Newly diagnosed; first home reading seems very low

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TeganKitty

TeganKitty

Member Since 2019
Tegan was diagnosed on Friday, started on Insulin yesterday evening, and we got our glucose meter (the Alpha Trak 2) this evening just before dinner/shot time. I took a reading and it read 85, which sounded awfully low to me. Our vet set her up on a dose of 1 unit twice a day, but I aimed for closer to .75 unit for her dose this evening when I saw that reading. Should I keep an eye on her and continue testing? Is this a big thing to worry about? Did I overreact? I'm still dealing with information overload/panic so I do apologize if I jumped the gun. Any help would be amazing. Thank you!
 
HiAmanda,
Your instincts are correct.
85 on the Alphatrak is low. It would have been better to skip the dose. Howeve now that you have given the insulin, you will need to test throughout the whole cycle to make sure Tegan doesn't drop too low.
Do you have any high carb food and / or Honey or Karo at home?
I would give Tegan some high carb food now, not a lot but manybe a tablespoon. If you only have dry give a bit of that. But we don't want to fill her up too much in case she drops low later and we need to get her to eat.
Is she a good eater?
You will need to test every hour to ensure that Tegan does not drop too low. The onset of the insulin is usually around +2.
You don't really want her dropping any lower and if she drops under 70 you will need to give her some honey.
Post each test and I will try and look in and see each time. I do have to go out in about 1 1/4 hours to collect kids from school but apart from that I will try and be here.
Remember you are in control because you are testing but as we have no data on how Tegan is going to react to the insulin, we have to be vigilant and test frequently.
 
Thank you so much for the reply. This is all so overwhelming. She ate some wet food earlier that wasn't terribly high in carbs, but I'll see if I can coax her to eat some high carb treats. She is typically a good eater. I'll keep you posted on the test results. And thank you!
 
Get another test 1 hour after the dose of insulin.
Do you have plenty of high carb treats/food as you may need quite a bit this cycle? And honey/Karo?
 
TeganKitty said:
She's at 117 after 1 hour.
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That is good. I would give her another couple of the high carb treats now.
The insulin will onset at around +2 so we want her to be up a bit higher I think for that.
You are doing well. It is hard in the beginning. But we can help you learn. Let's get this cycle safely over first though:)
Well done though on learning to test so quickly :D:D
 
Just in case Tegan drops too low and we can't get her up quickly........do you have an ER nearby and their phone number?
I don't want to scare you, and hopefully we won't need one, but it is always good to be prepared for all eventualities in cases like this.
 
Yes - we have an emergency pet clinic nearby. I've got that ready to go just in case - you scared me plenty with that first post (which to be clear I'm thankful for!). I fed her some treats which she eagerly scarfed down. I suppose if there's one way to learn how to test it's this! With a bit of luck she'll forgive me for all of these pokes. I'm just so grateful this community exists - without you all I never would have known to order a glucose meter at all. I'll post again at the top of the hour with her next reading. And THANK YOU!!!
 
TeganKitty said:
Yes - we have an emergency pet clinic nearby. I've got that ready to go just in case - you scared me plenty with that first post (which to be clear I'm thankful for!). I fed her some treats which she eagerly scarfed down. I suppose if there's one way to learn how to test it's this! With a bit of luck she'll forgive me for all of these pokes. I'm just so grateful this community exists - without you all I never would have known to order a glucose meter at all. I'll post again at the top of the hour with her next reading. And THANK YOU!!!
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That's good to know there is an ER closely, just in case.
I am very happy to help. I was helped in the beginning too by some very knowledgeable people. This is a wonderful supportive community with a lot of very knowledgeable people from all around the world.
She will forgive you I promise. If you give a treat each time you test she will learn to associate the testing with treats. Use low carb treats when testing normally though..
I will be out collecting kids at your next test but I will try and have a look for it on my phone..
See you then.
 
Back home......
374..... I think that confirms a bounce..
Cats can bounce when they have dropped low, dropped too fast or have dropped lower than they are used to being if they have been in higher numbers for a while. When one of these things happen Tegan's body thinks it has to save itself so she dumped glucose and regulatory hormones into the blood stream which sends the BSLs skyrocketing. Bounces can last from 1 to 6 cycles and once they happen there is nothing you can do but wait the bounce out.

Normal cat numbers are 68-150 on the Alphatrak 2 meter, but when you are first starting out, we suggest you don't shoot anything below 200 until you have some data. Then you can gradually reduce the "no shot number."
What I would suggest is that you set up Tegan's spreadsheet and start putting in all the BSLs, starting with the ones you have already got. Always test before every insulin dose to ensure it is safe to give the insulin, and then test again during the cycle to see how low the dose is taking her. If you can get one or two around the +4 to +7 mark that would be great. And don't forget the pm cycle as well as cats often drop lower at night. Even getting a before bed test is good. If the BSL is lower than the preshot number then it would be a good idea to test again later to ensure she is not dropping too low. If it has gone down further you will need to test until it starts to come back up a bit.
Here is the link to the SS. If you have any trouble setting it up we can help you.
http://www.felinediabetes.com/FDMB/threads/fdmb-spreadsheet-instructions.130337/

I suspect that Tegan dropped lower than the 85 you got at preshot (thank goodness you got the meter to test!!) so if I were you I would reduce the dose to 0.5 unit both cycles moving forward and seeing how that goes. You will need to hold that dose for 5 days (unless Tegan drops low again) to let the depot fill and the full potential of the dose take effect. We don't know how long she is going to bounce, so don't be disappointed if she is still high in the morning or the next evening. Keep to the 0.5 unit dose. Bouncing is normal in diabetic cats, especially in the earlier months as they get used to the insulin and its effects.
If you have a preshot below 200.....stall, don't feed, test again 20 minutes later to see if the BSL is rising....and post and ask for help. Put HELP stalling BSL xxx in the subject line to alert people.

Be careful changing over to the low carb diet as that will also lower the BSLs but as long as you are testing you should be OK. Just do it slowly.

We change the dose depending on the nadir ( lowest point of the cycle) not the preshot number, and we only increase or decrease the dose 0.25 units at a time. Our main objective is to keep kitty safe..

I think you can stop testing now. Maybe get a +6 just to see that those numbers are not still food influenced with the high carb treats.....I will watch for the test if you are happy with doing that.
Does all what I have said make sense? And are you happy to do as I suggest?
Ask any questions you like. It is a steep learning curve in the beginning but you have learnt a lot in just a day!!
I'll be around for at least the next 6 hours ( afternoon here in Australia) if you need me.
 
Yes that makes sense and is immensely helpful. I don’t recall whether she had ketones - I ordered some ketostix (should arrive tomorrow) and we plan to call the vet first thing about these results and lowering her dose. I’ll send along the +6 numbers and until then we’ll give her poor ears a rest for a bit. Thanks again for all the wonderful info and for helping me through a very stressful night!
 
Very happy to help and Tegan did us a favour by bouncing really as you didn't have to deal with a cycle of low numbers..
That's good you have ordered the ketostix. Always good to keep a check for ketones with unregulated kitties.
Tegan has had a strong response to the Lantus, a lot of kitties take much longer to start responding to it.
Could you let us know how you get on with the vet tomorrow and how Tegan is going please?.
Tell her she is such a good kitty for being so cooperative with the testing.:cat:
I'll keep an eye out for the +6
 
TeganKitty said:
579 at 6 hours. And of course I’ll keep you posted what I find out. Thanks again.
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Don’t be alarmed at that high number. She was just trying to ‘save herself’ from the low number. The bounce will last as long as it needs to, to get rid of the dumped glucose etc, so don’t worry if there are high numbers for a few days. My Sheba loved to bounce.
You have done amazingly well for a first day!!
 
Thank you so much again. Headed to bed after a very long night but I feel so much better. This is all very overwhelming, but having your support made a really big difference. Thank you so much.
 
Pre shot this morning was at 720. +4 was 266. Still trying to get ahold of our vet, spoke to a vet tech this morning who cautioned about dropping her dose, but we still decided to drop her to .5 this morning. The vet tech pushed for us to bring her in after two weeks for a glucose curve at the vet office versus us doing one at home. Waiting to talk to the vet about that too. Also created our spreadsheet to track - link in signature. I’ll update when I hear from the vet (trying to get her lab results too).
 
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Hi Amanda
The curve at home will be much more accurate than one at the vet. Don’t let them talk you into doing one at the vet. It is not necessary and is more expensive. I’m glad you stuck with the reduced dose. Tegan is bouncing from dropping low yesterday. If you kept the dose at 1 unit you run the risk of a hypo. Once the bounce resolves we will be able to see if 0.5 unit is enough and if it’s not, then you can increase to 0.75 units. Tegan is only just starting the FD journey and it can’t be rushed.
That big drop from Preshot to + 4 shows that the insulin is working and she could be coming off the bounce. I would try and get another test in this cycle to see low low she is dropping.
You are doing a good job.
 
At +9 she's at 187, and we finally connected with our vet, who told us to stay the course on 1 unit and said that it wasn't at all concerning that her numbers were low yesterday. So, we fired our vet and we have an appointment with a new vet at a new vet clinic on Friday who has lots of experience with diabetic cats (we are very lucky we live where we do!). Thank you so much for your help. We desperately needed a friend while going through this and your continued encouragement means a lot too :)
 
I read the initial post last night and was too sleepy to reply but was curious how Tegans numbers would pan out, so I followed this thread to read later. I'm very glad to hear she is doing well and didn't dip too low.

I just want to echo to @TeganKitty that you're doing great! Getting the data early on and trusting instincts to know when you need a second vet opinion is exactly the advocacy your kitty needs. She's lucky to have you! Give her some scritchies for me. ❤
 
Thank you! And just got her +2 numbers at 323 so it is a bit lower than preshot. Should I be worried about her?
 
MamaMug said:
I read the initial post last night and was too sleepy to reply but was curious how Tegans numbers would pan out, so I followed this thread to read later. I'm very glad to hear she is doing well and didn't dip too low.

I just want to echo to @TeganKitty that you're doing great! Getting the data early on and trusting instincts to know when you need a second vet opinion is exactly the advocacy your kitty needs. She's lucky to have you! Give her some scritchies for me. ❤
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Thank you! I have learned a ton in the last couple of days and never would have been brave enough to question what I was told without you all providing such wonderful information.
 
Because the +2 is lower by quite a bit than the Preshot, I would get another test in. You could leave it til +5 or +6. It will probably mean setting the alarm. Getting a + 2 gives you a good idea what the cycle is going to do. If the +2 is higher it will probably be a cycle where the BSLs stay around the Preshot or higher. If the +2 is about the same as the Preshot then it will probably be a cycle where the BSL comes down gently. If the +2 is lower than the Preshot then the cycle will probably be an active one and it is telling you to ‘ watch this cycle’. But in saying all that every cat is different (ECID) so getting data until you know how Tegan reacts is a good idea. Is that OK?
I’ll keep an eye out for the next test. :)
 
Tegan is dropping nicely during this cycle. Do you think you could get a +8 or +9? It would be good to see what she is doing during the cycles. She could drop further.
 
It’s too hard just to stay up. I always go to sleep and set the alarm.
Her AMPS are lower today than they have been so that’s good.
You might like to put your thoughts into the remarks column in the SS. Things like how Tegan is feeling, what food given, any ketones, etc.We look at that too and it tells us lots without going back over old threads. Just briefly. It’s good for you to look back on too.
 
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