Newbie - First Day of Testing Results

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megmonger

megmonger

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Hi everyone,

Just finished our first day of at-home testing. Managed to get readings every 4 hours during the daytime. I was thoroughly pleased with how well Abby and I did for our initial foray into ear-sticking. Not at all traumatic. This I can live with. :)

Anyway, our initial post with all our details is here http://www.felinediabetes.com/FDMB/threads/5-months-in-desperate-for-help.179060/

Her results are posted in her spreadsheet in my signature. Vetsulin, 7 units. Lowest reading was 202 and I haven't found where her nadir is falling at this point. (I'll try a curve every 2 hours next weekend when I'm home all day). Her pre-dinner reading was VERY high. Any suggestions on where to start? For tomorrow I plan to stay the course and just keep collecting readings as I don't want to change things up until I have a clear idea of what I'm doing.

Lastly, based on advice here today we started her on all wet food rather than including any dry food. She gets Purina Pro Plan entrees, which are 11% min protein (but for the life of me I can't find the carb content listed in the spreadsheet I have seen posted on this site).

Thanks for any assistance! :)
 
Grats on first day of testing! :bighug:
Can you give me the following from Guaranteed Analysis:
  • Protein
  • Fat
  • Fiber
  • Moisture
  • Ash
Usual nadir for Vetsulin is between +4 and +6 so hopefully next weekend you'll be able to confirm when hers is, for now. Nadirs can move ;).
Also, sorry to add another testing to your routine but you should get some ketone test strips for her urine. Pick up a long handled spoon, clearly label it Abby's, to collect a tiny sample for dip stick. Be careful switching her diet to all wet food, as it can have a significant effect on her BG. If you work during the week, I might be inclined to say reduce insulin with new diet. I will tag @MrWorfMen's Mom and @JanetNJ to advise by how much :)
 
Yong said:
Grats on first day of testing! :bighug:
Can you give me the following from Guaranteed Analysis:
  • Protein
  • Fat
  • Fiber
  • Moisture
  • Ash
Usual nadir for Vetsulin is between +4 and +6 so hopefully next weekend you'll be able to confirm when hers is, for now. Nadirs can move ;).
Also, sorry to add another testing to your routine but you should get some ketone test strips for her urine. Pick up a long handled spoon, clearly label it Abby's, to collect a tiny sample for dip stick. Be careful switching her diet to all wet food, as it can have a significant effect on her BG. If you work during the week, I might be inclined to say reduce insulin with new diet. I will tag @MrWorfMen's Mom and @JanetNJ to advise by how much :)
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Protein = 11.0% min
Fat = 2.0% min
Fiber = 1.5% max
Moisture = 80.0% max
Ash = 3.5% max

Re: ketone test strips. No biggie to add these, what's one more thing at this point lol. She was tested for ketones at the vet back in Jan and came back all clear but had not been tested since then. Does anyone have suggestions on what kind to buy and where to find them? I used to have some "Ketostix" from when I had gestational diabetes - do human ones work for cats?

And yes she is alone while we're at work on weekdays.

Thank you!
 
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Human ones are fine :)
That food is borderline, estimated carb content is 10%. Is that the DM Proplan entrees? You can use Friskies pate (non-indoor formulas with green can/lid) or Fancy feast pates ;)
 
Yong said:
Human ones are fine :)
That food is borderline, estimated carb content is 10%. Is that the DM Proplan entrees? You can use Friskies pate (non-indoor formulas with green can/lid) or Fancy feast pates ;)
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It's actually not labeled as DM, just the regular stuff. Curious as to how the carb is calculated, that is very helpful!

My vet had told us to stay away from the Friskies/Fancy Feast, saying they were like junk food is for humans? I would not be averse to changing, they would certainly be nicer to my wallet! Just wondering why they would have steered me away from those?

Ketostix on the shopping list now...
 
Friskies and Fancy Feast have earned a bad rep for quality food but even Dr. Pierson (the Vet who made our food chart) says these brands are still better than dry foods or prescription ones for diabetics. Most of us choose them because they are lower carb and more wallet friendly :). From the nutrition information I learned when I worked a pet store, wet foods are closer to their natural diet composition and are a big source of moisture, hence most have like 80% :cat: so it's still better than other foods if we can't afford those more expensive ones or make our own cat food.
 
megmonger said:
Just wondering why they would have steered me away from those?
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From what I have been learning from those here, vets don't really have enough experience with this to really know. The vet who diagnosed us tried talking us out of home testing, saying it was too difficult to do. Also said ONLY fancy feast, but didn't tell us pate's only for the lower carbs. Needless to say after 6 weeks we were nowhere near getting regulated. I have learned so much from those here and I know we are finally on our way to getting regulated.
 
megmonger said:
It's actually not labeled as DM, just the regular stuff. Curious as to how the carb is calculated, that is very helpful!

My vet had told us to stay away from the Friskies/Fancy Feast, saying they were like junk food is for humans? I would not be averse to changing, they would certainly be nicer to my wallet! Just wondering why they would have steered me away from those?

Ketostix on the shopping list now...
Click to expand...

Hello,
first of all well done both of you for cracking on so well with the home testing!

As for calculating carb content you might find this link helpful:
http://scheyderweb.com/cats/catfood.html

There's also a brilliant updated list of cat food with carb contents calculated already, I think you will find it helpful in understanding a bit more about cat nutrition and it will help you to make good food choices for Abby

http://catinfo.org/docs/CatFoodProteinFatCarbPhosphorusChart.pdf

Keep up the good work! :)
 
If it were my cat this is what I would do....


1. Lower the dose to 5 units.... Your cats bg is falling more than 50% in a cycle which is causing her pancreas to panic and release its own insulin which is causing the high pm spike. Lowering the dose temporarily will help calm the bounce. After a few days we can reevaluate and see if the dose is too low or if bouncing continues if it needs to be even lower.

2. No dry food at all unless it's Young Again Zero carb which is 1% carb. (Youngagainpetfood.com)... Switch your current wet to fancy feast classic which are all under 10 carb. That will help lower her overall bg.
 
It's difficult to suggest what to do in the way of reduction of the insulin dose to meet any dietary changes. Personally, I'd try to get the BG under better control before changing the diet. As Janet says, BG is dropping more than 50% from pre-shot to lowest point and that leads to bouncing. Trying to adjust doses to get the bouncing under control is hard enough but add in a diet change and more monitoring is definitely going to be needed. 5u of insulin is still a very large dose and could still be too much. I'd hold off any diet changes until you can monitor more closely (weekend perhaps) and then I would do the change very slowly to avoid any GI issues and more importantly, any BG surprises.
 
I had a veterinary dental specialist tell me that they had done a study and found that Fancy Feast was a major contributor to dental issues. When I asked which variety of Fancy Feast, she admitted she had not realized there were a multitude of varieties of Fancy Feast so had not asked for that kind of detailed information. OOPS! Incomplete data = flawed scientific paper. The look on her face was priceless! While there are a multitude of Fancy Feast offerings that could be considered kitty junk food, the Classics/Pates have as good and in some cases much better ingredients than the prescription diets the vets peddle. Vets get most if not all of their dietary training from the big gun pet food companies like Purina, Royal Canin and Hill's so they are brain washed into thinking those high priced foods are best.
 
JanetNJ said:
If it were my cat this is what I would do....


1. Lower the dose to 5 units.... Your cats bg is falling more than 50% in a cycle which is causing her pancreas to panic and release its own insulin which is causing the high pm spike. Lowering the dose temporarily will help calm the bounce. After a few days we can reevaluate and see if the dose is too low or if bouncing continues if it needs to be even lower.

2. No dry food at all unless it's Young Again Zero carb which is 1% carb. (Youngagainpetfood.com)... Switch your current wet to fancy feast classic which are all under 10 carb. That will help lower her overall bg.
Click to expand...

Spent some time educating myself some more on the Somogyi effect now and went ahead and lowered her dose to 5 units this morning. Your description here, as well as some hindsight recognition of symptoms that reminded me a whole lot of when I had similar "bounces" when I had gestational diabetes were enough to convince me it is worth the try. Thanks. :) I plan to keep her at that level for the week and then do a curve on Sat/Sun to see where we are at.

And thanks for the food recommendations as well. Now that I'm armed with some awesome info resources I'll dig in and do some more research on the wet foods for her. For now I'm keeping her on her Pro Plan Entrees since they aren't terribly high in carbs and she's used to them. After we've had a while to get things figured out (and I run out of my current stockpile of cans lol) we may end up switching. Will see where the readings take us, it sounds like! :)
 
megmonger said:
Spent some time educating myself some more on the Somogyi effect now and went ahead and lowered her dose to 5 units this morning. Your description here, as well as some hindsight recognition of symptoms that reminded me a whole lot of when I had similar "bounces" when I had gestational diabetes were enough to convince me it is worth the try. Thanks. :) I plan to keep her at that level for the week and then do a curve on Sat/Sun to see where we are at.

And thanks for the food recommendations as well. Now that I'm armed with some awesome info resources I'll dig in and do some more research on the wet foods for her. For now I'm keeping her on her Pro Plan Entrees since they aren't terribly high in carbs and she's used to them. After we've had a while to get things figured out (and I run out of my current stockpile of cans lol) we may end up switching. Will see where the readings take us, it sounds like! :)
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Do spot checks mid cycle between then and now... Esp around 5 hours post shot
 
JanetNJ said:
You may even go down to 3 or 4.... 5 may still be more than you need.
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As I'm learning more I suspect that as well. I haven't been able to get more mid cycle readings yet (work week) but already her numbers are improving and while maybe I'm just imaging it she just seems to be feeling a bit better. I'm so hopeful that we're on the right path, finally. :) I'll update once I have another curve this weekend to seek some feedback on what to do next.
 
megmonger said:
As I'm learning more I suspect that as well. I haven't been able to get more mid cycle readings yet (work week) but already her numbers are improving and while maybe I'm just imaging it she just seems to be feeling a bit better. I'm so hopeful that we're on the right path, finally. :) I'll update once I have another curve this weekend to seek some feedback on what to do next.
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Ya know, let's do 3 until the curve. I'd rather go a bit more conservative. Is that OK with you? Then with the curve we can see if bumping it up would be helpful. I'm more inclined to go conservative since you can't be there during the day.... Then we can curve Saturday and adjust for Sunday when you are home to monitor.
 
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Another vote for reducing the dose to 3u. Definitely looks like bouncing and the only way to get that under control is to get the cycle to even out more so Abby gets reacquainted with lower BG levels slowly. Trying to rush bringing the BG down makes it a harder and longer process to find the best dose.
 
MrWorfMen's Mom said:
Another vote for reducing the dose to 3u. Definitely looks like bouncing and the only way to get that under control is to get the cycle to even out more so Abby gets reacquainted with lower BG levels slowly. Trying to rush bringing the BG down makes it a harder and longer process to find the best dose.
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Thanks for the insight! Switching her to 3u and also it looks like I'll be able to be home Friday now so I'll get a curve then as well. :) Question - how would rushing bringing the BG down happen? I'm not sure I follow? Sounds like something I want to avoid so just want to make sure I understand what it would consist of so it doesn't happen!
 
JanetNJ said:
Those black pmps might be from dipping too much in the morning. Let's back it down to 3 units and see if it evens it out for a few days.
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Also would it help if I get an extra reading at a particular time? Until Friday I can't do morning or midday ones, but I could do a few hours after her evening dose or even check middle of the night. Does +4 hrs give useful info regarding bouncing or should I do something sooner like +1/2? I don't have many data points to go on yet, but from the first day when we did checks every 4 hours I didn't get enough info to pinpoint the nadir. It just looked super high right before each dose and then in the 200s for the intermediate checks. Thus why I'm wondering.

Thanks for everything :)
 
megmonger said:
Question - how would rushing bringing the BG down happen?
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When you give too much insulin and the BG drops suddenly or to unfamiliar lower or unsafe levels, the body's defence system revs up and pushes out hormones to push the BG back up. A diabetic becomes accustomed to the higher BG so their defence system clicks into action earlier than needed. There is a limited amount of stored glucagon. So if you give a huge dose of insulin (as in an accidental overdose) or if you give too much insulin for a prolonged period of time, the glucagon reserves can be depleted and render the defence system less effective. When you work to smooth out the cycle you are in effect recalibrating the defence system so it goes back to reacting more normally to lower numbers.

As for testing, if you can get a readings between +1.5 to +6 hours you will find the nadir so if you can get some random tests in those hours during the evening cycle, it will provide more clues as to how Abby is reacting. Most cats are going to nadir between +3 and +6 but it does move even in the same cat and some start dropping as early as +1.5. Catching early cycle readings gives you an opportunity to offer more food to try to slow the drop down to smooth out the cycle.
 
megmonger said:
Also would it help if I get an extra reading at a particular time? Until Friday I can't do morning or midday ones, but I could do a few hours after her evening dose or even check middle of the night. Does +4 hrs give useful info regarding bouncing or should I do something sooner like +1/2? I don't have many data points to go on yet, but from the first day when we did checks every 4 hours I didn't get enough info to pinpoint the nadir. It just looked super high right before each dose and then in the 200s for the intermediate checks. Thus why I'm wondering.

Thanks for everything :)
Click to expand...
4 is a helpful time. On average I think most vetsulin cats nadir around 5... But every cat is differen. My cat was usually lowest at 5, but sometimes it was 4 and sometimes 6.
 
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