 2015
    Thanks, so far I have only noticed a bit of a reduction since she started insulin. SHe is going to the bathroom just fine and hasn't thrown up at all. My Vet said that she figured it was just her diabetes and that she agrees that its gotten a bit better already
     
  37. Terrelle

    Terrelle Member

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    Jul 23, 2015
    I'm not sure but I'm pretty sure it was because of her eye complications and the did run several tests to diagnose it... I'm not completely sure though.
     
  38. Terrelle

    Terrelle Member

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    Jul 23, 2015
    Also please help, is 60 considered too low?
     
  39. Robin&BB

    Robin&BB Well-Known Member

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    Sep 28, 2013
    Too low (using human meter) is below 50. You're at 60 now @ +2 - if you have to go to bed soon, you might want to steer with a little canned food & recheck in the next hour to make sure kitty is rising more toward safe zone. (Which you're still in, btw, but you only have 10 more points to that cutoff #.
     
  40. Robin&BB

    Robin&BB Well-Known Member

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    Sep 28, 2013
    Did you get a preshot # right before you gave the insulin tonight? As didn't see one plugged into your spreadsheet.
     
  41. Chris & China

    Chris & China Well-Known Member

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    May 10, 2013
    If she drops below 50, that's when you want to get the High carb food out

    What I usually do is pop the top off a can of Fancy Feast Gravy Lovers and then put it back on and "squeeze" the gravy out into another bowl

    You definitely don't want to go to bed until she's stopped dropping and is staying in good numbers without having to have more food to "prop up" the numbers
     
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  42. Robin&BB

    Robin&BB Well-Known Member

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    Based on the numbers you were getting in the previous two cycles in pm that you had filled into the chart, she'll still be dropping by +4.
    I've often set multiple alarms during to night when Bat's doing a low cycle, just to make sure I get in those tests at +4 & +6.
     
  43. Robin&BB

    Robin&BB Well-Known Member

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    Sep 28, 2013
    Actually, I'm thinking you might want to get a +3 - which would be soon, right?
    And can you tell us your first name? Thanks! - Robin
     
  44. Robin&BB

    Robin&BB Well-Known Member

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    Sep 28, 2013
    Please let me know when you have that test result ...
     
  45. Terrelle

    Terrelle Member

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    Jul 23, 2015
    Yah sorry, Her pre shot test was 118 and she's now up to 79 and I gave her a bit of her usual food after her innitial low reading.

    Do you guys think it would be safe to tell my pet sitter if she's reading lower than 7 to give her .5 iu or not administor it at all? I'm only gone for a week and her numbers have never gone above 250. I would rather it be a little higher than too low while I'm gone

    and my first name is Terrelle btw :)

    Thanks again guys
     
  46. Terrelle

    Terrelle Member

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    Jul 23, 2015
    and sorry, by 7 I mean 126
     
  47. Elizabeth and Bertie

    Elizabeth and Bertie Well-Known Member

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    Sep 6, 2010
    Hi Terrelle,

    A reading of 60/3.3 is fine (if on a human meter; it could be too low on an Alphatrak meter).

    However,
    it's not just what the number is but also where it's headed.
    If I got a 60/3.3 at the peak (lowest point) of Bertie's cycle that would be a very nice result for him. But if I got a 60/3.3 and there was still some time to go until the peak of the cycle then I would take some action to ensure that it didn't drop any further.

    See this last paragraph from the FDMB general hypo info:
    "Always keep in mind that with low blood glucose and no symptoms, the BG you get is not as important as where it is headed. In other words, if you get a BG of 100 mg/dL or 5.6 mmol/L or less and there are still several hours or more before the insulin peaks, your need to watch your cat (and the numbers) carefully and take appropriate steps. With very low numbers and NO SYMPTOMS, a cat can be fine one moment and seizing the next."
    How to treat HYPOS - THEY CAN KILL! Print this Out!!
    .
     
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  48. Robin&BB

    Robin&BB Well-Known Member

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    Sep 28, 2013
    I didn't shoot below 200 (11.1), at the beginning of treatment (this was on ProZinc, btw). And you've been getting some pretty low numbers.
    Was that 118 directly before her last dose (I'm looking at SS) --- so does this mean she was dosed at +10 in the cycle? I am not familiar with the type of insulin you're using (I'm assuming it's not long-acting like ProZinc ...)

    Regardless, based on how low her #s were after tonight's dose, and that you'd mentioned in one of your earlier posts that your sitter won't be able to get many mid-cycle BG#s, I would rather see you have her err on the side of caution while you're out of town: meaning NOT have her shoot below 200 (11.1). And you're thinking along the right lines here: Better to be a little high than too low (and if your friend can't check a +3, +5, etc. regularly, how can you know if she's dropping too far?), than to risk a hypo event.

    She's responding well to insulin therapy, btw - impressive, considering the trauma of her very-recent surgery. Terry is quite the little trooper!

    Should have some of those more familiar with your particular insulin weigh in on this in the morning, too - so many good & wise people here!
    You're doing a great job!
     
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  49. Terrelle

    Terrelle Member

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    Jul 23, 2015
    the 118 was right before her does and it was 12 hours after the morning dose, I just wrote it wrong. My vet said to administor it anyways because she's usually high in the morning.

    My sitter will not be able to get any mid cycle readings unfortunately. The only reason I can is because I work ridiculously close to home

    She's on Caninsulin which from what I've gathered drops quickly and climbs slowly
     
  50. Elizabeth and Bertie

    Elizabeth and Bertie Well-Known Member

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    Sep 6, 2010
    '7' is a normal blood glucose number number for a cat.
    Normal blood glucose numbers are approximately 50 - 130/2.7 - 7.2 (although some cats will naturally read a tad lower or higher than this.)
    It not advisable to give insulin at normal numbers (there are some exceptions to this rule, but they don't apply here).

    The general advice here is that, for those new to dealing with diabetes, no shot is given if the blood glucose is below 200/11. That is to allow some buffer of safety while the caregiver gathers some data to work out how their kitty is responding to insulin.
    And with shorter acting insulins like Caninsulin it is especially important to have an understanding of how the kitty responds to insulin before attempting shots at lower preshot numbers.

    What exactly is Terry eating now?
    If you are getting preshot numbers that are too low to shoot (and I think you are...) then you could try holding off on the insulin and switching Terry to low carb wet at this point.
    The change in diet could make a considerable difference to her blood glucose levels. And it may be that she doesn't actually need insulin while you are away. She may be lucky and head into remission (ie. become diet-controlled).
    Let's see what others think...

    Eliz
     
    Last edited: Jul 27, 2015
    Reason for edit: Typo
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  51. Terrelle

    Terrelle Member

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    Jul 23, 2015
    back up to 118 now, and I haven't I haven't fed her since the last time I checked her. I think she must drop early in the cycle
     
  52. Robin&BB

    Robin&BB Well-Known Member

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    Sep 28, 2013
    What was her pre-shot# this morning (is blank in the SS).
     
  53. Terrelle

    Terrelle Member

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    Thanks elizabeth, I actually asked my vet about this and she is worried because it climbs so high usually by morning she doesn't want me to skip a dose. Keeping her other eye healthy is a big worry for us and when she sits around 14 it starts to not dilate properly
     
  54. Terrelle

    Terrelle Member

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    Jul 23, 2015
    my vet had told me not to check because she seemed to be doing fine. but I"m going to resume checking before each does is supposed to be administered
     
  55. Robin&BB

    Robin&BB Well-Known Member

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    You're kidding me! You really do need to check before you shoot a kitty with insulin. I have to disagree with vet on that one ...
     
  56. Terrelle

    Terrelle Member

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    Jul 23, 2015
    She's on Hill's w/d and I plan on transitioning her to a low carb food next week when I'm back and can monitor her really closely
     
  57. Terrelle

    Terrelle Member

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    I could see not checking if the kitty was on a regular schedule for a long time but it's only been a week and I also am far more comfortable checking. Although I hate doing it, I'd much rather poke her ear than have to worry.

    Also I'm pretty sure she didn't go low after her morning dose because she was in a great mood all day, super energetic and even played for a little bit which she hasn't done since her lens detatched:)
     
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  58. Terrelle

    Terrelle Member

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    Jul 23, 2015
    Do you guys think trying 1/2 a iu if its between 7-11 is a safer route and no does if it's under 7?
     
  59. Robin&BB

    Robin&BB Well-Known Member

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    Even then, you must check. You simply never know when a cat is going to pop a wonky pre-shot #. And even though we can sometimes "guestimate" what their patterns usually are after being on insulin for quite some time, kitties can always throw us curve balls. Without the data, some of those curve balls can be dangerous. Case in point: My cat is on only <0.15 U, as needed based on pre-shot #. More often than not lately, she does not need even that tiny dose. Yet TWICE this month - on just under 0.15U of insulin - she hypo'd on me at +3.5 to +4. So there's that ...

    So, Terrelle, keep on testing!:bighug: (Sorry if this posts twice; I keep ketting JavaScript error messages. Arrrgh!)
     
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  60. Critter Mom

    Critter Mom Well-Known Member

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    Start the food transition when you can monitor throughout the day. Do you have weekends off? That would be a good time. The combo of w/d and Caninsulin may mean a big drop in insulin requirements from the start of the transition.
     
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  61. Elizabeth and Bertie

    Elizabeth and Bertie Well-Known Member

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    Sep 6, 2010
    (((Terrelle))) that must be so distressing for you....

    I'm wondering if your vet doesn't want you to skip a dose because s/he thinks this is type 1 diabetes (and she thinks the pancreas won't produce any insulin and therefore the situation is 'stable'). However, the data that you've collected shows that Terry's blood glucose numbers seem to be improving. You are getting preshot (before insulin) numbers that are completely normal. This is very encouraging news in terms of Terry's diabetes. But I do understand that it may be causing challenges for you because you want to follow what your vet has suggested. ...Does your vet know that Terry's numbers have improved and that she is often in the normal range now?
    .
     
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  62. Robin&BB

    Robin&BB Well-Known Member

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    Sorry, Terrelle ... but I really must pop off to bed now (midnight-thirty here), but you are in very good hands with Elizabeth & Aine.
    Goodnight, all! zzzzzzzz
     
  63. Critter Mom

    Critter Mom Well-Known Member

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    Just had a look at Terry's spreadsheet. It might be an idea to chat with your vet about giving her 0.5 IU for a couple of cycles before you go away to see how that works. As Eliz says above, Terry has been in pretty much normal numbers for the last few cycles.

    Also re the food change, I would urge even greater caution. With those numbers, just changing a small portion of Terry's diet to low carb could see her dropping too low with insulin on board. Indeed, if Terry is still in normal numbers at the time of the food change, I'd be inclined to discuss with my vet the possibility of skipping insulin when the low carb food is introduced. w/d is stuffed with carbs. Replacing even some of that food may see Terry not needing insulin at all (based on her current numbers).
     
  64. Terrelle

    Terrelle Member

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    Jul 23, 2015
    Thanks so much guys, the plan is to transition her food when I get back and can monitor it.

    I just tested her again and she's at 9.9... this is why my vet doesn't want me to skip any doses :S I really don't know what to do
     
  65. Elizabeth and Bertie

    Elizabeth and Bertie Well-Known Member

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    Sep 6, 2010
    Terrelle,
    I'm sorry that none of us were able to respond to you sooner. (That pesky 'life' thing gets in the way of FDMB stuff sometimes. Darn it! ;) )

    That 178/9.9 is a bit of a jump up. Had she had any food shortly before that test?
     
    Last edited: Jul 27, 2015
  66. Bobbie And Bubba

    Bobbie And Bubba Well-Known Member

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  67. Terrelle

    Terrelle Member

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    I gave her food 4 hours prior but only some dry w/d
     
  68. Robin&BB

    Robin&BB Well-Known Member

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    Sep 28, 2013
    So you gave her some w/d dry right after her she popped that 60 at +2, is that correct?
     
  69. Terrelle

    Terrelle Member

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    Jul 23, 2015
    Thanks if it makes you feel better, Terry has not missed her eye at all!
     
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  70. Terrelle

    Terrelle Member

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    Jul 23, 2015
    Correct

    Edit: so I guess it was 3 hours after food, and this morning she was at 208
     
  71. Bobbie And Bubba

    Bobbie And Bubba Well-Known Member

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    Jun 15, 2015
    Thanks for telling me that. That is what the optomologist vet says too. Speedy recovery to your sweet baby.
     
  72. Robin&BB

    Robin&BB Well-Known Member

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    Okay, that's what I thought. So ... in an earlier post, you'd said your vet wants Terry's BG below 14 (=252 here in the U.S.).
    That rise last night to 178 @ +5 was in no way horrible/dangerous; is to be expected after a little of the higher-carb w/d dry food.
    (Is no where close to 14/252 - see what I mean?)
    And this morning's AMPS was @ 205 - also not a horrible #. (You're doing great with her newly on insulin, btw.)

    Remind me: When are you leaving town? Is there any way you can get in a daytime curve, say today or tomorrow? I suggest this only because with a little more data on what she does throughout a 12-hr. cycle when she's been shot @ around 200 may ease your mind a little re: worries about too high a spike in BG as relates to her eye problem.

    Is understandable why you're feeling anxious about this: Vet wants you to protect Terry's eye. But as Elizabeth had said a few posts back, it really does not appear that Terry has type 1 diabetes; perhaps your vet was just making an assumption there, but her responsiveness to insulin and rapidly improving #s would make it appear more likely that she's type 2 (like most diabetic cats are). But regardless, she was above 14 only once so far, and that was back @ AMPS on the 23rd.

    I would get some more data today, if you can, to ease your mind (and your vet's).
     
  73. Critter Mom

    Critter Mom Well-Known Member

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  74. Critter Mom

    Critter Mom Well-Known Member

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    Your vet is aiming to keep Terry's blood glucose levels below the renal threshold, by the look of things. Nowt wrong with the reasoning there.

    Maybe you could have a chat with your vet about your imminent trip, explain about the sitter, tell her about Terry's very good numbers and maybe come up with a situation where Terry is below the renal threshold for at least most of each cycle. If you could come up with a dosing strategy along those lines it might give a better safety margin for the sitter.
    .
     
  75. Bobbie And Bubba

    Bobbie And Bubba Well-Known Member

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    Jun 15, 2015
    Thanks so much, I am trying to stay optimistic that he will get controlled and then we can handle the eye problem. It won't be known if it is a cancerous situation until after the eye is removed and it is biopsied.
     
  76. Terrelle

    Terrelle Member

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    Jul 23, 2015
    I can only check her at noon and then after five cause I have to work. I just talked to my vet and she said to give her the dose and Then keep checking her but my sitter can't do that :(. I really like my get and I don't want to disobey her but I'm really worried, and I'm pretty sure there was a test she did that was difinitive to prove Terry is type 1 but I'm not certain
     
  77. Robin&BB

    Robin&BB Well-Known Member

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    Hi, again, Terrelle - Gee, is nothing quite like feeling you're stuck between a rock and a hard place, huh!
    How many days left before you leave town?
     
  78. Terrelle

    Terrelle Member

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    Jul 23, 2015
    My fingers are crossed for you
     
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  79. Terrelle

    Terrelle Member

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    Jul 23, 2015
    I leave tomorrow night
     
  80. Robin&BB

    Robin&BB Well-Known Member

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    Is there anyone else you know nearby who could possibly come in and test for you while you're gone? (In addition to your vet assistant friend, I mean.)

    Because your conundrum is pretty obvious here: You don't want Terry rising too high because of her eye; nor do you want her BG bottoming out when no one can be around to monitor/steer with food (a real possibility if you allow your friend to shoot her @ under 200.)

    If you can't get another helper in, the only other way I can see that you could possibly handle this is to have Terry stay at the vet's while you're gone - which, as we all know, is a pretty darned expensive option.

    Anyone else here have some ideas/alternatives???
     
  81. Critter Mom

    Critter Mom Well-Known Member

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    Sometimes one needs to go with the cat's numbers, not the vet's advice. The most important thing is Terry's safety.

    I'd suggest talking to your vet asap about giving a 0.5 IU dose tonight to see if it keeps Terry in safer numbers. There's no guarantee of that with any dose, but it would at least give you some data to work with and share with your vet tomorrow.

    What do others think?
    .
     
  82. Terrelle

    Terrelle Member

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    Jul 23, 2015
    I tried to talk to her and she just said to not give the dose and then check the numbers every two hours :S
     
  83. Critter Mom

    Critter Mom Well-Known Member

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    That's progress. Presumably you'll review things with her tomorrow before you depart?
     
  84. Robin&BB

    Robin&BB Well-Known Member

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    Does she mean tonight's dose?
     
  85. Maggies Mom Debby

    Maggies Mom Debby Well-Known Member

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    If this was my cat, I would cut the dose while I was away, whatever the vet said. Better safe than sorry. (There were times I did tell me vet that I wasn't comfortable dosing at her recommended amounts.)

    With no one there to test or observe Terry mid-cycle, I would reduce to .5 units while gone. Terry's numbers are so good after such a short period of time that one week on a half dose really shouldn't hurt her in the long run. One week of slightly higher numbers should be be easy to get back down again, while going hypo with no one there to catch could be very serious. There is a saying here that goes something like this "better too high for a day than too low for a minute".
     
  86. Robin&BB

    Robin&BB Well-Known Member

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    Debby has a real point here.

    And the problem with your vet telling you to "skip the dose" tonight (if that's what she meant) is that you're leaving in the morning, right? And then you've left someone else with the daunting responsibility of a kitty who may need a dose of insulin next cycle after a skipped dose "to see what she does" ... (someone who cannot regularly monitor for nadir drop, mid-cycle spike, etc.) when that skipped dose could set Terry up for a bouncing episode after the next shot of insulin. (Just sayin'...)
     
  87. Terrelle

    Terrelle Member

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    Jul 23, 2015
    Thanks, After talking to my mom (Who is a pharmacist) I'm going to cut it to .5 while i'm gone just to be safe :)
     
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  88. Robin&BB

    Robin&BB Well-Known Member

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    Sep 28, 2013
    You might consider starting that 0.5 unit reduction tonight after PMPS ck; you might well see a softer drop with the reduced dose than the 60 you got at +2 last night with 1.0 unit. Maybe won't require any steering #s with food, either, tonight. Will have fingers crossed for you!:)
     
  89. Terrelle

    Terrelle Member

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    Jul 23, 2015
    Thanks! That's the plan, cause at lunch today she was 4.4 and that's from 11.4 this morning so I just don't feel comfortable giving her a full iu tonight
     
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  90. Robin&BB

    Robin&BB Well-Known Member

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    Sep 28, 2013
    That sounds great! Will look forward to seeing her SS tonight.
     
  91. Maggies Mom Debby

    Maggies Mom Debby Well-Known Member

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    Terrelle, you are doing great with all this! Terry is lucky to have you taking care of her.
     
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  92. Critter Mom

    Critter Mom Well-Known Member

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    Jun 16, 2014
    How long will you be away?

    Here are some other things I would consider in your circumstances. Depending on Terry's numbers:

    1. Only give ONE 0.5 IU dose per day.

    2. Only give 0.5IU every other day.

    Because of drops like that, the lowest pre-shot number I gave Caninsulin to Saoirse was at 10/180 (Alphatrak). Even then with a small dose it still took her right down to the hypo threshold.
     
  93. Terrelle

    Terrelle Member

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    Jul 23, 2015
    Ok so she was at 118 so i gave her .5 iu so I can watch her cycle with it before I leave tomorrow night... depending on what numbers she reach I guess I'll decide if I want it to be only in the mornings or evening and morning. I know I'm not supposed to does under 200 but last night she didn't drop below 60 and that was with 1iu on the same reading

    Does that sound like I'm doing the right thing?
     
  94. Robin&BB

    Robin&BB Well-Known Member

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    Sep 28, 2013
    Hopefully, that redux to 0.5U will give you a lower drop tonight, since it's half as much ... I'll keep my fingers crossed while waiting to see what #s you get later in cycle. :)
     
  95. Terrelle

    Terrelle Member

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    Jul 23, 2015
    Also do cats generally react to the medicine the same way most of the time? is that how curves work?
     
  96. Critter Mom

    Critter Mom Well-Known Member

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    Jun 16, 2014
    @Robin&BB - Glad you're here to check in to see how Terry's doing this evening (I'm about to pass out).

    @Terrelle - There's no guarantee where any dose will take a cat. 118 is a low preshot for Caninsulin (and a bit more so for an evening cycle when more cats tend to run low). The data you get for the half unit dose tonight will hopefully be a very valuable guide for decision-making tomorrow before you leave. I'll check in tomorrow morning (passing out here) to see Terry's results for tonight and I'll post again (I'm in the UK so it will be there for you in the a.m.).

    EDITED TO ADD:

    Cats bodies are living systems, as are our own bodies. Bodies adapt minute by minute to changes in the environment - food, cold, thunder, affection, fright, light, dark, exercise, etc. When bodies are working properly the pancreas and the liver work in harmony to keep up a constant supply of glucose so that cells can use it as fuel. With a diabetic, insulin production gets screwed up so we give 'foreign' insulin to compensate. Unlike a healthy pancreas, foreign insulin doesn't come with an off switch so it will keep on working until it's used up. This happens on top of all the other variations in the body, so no two cycles will be identical.

    The purpose of our recording our kitties' data is to determine a pattern of response to a given dose of insulin so that we can make things as safe as possible.

    It's great that you're getting data on the 0.5 unit dose before you depart.
     
    Last edited: Jul 27, 2015
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  97. Terrelle

    Terrelle Member

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    Jul 23, 2015
    Thanks so much.

    Yah I know it is a low preshot but I really want to get an idea of what it will do while I"m here to monitor her.
     
  98. Robin&BB

    Robin&BB Well-Known Member

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    Sep 28, 2013
    Nope! Not only is every cat different (you'll see the cautionary acronym ECID around here a lot), but even when a kitty has a pretty well established pattern on spreadsheet on a particular dose, there's always a possibility that kitty will throw you a curve ball somewhere in the cycle. This is why BG testing - including a mini-curve or full curve every now and then - is so very important.

    Something as simple as seeing a bird or squirrell outside the window can spike a cat's BG; a dosage shift can result in a wider swing either way (sometimes hypo zone with dose increase); transitioning from high-carb food to low-carb can dramatically reduce the need for insulin. Some cats take several cycles to "settle in" to a particular dose; others don't. This is why we all think that a vet who says someone with a kitty on insulin "...doesn't need to monitor the cat's BG @ home" is not all that well-versed in treating feline diabetes.

    Make sense to you? It's good that you ask questions! I like to think of it as: "Curiosity heals the (diabetic) cat."
     
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  99. Terrelle

    Terrelle Member

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    Jul 23, 2015
    Thanks,

    my vet did say she' liked the idea of home monitoring she was just worried that the ear testing would upset terry while her eye was healing...

    Also, if they don't react the same every time then what is the point of monitoring their glucose so closely? Just curious because I thought the reason was to adjust as necessary but if you don't know how they will react at all then how does it help? Aside from attempting to prevent hypo of course
     
  100. Robin&BB

    Robin&BB Well-Known Member

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    Sep 28, 2013
    @Critter Mom - Good grief; is it 4:30 am where you are? Did you have to pull an all-nighter? Small wonder you're about to pass out!
    Pleasant dreams, Aine! (zzzzzzzzz)
     

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