Newly diagnosed 15 year old

Just returned from vet. Tasha's weight up to 5.3 (yeah!) Vet is on board with the home testing (phew!) Took my meter with me - mine read 188 / theirs 130. Going back Thursday just to keep an eye on things while we are going through this regulation. Going to get to work now! Thanks!

 

Really interesting that the meter at the vet read lower than yours. Hmmm, I always thought that it would be higher if they use an animal meter? Plus the vet stress issue, usually the kitty goes higher. Either way, good number and great news about the weight gain for your tiny little girl! :smile:

 

Yeah, I know. And I am WAY too much of a "newbie" here to even make this comment - so, let's just say I'm thinkin' "out loud" .........because a spread of 58 could be HUGE at a crucial moment!
Do most people take THEIR meter as well?
1) Could HER meter be old?
2) Could MY meter be defective? ........ how do you know this stuff? Should I get an "animal" meter - if the animal & human are DIFFERENT - why are we using them?


.........like I said, just thinkin' out loud.........

 

We use the human meters because they are accurate enough for our purposes and the test strips cost a whole lot less.

Yes, people often take their meters to the vets to compare.

Meter variance can be 20% plus or minus, even on a human meter. They are allowed to be this 'inaccurate' by law.

188 yours/130 vets
188 plus 20 % = 225
188 minus 20% = 150
130 plus 20% = 156
130 minus 20% = 104

At the vets, did you test on the exact same blood drop? Within seconds of each other? That can make a difference.

 

It's a little more complicated than just percentages. It also depends on whether the meter being used is calibrated for whole blood or plasma equivalent and what the assay method is (e.g. Glucose oxidase).

 

Deb: Yes, same blood / within seconds. I was just notating out of curiosity. :idea:

Marje: Tashie was out of the BLACK this morning --- I also put LC food down at 11 PM as she was ravenous yesterday and I thought it might also keep her lower during the night. Do you think she might be coming out of her "bounce"? You (or someone) had said that it took about 72 hours - which would have been last night / this morning.

B

 

Think of it as Celsius vs Fahrenheit. You're still measuring for the same thing, using different scales. There reference values for each.
Ex water freezes
@ 0 degrees Celsius
@ 32 degrees Fahrenheight

Ex hypo range for cat on insulin
@ 40 mg/dL human glucometer
@ 70 mg/dL AlphaTrak

 

BJM: Thank you - as I am a "newbie" I am just trying to be alert and note anything I see that either I don't understand or doesn't make sense to me. I'll let this question go to the back burner of my mind now to make room for other things! @-) Thanks for the response and analogy.

B

 

Hi Bernadette,

Are you able to get a mid-day test today? We are still trying to determine how low Tash is going at mid-day. She is such a tiny kitty and even a 0.5U dose could have a big affect on her BG (blood glucose) numbers.

Yes, a bounce can take up to 72 hours to clear. Another thing that might be going on is that Tash is dropping low at night. I know it's really hard, but we do need you to try to get a test before you head to bed each night. That will tell us which direction she is going, up or down.

I'm really worried, that Tash might be dropping low every night, not just clearing a bounce to show that high number in the morning.

I would like to see a test after PMPS as late as you can make it. If PMPS is at 7 pm your time, a test at 11 pm would give us a +4 and be very useful information. Would you try to do that please?

Leaving food out overnight is a good idea. Many cats drop lower at night, and will go eat something if they feel their BG dropping. Sort of trying to raise their own BG with some food like Marje had you do the other night.

 

Bernadette

Just want to clarify that a bounce "can" take up to 72 hours to clear but not all do. Some clear in hours. Also, food will not keep her low....it will help to keep her from going low but if she has too much insulin on board, even LC food might not be enough.

Here's what Im thinking...I believe she might have been ravenous because her numbers were too low if that is not a normal pattern for her. That is a very characteristic sign of a cat whose numbers are low. Of course, they are also hungry when they are too high. ;-) But I know if Gracie is on the counter, she is low. Many other members remark that their cats will wake them up wanting to eat and the numbers are low.

Unfortunately, they don't always let you know when they are low by wanting to eat. Fickle creatures

I really think you might be in a cycle of high at PS, dropping low mid to late cycle, bouncing back up at PS. This is not the way to work this insulin.

 

Marje, I'm at work - what are you suggesting? Can't test MID day today but can do a +3 or +4 tonight and a +6 tomorrow? What are you suggesting ? What do you mean when you say "this is not the way to work this insulin"

.......confused again! Just when I THINK I get it, I don't. Please bear with me

 

Lantus 101 (terse version :smile

1) give the same dose am and pm, at 12 hour intervals

2) dose adjustments are based on the nadir - the lowest glucose level after a shot. This is somewhere around +5 to +7 hours after a shot of Lantus

3) you need to wait
a) at least 5 days (10 shots), on the same dose, before using a nadir to adjust dose upward if on the 1st dose
b) at least 3 days ( 6 shots), on the same dose, before using a nadir to adjust dose upward if on the 2nd dose

4) a) if it is less than 1 year of diabetes and the glucose goes below 50, a dose reduction is earned
4) b) if it is more than 1 year of diabetes and the glucose goes below 40, a dose reduction is earned

5) when on insulin, if you get a glucose level below 40 mg/dL on a human glucometer, it is treated as a hypoglycemic episode. The glucose may be too low for the cat and you must take action to raise it because if the glucose continues to drop, it could kill the cat. The cat may or may not have symptoms; we treat 'as if' to prevent the possibility of the more serious situation.

6) if a cat goes too low, or drops too fast, on a dose, the body may 'bounce', that is, release counter-regulatory hormones to release stored glucose. These elevated numbers may take 3 days to level back down.

 

Below 40 is a low number, yes....and it is something to deal with immediately. But not all cats have clinical hypos. There are many cats that get below 40 and are fine. Do we like it? NO! Do we want them up immediately? YES! But it doesn't mean they are having a hypo.

Bernadette...I'm trying to get to work do I will have to explain it more in depth when I get home. I know you can't get a mid cycle during the work week. But an out the door or +2 test and an in the door will help. On weekends, you can get some midcycle tests.

 

No problem. I thought this was a "NOW" issue. Again, we can to a later test tonight and a mid day tomorrow. And, I was thinking that she hasn't been on this new dosage (.5 U) for a full 3 days yet. TONIGHT will be the end of the 3 days.

We'll chat later when you have time :YMSIGH: ........there is nothing I can do NOW anyway

 

BJM: Thank you for the info!

 

Just a note....they haven't been on the forum but about a week. They haven't decided they are following a TR protocol yet so it's best to not quote the protocol until they get the basics down and are a little more comfortable with the basics.

 

Just "felt" something was wrong - ran home, Tashie seemed subdued and not that good - I wasn't SURE if it HYPO or what,it didn't feel right. Couldn't catch her, neighbors son came and helped - rather than ASSume it was hypo and give Karo, took her to vet. ****DID NOT GIVE KARO
Tash was at 516 between +8 & +9. WAY too high. That is why she isn't feeling well - I have been instructed to give 1U at regular time tonight and do NOTHING in the morning - her "normal" morning time is 7:30 but I am to take her down to the vet at 8 AM and they will do a glucose screening - I will take the insulin, the syringes, and OUR meter so they can read on both. Also taking food.

I THINK that you may agree with this as you said something about her dropping & spiking etc; I do have to say that when we gave Tash 1U x2 she seemed at her best. Although, if I would have given her 1U the other night she would have gone WAY low when I gave her the 0.5 that I shouldn't have.

Vet is thinking it MIGHT be 1U in the morning and 0.5 at night - can't really say right now.

Exhausted AGAIN!

 

Lantus seems to do better with equal am and pm doses. Perhaps a compromise would be 0.75 units. You'd have to eyeball the syringe to measure between the lines; magnifiers can help you see to do this.

 

Thanks! I will suggest this to her (the vet)

 

this is how 0.75IU looks - note the position of the black plunger

 

I'm very concerned that Tash is bouncing really high from some big drops overnight.

Bounces from those low numbers like you got a couple of nights ago, can take up to 72 hours to clear.

I'm afraid if you increase the dose before the bounce has cleared, that will be too much insulin for Tash and she will go really low again, down into the low double digits.

 

It's been 72 hours

 

we are going to get a reading and have decided to dose at .75U - taking it up in between.

 

Thats assuming of course there wasnt another low last night. I am telling you, Tashie wants mommy up all night testing lol.

Sounds good but rememeber that pre shot! And if its under 200.. dont shoot..

 

Wendy, mummy IS up all night!

 

lol. so quick test

what are you going to do if she is under 200 at preshot?

 

Actually, it will be 72 hours tomorrow morning from that low on PMPS for 5/26. We start counting cycles after the one in which the bounce occurred.

A bounce is caused by the BG dropping lower than the cats body is used to. The body pumps out glucogen and counter regulatory hormones to raise the BG level up to what it considers normal. This lower BG, does not have to be below 100 for this effect to kick in. Any steep drop will cause this.

Tash has been bouncing every day with more low numbers.

Here are two examples from your SS data:
On 5/27 AMPS cycle, Tash dropped from HI (>600) to 157 in 6 hours, a very steep drop and caused another bounce.
On 5/28 AMPS cycle, Tash dropped form Hi (>600) to 188 in 4 hours, a very steep drop and another bounce.

We don't know what happened overnight on those two days because there is no test data.

Those steep drops and bounces are often caused by too much insulin.

There is also a strong possibility that there have been more really low numbers since 5/26. No tests to show that though, only my gut telling me that.

 

Me too - if it was my cat I would be getting a +5 for sure.

 

Bernadette

I'd just like you to look at Terontos SS and see if you see any similarities with Tashie.

10/13
AMPS: 291
+6: 104
PMPS: 476

10/15/11
AMPS: 513
+6: 133
PMPS: 234
+1: 325

That's some serious diving and bouncing. If Pauline hadn't gotten any tests, we would not have seen what he was doing...notice how we had her decrease his dose and he was off insulin quickly.

Do we know absolutely that Tashie is doing this? No...but the patterns are similar and we've seen them before.

You hold the syringe....I only ask that since you've increased, that you try to test more.

I will also suggest that you will get better data if you test at home. Being in the vets office all day and having them poke her ear with a needle won't help her numbers. And if she is in a bounce all day, the vet will feel a dose increase is warranted....when it might not be.

 

Bernadette - how is Tashie doing? I see she was at the vet! No surprise on the 53 if he gave her 1unit and wasnt eating.. so glad you didnt give her a 1 that night.

Is she eating now?

Wendy

 

Wendy, thank you for asking. I've been quiet for a few days as I had to just step back and get my head around all of this. I was feeling completely overwhelmed and my head was just blocking out information. Then, yesterday, someone made the comment "Duh" and it set off a light bulb for me ........ I realized that I had it all BACKWARDS. I'm now 2 weeks into the diabetes and 1 week into the FDMB - guess I'm a little slow but this is what was going on with me:

When I have taken Tash to the vet - especially in week 1, when they tested her and she was at higher numbers, they instructed me to increase the insulin. She was started on a dose of 1U X1 - then upped to 1u X2, then I was told to up to 2U - now, I NEVER did this, thank God as I joined the board and was told to get syringes rather than use the Lantus needles. I did not UNDERSTAND, until now, that when the vet was getting HIGH numbers, it was just that part of the cycle for her, I wasn't realizing HOW insulin works.

Therefore, in my head, because she was having HIGHS, I thought she needed MORE ...... in my head, the HIGH numbers scared me worse than the LOW. Duh!

So, I finally got it! Hey, I'm a blonde, what can I say! Completely embarrassed! Better late than never I guess.

I have updated Tasha's SS. I am dosing at only .05U. She is having some highs but I think she is a bouncing girl - just don't want her to bounce too low. We are going to step up the home testing - more tomorrow than today due to "life"

She is eating well and I can now tell just by looking at her if she is HIGH or lower. When she is under 200 she is much brighter and more social, when she is HIGH she looks "hot" and her eyes are teary.

Thanks again for asking - any advise on where we're going?

 

Sounds to me like you are going in the right direction.

More testing in the middle of the day to pinpoint the nadirs can be helpful. The nadirs do not always stay the same time, they can move around.

A lot of people get really scared by those high numbers. Yes, if you get those high's over 300, it's a good idea to check for ketones with the urine dip sticks on a daily basis.

It's the lows that are scarier. They can kill quickly, in less than a day. The highs, they take longer to inflict damage and kill, over a period of months or years.

 

Thanks! Do you know anything about the Google SS I am using? I have a few questions.......

The HIGHS were the ones that scared me - now I am WANTING them a bit more - know what I mean! Duh!

 

What are you questions on the google SS?

I use it myself so hopefully I can answer your questions.

 

High numbers can be a result of two things - too much insulin or not enough.
If the numbers are consistently high, its probably not enough insulin.
If the numbers are bouncing up and down, its too much insulin.

I saw a quote "Better too high for a day, than too low for a moment."

Always always always get a preshot test. If its the only test you are able to do. The worst thing you can do is shoot her when she is low.

Be careful of judging soley by this... you will see teary and tired likely if she is very very low.

Who knows? Its tashie leading this dance, we only follow!
Protocol says at least 3-5 days (thats 6 -10 cycles) on a dose to see how its working unless she drops under 50. We have to start counting from last nights 0.5IU - thats cycle 1. This morning is cycle 2. and so on. We re-evaluate at cycle 6. See below for protocol fyi which i edited a wee bit to make a bit clearer.

Wendy

 

Deb: when I have a high number in the 1-12 cycle it is NOT turning black like it does pre shot? On 05/27/13 it did but in the following days it didn't. Also, I was looking at someone's SS and they were able to put some more info in the numbers boxes - like, for example, in the +4 box, she was able to note that it was actually a +3 1/2 reading - mine won't let me do this? Hope I am explaining correctly - just republished me SS, you should be able to "see" what I'm saying ?

 

I am so glad to see you back! I was worried. I have been watching the SS and did this ------>>>> when I saw you dropped the dose on your own!!!

I think when you are ready, you might want to consider posting in the Lantus TR ISG. If/when you do, please be sure and copy the link to this post and paste it in your first post in that ISG.

To do that, open a new post, put your cursor in the text box, click on the box above the text box. It will then put this in the text box: [url]

Paste your copied browser link from this post in between the two boxes:

paste link here

Hope to see you there.

 

Thank you. I might do this later today. Don't want to go into overload (again) .....DUH! Can only tax my brain so much right now - blonde, you know!

 

Bernadette

Your SS might have lost some formatting in the cells in between the preshots. If you will PM me, I can help you with that.

Yes, you can add other numbers, like a +3.5 test. For example, if you test at +3 and +3.5, go to the +3 box, and type in (I'm just making up numbers as an example)

80; 92 @ 3.5

Then you will need to manually color code it. Go up to the editing toolbar and you will see what looks like a pitcher. Click on the box you want to color, then click on the pitcher and select the color. It should color it in. You can also do this with the black numbers in the middle or, as I said, PM me and I can fix the formatting on your SS.

 

Bernadette

If you see this and you get a number below 200 at PMPS, could you please NOT FEED her and post. Let's see where she is. Maybe if she's not too far below 200, you could shoot.

AND if you see this, if you can get a +11, that would be great. It would give us an idea if she's dropping or up a bit.

Thanks!

 

Didnt I read somewhere you were gojng to to do more testing today or did I imagine it? Can you get a night time test tonite?

 

Hey Ohio Neighbor :smile: You are really learning fast, doing a fab job and going in the right direction; kudos to you! Maybe a suggestion: If you can afford it, I strongly advise getting a second meter; you never know when they can be "off", what if it took a good hit by being dropped on the floor and think about what would happen if you're up late getting tests because her BG's are low and you either: run out of strips, glucometer doesn't work and the store(s) where you buy them are closed (or you can't get right to the store)? I actually have 3 meters (Relion & Arkray, which is a ReliOn generic and a True Result). When I got low readings on Gobbles, I would check him on two meters using the same drop of blood. As for her moods: that is exactly how Gobbles was--when he was pushing 400 or over, he became somewhat lethargic and when in the mid-200s and lower, he was perky and much more social. However, be advised that a lot of cat's don't show hypo symptoms--the lowest reading I ever got on him was, I think 44 (I'm too lazy to scan his SS at the moment) and he acted exactly the same as when in the 200's range... Lots of hometesting is beneficial; helps to get to know how she reacts, nadirs and builds history on her patterns; it also keeps her safe as you will know what to do if she gets real low (if someone has not suggested the "hypo" toolbox, let me know, but I'm sure someone did and you're covered). One thing about the "hypo" toolbox, I advise that you keep several different flavors of gravy-style food--sometimes Gobbles' would be very finicky when I needed him to eat, and I would end up opening maybe 4 or 5 cans when I desperately needed to get his BG up Have a great Sunday!

 

Hey guys, thanks for the words (and prods) :lol: Yes, I did say that we were going to try to step up the testing TODAY is the BIG test day - had a lot going on yesterday and I was alone with her, had no help. Yes, you might be saying ..... what, she is just a little 5 pound ball of fur, what is mummy's problem? Well, she is a whippet and it's a 2 man job with her - she crawls into places or finds new hiding places and, trust me, it is not easy. Also, if I have to do a 15 minute chase she is so worked up by then (as am I )

I am going to try to get a test in EVERY 2 hours today - wish me luck!

Good idea on getting a second meter! And I completely get what you are saying about opening 5 tins of food!

 

AMPS - done! I am on it! PROMISE!

 

Shake that treat bag! Teach Tash to come running for those tests. :lol:

Some people very nonchalantly say, "Test and Treat time now" or "Time for your ear pokies and treats" and the cats come running to their spot for testing.

I picture Tash as more of a sauntering type, saying something to herself more along the lines of "Well, I'll suppose I'll come for my test. I do get those yummy treats. I guess it's worth it, to trade an ear poke for a treat. But I'm not going to let Momma or Poppa know that."

Good luck on corralling Tash for testing today. It will be interesting to see what the numbers are.

Have you read this document on the psychology of ear testing? https://sites.google.com/site/michelangeloprofilefdmb/feline-diabetes/ear-testing-psychology You may get some insights into making Tash more comfortable with the testing and not have to chase her down. This was written by member Kpassa and I think it has some great tips.

 

Wendy, you are funny! Tash does not "do" treats - she will ONLY eat food from a bowl. She wasn't a nightmare this morning - hoping that is a sign for the rest of the day :razz: We'll see! She has a mind of her own, as prissy as she can be, she can almost go ferrel on me. As far as the ear testing - will read now. Tashie did say that she wants some diamond studs for all her piercings! ......next she will want her belly button done - a mummy has to draw the line!

I can tell she is feeling better today - think she was beat from the day at the vet and due to the high dose. I *feel* she is "leveling" a bit - guess we'll see today! I will update my (cleaned up) SS all day - and THANK YOU guys for all your support! xx

 

I laughed so hard after reading this. Thanks!

Well, she is still underage at only 15. You are still the momma bean and can say no to piercings. But those teenagers often go ahead and ignore their parents anyway. ohmygod_smile What are we going to do?

You could drop the treat into the bowl. See if that works. Have you tried the Halo Liv-a-little freeze dried chicken treats? My cat Wink will do anything for one of those treats.

 

Wendy, where do you get them? Also - is it okay to ALSO get some EVO LC food? As they are eating SO much more, want to try to expand the variety - yes, we have EVERY flavour of LC FF but is it okay to mix the brands?

PS. Next year, Tash will want her driving license and I see her either with a little MG convertible or a pink Vespa scooter! Girls!

 

Deb here not Wendy.

I get the Halo Liv-a-little treats at Petco. I think Petsmart may have them also but website was not cooperating this morning. Also mail order from Chewy's or Wag's.

Chewy.com has the Halo Liv-a-littles treats on sale, 2.2.oz jar for $7.99. I usually stock up and order enough treats plus something else to add up to the $49 for the free shipping.

I vote for the pink Vespa scooter! I can definitely see her driving that around town. :lol: :lol: :lol:

 

Merci! Maybe she can have the pink Vespa & Bo can get the blue one - there is a gorgeous turquoise blue one! Get a visual!

 

Shoot, not the insulin. I mean darn it, dang nab it, I forgot to answer your question on the different foods.

Yes, of course it's ok to add more variety to the menu. People don't like to eat the same thing meal after meal. Why should our kitties be any different. All the EVO canned foods are under 6% carbs, an excellent choice for our diabetic cats. Keep under the 10%, some people like under 8% but I'm not that picky.

Whenever you want to check a food, there is Dr. Pierson's food chart here: http://www.catinfo.org/docs/FoodChartPublic9-22-12.pdf

There is also this shortcut list by member Rhiannon and Shadow of all the low carb foods: http://felinediabetes.com/FDMB/viewtopic.php?f=28&t=94685

Wink was really picky when I first switched him from dry to low carb wet, only wanting to eat the Fancy Feast Turkey & Giblet. I was so worried that he would refuse to eat that only food one day so I kept trying to get him to eat more variety. It worked and now he will eat anything I give him.

Blue is my favorite color and turquoise blue my absolute favorite.

 

This thread is getting crazy.

Bernadatte - please start a new one.. and in your first post put a link to this one.

Wendy

 

I agree! What should I call it?

 

Well, you're posting over in the Lantus TR group as of this morning, so you could ask all your questions over there instead of starting a new thread here in Feline Health. It's up to you.

It can get confusing some times when people post in both forums without mentioning that fact in their posts. You get two different sets of advice.

 

I'd prefer to just post in one place. It's getting too much to manage confused_cat .......If it's okay, I will just leave this "as is" and see what happens in Lantus Land? Not sure I can deal with both :?

 

I didnt notice you were joining us in Lantus land.. post there instead.. its great! I am on there too every day.

 

Boris...I know how you have been feeling! I have a very shy cat as well. He was recently diagnosed w/ diabetes & my vet said this is only her 3rd diabetic cat, so out of total desperation joined this forum & it has been a total God send. Everyone is very helpful. We started my boy Gilbert on a pill 2xday for a wk & it was not working so she told me I was going to have to start giving shots...I nearly passed out!! :shock: Everything is cool now though. I put on my big girl panties & started learning. My vet didn't want me testing @ home, but it is about 45 minutes to her office & it stresses Gilbert out really bad to go, so I went to Walmart...got the reli-on tester & have never looked back. Just changed my boy from Novulin to Lantus & sure hope I can get his #s down. He does so well w/ the ear pricks...he doesn't even hardly run away anymore. My other 4 cats got tested too when I 1st got the kit & they are more freaked out by it than he is! Good luck!