Opinions about Glucose tests!

Hello!

Would anyone mind checking out Cosmos' Spreadsheet linked by my signature?

We started going back up.... we'll need to just keep tracking. The best he had was around 2 units... however - he only had that for barely a bit and than had some of his worst numbers.... I feel like they are all over the place.

We DO know that we need to be giving him somewhere between 1.4 and 3... it's just a matter of tweaking it down I suppose!

Thanks for any info you may be able provide OR any observations or comments about the process - etc!

~ Abbey

 

Forgive me if there have been previous posts about this, and I am just not up to speed, but why did you drop the dose from 2u?

 

We kept going down because he’d had that super high number in the four hundreds, than he just stayed in the 300s. We want him down to mid 100’s to mid 200’s right?

 

The color coding on the spreadsheet helps you - you want to see him make it to the blues, and eventually, get into some dark greens. You want him to stay at least below the renal threshold for as much of the time as possible That is supposed to be around 225/250 on a pet meter (so, it would be a little lower than that on a human meter).

His numbers are staying higher than desired, so he appears to need more insulin, not less. If it was me, I would go to 2u twice a day and hold it for several cycles to see how it goes. The more consistent you can hold the dosing, the better - meaning same dose AM and PM and hold doses for several cycles before changing - the only exception being if he has a crazy low pre-shot number that requires you to reduce/skip a dose. It appears that you have changed the dose three times just within the last two days. Consistency is important.

If you stay with 2u a couple of days and he continues to stay too high, you can increase to 2.25 and hold that for several cycles. You always want to get a pre-shot test in so that you know it is safe to give the shot, and continue to get mid-cycle tests when you can so that you can judge the impact of the dose. If you have a day off when you could do a curve (test before a shot then every two hours after the shot until the next pre-shot test), that would help you get a better picture of the impact of the dose.. you can see when he starts to drop, when he is at his lowest and when he rises.

As he starts to come down some, he may bounce a bit from being lower than he is used to, but as long as he is not going TOO low, you can usually hold the dose and let the bounce pass. If you want help deciding when to change the dose, just start a post here, and as long as there is spreadsheet data to review, there are always people willing to help out.

 

this doesn't make sense to me. If you want his bg numbers to go down you don't lower the dose.
Lowering the dose is going to keep him in higher numbers. I agree you need to raise his dose back to 2.

 

Can you add more info to your signature? Click on your name at the top right corner and choose signature. Add info such as your pets name, date diagnosed, insulin type, food you're feeding and any other health concerns.

I assume from the chart that you are using u100 syringes and a conversion chart? You may want to add that in your signature as well.

 

I agree...I think he needs more insulin. FurBabiesMama gave some pretty good info...I agree with what she said.

You are testing for ketones, right?

 

We haven't tested for ketones yet. Ok... we'll try two. It's looking like he's been in the 200's more often than not the last couple days though - which is why I question if he needs to be at 2.... ... I just want to make sure I'm doing the right thing!

Also, currently, I'm in the process of trying to find a job... we have bedbugs from a neighbor AGAIN (we had them last year about this time)... and I'm just freaking out all over the place.... sorry to air that out here.. just.. it's an element of the worry and wanting to make sure I'm doing all I can the right way!

 

To note as well: he's super hungry so he's eating - if that needs to be noted. I know it's not a good thing if they are also not eating!

 

I added more info to my signature! Thank you for the tip!

 

We only lowered the dose because we were concerned that his blood sugar had been kicked back up because we were giving too much insulin, rather than not enough... and when he was having those good numbers there with the blues/some yellows - he followed that up with a really high number and than 300's really consistently enough since. Obviously trying to make sure that what we are doing is helpful... but since he's been in the 300's for so long - we think it needs to go up so we've been going up every couple of days to see how it goes. We saw a few 200s in the last couple days so we thought maybe his dose is somewhere between 1.2 and 1.6.

I included more info in my signature AND included this link of the thread where we were concerned about his insulin numbers.

THANK you for the responses. <3

http://www.felinediabetes.com/FDMB/threads/somogyi-rebound-or-not-enough.196110/#post-2195896

 

Please don't worry. You're doing just fine! We are here to help you figure out the dosing, so post as often as you need and we can help out. You don't need to get it all figured out on your own. It sounds like you have a lot to deal with right now. Hugs to you!

 

Thank youuuu for the kind words. They are important and very much appreciated!

 

We are thinking he needs to go up to that 2.2! Everyone think that's a good idea? Just double checking our work. AND I didn't want to keep jumping around everywhere with dosing - it's been quite a few days and he's usually in the 300s (same as before). Come on 200s and 100s!

 

I would probably increase to 2.25.

I assume your U40 syringes have 1/2 unit markings? So, you have to 'guesstimate' anything that does not fall on the half unit.

 

Definitely time for an increase! Yep, if you're using u-40s 2.25 is easiest..if you have u-100s I'd do 2.2.

 

They are weird markings... they are labeled by 2, 4, 6, 8, 10, and 12 units with five ticks in between... had to make this handy dandy little sheet to make sure I was getting it right!

 

... So.... I'd be looking at 2.4 to be on a "tick" or I'd have to go half way between ticks to get 2.2... so maybe 2.4 is in order... but.. 2.2 might be better so that I don't "skip" his perfect dose on accident?

 

Yuck. Are they U40 or U100 syringes? I have not seen any with markings like that. (I know you said U40 in your signature.. just triple checking.)

UPDATE: Never mind..I just found/looked at your other thread about the syringes. Weird!

 

Thank you Rachel. I attached my photo of the units on our particular syringes... we have U40... but... they are by 2s... with 5 ticks in between. 2.2 would be just between "2" and 2.4" in this case. (I know, weird units of measurement!)

 

Yeah... it's weird. Here's a picture... Strange right? (u40) "2.2" is probably in order just as not to miss anything (mid between)?

 

Yes, 2.2 for now. It's not so much about missing the dose with such small changes, (if you go too high you'll see it in the numbers and reduce again), but more to avoid too big of a change all at once that can cause them to start bouncing.

 

We may even go 2.4 soon.... it's frustrating he keeps chilling in the 300s (seemingly... regardless of what we are trying)... HOWEVER - I am guessing patience is in order. But.. I forsee tomorrow or the next day going up. <3

 

Yes, you only need to hold a dose for three cycles before the next increase. But you do need to get at least one mid-cycle in so you know how effective the dose is being. Those pre-shots don't really tell you if the dose is having any impact because by the time the pre-shot numbers roll around, the insulin has worn off. They are important to make sure Cosmos is safe, but they don't tell you (or us) what to do about the dosing.

Assuming that you gave 2.2 last night (it's missing on the spreadsheet), I would say go ahead and move to 2.4u this evening or in the morning if you can get a mid-cycle test in there anytime between +4 and +7.

 

Thank you. Yes, 2.2. I got things updated to the 270 reading he just got before food! Managed to rock a mid today! I plan on doing that tomorrow morning too!

 

First BLUE in a LONG time guys! Yayyyyyy! Did 2.4 this AM.

 

Woo hoo!

 

Thinking about going up to 2.5 Giving it today to see how it goes! A lot more yellows but they all seem to happen during those mids of course (ESPECIALLY the early early AM mids)!

 

Checking in here! Wouldn't mind seeing what people think.

Currently... his numbers have been more in the 200 range than anything else. HOWEVER... we are having some problems with peeing in certain places.

1) We have been stressed out personally since late June 2018. Extra so I would say the last couple weeks of July. (the couple weeks were were in our old apartment I noticed that he'd peed beside the couch in our living room). Another note is I rarely was home (my roomie and husband were regularly) due to not being able to be in our place mentally - I would come home to sleep. Otherwise, I would be sure to find things to do outside our place. We had found one bed bug at the end of June (and the LAST summer we'd had MONTHS of actual bedbugs finding out that a neighbor wasn't telling our landlord... WHICH is why we were able to get out of our lease this time even though - we only saw one. We had to process/check/treat all we could between the old place and this one.. (also pre treating the entire new apartment - not messing around). Needless to say I had some BBPSTD from LAST year and than seeing one just was too much...


2) We have been in the process of packing up our apartment in July as a result. We moved in officially to the new place on July 6th. When he got to the new place. He peed in two places that weren't the box (both in the roomie's room - but she hadn't lived in it yet really - just a couple of her items in there). We placed the box in the broom closet with the door open and quickly realized that this was a bad call as no ventilation and making the whole apartment not so livable scent-wise finally deciding on the bathroom as the perfect place - there's a small closet we leave open there (the old place - the box was in a open closet too). AFTER a couple days - he peed by the roomie's dresser in the AM, she came home that night, and he peed into her closet over a ton of her leather and leather shoes (she does some leather working!). .... And than the spot he tends to pee on the most is to the a few feet from the original closet we had the litter in.

TODAY, we took his urine sample to the vet to be sure it's not a UTI issue. I have checked his ketones randomly and nothing has come up weird. The vet seems to think it's behavioral which is good and bad. we tried buying new litter and a new box. We placed a urine pad dealy under it too (because most of the time whatever box he does go in, he doesn't always turn around - probably due to the mild neuropathy he has endured due to diabetes. We have fake wood floors so the pee cleans up quickly and nicely. We also spray on enzyme cleaner/odor removal every time afterwards or on top of his mat that's by the new box. (I hope the new box can be moved slowly over to the other box in the bathroom - where we want him to go over the next week or two!) We have also tried placing foil after cleaning it all up - that hasn't seemed to work either - so.... that box moving idea is all we have right now!

So.... a couple things to look at I guess; checking in on his numbers... and than his pee problem. I had a good cry today about it... just WOW. Needed to do that. AT least he isn't regularly in the 300's and 400s... although his all time average on glucose levels is 300 somethin.. small steps!

Hey, thanks for reading if you made it this far! AND sorry I haven't even really checked in! Things should be chilling out starting this week - and they already have some - but I think we all feel uneasy and frustrated about Cosmos' issues. I'm sure he is too! Poor guy. He gets play and cuddles and we try not to yell at him when he pees - but man, it's challenging sometimes in regards to that problem!

Take care,
Abbey

Note: He's also ravenously hungry all the time and pees a STORM when he does pee. Very diabetes related of course. Super talkative also - always ALWAYS wants food - even right after you feed him a bunch. I am feeding him good ol' BFF food - he gets real pieces of chicken snacks/fish snacks/sliced turkey on occasion also. We just try to feed him more throughout the day to balance him out! AND when we eat so we can eat in peace.

 

Ack! Bed bugs! I would freak out after seeing one too...I don't blame you one bit!

Well today's cycle was really beautiful with that green! Numbers wise, I think you're seeing some bouncing. You get a nice cycle like today and then probably those reds and pinks are a reaction to that low.

Pee-wise, let us know how the urine test goes. My GUESS is you're seeing some idiopathic cystitis. That's basically bladder inflammation of unknown causes (I know, what a frustrating diagnosis!). It's often brought on by stress and with the moving and the you not being home (for good reason!) and other things going on, it could cause a flare. Two of mine have it. We treat flares with pain meds (bupe) and I give CBD oil daily as well as a glucosamine supplement to try to strengthen the bladder. I also give raw food with lots of extra water to help. Mine still get flares, but we just treat with the pain meds and then move on...I have a standing order for bupe in with my vet. It's pretty much diagnosed by ruling out things. We did a UA, sent urine out to be cultured and did an ultrasound. With that, we went with the cystitis diagnosis...and while it SUCKS, I've learned how to deal with it and made my peace. I cried plenty of times about it too (you should see me following my cat to the litter box sobbing when she's actually fine...I'm sure she thought I'd lost my marbles!).

Anyway, cystitis isn't terrible because it's inflammation, no infection. So it doesn't need antibiotics which is good and bad...since you want to give meds but AB can be a pain to give. Let us know what the vet says on the urine. If it's an infection, that's something that can be treated. If it's not, I can give you some more info on cystitis and so can Kris...she's dealt with it too. She's also talked me off the ledge a few times!

The box moving idea could definitely work...just take it slowly and move it a bit at a time. And let us know when you hear from the vet!

 

Keep in mind that because you are using a human meter, numbers in the mid 200’s are actually in the 300 range on a pet meter. So he’s not really that low.

 

That's true, on a pet meter his numbers would probably show higher. Since you're using a human meter, though, we can just focus on the numbers you're getting with that. The good news is we see more of human meters, so we actually are very used to talking about kitties in their human meter numbers!

 

I do use the correct chart at least for the human meter.... but yeah...

He did NOT have a UTI infection which is good... but the vet seems to think it's behavioral.

The good-ish news is that he's using that new box we set up - but it's in the spot he's been CHOOSING to pee.. so it will be a matter of moving it once he's used to using it a lot. (Also, a different litter just for a chance since new box.... ). That might be part of it.

<3

 

good idea. you can try moving it inches at a time toward the place you want it to be. haha

 

Well on the good news side, he doesn't have any sickness! Yay! But yes, that is also bad news. Have you looked into Cat Attract litter? It's supposed to be great for behavioral issues.

 

We tried that last week weirdly enough (the Cat Attract litter).. We are now trying to feed him/put his food bowl etc where he's been going the most to see if that doesn't slow him down. The only cat toilets are in the bathroom now (there are TWO boxes in there) just to make things more spread out and cleaner - also been staying on top of keeping them clean too. He seemed to have peed on the little mat NEAR his cat bowl/food today... but not on it.... it's a struggle for sure!