Opinions on Harleys Numbers

We are still testing the big guy and his numbers kind of vary. I made up a spread sheet for him but instead of using
AMPS - I use AMBM meaning before meal & PMBM.

Most of his numbers have been in a general range but last night I took his BG @ 10:20 to see where he was sitting right before we went to bed and it was the lowest I have seen at 138. It was so low I took it twice!

We feed in the morning at 6:00 am and if they have food left it stays out all day, if they run out and we are home we put one can out mid day and then feed again at 6:00 pm. We have recently started putting out another 5.5 oz can when we go to bed so that Harley doesn't have to go 12 hours before a feeding. Is this the right thing to do?

 

138 is progress

As for feeding routine, do what works best for you guys. We feed breakfast, a midday snack if they are hungry, dinner and bedtime.

 

Any idea on what might make him throw a 138 out of the blue?

 

But you don't know that it is 'out of the blue' because you have few tests inbetween.....

 

Hi,
Harley is not on insulin? This is very good news! His lil pancreas is trying to work! You may need to intervene if you don't see continued progress, or if his numbers begin to creep up, but so far, very nice!

 

I am guessing that you are recently dxd with diabetes and that is why Harley isn't on insulin yet? Although Tasha was just dxd less then 2 weeks ago, I have a daughter who is diabetic since age 3 who is now almost 21. Some times in the beginning, diabetes is like a spigot that shuts on and off. That could account for the occasional number in the blue. Sometimes, Harley's islet cells will produce insulin that is receptive and sometimes not. You also have so few numbers that it is hard to tell what is going on. During the day, try taking some numbers at the same time each day and look at them vertically as to see what is going on at a each time of the day. A sample of 3 is useful. Anything less then 2 hours after eating wont tell you very much.
Why are you waiting to put the cat on insulin? Are you trying to do it by diet alone? I would think even a small amount say .25 of Lantus (BID ) would be helpful in getting Harleys numbers in the blue or green most of the time. Harley may need it only for a short amount of time, and may end up in remission after a short period on insulin.

My opinion is based on my knowledge of diabetes but not my knowledge of diabetes in cats. I am new to feline diabetes, so I am no expert on it. I am finding that the only major difference is the time it takes for insulin to metabolize in a cat in twice as fast as in a human. So far that is really the only difference I have found. Also, they are less likely to sneak a candy bar and hide it in there room. lol

 

Yes he was recently diagnosed and to be truthful I have been trying to regulate him without insulin. I was just hoping not to have to spend a couple of hundred on insulin just to find out he doesn't need it. Things are pretty tight right now for us.
Today on my lunch hour I went to Walgreen's to get some prices and they are kind of scary. The cartridges were something like 211.00, the Pen w/cartridges was 221.00 and the vial was 112.99. Is that about average everywhere?

 

Yep it is, but you can save money by buying from Canadian pharmacies (even if you are US), and also by utilizing store discount cards. ie: I get my insulin from Rite-Aid which has a prescription drug card. That card saves me about 20% on every vial. If they sold Levemir in the vial in Canada, I'd be getting mine from there. It very much pays to call around to ALL the pharmacies in your area, including warehouse clubs with pharmacies, grocery stores and all the drugstores.

Give it another couple days on food only, it seems to be working. Did Harley recently have a bout with illness, or receive steroids or any other medications?

 

No recent medications that I can remember. He has been on Wysong Uretic for several months because he tends to get Urinary blockages. He also has developed pain in his front legs and the vet says that is arthritis. He put him on Metacam for that but since he is better I have not been giving him much of that because it scares me.
I can't think of anything he has gotten that should cause high BG's.

 

From your numbers. I don't see anything "working" yet. The 138 means very little and you have very little data. The sooner a cat is on insulin if there is a chance for remission from what I have read, the better. You may only need it for a few months, but if you wait too long you may need it for longer or always. Then it becomes really expensive. Do you know anyone who is a diabetic who is on Lantus? If you do and their insurance covers it, they may have an extra unopened vial or pen at the end of the month they may be willing to part with for a small price or just give you. I am using an extra pen of my daughters. Because Tasha uses so little insulin (under 1 unit) I need to use a syringe with it instead of using it like a pen. They are sold in boxes of 5 pens and she always has some left over at the end of the month, so I use it for Tasha. If you find someone to give you a pen a month, I can tell you tips on how to use it. It is different then filling from a regular vial.

*Edit: I should not have rushed to judgment regarding Harley and starting him on insulin. I have been reading veraciously and this is what I have found, but nothing is as good as experience. It makes sense to act cautiously. Document everything and try to get more numbers in the daytime, or in the middle of the night if you have to. In my experience random numbers supported by no repetition mean little. I cannot imagine that rule would not hold true with animals as well. I hope it works out that you don't have to put Harley on insulin. It is not my intention to give you wrong information or steer you wrong.

 

I think it's possible you need a touch of insulin.

Like you I tried just swaping from dry to wet (plus a vet that refused to prescribe insulin and you need a script here)
She was 482, week later 257, but couldn't get her down anymore than that.

Have a look on supply closet and post on there too and see if someone woud just sell you a single cartridge (3ml). It can last for up to 6months, though there seems to be a lot of variation from 28 days +

Yu then use syringes as the doses are so small. As your numbers are fairly low, it may be that you start with .5u instead of the usual 1u recommended here.

Linda is right, with Lants for example, the sooner kitty is using insulin after diagnosis the graeter chance of remission. ALl the time in diabetic numbers, damage is being done.

We used Levemir which in $ was probably about $180 for 5 3ml-lasted well over 6 months. Cheaper than Caninsulin/Vetsulin (as well as much better results)

 

For both Linda and Kate,

I can respect your opinions as people who have not seen cats go on insulin that don't need it, however neither of you is apparently watching this cat trend down and manage 130 pt drops on his own, without insulin. Perhaps reviewing the spreadsheet again will give you two an idea of what exactly is bringing his numbers down.

If you think it's important that the OP spend $200 on insulin she may not need, by all means, tell her that, but please do take a look at that spreadsheet again before deciding what I said is incorrect.

 

With all due respect, I have been dealing with diabetes for 18 years. The information she has is scarce to say the least. To get an idea of what is really going on you look vertically at the numbers not across. The reason for this is that everyone, diabetic or not has fluctuations throughout the day. The pre food numbers are very consistent with very little change. She needs to check at the same time each day for at least 3 days to have enough data to see if there is a change. You must compare 2:00 on Tuesday with 2:00 on Wednesday not 2:00 on Tuesday with 4:00 on Tuesday to see if there really is a trend down. I do not see a trend down on the pre food numbers and that is all the data that is worth looking a at the moment until she gets more numbers at the same time throughout the day. I do not wish to see anyone needlessly spend money on insulin if they don't need it. Hopefully she wont need it. I just think she needs more numbers at other times to make an informed decision.

 

You have been dealing in human diabetes. This is feline diabetes, which is in fact different than human diabetes. I understand that you want to help, but please remember this, we must first do no harm.

 

True, but diabetes is diabetes and bg numbers are read the same in animals and in people. Even the ranges are the same. The only big difference is in the speed of metabolism of the insulin when adding a non animal insulin like Lantus etc. I agree, do no harm and before she does anything she should be checking her numbers the same time each day. There is really not enough information except for the pre food numbers and they are pretty flat except for the first 2 numbers very early onset which were high. You cannot trend across unless you have at least 3 reading on the different days at the same time to see if there really is a trend or not.
I'm just saying I think she need more information. More numbers before knowing how to proceed. I don't see how gathering more information can be considered harmful.

 

This kitty has been going through a food change, transitioned to wet food and the numbers starting showing yellow and blue.

We've always stressed over the years that you have to hometest even more when transitioning to wet food because sometimes a change to a species appropriate diet is all that is needed.

I just adopted a diabetic who was getting 2U of Vetsulin BID, a couple of weeks before moving up here, Venita told the foster to change his diet to wet food only. From the very first day he got here he has not needed insulin once.

This cat's pancreas may be healthy and with the food change, this cat may quickly become diet controlled. The yellow numbers she seeing now are numbers that most newly dx FDs wish for even giving insulin.

If it were me, I'd hold off a bit longer and see if by consistently feeding canned only this cat doesn't go into remission.

 

One problem I have and will continue to have is that I can only check daytime numbers during the weekends. I work in one small town and live in another so there is not chance to go home for lunch.

I can try to get an after meal test after the evening meal. What would be the best time to do that ?

 

I am not clear why after a week of having a diabetic cat, that you believe feline diabetics and human diabetics are the same thing. I can assure you that while there are similarities, they are not one and the same.

There is plenty of information for me to say that we do not have enough cause to recommend she go fetch insulin and start pumping it into her cat.

If you will look on 1/13, 1/23 and 1/26, you will note that she was feeding dry food and getting readings much higher than she is getting now. No surprise, we all know what dry food can do.. much like Twinkies can do to a human diabetic. She subsequently dropped the dry, and went to wet. This reduced her numbers even further. On the days where she has spot checks, we can see rather stark evidence of pancreatic activity. An untreated cat will not fluctuate like that. An untreated cat should not have even have numbers in the 100s. Finally, this cat has been diagnosed as a diabetic for over 3 weeks and not receiving insulin. That fact alone causes sufficient doubt in my mind that he may become diet controlled without insulin.

It DOES happen, and that is what you as an advisor will need to know. There are many of us have been here long enough to see it.

 

FWIW - I have to agree with Carolyn and Jen - holding off on the insulin considering you mentioning that finances are tite right now.

You've already seen a big change just with changing to wet food.

Just some food for thought - I'm a pediatric ICU nurse and take care of many (unfortunately) diabetic kids. The difference here is kids are Type 1 diabetics - They will always need insulin. Cats are usually NOT type 1 - they are usually considered type 2 - so many CAN be diet controlled. And the range in cats for BG's can be anywhere from 50-130 depending on what reference you read.

Also - human diabetics have their medical supplies covered by insurance - feline cat moms/dads don't. It can wind up to be a huge expense for some of us. I only say this as my Merlin had something more than "just" diabetes and I know how much some of this can run and what we put out each month. My second diabetic kitty Boris was like Jen's - off insulin within a week of coming to me with being switched to canned only food.

What I wonder for you Harley's mom - can you test more often on your day's off? That would help everyone out more and be able to give you better advice then. It would help everyone see a better pattern of what Harley is doing before and after he eats. And then make the big decision of whether or not insulin really is the way to go right now.

 

Try to get numbers when you get home from work, and also before bed, plus your pre meal tests and maybe an occasional post meal test, whenever you can feasibly fit one in. The goal is to try and see how much Harley is moving during the cycle, so get what you can in between those feedings. You don't have to get the same ones every time, we're just looking for whether those numbers are climbing, staying the same or dropping. If he can't hold his own without insulin, those numbers will tell you that. If he continues to be able to bring himself down, and you see more and more numbers in the 100s, you may be able to get him stable without insulin. If he starts to trend up, or goes into a holding pattern with those numbers, he'll need the bump from exogenous insulin.

Now.. was he diagnosed by fructosamine?

 

As far as I know they did not do a Fructosamine test. I know they did a BG test and there was sugar in the urine but even though I asked the receptionist if a Fructosamine test was done, she did not see that on the chart. She did say something about the sugar in the urine being over 2000 (I hope this is right) and that he had no ketones in his urine.

One other question I have is about testing. If I test him before a meal, then put their food down and leave it. Then I test him 2 or 3 hours later. I can't be sure he didn't just nibble some leftovers. Harley tends to eat small amounts and go back once in a while. Does this matter to much?

 

harley's mom, don't know your first name, you have the benefit here of some experienced feline diabetic owners versus a relative newbie who only has experience with childhood (human) diabetes. this is an open forum in which everyone is encouraged to participate and i understand it's hard to figure out whom to listen to, so sometimes it helps to check profiles.

you'll probably see that carolyn herself owns a feline diabetic who was diet controlled without insulin (roxy). i agree with her and the others that it doesn't seem necessary just right now to invest in insulin you might not need. if it were inexpensive it might be a different story. but because of the price and because of your cat's response to the diet change i'd monitor further if i were you.

there's no set rule about when you test or having to test the same time each day. most important thing is to test before you shoot insulin. that rule is sacrosanct. otherwise, test when you can get a moment like right before bed or 3-4 hrs after you feed. yes, your cat may end up needing insulin but as long as you can keep to a low carb canned/wet food diet your cat's pancreas may be healing on its own and insulin may be unnecessary. [this comment is based only on your cat's specific response and not for any owner of a feline diabetic.]

as for harley's eating, that's great. we really love it when cats eat smaller meals spread apart. i think it helps the pancreas a lot, too, by not overloading it with carbs.

welcome aboard and really glad you're already hometesting. that's wonderful.

 

I really don't have to much to offer here, except that I think you are doing a great job trying to get Harley's bg's under control w/ just diet alone. There is a noticable difference in his numbers just by taking away the dry food, and I feel that it would be in Harley's best interest to continue to do what you are doing and get lots of data. If numbers don't change or begin to go up, then maybe insulin is needed.

In regards to testing times, since I can't get any day time checks in until I get home from work (unless my mom is home and gets one for me), I set my alarm to get up at 1:30 a.m. (Spot's +7) and get more data that way. Yes, it is a PIA to do this, especially when I only get 6 1/2 hrs of sleep a night, but I get lots of good data. Sometimes I switch it up and set alarm for +6 or +8.

 

Ok in regard to the fructosamine: In my humble opinion, a proper diagnosis of diabetes can not be made with simple glucose testing. I am not saying you need to go have one done, but I would not be inclined to recommend you start insulin without the precaution of having one. It is possible Harley had or has an illness of some sort that is currently undiagnosed. Please be watchful for any symptoms or behaviors that you deem abnormal, or whatever previously waylaid him has moved on. It is also entirely possible that Harley *does* have the very earliest stages of diabetes and that it was caught so quickly that food change alone reversed the progress.

As far as testing and feeding schedules, just put asterisks in the hour columns linking to notes in the right column denoting when he snacks or has an extra meal. It will be helpful to show when his pancreas is "under food load" and what happens after meals to his blood sugar. Don't put unfair restrictions on yourself or Harley, in other words, just make notes of what happens and when.

 

I made a post a minute ago and apparently hit the wrong button because I can't find it anywhere???

So here goes again. My name is Donna and I am the mom of 5 cats and 6 Chihuahuas!

I want everyone here to know that I appreciate the heck out of all you guys that care enough to give your time and experience to those of us that come here all teary eyed and scared to death.
I know that EVERYONE that has given me advice has our best interest at heart and even though the ideas may differ I know that everyone wants the best for Harley.
After reading all the posts here I have decided I will wait a while before thinking of going with insulin. If Harley can be regulated by food alone then of course that is what I want but at least I feel confident that if his condition warrants insulin I have found a place where I can get good advice and people who know what I am going through.

Thanks for everything, all information is greatly appreciated and I hope you see Harley get better by the day!

Just took a BG on him too - 3 hours after meal - 153

 

I think you are doing great lol! And I think you are fine holding off...you've been pretty diligent and you're pretty aware that if things go sideways or upwards you might have to start...

Jen

 

Hi Donna, it's very nice to meet you and your brood! :smile: We will be watching your posts and spreadsheet closely because the last thing we will want to do is endanger your precious boy. If it even remotely begins to look like he needs insulin, we will recommend you talk with your vet about the next steps. You are really doing a great job for him, so be sure to take time to congratulate yourself on all the work you've done and information you've gathered. Go you! :smile:

 

Due to time zone difference I am late to respond.
I have seen cats put on insulin that don't need it. I'm sorry Carolyn, it's blatantly obvious Harley has dropped over 100 pts at certain times.
Lucky did exactly the same. I had 7 weeks of no insulin and monitoring.Her numbers did come down, but they didn't stay down.
Every cat that has type 2 Diabetes has a partially working Pancreas.The difference is how much of it is working.

I don't see anywhere in my post staing anyone was incorrect on their advice and I also see like me you offered suggestions of where insulin could be purchased.
I wasn't thinking Donna was going to go rush out the door and buy insulin. Apologies Donna if that's how my post came across.

I sincerely hope you can get his numbers down.
I don't know who said it now Carolyn, but if you managed to get your kitty into non-diabetic numbers through diet, maybe you cold offer Donna some tips on feeding and a cut off at which point insulin may be needed?

I shall most certainly be interested to see how you guys fair. :mrgreen:

One other point. Can we be perhaps more thoughtful about criticising newbies. As for saying checking people's profiles-you won't see one for me cos I'm not so clever with the technical stuff. It looks like I joined in January 2010! when in fact it was around Sept 08.
I'm also wary of time length. It's what knowledge people have gained in the time that they have been on the board and how much reading/learning they have accumulated.
I sincerely hope I haven't riled anybody here because pretty much everyone on this thread are long timers who do know their stuff and I respect all of you, but I'm a strong advocate of peer group and pay forward and everyone having a chance to voice their opinions without being villified, as long as that advice isn't harmful to a cat.

 

welcome, donna.
we will be eagerly watching to see whether harley manages to get his pancreas healed enough without insulin. we used to hear that happens to about 30% of cats. not sure what the figure is now, but he's doing great.

my cat wasn't diagnosed via fructosamine. the vet used the level of glucose spilled into her urine and her blood glucose level. she was also tested for infection or anything else going on, and came up negative. after you have a certain amount of data from home testing, it's basically the same as a fructosamine anyway, as it measures blood glucose over time.