Took Boots to the vet

Discussion in 'Feline Health - (Welcome & Main Forum)' started by Jade77, Aug 15, 2013.

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  1. Jade77

    Jade77 Member

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    It was MUCH better than Banfield, but left me a little confused. First, the dr said the human meters are not accurate. She said I could get one specifically for cats, but they are close to or more than 200 dollars. Instead, they gave me a product called glucose chips, which I am to put in his litterbox and check daily for any color changing of the chips. And I did get a scrip for the lantus pens, but she told me not to give him his PM shot yesterday, and no insulin for today either. When they checked his blood at the clinic it was 76 with their meter meant for cats. The weird thing is we had just checked his blood 2.5 hours earlier and our meter said something like 250..? So Im unclear on when she wants me (if at all) to administer the new insulin..she told me that his number was so low he might not need insulin. Im just very confused and I think I will send the office an email to clarify what I am supposed to do now. They told me not to use the human meter anymore, to use these chips and see how his sugar levels are based on their color. Has anyone else ever heard of this?
     
  2. BJM

    BJM Well-Known Member

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    1) they are accurate enough and we have reference values for using them in cats. See bottom of this post.

    2) Purina Glucotest will tell you if glucose is spilling in the urine. This is urine collected since the last void and only reflects if the blood glucose was over about 240 mg/dL during the time the urine collected. It is less precise than home blood glucose monitoring!

    3) He drops like a rock on the Humulin and was low enough that more insulin would send him into hypoglycemia. This is to be avoided!!!


    Here are some glucose reference ranges used for decision making using a human glucometer:

    < 40 mg/dL
    - 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
    - If before nadir, steer with food, ie, give modest amounts of medium carb food to keep from going below 50.
    - At nadir, often indicates dose reduction is earned.

    50 - 130 mg/dL
    - On insulin - great control when following a tight regulation protocol.
    - Off insulin - normal numbers.
    (May even go as low as the upper 30s; if not on insulin, this can be safe.

    > 150 mg/dL
    - At nadir, indicates a dose increase may be needed when following a tight regulation protocol.

    200 mg/dL
    - no shot level for beginners; may slowly reduce to 150 mg/dL for long-acting insulins (Lantus, Levemir, and ProZinc) as data collection shows it is safe

    180 - 280 mg/dL
    - 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, 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.
     
  3. Deb & Wink

    Deb & Wink Well-Known Member

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    Bullsh*t! Another uninformed vet, trying to get you to spend hundreds of dollars on a pet specific meter. Until about 12 years ago, there were no pet specific meters. Only human glucometers. Everyone that tested used a human glucometer. Then Abbott Labs jumped into the lucrative marketing niche in 2006, and convinced vets that the human glucometers were not accurate and they and their patients all needed Abbott Labs brand new product, the Alphatrak.

    IMHO, human glucometers work just fine. BJM gave you the reference ranges. Alphatraks are expensive and no more accurate (same +/- 20% accuracy) than human glucometers. My recommendation? Don't waste your money on the expensive Alphatrak with it's $$$$$ test strips. Use the money for cat food instead. ;-)

    Would have been nice if you tested your meter and the vets side by side at the same time, on the same blood drop. A lot can happen in 2 and a half hours, and the Humulin drops Boots fast. I'm not surprised you got that lower reading at the vet.

    The glucose chips work like the urine glucose/ketone test strips do. Checking for glucose levels hours after they have happened. How much did the chips cost you?
     
  4. Jade77

    Jade77 Member

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    under 10 bucks. And they said I only had to use 10-15 of the chips per day, so the packets last a while as long as I keep it closed and in a sealed bag.
     
  5. Wendy&Tiggy(GA)

    Wendy&Tiggy(GA) Well-Known Member

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    You know what? You got the insulin and they dont know what you are doing at home so I would ignore some of what they said

    1. the relion is almost as good as a pet meter and cheaper. Many people use it here happily. So keep using it. Also its much more accurate doing blood than testing pee with those strips.

    Blood test- gives you a detailed look what he is doing during the day. If he goes up and down like you have seen - for example down to 20 (way too low hypo!!) and up to 500 (high) then you will know that and because he dropped under 50 you would know to reduce the insulin dose. Or he could sit at 200 all day and you would see that - and you would think thats ok

    Pee test- only gives a rough average over the day and depends too how much he drinks and how often he pees. So on a day he went to 20 and 500 it might tell you that today his sugar was mid range.. but it would say the same if he was 200 all day.. so its useless!

    2. YAY on the Lantus. You want to give it twice a day - the 76 they got was probably the old insulin in his system. Remind me of his weight and we can recommend a nice safe starting dose. We will want to wait at least 12 hours from his last novolin shot before starting and you wont be shooting under 200 for now.

    Wendy
     
  6. Jade77

    Jade77 Member

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    That's exactly what I was thinking of doing lol! They are really nice people there though, so I will keep using them for check ups and in any kid of emergency situation where Boots needs to see a vet. They were really thorough, the dr took plenty of time to talk to me and charged me very minimally.

    The thing that confused me about their blood test over mine is that he got the shot at 11am. WE tested him at +4 (at home, before the vet) and got 235. The dr tested him at +7 and got 76...I don't understand that at all?

    Also, when I woke up this morning after not giving him insulin for a day and a half, the chips in the litterbox were the darkest color they could be, which means lots of glucose spilling into his blood. So we gave him a dose early this morning. No one was at home to test him, so we didn't get one til +10 unfortunately. But it was only 91. Gabe tested him 4 hours later and got 329. So everything is all screwed up now and I don't get why his numbers are coming out how they are.

    My bills were higher than I anticipated so I have to wait til thurs to fill the lantus scrip, but I still have humulin N so I will use it til I can get to the pharmacy thurs, and I don't know if Im comfortable starting him on this during the week when we are both gone most of the day. So I think I will start him on it next saturday. I'll be gone most of the day, but Gabe will be home and can test and monitor throughout the day. Boots has gained a pound since I started the insulin (yay!!!) so he is now 12.76 pounds.
     
  7. Wendy&Tiggy(GA)

    Wendy&Tiggy(GA) Well-Known Member

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    Can u update your SS with these numbers you just said?
     
  8. Jade77

    Jade77 Member

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    Just did it. Sorry, long night at work last night.
     
  9. Wendy&Tiggy(GA)

    Wendy&Tiggy(GA) Well-Known Member

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    Ok am a little confused by the numbers - if 91 was at 4.30 and 498 was at 9.30 shouldn't the numbers be separated by more columns ie

    +4 91 (4.30pm?)
    +9 329 (9.30pm?)
    PMPS 498 (11pm)
     
  10. Jade77

    Jade77 Member

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    It's because his shot was at 530 am. We didnt get a chance to give him a test between then and 430 pm, and the test at 430 was 11 hours after his shot. He didn't get a shot 12 hours later, because his BGL was still so low. We waited to shoot til I got home that night at 11pm. There is no +16, and I considered the PMPT to be the 498 that we got at 11pm. Does that make sense?
     
  11. Wendy&Tiggy(GA)

    Wendy&Tiggy(GA) Well-Known Member

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    Ummm no but maybe put the green number in a column that shows how many hours prior to the red one it was..
     
  12. Jade77

    Jade77 Member

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    I don't know how to do that. 91 was +11, which is the last column, the next one is for the PMPT. 329 would be +16, and there is no column for that. He didn't get his shot until 1130 pm, 18 hours after his last shot. 498 was what we got 30 mins prior to his PM shot.
     
  13. Wendy&Tiggy(GA)

    Wendy&Tiggy(GA) Well-Known Member

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    Ok I am tired which doesn't help, how many hours passed between the 93 and the PMPS? 7?Then put the 93 at +5 and you should be fine. Just want to show that he didnt shoot up that high in an hour. Maybe document it all in your comments box,

    Wendy
     
  14. Jade77

    Jade77 Member

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    5 hours passed between those tests. I just documented it like you suggested. It hasn't happened since, I wonder if it was just wacky because he was off the insulin for a day and a half. Sorry it's so confusing. We are starting the lantus this weekend, so hopefully things will get a little less crazy.
     
  15. Wendy&Tiggy(GA)

    Wendy&Tiggy(GA) Well-Known Member

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    Hey there

    Hows things going? Is everything ok? Did you start Lantus?

    Wendy
     
  16. Jade77

    Jade77 Member

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    Hi Wendy :)

    Things are going the same. I was planning on starting the lantus yesterday but my day got hairy and I didn't get to the pharmacy in time, so I took it in today and will be picking it up shortly.

    I'm unclear on when it's okay to start the new insulin though. Is it safe to give it to him as his PM shot? He had his am shot at 530 (too early for the pharmacy to be open) so he had a shot of humulin.

    Also the scrip says to give him 1.5 units. Is that safe? He was only getting .5 of the humulin because 1 unit dropped him really low.

    Thank you for checking on us!
     
  17. Wendy&Tiggy(GA)

    Wendy&Tiggy(GA) Well-Known Member

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    What weight is he? We can work out a starting dose from there.

    Since he is prone to ketones I would start him tonite IF he is over 200.

    Wendy
     
  18. Jade77

    Jade77 Member

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    Scratch that...won't be starting the lantus. I can't afford the syringes for it!! Gabe just went to CVS to fill the scrip and they wanted 65 for the pen and ANOTHER 50 for the needles you need :/ I was unaware of that cost and another 50 is not in my budget for this paycheck.
     
  19. Squeaky and KT (GA)

    Squeaky and KT (GA) Well-Known Member

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    You DO NOT NEED and CANNOT USE those PEN NEEDLES! You will use the same syringes you're using with Humulin. When you open the pen, there's the same rubber diaphragm, just a bit smaller.

    HUGS!!!!
     
  20. Jade77

    Jade77 Member

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    I don't think they were willing to sell him the pen without purchasing the needles...I don't understand. If I can't use them why are they forcing us to buy them?
     
  21. Jade77

    Jade77 Member

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    Gabe is telling me that the pharmacist told him the needles have to be used with the pen, you can't use it any other way. It doesn't have that rubber seal like the vial has, and you dial the amount you intend to give, which means I can't give him 1.5 units. I was under the impression that you could use syringes like with the vial. But this is something that I cant afford.
     
  22. Wendy&Tiggy(GA)

    Wendy&Tiggy(GA) Well-Known Member

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    The pharmacist is wrong, if they take the lid off the pen there is a rubber end you can insert a syringe into. You don't use the dial. I do it all the tme. I will find a picture.

    Wendy
     
  23. Wendy&Tiggy(GA)

    Wendy&Tiggy(GA) Well-Known Member

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    Here is picture .. You can clearly see the grey end of the pen and the syringe being inserted.

    [​IMG]
     
  24. Jade77

    Jade77 Member

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    I see it. I just sent Gabe back out to get the pen, so we can use it for his 530 shot. Boots weighs about 12.5 pounds according to the vet.
     
  25. Jade77

    Jade77 Member

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    Got the pen! We are going to give him the dose recommended by the dr and test him in two hours.
     
  26. Jade77

    Jade77 Member

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    Is there a certain time I should feed him now that he is on lantus?
     
  27. Wendy&Tiggy(GA)

    Wendy&Tiggy(GA) Well-Known Member

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    what weight is he ? we need to work out the correct dose?

    The idea is you test, shoot (if BG is over 200 for now) then feed. You can feed pretty much any time all day but no food for two hours prior to the shot to make sure his preshot level isnt influenced by food.

    Let me know on the weight
     
  28. Jade77

    Jade77 Member

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    12.5 pounds I think
     
  29. Wendy&Tiggy(GA)

    Wendy&Tiggy(GA) Well-Known Member

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    Can you weigh him? Its kinda important ( give or take 1/2 lb) and let me know if he needs to lose or gain any
     
  30. Jade77

    Jade77 Member

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    it's 12.7. And I don't know if he needs to lose or gain, all the dr said was that the pound he's gained was good.
     
  31. Wendy&Tiggy(GA)

    Wendy&Tiggy(GA) Well-Known Member

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    Ok then starting dose of 1.5 is totally fine!

    Wendy
     
  32. Wendy&Tiggy(GA)

    Wendy&Tiggy(GA) Well-Known Member

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    Just checking though - what kind of syringes do you have - do they say U-100 0.3cc or 3/10cc?
     
  33. Jade77

    Jade77 Member

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    they say 3/10 cc. 31 gauge 8 mm
     
  34. Jade77

    Jade77 Member

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    I gave him the 1.5 and we have been testing him hourly to see how it drops his BGL. PMPT 512, +1 HI (600 BGL or higher) +2 377
     
  35. Wendy&Tiggy(GA)

    Wendy&Tiggy(GA) Well-Known Member

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    ok perfect. Please update your SS though ? Add the data to bring it up to date and add a line between yesterday and today saying "switched to lantus" big and bold so we can see it

    Keep the lantus in the fridge (not the door). Do not shake or roll. Should last 6 months. Dont inject air into it either. Expel the air first then , hold the syringe plunger firmly and insert into the pen and withdraw the insulin.


    Wendy
     
  36. Jade77

    Jade77 Member

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    Updated. I did attempt to put that he started the lantus in bold letters in the middle but I wasn't successful, it's in the notes section. His +3 was 357, so the lantus is slowly bringing it down
     
  37. Wendy&Tiggy(GA)

    Wendy&Tiggy(GA) Well-Known Member

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    Ok good. So you have a little learning to do on this insulin..

    First.. Lantus is a depot insulin which means the depot slowly fills up or drains over time. That means it takes a few days to see the effect of a dose change.. Whether an increase or decrease. Patience is key.

    In your case we have to initially build up the depot to a good level. This could take a week. So don't panic if the numbers are high to start. We give this first dose a week to settle. We will reduce it immediately though if he drops under 50. With lantus the lowest point of the day is most likely to happen 5-7hours after the shot. So that's a good time for a test.

    I usually recommend four tests a day if you can manage it

    - always before each shot.mandatory.
    - 5-7 hours after the morning shot if/when your schedule allows
    - before bed (2-3hours after evening shot). And if this number is lower than the preshot by more than 20% you might want to set the alarm for a mid night test as it can imply an active cycle.

    Also for now don't shoot under 200.

    Ask lots of questions!!!

    Wendy
     
  38. Jade77

    Jade77 Member

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    Gotcha. We are tring to test 4 times a day every day, but schedules aren't permitting that lately. We shoot at 530 am, but both of us have been doing AM shifts lately, so Gabe isn't home to do a test til about 330. And Im not home til after the next shot :/ This shouldn't last more than another week or two though.
     
  39. Wendy&Tiggy(GA)

    Wendy&Tiggy(GA) Well-Known Member

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    Whatever works with your schedule . Just make sure at least you get a test before every shot and maybe one before bed..

    Wendy
     
  40. Deb & Wink

    Deb & Wink Well-Known Member

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    We understand that life gets complicated sometimes and you can't always get the suggested tests when your schedule changes and leaves you no choice. You do the best you can, maybe testing at odd times like when you get home or Gabe gets home and that helps to fill in the SS.
     
  41. Jade77

    Jade77 Member

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    I don't understand anything that it going on with my cat. He got a shot at 530 last night. I checked his BGL every hr for the first 7 hours. Now, right before his next shot, the meter says 119!? Im not giving him his shot because I have no idea what will happen and no one will be home for a good chunk of the day, so if he drops too low no one will be here to do anything. I don't know how much longer I can keep doing all of this :/
     
  42. BJM

    BJM Well-Known Member

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    Oct 6, 2010
    We do suggest newcomers not shoot below 200 mg/dL as there isn't enough test data to show it would be safe for your cat. As you home test between shots and gather data on your cat's response to insulin, you may gradually reduce the no shot number.

    Be patient with yourself. There is a lot of information here, plus each cat is different (ECID) and may need tweaks to the process because of them.

    With Lantus, the effects are cummulative. You've just started using it last night at 1.5 units and this mornings pre-shot was barely above 100 mg/dL. I think a decrease of 0.5 units down to a 1 unit dose makes sense.
     
  43. Deb & Wink

    Deb & Wink Well-Known Member

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    You made the right call Jade, skipping the shot of insulin. Since you're not home to monitor and don't have much data yet with the Lantus insulin, skipping was the right choice to keep Boots safe.

    You were giving Boots 0.5U of humulin insulin, but your SS says 1.5U for the first dose of Lantus last night. That may be why he dropped low this morning. I know Wendy said 1.5U starting dose but we may rethink that.

    It will be ok Jade, really it will. You can do this with our support and your love for Boots.

    When you get a chance, would you please update your signature and cross out the Humulin ( s edit command) and put in Lantus. Thanks.
     
  44. Wendy&Tiggy(GA)

    Wendy&Tiggy(GA) Well-Known Member

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    I think drop to 1unit. Deb/BJ - thoughts?
     
  45. BJM

    BJM Well-Known Member

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    Yes. With the cummulative impact of Lantus, dropping to 1 unit makes sense for this evening. If the pre-shot glucose is still low, between 100-150 mg/dL, I'd be inclined to take it down to 0.5 units.
     
  46. Jade77

    Jade77 Member

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    okay, so when he gets his evening shot, I should make sure he's over 200 and only give 1 unit? And if he is still under 200 only give .5? Sorry if there's a delay in my responses, I'm at work.
     
  47. Wendy&Tiggy(GA)

    Wendy&Tiggy(GA) Well-Known Member

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    Sort of. No shooting at all if under 200. If over 200, give 1 unit.

    Wendy
     
  48. Jade77

    Jade77 Member

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    Got it. Gabe will be the one shooting tonight, Im pretty sure I will still be at work. I will keep you all updated. I know I've said it many times, but thanks for all the support and advice.
     
  49. Wendy&Tiggy(GA)

    Wendy&Tiggy(GA) Well-Known Member

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    No problem. I am glad Boots is doing so well now. with he DKA he had a few weeks ago, it was touch and go!

    Keep us updated and ask lots of questions!
     
  50. Deb & Wink

    Deb & Wink Well-Known Member

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    I concur on the 1U dose. She was only giving Boots 0.5U of Humulin, so I think lowering the Lantus dose makes sense.

    I'd rather we bring Boots up slowly if needed. We want to keep him safe and it looks to me like the 1U will help do that.
     
  51. Jade77

    Jade77 Member

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    We gave him just the 1 unit tonight, so we will see how he does with that.
     
  52. Wendy&Tiggy(GA)

    Wendy&Tiggy(GA) Well-Known Member

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    Lets give it a few days. We might need to tweak it again if it doesn't work. There is a little fiddling with dose at first. Don't shoot under 200 for now and drop the dose again if he goes under 50 at any point,

    What was tonites BG?
     
  53. Jade77

    Jade77 Member

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    okay, I will. He drops so much slower on the lantus, should I still be testing at the 3 hr point or wait a little longer? So far at 3 hours he hasn't gone down much. Seems to be more around the 6/7th hour that there is a significant drop.
     
  54. Wendy&Tiggy(GA)

    Wendy&Tiggy(GA) Well-Known Member

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    It's always a good idea to get a+2 because it does give u an idea of his nighttime plans .. If he is rising for example u might not even need a +6. However it would be good to get tests at slightly different times since not all cats nadirs are exactly at +6 so for example tonite get a +2 and +7..
     
  55. Jade77

    Jade77 Member

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    well he was too low again to give the AM shot. I just don't understand hat I'm doing wrong.
     
  56. Wendy&Tiggy(GA)

    Wendy&Tiggy(GA) Well-Known Member

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    How low was he?
     
  57. BJM

    BJM Well-Known Member

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    You may not be doing anything wrong. He may be getting better!
     
  58. Jade77

    Jade77 Member

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    He was 170 this morning, 12 hours after his last shot. Getting better is a nice thought, but he still has numbers in the 500's and even higher on a regular basis, so I don't think so..I just got home from work, Gabe tested him at 530 this evening and he was at 355. Gabe gave him .5 to see what happens with that.
     
  59. Wendy&Tiggy(GA)

    Wendy&Tiggy(GA) Well-Known Member

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    Probably because you skipped this morning. He still needs insulin right now but his pancreas may be healing or he might just need a lower dose of lantus.

    lets see how you get on with 0.5!

    Wendy
     
  60. Jade77

    Jade77 Member

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    He was 304 at +3. Should I just keep checking every couple hours til I go to bed?
     
  61. Wendy&Tiggy(GA)

    Wendy&Tiggy(GA) Well-Known Member

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    Sure... Maybe get a +5 or +7 for a change?

    Wendy
     
  62. Jade77

    Jade77 Member

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    okay. I think I'll get both and just stay up a bit later than normal. I'm off tomorrow anyway.
     
  63. Wendy&Tiggy(GA)

    Wendy&Tiggy(GA) Well-Known Member

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    Got any new results for me?

    Wendy
     
  64. Jade77

    Jade77 Member

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    I just updated his SS if you want to check it out...that .5 doesn't seem to be as effective as it should be, but 1 unit was too much. I wish I could be home a full day to get a test every two hours, but it just isn't happening til this darn holiday is over.
     
  65. Wendy&Tiggy(GA)

    Wendy&Tiggy(GA) Well-Known Member

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    No worries. Lets give it a couple more days to let the depot build up. If we dont see better numbers then we increase to 0.75. So please keep your SS up to date if you can so we can decide when that should be. when do you think you can get day tests in?

    Are you checking his pee for ketones?

    Wendy
     
  66. Jade77

    Jade77 Member

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    I am off work (so far, I was called in the other day on my day off) monday, so I should be able to do some better testing that day. And yes, Im checking his pee with the strips and they say no ketones. He is acting like his normal self still, eating well and drinking well but not excessively. Im considering investing in one of those alphatrak meters in the next couple of months, when I can fit an extra hundred bucks in my budget. What is your opinion on that meter? My vet says they are more accurate.
     
  67. Wendy&Tiggy(GA)

    Wendy&Tiggy(GA) Well-Known Member

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    Its a little more accurate but the strips are more expensive too --- and the Relion is more than good enough. Honestly its not worth the extra money in meter cost and strips which you use more!

    Wendy
     
  68. Deb & Wink

    Deb & Wink Well-Known Member

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    IMHO, save your money and buy cat food or some toys for Boots instead of the more costly Alphatrak meter and it's pricey test strips. The human meter you are using is good enough. It accurately measures the lows, which is where you really want the accuracy. Anything really high, is high and it doesn't make a big difference if the high is 300 or 400. You know at the high numbers, to keep up the testing for ketones and that the cat needs to still be on insulin. High is high.

    You can look at Wink's SS to see some parallel testing between the Alphatrak and the Relion Confirm. The only reason I started with the Alphatrak, was the shelter gave it to me to use. Then, they did not want me to test much. So I bought a Relion Confirm myself, so I could be more comfortable with using more test strips and not worrying about the cost so much.
     
  69. BJM

    BJM Well-Known Member

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    Oct 6, 2010
    Its like reading temperature in Celsius vs Fahrenheit. Both have reference values for freezing (0 Celsius, 32 Fahrenheit) and so forth.
    At the lower end, the difference between an AlphaTrak and a human meter is about 30 mg/dL.

    ALL meters sold in the US are permitted to test within 20% of what a lab would get.
    A test of 50 mg/dL means the true glucose value is somewhere between 40 - 60 mg/dL, a span of 20 mg/dL.
    A test of 500 mg/dL means the true glucose value is somewhere between 400 - 600 mg/dL, a span of 200 mg/dL.

    Note that as the test values go higher, the range in which the real glucose level lies is much wider. At high numbers, it really doesn't matter - high is high. You have to figure out what you are going to do about that, following the insulin dose adjustment protocols and recommendations for food.

    We're more concerned about numbers at the low end, due to the risk of hypoglycemia. Whenever you have an unexpectedly low number, test again and maybe test yourself. If the 2 test values are within 20% of each other, they may be considered the same.
     
  70. Jade77

    Jade77 Member

    Joined:
    Jul 15, 2013
    okay, that makes sense. I just realized that I am NOT off on monday, wrote it down wrong. Im off tues but Im going to be gone for 2 hours in the AM for a managers meeting. But if Im only testing every two hours to do a curve, I can test right before I leave and test as soon as I get home.
     
  71. Jade77

    Jade77 Member

    Joined:
    Jul 15, 2013
    We have been starting to get numbers that are higher 3 hours after his shot that the preshot test...not way higher..I think today he was 14 higher. But it's still weird. Anyone ever experience that? Does it mean the dose needs to go up?
     
  72. Jade77

    Jade77 Member

    Joined:
    Jul 15, 2013
    well I just got a +5 and he's now 40 higher...what in the world?
     
  73. Wendy&Tiggy(GA)

    Wendy&Tiggy(GA) Well-Known Member

    Joined:
    Nov 15, 2011
    When do you think you can get a test during the day? He could be bouncing, although these readings are all within 20% of each other which is within meter error... Essentially making him flat pink.

    End tomorrow we don't see anything but pink then maybe its time for an increase.
    Wendy
     
  74. BJM

    BJM Well-Known Member

    Joined:
    Oct 6, 2010
    A small spike about 2-3 hours after food at shot time is common.

    Fast or large glucose drops may provoke compensatory hormones to release stored glucose and elevate the level. We call it bouncing.
     
  75. Jade77

    Jade77 Member

    Joined:
    Jul 15, 2013
    I won't be home all weekend...retail is brutal on holiday weekends. But if Gabe isn't out working I think I will ask him to get a test every two hours tomorrow, so we can try and figure out what's going on.
     
  76. Wendy&Tiggy(GA)

    Wendy&Tiggy(GA) Well-Known Member

    Joined:
    Nov 15, 2011
    Even if he can get 1-2 midday tests that would be great. If we dont see any yellow (at least) by end today I am thinking you may want to increase by 1/2 unit to 1 unit.

    Wendy
     
  77. Deb & Wink

    Deb & Wink Well-Known Member

    Joined:
    Jan 31, 2013
    I know about those holiday weekends when you work retail. That was what I was up to all day today.

    I'm still thinking that Boots needs an increase too. He needs an increase real soon, with all those stinky pinkies I see on his SS.
     
  78. Jade77

    Jade77 Member

    Joined:
    Jul 15, 2013
    Okay, so Gabe got a bunch of results after Boots' AM shot, I have updated his SS (almost all pink numbers) so if anyone is up and wants to review it and give me opinions That'd be appreciated :)
     
  79. Wendy&Tiggy(GA)

    Wendy&Tiggy(GA) Well-Known Member

    Joined:
    Nov 15, 2011
    Yep tomorrow morning I would increase to 0.75

    Wendy
     
  80. Deb & Wink

    Deb & Wink Well-Known Member

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    Jan 31, 2013
    Agreed, Time for an increase in Boots dose, up to 0.75U.
     
  81. Jade77

    Jade77 Member

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    Jul 15, 2013
    okay, thanks!
     
  82. Wendy&Tiggy(GA)

    Wendy&Tiggy(GA) Well-Known Member

    Joined:
    Nov 15, 2011
    Good job on the dose increase - and all the testing!

    I think if she is pink/red you can test every 2 - 3hours instead of hourly.. give her ears a break. But if you start to see low yellows and dropping then increase to 1-2 hours.

    Same routine. 3 days and increase to 1 unit if she is still not showing any blues or greens. Keep me updated though!

    Also you might want to go over to the Lantus specific support group and check it out. Read the Stickies at the top of the Topics section. Read a few condos posted by other members. check it out - its full of Lantus only users and very experienced members who advise on dose. I post there for my cats every day or so too. It has a great sense of community: http://www.felinediabetes.com/FDMB/viewforum.php?f=9

    Wendy
     
  83. Jade77

    Jade77 Member

    Joined:
    Jul 15, 2013
    Thank you for checking up on us :) I am still discouraged by all the pink I see everywhere, though I did get a yellow at +6 today. I have actually attempted to check the lantus groups out a couple of times but I am being overloaded at work and I haven't been home for more than a few hours a day in..I don't even know anymore. Something like 2 weeks, possibly more. I am hoping that when my meeting is done at work tomorrow I can look them over, and while my little one is down for her nap as well. I noticed that there are two diff groups, tight regulation and relaxed..whats the difference? I'm assuming I would be a part of the relaxed group, since I am not home nearly enough for tight regulation.
     
  84. Wendy&Tiggy(GA)

    Wendy&Tiggy(GA) Well-Known Member

    Joined:
    Nov 15, 2011
    Really the difference between the protocols is how aggressive you want to be - I like tight as it gets them into better numbers faster and makes the most of the narrow 6 month window that is for remission. Thats how I have been guiding you so far..

    Anyway I am thinkingB oots may need another increase soon as per the tight protocol... To decide if a dose is needed you look at the "nadir" or low point of the day. And kinda do an average over how they are on the current dose . So in your case because you are seeing some yellow I would probably increase by 0.25 on Wednesday morning if you dont see blues and greens by end tomorrow. If you see either of these we would give the dose a couple more days. Or if you see a number under 50 we would drop the dose.

    Wendy
     
  85. Jade77

    Jade77 Member

    Joined:
    Jul 15, 2013
    Yeah, I'm thinking he needs an increase too, doesn't matter what time we test him, he seems to almost always be in the pink, I think we have only gotten two yellows since increasing him to .75. Once my little one goes down I will start reading in the lantus groups. Is there a certain time I should or should not be feeding now that he is on lantus? Since we are home so sporadically lately I have just been making sure there is plenty of food out because my other cat, Freya, looooves wet food, and she sometimes eats a bunch of it before he even gets to it.
     
  86. Wendy&Tiggy(GA)

    Wendy&Tiggy(GA) Well-Known Member

    Joined:
    Nov 15, 2011
    Its up to you how you feed as long as you dont feed for 2 hours before the shot time so that your preshot test isnt influenced by food. I like mini meals through the day or free feeding as its less stress on the pancreas than a couple of big meals.

    Time an increase to 1 unit.

    Wendy
     
  87. Jade77

    Jade77 Member

    Joined:
    Jul 15, 2013
    Oh, I didn't know he shouldn't eat for two whole hours before the preshot..well, I know now. Should we increase tomorrow?
     
  88. Wendy&Tiggy(GA)

    Wendy&Tiggy(GA) Well-Known Member

    Joined:
    Nov 15, 2011
    Yep I would.

    Wendy
     
  89. Jade77

    Jade77 Member

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    Jul 15, 2013
    Well...we increased the dose this morning and +6 Im getting a way higher number than I did at preshot. I'm at a loss. I don't know what is going on or why I can't get his BGL to drop. :/ I'm very frustrated.
     
  90. Wendy&Tiggy(GA)

    Wendy&Tiggy(GA) Well-Known Member

    Joined:
    Nov 15, 2011
    Remember that lantus is a depot insulin and takes 3 days to build up in the cats system. So you won't see the impact of the dose change for another day or two.... Patience! It's important not to rush things as you can skip past the good dose.

    Did you check out the lantus board yet?
     
  91. Jade77

    Jade77 Member

    Joined:
    Jul 15, 2013
    Yes, I checked both out. It's a lot of info and difficult for me to try and remember all of it. I don't really understand the difference between the tight reg group and the relaxed group though.
     
  92. Wendy&Tiggy(GA)

    Wendy&Tiggy(GA) Well-Known Member

    Joined:
    Nov 15, 2011
    Well I would recommend you go onto the tight group . Its more active and more experienced members there. I am on there myself for my boys. I would like their eyes on Boots. They will also help guide you are regards the protocol as long as you keep asking questions!


    Here’s how to post:
    Every day ( or as often as you can) you open a new thread/post. We call them "condos" (short for condition report, or the home you live in and the cat trees some people have)

    Subject line: The subject has the date/cats name and BG readings ie 09/6 Boots AMPS 429 +5 335 You add a ? icon if you have a question. You should update your subject line in the very first post for the day as you get a reading, or whenever you have a question. For your first post put "newbie" also in your subject so everyone can welcome you!

    Contents: The contents of your post have a quick update on how your cat is feeling as regards the 5Ps ( peeing. pooing, preening, playing and purring) and any questions and a link to your previous post ie : Today Boots was in a good mood, playing and eating well. But he is peeing a lot and his BG is really high. Should I increase the dose?


    Wendy
     
  93. BJM

    BJM Well-Known Member

    Joined:
    Oct 6, 2010
    For those of us with erratic schedules, difficult to monitor cats (ex - a feral, working with someone else who has a diabetic cat but can't test) the Relaxed forum is where we hang out.
     
  94. Jade77

    Jade77 Member

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    Jul 15, 2013
    With my erratic schedule, would I be better off in the relaxed group? I do test quite often..so it's erratic but I'm on top of testing most of the time..
     
  95. Wendy&Tiggy(GA)

    Wendy&Tiggy(GA) Well-Known Member

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    Nov 15, 2011
    Its up to you. Tight is more active but if you can post every few days they will happy - they get worried when they havent heard from you for a few days.. like me.
     
  96. Jade77

    Jade77 Member

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    Jul 15, 2013
    Okay, I'll post there tomorrow morning :)
     
  97. Jade77

    Jade77 Member

    Joined:
    Jul 15, 2013
    I'm starting to think he may be getting into the dry food that my non-diabetic kitty eats :/ I noticed these random spikes in his blood sugar, then I caught him creeping up on the dry food bowl I keep in the bedroom for Freya. But I live in a pretty small apt, so I have no way of keeping him from the food, aside from locking one of them in a bedroom while the other roams. And I can't keep a litterbox back there or they will ruin the carpet.
     
  98. Wendy&Tiggy(GA)

    Wendy&Tiggy(GA) Well-Known Member

    Joined:
    Nov 15, 2011
    Could you switch her to wet or a low carb dry too?
     
  99. BJM

    BJM Well-Known Member

    Joined:
    Oct 6, 2010
    You might put the civvie on a low carb dry so that becomes a non-issue. Evo Cat and Kitten, Young Again 0 Carb (internet only), Stella and Chewy's freeze dried (meant to be rehydrated) are some options.
     
  100. Jade77

    Jade77 Member

    Joined:
    Jul 15, 2013
    Feeding them both the wet food would be kind of pricey. 5 bucks a day really adds up when you don't have much extra money. Is there a low card dry food out there?
     
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