New to this but learning...

Hello all, my cat Rascal started getting sick end of September 2015, vomitting a bit lethargic and then the continous water drinking and peeing during oct/nov. He is a short haired tabby weighing in at 14 lbs, he's a big boy, big boned not just fat. Anyhow my vet thought initially he may have CKD but after testing his urine and blood and finding high levels of glucose in both he as tagged as diabetic. Two weeks now on Vetsulin 2 times per day. Started on 2 units and now on 4 which seems effective. I have lots of worry's about making him hypoglycemic and luckly no issues so far. I have ordered a gluco meter for home tests and plan to get him into vets for a glocose curve soon. I have so many questions not sure where to begin but I hope I can get some answers here. Thanks

 

Hello, Rascal's Person. Welcome to you both.

It's good to hear that Rascal's responding well to his insulin therapy. I can relate to your worry about hypoglycaemia: the vets that first diagnosed my Saoirse were not supportive of home testing at all and for the first few weeks of her treatment I hadn't a clue what was happening with her blood glucose levels, and I was a nervous wreck. We moved to a practice nearer our home and the new vets were much more progressive with regard to home testing and taught me how to test Saoirse's blood glucose levels. I'm glad to hear you have a glucometer on order. I can say with confidence that it will give you much greater peace of mind being able to monitor Rascal at home.

Be sure to ask any questions you can think of. There are plenty of us here who will be only too happy to help you both in any way we can. You've found a great place to learn and get support.


Mogs
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Welcome.
Vetsulin is not the best insulin for most cats since it does not last long enough. Good insulin are the human Lantus and Levemir and the pet insulins ProZinc and BCP PZI.
Most of us here test or cats blood glucose at home using a human meter. What meter did you order?
We test before each shot and periodically between shots. We record our reading and other info in a spreadsheet. See:http://www.felinediabetes.com/FDMB/...te-a-ss-and-link-it-in-your-signature.130337/
Do a curve at the vets is not typically good since vet stress can raise BG by 100 or more points (USA) due to stress.
What are you feeding? A low-carb canned is best. No reason for a prescription food. Here is a list of commercial low-carb canned

http://www.felinediabetes.com/FDMB/threads/shortcut-shopping-list-all-8-or-less-updated.117688/

Here is a link to home testing blood sugarshttp://www.felinediabetes.com/FDMB/threads/hometesting-links-and-tips.287/

 

I had no idea there were different varieties of insulin. He's on 4 units/2x/day and currently it seems to be working okay at this dosage.
He has been on Purina NF wet food as initially vet thought he had CKD as of course symptoms are so similiar. The high level of sugar in blood and urine proved that his issue is diabetes. He also has been eating some Hills K/D dry food but very limited amount.
I am in the process of moving him to all wet food diet and onto something like Wellness Turkey canned which is low in carbs. Interestingly I hear this can lower a cats blood sugar levels but the vet was not too concerned with my cat about lowering the insulin dose just yet. I believe his blood sugar number was in the 500's real high. I'm just watching him closely for any signs of hypo condition..

I ordered the made for pets Alphatrack 2 glucose meter. I have put a call into the vets to get some clarification from them as well on what they recommed but can see the cost of this meter and test strips adding up quickly. If it turns out a human meter is sufficient I will return the one ordered. thanks for all the info. Don

 

Hi again, Rascal's Person.

I see that you're planning to transition Rascal onto a diet exclusively of low carb wet food. You are absolutely right to be concerned about the effect of the transition on Rascal's blood glucose levels because the lower carb food may lower blood glucose levels very significantly. 4 units BID (2x per day) is a fairly substantial dose of Vetsulin and may need to be adjusted from cycle to cycle* as the food transition progresses. You really should be home testing - before each injection and also at various points during each cycle) - BEFORE making the transition so that you will be able to keep Rascal safe. Doing the low carb food transition when not home testing carries a much greater risk of a cat becoming hypoglycaemic.

While there are Alphatrak 2 users here (I'm one), most members tend to test with human meters (NB: using a cat-specific BG reference range) because, as you've already observed, the test strips for the veterinary meter are quite pricey. If you let us know which country you are in members will be able to suggest suitable meters available in your part of the planet.

I can't recommend having the ability to home test highly enough. The peace of mind it gives is phenomenal.



Mogs


* Cycle = time period between insulin doses. (Majority of cats are dosed twice a day, so in that case each insulin cycle would be 12 hours.)

 

thanks for the info Mogs. I believe the food he has been eating mostly (wed food) is already low in carbs, he gets a very small amount of dry kibble. I don't know why but my vet is not real concerned with him having too high a dose of vetsulin? He so far has been a great veterinaian and am trying to have confidence in him with this too. Due to being right in the middle of the holidays here in the U.S., it's tough even talking to a vet right now or a tech. I am about out of his prescription k/d wet food so I asked the vet about transitioning to a commercial high quality low carb wet food and he said go for it. So I am going from wet food to wet food and maybe this is why he is not as concerned. As the new year begins and I can work with my vet I want to attempt to being home glucose testing....

 

It's good that Rascal's on mostly low-carb food but be sure to keep a watchful eye on Rascal with the k/d being removed from his diet. It's fairly high in carbs. I just had a gander at the Hill's website and the chicken flavour canned food is 35.4% carbs (dry matter basis - link below). I don't know what flavour Rascal has been eating but I assume that the carb content would be similar across the range of k/d canned varieties.

http://www.hillspet.com/products/pd-feline-kd-feline-renal-health-with-chicken-canned.html

Do you know roughly what Rascal's pre-shot and mid-cycle numbers were when the vet decided on the Vetsulin dose? It would be great if you could let us know so we can get a better picture of where Rascal's at at the moment.



Mogs
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It's tough during the holidays for starting all this. But the earlier you start the faster Rascal will feel better.

I'm an Alpha Trac user also. Because I didn't know about this board or even think a human meter would work on a non human.

The strips are expensive. I try to catch them on sale. I order online. Smokey always knows the day they arrive because I swear he plans it. Within 24 hrs of arrival we will go through one bottle immediately. There is a human strip that can work in the AT meter some here do that.

You will do just fine with what ever you use. Some cats do very well on Vetsulin. There are people here who can help you. Once you have the basics down and the data. You can tweak things later.

Most important is getting insulin started.

Weclome, breathe, pick our brains. Looking forward to your progress.

 

Welcome to FDMB.
Many of us use and inexpensive human meter with feline specific reference values (listed in my signature link. )Plus, all the guidelines here were written using human glucometer reference values. While you work on home testing, take a look at my signature link Secondary Monitoring Tools for additional assessments which you may find helpful in evaluating your cat. He is more than a glucose number.

 

I decided to buy a ReliOn gluco meter and test strips. I'm watching you tube videos learing how to get blood out of my cats ear.
I tested last night and it read 250. Before feeding him tonight his blood test came out at 110. With such a low value I feel I probably should NOT give him his shot on insulin tonight as that is low? Thinking I wait until morning and test his blook again before morning meal?
I'm new to reading the blood levels and wonder just how accurate the meter is? Any feedback appreciated.. thanks

 

Congratulations at managing to successfully test so soon! You are progressing at lightning speed at learning this sugar dance.

I am not a Vetsulin user and can't give you any dosing advice, but with a reading of 110, I think you made the right decision especially since you are just getting started testing. As a general rule of thumb for those very new to this dance, we suggest no insulin if the pre-shot reading is under 200. Rascal likely will test high in the morning but shooting at a reading of 110, could potentially send him too low. The problem is that no insulin is not always the right answer either. I believe the shot scheduling with Vetsulin is a little more flexible than with some other insulins because it doesn't always last a full 12 hours in cats but with that low a reading, it may be that it is lasting in Rascal. ECID (every cat is different). If you just removed all the dry kibble from Rascal's diet, it may be that he needs less insulin now. Hopefully someone with experience with Vetsulin will chime in here.

Meters can all have a variance of+/- 15 -20% depending on the reading. So when you got the reading of 110, it could really be 15-20% lower or higher than that. The meter gives you a rough idea of where Rascal is at and you can make judgement calls based on those readings but those readings are estimates rather than exact readings. Even a reading 20% higher than 110 would cause me to hold off on his shot especially when you were giving 4u.

 

Hi Rascal's Person (Be nice to know your name, too, if you care to share. )

You're going great guns with your home testing! Well done catching that low preshot number of 110 - and that you held back on the insulin because of the lower reading.

From what I've read here, I think that in the US glucometers are legally required to be accurate to within +/- 20% of actual. (@BJM - is this correct?)


From your earlier posts:

Vetsulin can drop the blood glucose level quite hard and fast and, though not huge, 2 units is a significant insulin dose. If Rascal were mine (and assuming that he has no history of throwing ketones) I would skip the dose tonight for safety reasons (and doubly so because you don't yet have a body of data to know exactly how Rascal is responding to his insulin). Other members may have different views.

Per your earlier comment about almost being out of k/d food, has the proportion of low carb wet food in Rascal's diet increased now? If yes, the reduction in dietary carbs could be influencing tonight's low preshot result. I would suggest that you get another test in later this evening to see where Rascal's blood glucose is heading. All data is valuable.

I am concerned that Rascal may need to have his dose adjusted downwards, especially if most (if not all) of his food is now lower carb. To that end, I strongly recommend that you post a new thread on the main Feline Health board asking for Vetsulin dosing advice BEFORE Rascal's next dose is due. More people are likely to see your thread there. I suggest giving the new thread a title along the lines of "Vetsulin Dosing Advice Needed". Include any test data that you have in the thread, together with the insulin type and dose, your meter type (human and vet meters use different reference ranges), and Rascal's food info. These details will help members reading your thread to offer you better help. (We can help you set up one of our spreadsheets for storing Rascal's data, too.)


Mogs
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The FDA currently stipulates meters in the US must read within +/- 20% of what a lab would get something like 95% of the time. There are some meters which read within a smaller range than that in Canada, as their requirement is more stringent. The FDA is considering a tighter range for new meters; I don't believe it has been set yet.

 

@BJM - Thank you!