Worried about cat's BG levels (newbie)

Hello all, can anyone give me any advice. My 16 year old has been on insulin since last Thursday (1wk) she is on 1u of Caninsulin x 2 times a day. I recently bought a glucometer to test her, and am gradually getting her used to it (I'm not fantastically good at it!)
If anyone can help me figure out better what to do and when to panic...
23rds Aug pre food PM was 361
24th Aug pre food PM was 339
25th Aug pre food AM was 363
1PM +5.5 was 286
7PM pre food +11.5 was 405!!
Don't know what to do as am quite worried about it but no money left for vet at the moment, so any suggestions would be very helpful. TIA

 

The 405 is high, but not horrible....we've seen cats over 600 here. Do you have some urine ketone test strips? It's a good idea to check for ketones when they're running that high

Can we get some more information from you?

Your name/your cats name? So we know who we're talking to

What type of food are you feeding?

Caninsulin isn't a great insulin for cats....it can take them down "hard and fast" and then wear off before the next shot...do you live in the UK? (looks like it from the times)....They've just recently approved a much better insulin for use in cats called ProZinc....before that, you were required to start with Caninsulin and could only change insulins if you could prove your cat didn't do well on it. Other insulins that work well in cats are Lantus and Levemir

 

Thanks so much for your reply, I did post in the new user bit but don't know how to link to this...
'Hello all, I have heard great things about this site so here I am ready to ask for help. Honeybun is 16 years old, newly diagnosed a week ago today due to being lethargic and losing weight but eating a ton! She is on 1u Caninsulin twice a day, and I have just purchased a home kit to test her myself as the vets have had all my money and I don't have any other option! This is all very scary but I am hoping that you will all share your wealth of knowledge with me Honey lives with 3 other cats and the vet says sh has no other health issues apart from the nasty old diabetes!'
The vet just stuck her on it and then wanted to do another fructosamine test tomorrow (she had one last Fri), but i just don't have all the money extra to pay her for this, so thought it might be best to home test for a few weeks until I can afford it. I am seriously thinking of changing vets so have heard on a Facebook FD forum that Lantus was very good and Caninsulin wasn't particularly good!
Food is now Sheba pouches, she doesn't have dry food but is very hungry during the day as she was used to grazing and having quite a few meals prior to this...in fact she is pestering me now even though only fed an hour ago!

 

Oops, and I am in the U.K! My names Rachel I do have ketone sticks for when I am low carbing, will these work for her? I have 4 cats so will have to isolate her.

 

yes they will!! Ketones are ketones...anything more than "trace" is an emergency

Here are some Urine Testing tips...maybe you'll find something that works for you and Honeybun

 

It's actually better for the pancreas to deal with multiple small meals than 2 big ones so it's OK for her to have snacks.....the only caveat is that with Caninsulin, it's important that they have a good sized meal about 30 minutes before shooting so that when it "hits", there's food on board

The only time we really don't want them eating is the 2 hours immediately before Pre-shot times (the test you'll want to get before feeding/shooting)

If you can, you should try to get a test in about 3 hours after the shots....the nadir for Caninsulin is usually +3 to +6 (3 to 6 hours after the shot)

 

Thank you, that is good to know. The diabetes nurse at the vets gave me the impression I was to feed her and then inject her fairly soon afterwards! I will wait 30 minutes from now on. She had her last shot at 7pm GMT so 2 hrs ago roughly. I know she has been feeling better as today when I called her in she came moseying in from the end of the road - the last couple of months she has only been going out by the front door and lying in the bush, so she is back to her old tricks! She really doesn't like the ear testing, but I will get there with her, I think she gets a little stressed by it as I can't always get it right the first time - but I am getting better! Using a warm wash cloth in a plastic bag and a torch behind the ear, with a treat after, often the needle seems it doesn't pierce the skin properly but I think that is because I haven't done it firmly enough. Really appreciate your help Will try and test in an hour and check what levels are. I have a pouch of ridiculously expensive litter to use when the vet wanted me to get a urine sample before so will maybe try to isolate her and get that tested too.

 

Hi Rachel, your numbers are not horribly high considering you are just starting out and 1 unit twice daily is at the lower end of the start point for Caninsulin so I wouldn't be too worried about that at the moment. It is better to start low and take things gradually. If you want to feed more than twice a day then I would suggest splitting morning and evening meals into 2/3 before the shot and the remainder 3-4 hours after. Insulin should be given about 3o mins after feeding. You should feed a low carb wet food - the UK food list is here https://docs.google.com/spreadsheets/d/1J5JpMe6TDXrHq_aTl9hUtHy6Gs9oRBqlz4nPGKxtySA/pubhtml. If you change her food you should do it gradually (I did it over a week) and make sure you are testing regularly. The alternate licensed insulin in the UK is Prozinc and vets would be unlikely to switch you to Lantus from Caninsulin as they are obliged to give the licensed insulins first and justify use of unlicensed insulins before use. I have only just switched insulins after 4 months on Caninsulin and did get good overall control but numbers varied a lot day to day so have changed to try to get more consistent numbers. Don't be put off giving Caninsulin a good go as some people get very good control or even remission.

To get a urine sample for ketone testing try aquarium gravel in the tray, cling film over the litter - or even a spoon to catch some urine - I do the 'sneak up behind with spoon' trick to catch urine whilst she is performing.

If you can set up a signature and a spreadsheet to record her numbers we will be able to give better advice and help. There are a number of us from the UK and other parts of the world on the board familiar with Caninsulin who can help support and guide you. You will need one of the 'world' spreadsheets as a lot of us 'think' in the UK numbers and the spreadsheet automatically changes it to US numbers for people who are not familiar with our measurement scales. You will need to set up a google account if you don't already have one. At some point you will need to do a curve to determine how she responds to the insulin but we can talk you through how to do that.

Welcome to the board!

 

Brilliant! Thank goodness - I read the numbers and panicked, then scoured the net for info, then panicked a bit more! So i will keep on with the Caninsulin, due to get some more tomorrow or Monday so I have plenty. It's such a responsibility, it feels like having a baby all over again! Aquarium gravel sounds like a great idea, she also had a UTI when I took her in which I had suspected, but that seems to be clearing up nicely as there are no frequent litter box trips. She seems a lot brighter and has given two of the younger boys a good slap a few times - they had become complacent and been taking liberties - now they are back to giving her a wide berth!!

 

Just tested her- with more confidence thanks to all you guys on here! Got it right 1st time, shes 241 thats +3.5 from her PM shot

 

Welcome! My numbers were really high the first few weeks but gradually we were able to get her in control. My cat uses vetsulin which is the same as Caninsulin. Some will tell you it's not a good insulin, but I have found it to work well for my cat.

 

So after cancelling my vet appt for today, said vet calls up and asks why. I tell her I am home testing, checking her regularly with a human meter and I have no money left but will make an appt in next couple of weeks to have a fructosamine test. She tells me to stop home testing with a human meter, that lots of cats become very ill because they are very inaccurate for cats readings and that if I am worried about her looking ill I should take her in for a test immediately. She was very insistent about the meter being wrong and not to rely on it. I told her I have online support and am to do a curve soon. She said I can get some more insulin Tues but that's it until they see her again. I am in the UK. Thoughts please

 

I think your vet needs some education! There is nothing wrong with testing using a human meter - its just that they don't match the reference ranges for the lab tests for cats, the pet meters do but they are expensive as are the strips. Fructosamine just gives an indication of the cats average levels of blood sugar in the previous two weeks which as she is just newly diagnosed is bound to be high and won't tell you anything you don't already know. The spreadsheets on this site have ranges for readings (depending on which type of meter you have - human or pet) which help with getting control of glucose levels. We will talk you through this once you have the spreadsheet up and running. My vet likes the fact I am home testing as she has the link for Cappuccino's spreadsheet so can monitor remotely and realises she has an informed owner on her hands who is confident in how to manage feline diabetes. Sadly most people with diabetic cats it appears don't home test so your vet may not have come across this before.

Here is the link to the consensus guidance on feline diabetes - which includes authors from the UK - David Church is one of the principal researchers at the Royal Veterinary College looking into feline diabetes, and the guidelines clearly state home glucose monitoring is desirable. You could point your vet at the guidance and suggest they speak to a specialist. http://www.ncbi.nlm.nih.gov/pubmed/25701862

You can help educate your vet by demonstrating you are committed to getting the best for your cat. If they are not prepared to work with you then it might be time to look for another vet.

 

Agreed with Alexi. There is nothing wrong with using a human meter if you know what the numbers mean. It's like Celsius versus Fahrenheit. They are two different ranges of numbers, but you only use one, and you know how to determine how hot/cold it is based on the number ranges you are given.

Fructosamine tests are quite useless if you are home testing. It will not tell them anything that home testing wouldn't, in fact, it often causes vets to want to change the dose based on an "average" over a few weeks, rather than how low or high the cat goes on a day-to-day basis. I went for one Fructosamine test and then I started home-testing with a human meter, eventually getting my cat into remission. Most veterinarians are not well-versed in feline-diabetes, but there are some that are willing to learn and work with you - this one doesn't sound like that type of practice.

Honestly I'm surprised they called you and questioned you about why you cancelled your appointment. In my opinion, it's none of their business, it could have been for an assortment of reasons - sounds like they just wanted to collect that money for your visit.

 

Thank you! I was left quite stressed out by it as she was very annoyed and I couldn't figure out why I need a frustosamine test after a week, when it measures 2 or 3 weeks and surely she won't be stabilised within a week? She only had a fructosamine test a week ago on day of diagnosis. She told me the meters were very dangerous to use on cats as they measured differently and she could get very ill. Ring her up and take Honey in immediately if I thought she looked unwell. She sounded more annoyed when I told her I was doing a glucose curve Monday -presumably because she won't get £130 for doing it! She then tells me no more insulin after I collect Thursday without a consultation (£32) and no doubt more bloods. I will print that literature out, thank you, along with some I've got from the FB group and will have it all with me for back up! A change of vets is in order I think, as I don't like scare tactics and I think it's awful that I migjt have gone out and borrowed money for more tests and visits if the online community wasn't so strong! Very angry about it now!

 

My vet is not well-informed in feline diabetes so after I found this site, I adjusted his doses based on the protocols here and Carter went off insulin after 4 months. I did that, with the help of people here - if I had followed my vet's initial advise, Carter would still be an un-controlled diabetic or worse, and I wanted to give him the best chance at remission. I still take my pets there for non-diabetes related things, and my dog goes to their great boarding facility, but as far as the diabetes is concerned - she's accepted I have a handle on it, and it's not something we discuss further.

The important thing to know on a human meter is the normal range is "50-120" and UNDER 50 is hypo, where you would then need to give honey/syrup or high carb food. If you know that, and you're home-testing and posting on the board when you're unsure or have questions, you have all more tools than could ever be provided with a Fructosamine test. Remember, they work for you - not the other way around. This coming from someone who worked at a veterinary hospital for 5 years.

 

I was surprised too! I mean, I cancelled Tues and they hadn't written it down so receptionist called first and i explained and then vet calls 15mins later! She asked me why I wasn't bringing her back and I told her - I spent this months rent and council tax money plus some on her last week in 3visits over 2 days and the pot is empty!! All she did was repeat what she said earlier. I said I'll try and get her in within the next few weeks but she still tried to bully me a bit and I was super anxious when I got off the phone so headed straight here and to FB!! Won't be going back there!!

 

Yeah, she does work for me the little upstart!! I have to remember that!! No wonder the practice is the largest in the county with tactics like this!

 

No need to let yourself be bullied. I'm sure there are other veterinarians that will be more willing to work with you moving forward.

 

£32 for Caninsulin? Does that include syringes? I paid max £15 for the 3ml vial and you can get syringes online - I pay around £10 for 100 and they have half unit markings as well. If you need links for supplies just let me know and I will post the links to where I get mine. Which meter do you have?

 

Its the £32 just for her to say hello to me! The insulin was about £11 i think and the needles about 15, but was advised not to buy needles online as they come in different sizes and people have gotten the wrong ones and given the wrong dose blah blah blah. You just buy the exact same thing surely?! Yes please to the links I bought a Benecheck from Amazon as strips were fairly cheap and apparently its endorsed by the NHS. The reviews were good.

 

Hello Rachel!
So great you found us - lots of help here!
I'm not that far from you, I'm in Suffolk.
Welcome you to the FDMB.
Just quickly (sorry but have lots to do at the moment);
your vet is rubbish.
Don't bother with another fructosamine test. Testing at home is best as cat is in his own environment and numbers are not influenced by the stress at the vets.
Human meters are used by some vets as well so to tell you that some cats got very sick because the owner used a human meter is not true.
Paying for the AlphaTrak meter at the vets is very expensive unless you have insurance.
Which human meter do you use?
I also noticed that you do low carb diet and you check for ketones in your urine, is it right?
Funnily enough I'm doing ketogenic diet at the moment and I wanted to check for ketones but testing urine is not the best way of doing it. There is a meter called Freestyle Optium from Abbott's and it tests for glucose and ketones. It is rather expensive way of doing it as test strips are quite dear.
You doing great with your kitty. I have some experience with Vetsulin (Caninsulin) so I could offer some feedback as I had Rocky in remission twice while on it. He is in remission again now after 8 months (!) of different insulin.
Read everything you can on this website. Check other cats SS.
Good luck and post questions, will do my best to help you. I have received so much help from others, now it is my turn to give back.
Hugs,
Marlena

 

Here you go - syringes http://www.vetuk.co.uk/insulin-syri...nsulin-syringe-with-needle-box-of-100-p-11335
Keto-diastix - https://www.amazon.co.uk/gp/product...sfl_title_2?ie=UTF8&psc=1&smid=A34SOAYNWXXE7T

You seem to be sorted with the meter.

 

My vet doesn't charge for a 'hello', phone calls, or emails. I get charged for tests but not a consultation fee if it is just a blood test, anything that involves examining the cat does get charged. I can order insulin by email from them and just have to call in to collect it. I seem to be getting a bargain!

 

Hi Marlena, thank you!! It really annoyed me as just about everyone on here uses a human meter!! Maybe there's an angling to get me to buy one from them I did wonder afterwards about that. .. have got the Benechek and I think it measures cholesterol too but not ketones. I will keep that in mind though as I have fallen off the keto wagon today but hoping to get on it strictly in weeks soon to come...I am a bit of a rebounder!!
I was born in Suffolk, in Bury St Eds

 

Alexi, I am now thinking about moving so I can use your vet. It would appear to be cheaper in the long run!!
I don't imagine my vet would do anything for free. She'll probably try and charge me for cancelling the appt. I got charged the £32 on two concurrent days about the same thing plus a diabetes nurse consult at £42 on top! That's without all the blood tests etc. They kept her in for a few hrs after her 1st dose of insulin and charged me £21 for a blood glucose prick test! My meter, with strips and lancets and delivery only cost me £31

 

Well well well, Bury not far from me but I'm not a Suffolk folk if you know what I mean.
I've been living in Suffolk for 12 years now after leaving very hectic place like London. I really like it here.
I'm curious about you diet so maybe we can have a chat about it. I will send you a private message at some point this weekend, is it all right?
Love seeing another person from the UK here as there aren't many of us.
I'm sure my dear friends will welcome you very warmly and offer their expertise, clever people.

 

Don't think I've quite got the hang of the reply thing yet!!

 

Hi Rachel, just a quick hello from another UKer to welcome you to the board and wish you good luck with your FD journey. You seem to be getting the hang of things very quickly - good on you! Do keep coming here, reading other people's posts and asking for clarification on anything... There are some very experienced members here who will give you all the help and support you could ever need!
Best wishes
Diana

 

Thanks Diana! I am trting to hoover up every bit of info I can My girl is definitely looking brighter every day, so happy

 

I've just realised it was £15 for 30!! So they are making quite the markup at vets. No wonder she told me not to buy online!!

 

Rachel @Rach & Honeybun, it looks like you're doing just fine with the testing now (judging by your SS).
Is Honeybun OK with it..?

Eliz

 

Hi Eliz,
we are doing good on the testing (she tolerates it for chicken) I am still very paranoid about her though!! I suppose that's normal at the beginning...
I am off to pick up more insulin tomorrow and change vets, then will book her in for a couple of weeks time (money allowing) and take my newly acquired print outs, spread sheet, graphs and knowledge and hope this one listens to me and doesn't try to fleece me
Do you have any advice re her numbers? I upped her from 1u to 2u Caninsulin - will it take time for it to even out, or is it just because it's not the greatest of insulin? I know a lot of people have problems, but equally quite a few seem to do just fine with it.
I have just updated her SS for today...
Still so much to learn!!

 

The 2 units seams to be working out for you.... I see you already have a few blue numbers. Hold this dose for a while. If after a few days it starts going too low midday I would dial it back to 1.5. It does take some time to even out.

 

Hi Rachel,

I agree with Janet that, at this point, the 2 units seems to be working well for you.
I would've suggested a more conservative .5 increase rather than a whole unit increase; but you can always reduce it if the BG starts getting too low at the peak of the cycle, or if the increased dose causes the BG to drop too fast.
You may also want to revise it if you see a 'lower than expected' preshot number.

Also, do be aware that, in some newly diagnosed cats, the insulin requirements can suddenly drop quite a bit as the cat's body 'gets used' to using it (ie. the glucose-damaged cells recover and can utilise insulin better). So you might find yourself having to back-pedal on the dose.

You may well start to see the numbers come down as her body begins to heal. So, don't think that the picture you're seeing now will necessarily be what you see in a few weeks' time...

I think it's too early to tell whether Honeybun will do well on Caninsulin or not. But if it turns out that it isn't working sufficiently well for her there are other insulins that your vet can prescribe.
Prozinc is a cat-specific veterinary insulin that is now available in the UK, and some vets are now offering it as an alternative to Caninsulin. But your vet may also suggest a 'human' insulin such as Lantus/glargine, Levemir, or Hypurin bovine PZI. These human insulins are not licensed for cats but your cat can prescribe these under the 'cascade system'.

What are you feeding Honeybun?
If you've recently lowered the carb content of her food then her BG may continue to reduce as a result of that....


You're doing amazingly well, Rachel, especially given that Honeybun was diagnosed so very recently. I think she's very lucky indeed to have you as her caregiver.

Eliz

 

Just echoing what Eliz has said above, Rachel - you really are doing very well indeed! Carry on "hoovering up" all the info you can and remember in the midst of it all to chill out when you can and give yourself a few rewards for doing so well (we recommend chocolate, wine or cake but you may have your own favourites!)

Again, well done that girl!

Diana

 

Ahhhh, thank you so much for your kind words and advice everyone! I will do anything for my Honeybun
I have had a lot of help and information from a couple of Facebook forums and on here -so much to learn but I am keen to find out as much as I can and get her feeling better again!!

She was on all sorts of food before, she got so fussy I was buying her sachet food, but basically whatever was on offer, mostly Whiskas in gravy as I thought it would help her for it to be moist - little did I know it was full of carbs (I have 3 other young boys who are VERY keen to finish off whatever she leaves, the pests!) but have looked at the low carb list and ran out and bought her Sheba the day after she got diagnosed and now have stocked up on Whiskas 7+ and lowest carb Whiskas tins for the boys in case she gets into their food. I would like to go back to Sheba in the future perhaps, but unfortunately things are tight at the moment after the vets so will do the best I can. I did spend a good while in Sainsbury's today comparing all the foods on the Cat Carb Calculator app and was amazed how much they differ, and how you think something 'natural' is full of carbs and fillers!

I am a little worried about that dip she gets +3/+4 and it seems to go lower still in the evening, I have bought new syringes that have half dose increments in case I need to lower it at some point, but I'm guessing it takes time as it's all still pretty new to the body...

I think I may start testing my own BG at the same time as I do hers out of sympathy, and treating myself to a glass of wine every time Of course I will have to do a full week of 12 hr curves on myself just to make sure all is well



P.S Janet, I see you are giving your kitty Cosequin for joints, have just googled it but too expensive for me atm, my friend said she gives her dog a supplement called Devils Claw, which is much cheaper and supposed to have good results - have you heard of it or had any experience? I will have to do a full Google research trip on it tomorrow