Sooty update and more advice needed

hi

Update on Sooty and our diabetes journey so far.......

In brief, he started at 2.5 (too high) so reduced to 1u. he wasn’t reacting well to insulin (well no reaction at all and v lethargic) so urine sample taken and identified infection. Antibiotics given and he seemed to pick up and seemed to be coming back to life.
He went into vets for glucose curve and they gave him 1.5 (he started at 20 and dropped to 4.4). Being at the vets though he didn’t eat his usual amount (he normally grazes through the day).
We’ve been on 1.5 now for a few weeks and the last few days he’s started drinking loads again.
I tested him tonight and he was 24.3 so we decided to give him 2u to see how he does.

My q is - if he’s always hungry (which he seems to be the last few days) am I fighting a losing battle with the 1.5u ?
Is the insulin dose of 1.5 too low and that’s making him hungry ?
Also have I done the right thing giving him 2u tonight ?

I’m going to test his bg again 3+ to see how he is doing.

 

We're a bunch of broken records here! We NEED to see all your BG data on the spreadsheet we use here in order to give good advice.
http://www.felinediabetes.com/FDMB/threads/fdmb-spreadsheet-instructions.130337/
Someone can set it up for if needed.

Re dose: we generally recommend changes of only 0.25 u at a time. That has to be eyeballed on the syringe and it's a lot easier if they have half unit marks.

Useful info to add: we also rely on short info summary you have in your signature (the light grey text you see under my post) to get a feel for the basics before we advise. Here's how to set yours up:

• click on your name in the upper right corner of this page
• click on "signature" in the men that drops down
• type the following in the box that opens: kitty's name/age/date of diabetes diagnosis/insulin you're using /glucose meter you're using/what he eats/any other meds or health issues he has.

 

I’ll have a go at getting the ss up and running with some info.
To be perfectly honest I don’t like testing his bg too often (it stresses us both out) and I don’t want to put him through too much.

Reading some of the recent posts here too will I ever get his levels stabilised ? I thought things were going so well (hence why not been posting) and a bit disheartend that we seem to have gone downhill

 

Many, many people arrive here thinking the same way. We all found it stressful and daunting at the start - I know I did. Then, somewhere along the way something happens (a hypo episode, a brush with diabetic ketoacidosis) or doesn't happen (good control of BG, good clinical signs) and we realize that the best tool for knowing what's going on is home testing.

 

Hi Amy
I have to agree with Kris above - we do need to see some data ideally in the form of a spreadsheet to see how any one dose of insulin is acting over the course of a 12-hour cycle. I know it seems a bit of a pain and I know testing blood from a kitty's ear isn't the most fun thing to do, but it's what most of us have to grit our teeth and do if we want to try to fathom out the FD dance. As you may have read here, treating FD is a marathon not a sprint and it does involve a fair bit of commitment on the part of the caregiver. The choice is yours, of course, but trying to establish some sort of routine for testing and then posting the results here so we can give you informed advice is the very best way forward.

 

I’ll give the bg testing a go again and post in a ss.
How often do I need to test to get some pattern or idea of what’s going on ?
I know you’ll say as often as I can !!
If I do 3+, 9+ and pre shot is that ok ? Or would 6+ and pre shot be better ?
Or probably even better 3+, 6+, 9+ and pre shot ?

I am committed to this, I’m just a bit disheartened tonight with his drinking lots again and of course I want to do the best for him.

 

Can you remind us what insulin he's on (this is the sort of info to put in your sig). Different insulins have different actions so it helps us to know how to comment on bg results if we know the insulin being used.

Ok so ideally, you want to do a curve, which means testing every two hours over a 12-hour period. You don't have to do this every day! - but it would show the bg number pre-shot and then at +2, +4 etc up to pre-shot again. This gives invaluable information about how the insulin is working - at what time it takes effect (onset), how long it lasts (duration) and what the lowest point is (nadir). It's called a curve because if you plot the numbers on a graph, the result should be a gentle line like a "smile".

That's what you'd do if you want to get a good picture of what a dose is doing. Otherwise, in terms of how often you have to test, the answer is always pre-shot as a very minimum, plus at any other points during the cycle when you're specifically trying to determine onset, duration or nadir. Does that make sense? Basically, the more info you can collect and report here or to your vet, the better everyone will be placed to answer your questions!

@Kris & Teasel - anything to add?

 

I think I’ve done my signature and put that he’s on Caninsulin - Sorry if I haven’t done it right.
I’ve read about the curve and when they did it at the vets he had quite a nice smile curve (although dropped a little too low to 4.4).
I’m working at home tomorrow and I’ll give it a go - we’ve got the vets on Wednesday.
As soon as I’ve got results I’ll pop into a ss.
I know I’ve got to do it and 2 mins after I’ve done it soot seems to recover quite nicely (with a chicken treat !)

 

Here's the basic testing routine we recommend:

1. test every day AM and PM before feeding and injecting (no food at least 2 hours before) to see if the planned dose is safe
2. test at least once near mid cycle or at bedtime daily to see how low the BG goes
3. do extra tests on days off to fill in the response picture
4. if indicated by consistently high numbers on your spreadsheet, increase the dose by no more than 0.25 u at a time so you don't accidentally go right past a good dose
5. post here for advice whenever you're confused or unsure of what to do.

This is useful: http://www.felinediabetes.com/FDMB/threads/hometesting-links-and-tips.287/

 

Hi

I’ve done 2 tests so far and I’m getting into the swing of things (and so is Sooty - reluctantly).

I’ll add them all to a ss at the end of today but so far

6.00am - 22.4 no food for 2hours prior
6.00am fed
6.30 - 1.6u given
08.30 - 16.4

I’m going to test at 11.30, 1.30, 3.30 and 6.00 and should have a full day of results.

Q is - if he is hungry (which he will be) can I feed him ? I’d normally feed during the day so any results I get would reflect our usual routine.

Thanks
Amy

 

Good to hear you're getting into the swing of things - as with so many things in life, it's all about establishing a routine and then it all starts to flow more easily...

So the good news is that Sooty is responding well to the insulin. A drop of 6 points at +2.5 and at those numbers is typical of Caninsulin - it tends to take effect fairly quickly and get used up quite fast. It will be interesting to see how much further he drops and how long it is before the insulin starts to peter out and he starts rising again,

If he's hungry (which diabetic cats usually are) you can pretty much free-feed him, as long as it's wet low-carb of course, or pure protein such as pieces of chicken. There would probably be a food spike afterwards but if you make a note of when food was given on your ss, it will be easier to take account of this.

Just one more thing - this is an international board with only a very few members from the UK so people are in many different time zones. So when you give bg data in a post, it's better to use the standard way of reporting this as follows:

AMPS (morning pre-shot bg) - 22.4
+2 (2 hrs after insulin) - 16.4
+4 -
+6 -
+8 -
+10 -
PMPS (evening preshot) -

That way everyone can see at a glance how the insulin is working. But when you get the ss going you won't really need to do this as all the info will be there.

 

+4 12.4

We’re still dropping which is good (I guess)

 

Bit more of an update.
It was going so well......
+4 12.4
+6.5 19.2
+8 20.4

So it looks like his nadir was around 12 which is still too high ?
I’m testing preshot in about 45 mins and will have a good idea whether it’s safe to shoot (I suspect it will be !)
Also I’ll put all this on a ss - I couldn’t save the template from my iPad so I’ll hijack my husbands computer later on.

Because also I’ve tested so frequently today my confidence in testing has grown and Sooty seems to be getting used to it too which is the main thing (although I do treat myself to a coffee after I’ve tested)

 

This is so wonderful to read!

Let's see the spreadsheet before we decide about dose.

 

Good! All going in the right direction re testing!

 

I haven't seen what your baby's been eating - brand, etc. how much in 24 hours, how much water add if any etc.? I'd appreciate it it.