Newly diagnosed

Did you get your new supply of test strips? If not, and you need to hoard the ones you have, we understand. In circumstances where you don't have a lot of test strips, and can't get any for a while, it's best to save them for the pre-shot tests.

How is Zoey doing with the 5 P's (peeing, pooping, purring, preening, playing) and how is her appetite? Remember, your cat is more than a set of numbers.

Hope you are having some time for yourself this weekend and will be doing something fun to celebrate the Labor Day holiday.

 

Thank you guys for being understanding. Yes I got the test strips I tested her at 8pm 145. And I fed her. So do i wait until 10pm and test her again ? For some reason I always don't know what to do for her
And she is doin great with the 5 p's. my only concern beside the diabetes is her hair balls. What can I give her for that normally I would give petromalt but I'm afraid the sugar is too high. So I bought the grass but she is still throwing them up. Any advice for that ?
Thanks

 

Cocoanut oil, the liquid. Butter. Two things that others have recommended to help with the hairballs.

 

Hey there

How is she doing now? Haven't heard from you for a couple weeks
Wendy

 

Hi

Thank you for asking. She had been doing well. The vet is happy with her numbers. I am still having a little trouble with her hair balls. I haven't updated her spreadsheet in a while but I have been keeping track in her book. I will update now. Thank you again and hope you all are well

 

Her numbers dont look bad - you are getting more blues. The more time she spends blue, the more her pancreas heals and the better chance for remission.

Usually at this point I would recommend you start to shoot her at lower numbers .. so for example instead of skipping when her preshot is under 200, you would shoot instead at 175.. then 150 and gradually reduce your no shot number. Our mantra is shoot low to stay low - and it can help to tip a cat into remission. Here is a primer on shooting low. http://www.felinediabetes.com/FDMB/viewtopic.php?f=9&t=147

However in your case we just dont have enough data to know if this is safe to do!! and we dont even know if she is already dropping low mid cycle and may be approaching remission already. Is there any way you can get some mid cycle tests during the day (weekends?) and a before bed test?

Wendy

 

So last night she was down to 95 so I skipped thinking that's way to low now this morning she ended up jumping on the counter and drinking the mild from my kids frosted flakes. She had never ever jumped up on anything before like that. When I took her bg this mornin of course it was high bc of skipping the night before It was 374 so I gave her a shot. I can only imagine all the sugar in that cereal so she will prob sky rocket ugh

 

You may find the following helpful.

Here are some glucose reference ranges used for decision making using glucometers. Human glucometer numbers are given first. Numbers in parentheses are for non-US meters. Numbers in curly braces are estimates for an AlphaTrak.

< 40 mg/dL (2.2 mmol/L) {< 70 mg/dL for an AlphaTrak}
- Treat as if HYPO if on insulin
- At nadir (lowest point between shots) in a long term diabetic (more than a year), may earn a reduction.

< 50 mg/dL (2.8 mmol/L) {< 80 mg/dL for an AlphaTrak}
- If before nadir, steer with food, ie, give modest amounts of medium carb food to keep from going below 50 (2.8).
- At nadir, often indicates dose reduction is earned.

50 - 130 mg/dL (2.8 - 7.2 mmol/L) {80 - 160 mg/dL for an AlphaTrak}
- On insulin - great control when following a tight regulation protocol.
- Off insulin - normal numbers. (May even go as low as the upper 30s (1.7 mmol/L){60s for an AlphaTrak}; if not on insulin, this can be safe.

= 150 mg/dL (8.3 mmol/L) {> 180 mg/dL for an AlphaTrak}
- the lowest level pre-shot for ProZinc, PZI, or other non-depot insulins.

> 150 mg/dL (8.3 mmol/L) {> 180 mg/dL for an AlphaTrak}
- At nadir, indicates a dose increase may be needed when following a tight regulation protocol.

200 mg/dL (11.1 mmol/L) {230 mg/dL for an AlphaTrak}
- no shot level for beginners; may slowly reduce to 150 mg/dL (8.3 mmol/L) {180 mg/dL} for long-acting insulins (Lantus, Levemir, and ProZinc) as data collection shows it is safe

180 - 280 mg/dL (10 - 15.6 mmol/L) {may be 210 - 310 mg/dL for an AlphaTrak}
- Any time - The renal threshold (depending on data source and cat's renal function) where glucose spills into the urine.
- Test for ketones, glucose is too high.

>= 280 mg/dL (15.6 mmol/L) {may be >=310 mf/dL for an AlphaTrak}, if for most of the cycle between shots
- Uncontrolled diabetes and thus at risk for diabetic ketoacidosis and hepatic lipidosis
- Follow your insulin protocol for dose adjustments
- Test for ketones; if more than a trace level of ketones, go to vet ASAP.

 

Whenever you can, get tests in the +5 to +7 hours after a shot, as that is the most likely time span where the nadir will occur, and dose adjustments are made on the nadir.

Ideally, you want a dose you can give safely every 12 hours, that keeps the cat from going too high, and doesn't take the cat too low. If you don't have enough mid-cycle data to shoot below 100 mg/dL and be confident that is safe for your cat, you need to back off on the dose 0.25 units. You'll have to eyeball it as syringes don't measure that finely.

 

Thank you :smile:

 

hey there

Just checking in to see how things are going?

Wendy

 

The same. High 200's. I have noticed that she has gained some weight so that must be a good sign.

 

For sure - it means the insulin is allowing her to process food.

Quick question though - how do you know without mid cycle tests if she is in remission? How do you know if she is going too low.. or not low enough? Whats your plan here? Just cuirous.

thanks
Wendy

 

Good question. I guess I should start testing her at the 6 hour mark. The vet only seems to be interested in the two numbers and how she is eating and peeing.
I figured once her numbers start getting lower I would begin to test mid cycle as of right now they are staying the same. I am about to update her ss now

 

Ok but the thing is that she can still be high at preshot and too low mid cycle. My Bailey is like that - he routinely is over 300 at preshot and under 80 mid cycle. Thats the way Lantus is supposed to work! See below... So you cant tell what the low numbers are without testing.

Example of an active Lantus cycle:

+0 - PreShot number. For example my Bailey is usually over 200 and frequently over 300.
+1 - Usually higher than PreShot number because of the last shot wearing off. May see a food spike in this number.
+2 - Often similar to the PreShot number.
+3 - Lower than the PreShot number, onset has started.
+4 - Lower.
+5 - Lower. At this point until +9 my Bailey can drop under 80 and sometimes even under 50.
+6 - Nadir/Peak (the lowest number of cycle).
+7 - Surf (hang around the nadir number).
+8 - Slight rise.
+9 - Slight rise.
+10 - Rising.
+11 - Rising (one of the quirks of Lantus/Levemir: some cat's blood glucose numbers dip around +10 or +11... not to be confused with nadir).
+12 - PreShot number.

 

So I tested every hour I could today. Weird how she was under two hundred at preshot tonight as she usually is over. What is everyone's opinion on the numbers I got today

 

Fanstastic. It looks like she surfed the blues!can you get a test in a few hours? Want to see if she is dropping low at night.

 

I'm going to test at 1030 which will be two hours after her shot.

 

Signs of progress:

Drinking less water and urinating less.

Reduction in ravenous appetite; eating appropriate amount for size.

Return of pre-diabetes behaviors - play, grooming, etc.

 

Yes she has been showing positive signs all around. Peeing and drinking less ,not as hungry and playing more. She is even carrying around her favorite toy mouse like she use to. I'm glad she is feeling better just wish she would go into remission I feel terrible testing her and giving her the shots. I was hoping for a quick turn around but I am still just as happy that she is feeling better and doing well

 

Also do I try testing everyday at the 6 hour mark?

 

yes that would be great 0 if you can vary a test between 5 and 7 every day for a few days we will see how this dose is working. If she stays yellow and blue I would recommend a slight dose increase.

 

Ok. Sounds good. I just did a +5 and she is at 228.

 

I hope someone sees this soon. She is due for her shot but she is 111 do I just give her half of 1 unit

 

I see you gave 1 unit.

Might be a really good idea to check at +2 or +3 to see what is happening.

Just to be prepared in case you need to steer the numbers - have you got ample test strips? High carb food &/or syrup?

 

She is now at 182 +2 and yes I am all ready and going to watch her I feel that everytime she goes low and I skip She goes through a week of trying to get back down. I figured it was time to see what happens.

 

Looks good Jackie!

You can probably relax for now, but it'd be good for you to get another test somewhere between +5 and +8 since the nadir is usually in that area.

As you get more testing in, you'll learn how Zoey responds to both insulin and food. As you get more familiar with the protocol, you'll start to lower your "no shot" number down from the 200 we tell everyone to start at.

You will need to learn to "Shoot Low to Stay Low"....which just means you'll shoot low numbers and you'll know it's safe because you'll know how Zoey reacts. The more time we can keep them in the 50-120 range, the more their pancreas has a chance to heal...and hopefully begin to produce it's own insulin again!!

 

You mentioned skipping because of pre-shots. Taking a look at the data you have so far, I think you can lower your pre-shoot limit to 150 mg/dL if you will check around +5 to +7 hours after shooting to keep him safe. This is a first step to shooting low to stay low. The nadir levels you have so far show that this could be safe. You can do it increments, if you prefer, such as 175 mg/d for a week, then to 150 mg/dL, or you can go in smaller increments, whatever is best for you.

 

I agree with BJ, plus you might want to try an increase to 1.25. I am not seeing any greens and we want him a bit lower.

 

Yes I am going to call the vet to see if I should up her insulin. She had gone up yesterday and I had made no changes to her food. Do you think that since she has gained weight she needs the increase ? I have her a little more than 1 unit this morning but not sure if it is enough to make a difference.

 

Having her gain weight is just a sign that the insulin is helping her to process the food she's eating. It's a good sign since prior to diagnosis, most of our kitties were literally starving despite eating massive amounts of food. Without insulin, the body can't break the food down so that it can get into the cells.

It's important that you keep the same dose for both shots, not add a little (or remove a little). Lantus needs consistency. Increases and decreases per protocol are done in .25 units

That being said, it's really not possible to know for sure what's going on with her because of the lack of mid-cycle testing. It's possible she needs an increase. It's possible she went really low during the cycle and is bouncing. Bouncing happens when insulin brings the blood glucose low and the liver freaks out and releases hormones and sugar to bring it back up to where it's "used to" quickly. Bounces can take up to 72 hours to clear, but as you get her under better control, the bounces won't go as high, and won't take as long to clear.

It might be safe to increase her to 1.25 units every 12 hours, but again, without more mid-cycle tests, it's impossible to know for sure where her blood glucose is going during each cycle. If she's going low during the cycle and then bouncing up, the last thing you'd want to do is increase.

Most of all, we want to keep her safe...then work on bringing her numbers down

 

I am going to try to get some after four hours tests in today , i should be able to get home for it

 

Is it possible to have two different readings at the same time. I tested her one ear and it was 83. So I said let me see the other ear. And that was 53.
To me that seems like a big difference.
Do I still give her 1 unit. I will not be around today from now until 2 or 2:30

 

I feed and retested her bg. It was 129!so I have her 1 unit

 

meters can vary by 20% - i would average the 2 numbers.How long after you fed did you test? Food will raise the BG. In future, wait 30 minutes , dont shoot or feed and retest.

Please get some mid cycle tests today - i worry she will drop too low.

Wendy

 

At +6 she is 213. So she is up.

 

Thats good to know. Best to get a +2 or +3 in those cases where you shoot low because sometimes they tank fast and bounce up within a few hours. So she could have gone lower at +3 and then bounced up to +6. Anyway its good data and if you are able to get a +2 or +3 you now know you can shoot as low as 100.

Also do you want to start a new thread? This one is getting very long..

Wendy