Dude, newly diagnosed blood glucose PMPS @ 143, 4th test

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jmichaelp

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Hi, I cannot save profile info & no one has gotten back to me about it via the "contact" option.

I last gave him 2.5 units of Lantus at Midnight last night. He had 39g of Hill's a/d + FF Salmon Feast Pate with a couple of drops of added salmon oil (for palatability/calories) at Midnight. I'm syringe-feeding him. This morning at 10 am he had 40g of the same food. I took his blood glucose at Noon & found 101 mg/dL. He was at 144 mg/dL on 4/27 @ 10:30 pm, 459 mg/dL on 4/29 @ 8pm, 268 mg/dL on 5/2 @ 11:30pm, 418 mg/dL on 5/3 @ 7:05pm. I fed him 18g of the same food at Noon (that's all he wanted). I SKIPPED the Noon Lantus injection.

Is there anything I should do? vet hasn't been helpful.

Dude is an 18 y/o neutered male indoor cat. I'm using 2.5 units of Lantus 2x/day. I'm testing every 2-3 days (vet originally told me to wait a week b/c there's a lag from starting until things settle down) using Contour next GEN. Medical history: Asthma diagnosed in 2009 Flovent every other day (EOD), IBD & a benign heart murmur both diagnosed via ultrasound in 2016, Prednisolone 2.5,mg EOD, UTI diagnosed 4/26 Zeniquin daily Pancreatitis, CKD

Blood work anomalies (3/23/24):
ALT (SGPT) 121 (HIGH) 10-100 IU/L
BUN 50 (HIGH) 14-36 mg/dL
Creatinine 2.7 (HIGH) 0.6-2.4 mg/dL
SDMA 15.9 (Mild Inc.) <15.0
AMYLASE 1,266 (HIGH) 100-1,200 IU/L
PrecisionPSL 27 (HIGH) 8-26 U/L

Blood Glucose was 148 64-170 mg/dL at this time

Blood work anomalies (4/26/24):
Glucose >686 (HIGH) 71-159 mg/dL
BUN >130 (HIGH) 16-36 mg/dL
Creatinine 5.8 (HIGH) 0.6-2.4 mg/dL
Phosphorus 8.2 (HIGH) 3.1-7.5 mg/dL
Potassium 3.2 (LOW) 3.5-5.8 mmol/L
Sodium 144 (LOW) 150-165 mmol/L
Chloride 100 (LOW) 112-129 mmol/L
SDMA 37 (HIGH) <14.0
AMYLASE 1,266 (HIGH) 100-1,200 IU/L
PrecisionPSL 27 (HIGH) 8-26 U/L

Urinalysis anomalies (4/26/24):
Glucose 1,000 mg/dL
Bacteria Cocci *Suspected prescence
 
Hello and welcome here. Posting on the Feline Health forum is what we ask people to do first.

Sounds like Dude is one complicated kitty. Good for you for looking after all his needs. Can you tell me how long ago he was diagnosed? What were the signs he was diabetic? There is a bunch of background information people like to find out about the cat, cause it influences how we can help you. That information we typically put in our signature. More information on that here:
New? How You Can Help Us Help You!

I'm suspecting that he might be on too high a dose of insulin, but need more information first. Are you giving the insulin with a pen or syringes?
 
Wendy&Neko said:
Hello and welcome here. Posting on the Feline Health forum is what we ask people to do first.

Sounds like Dude is one complicated kitty. Good for you for looking after all his needs. Can you tell me how long ago he was diagnosed? What were the signs he was diabetic? There is a bunch of background information people like to find out about the cat, cause it influences how we can help you. That information we typically put in our signature. More information on that here:
New? How You Can Help Us Help You!

I'm suspecting that he might be on too high a dose of insulin, but need more information first. Are you giving the insulin with a pen or syringes?
Click to expand...
Thanks for the reply. I don't understand the forum system, from reading I thought this was the correct place to post. can you point me in the right direction or can I get this post moved?

Diagnosed on 4/26 as shown in his blood work/urinalysis above. He started with increased water intake a couple of weeks before & a couple of weeks before that had the indication of mild pancreatitis & a little higher than usual BUN. He had been eating Hill's k/d. I weigh him weekly to monitor his IBD & though he had lost a couple of ounces, it wasn't until 3/26 testing that I found he had lost nearly 1 lb since my last weighing.

I tried & cannot save anything to my profile as directed. No one has gotten back to me to help with that.

What other information can I supply? Was I right to not give the Lantus? It's very difficult to get blood to test, about 1/2 the time it fails to draw blood or not enough despite using the tricks I've read about. The pricks aren't healing quickly either.
 
This is the correct place to post.
jmichaelp said:
I cannot save profile info & no one has gotten back to me about it via the "contact" option.
Click to expand...
I was commenting on this.

You can put information on both the signature and the profile. The signature is easily viewable at the bottom of each post - you can see the information I have below my post. To edit the signature, click on your name on the top right. There is a drop down and a Signature selection on the left side of the menu. Select it, and a editing box appears. Save changes when done.

For the Profile, select your user name below your avatar on the left had side of this post. A pop up will appear that allows you to select the Profile Page. Similarly, a text box appears that you can enter information into.

This post has a bunch of basics on how to use the forum,
HOW-TO USE THE FDMB: The Basics

Did he start at 2.5 units? Normally we'd start around 1 unit and increase from there. Seems like he might be on too high a dose. If you can fill in the spreadsheet - details in the link I included in post 2, we can have a better idea what is happening.

Home testing is hard at the beginning, it takes practice. Some tips in here: Hometesting Links and Tips
 
He started at 2 units. He had a reading of 144 mg/dL after 3 days at that dosage. The 4th day at 2 units it went up to 459 mg/dL.
The 6th day the vet told me to increase the dosage to 2.5 units. On the 7th day it registered 268 mg/dL. On Day 8 it was up to 418 mg/dL. On day 12 (today) it was 101 mg/dL at Noon & 210 mg/dL at 2:50 pm (4 sticks to draw blood).
 
The AMPS and PMPS cells are for the blood test we do before giving insulin in the AM and PM. We typically give insulin 12 hours apart, so it's the equivalent of the +12 or 12 hours after the previous dose of insulin. I presume for the days not on the spreadsheet, he still got the same dose (April 28 and 30th)?. You could add a line showing that dosing. Lantus is a depot style insulin so it's like it builds over time. If you skip a dose it makes a difference in how we look at things.

When you skip a dose, could you put either Skip or NS (for no shot) in the units. By the way, skipping was the right thing to do. When people are new to this forum, we suggest skipping if under 200 at shot time, unless kitty has recently been through DKA or diabetic ketoacidosis, a life threatening condition.

I presume you are using syringes to give the insulin? If so, do you have U-100 syringes with half unit markings on them? I think you need to lower the dose a bit. So you won't have to keep skipping. It's better to give insulin all the time, but with a lower dose.
 
Wendy&Neko said:
The AMPS and PMPS cells are for the blood test we do before giving insulin in the AM and PM. We typically give insulin 12 hours apart, so it's the equivalent of the +12 or 12 hours after the previous dose of insulin. I presume for the days not on the spreadsheet, he still got the same dose (April 28 and 30th)?. You could add a line showing that dosing. Lantus is a depot style insulin so it's like it builds over time. If you skip a dose it makes a difference in how we look at things.

When you skip a dose, could you put either Skip or NS (for no shot) in the units. By the way, skipping was the right thing to do. When people are new to this forum, we suggest skipping if under 200 at shot time, unless kitty has recently been through DKA or diabetic ketoacidosis, a life threatening condition.

I presume you are using syringes to give the insulin? If so, do you have U-100 syringes with half unit markings on them? I think you need to lower the dose a bit. So you won't have to keep skipping. It's better to give insulin all the time, but with a lower dose.
Click to expand...
Thanks for letting me know I did the right thing. Still no reply from the vet, second email with no reply...

I'm using U-100 syringes. I'll back off to 2 units tonight.

The spreadsheet doesn't make any sense to me. I put the time for any a.m. test in the AMPS column & for any p.m. test in the PMPS column. I put the test result in the "+" column corresponding to the approximate time since the last insulin shot. How is it supposed to work?
 
jmichaelp said:
The spreadsheet doesn't make any sense to me. I put the time for any a.m. test in the AMPS column & for any p.m. test in the PMPS column. I put the test result in the "+" column corresponding to the approximate time since the last insulin shot. How is it supposed to work?
Click to expand...

@jmichaelp

About the spreadsheet to make it easier for you to understand
AMPS - means AM Pre Shot the first test you take in the AM ,you need to withhold food 2 hours before testing so it's not food influenced

Units is where you would put how much insulin you gave


+1 is one hour after giving insulin if you were to test then that's where you enter his _BG number
+2 two hours after giving insulin. ditto
+3 and so on until you get to PMPS - PM pre shot withhold food 2 hours before testing

+1 same as you do for AM cycle

We don't give times because we are all in different time zones that's why we use the + numbers



You can look at any members spreadsheet to see what it looks like, it's at the end of everyone's signature just tap on it

On your spreadsheet where you have


04/29/2024 459 8.5 hours after
You need to go back and put 459 @+8.5 in the 8 cell or square that means 30 minutes and color code it manually with the color listed for the BG numbers


05/02/2024 268 5.5 hours after
You need to put 268 @+5.5 in the 5 cell or square that means 30 minutes and color code it manually with the color code listed for the BG numbers

05/03/2024 418 7.5 hours later you need to put 418 @+7.5 in the 7 cell or block than means 30 minutes and color code it manually with the color code listed for the BG
These are how to list the BG numbers if you aren't testing exactly on the hour

0.25 means 15 minutes
0.5 means 30 minutes
0.75 means 45 minutes

Also about the U-100 syringes you are using do they have the half unit markings on them?
We use these since we adjust the dose by 0.25 units at a time when an increase or decrease is needed. These make it easier to do that
You want the ones on the left
  • Full and half-unit syringe scales:
49823063143_3437e9e997_o.jpg



https://www.amazon.com/UltiCare-31-Gauge-Veterinary-Insulin-Syringes/dp/B009LTE0DO

You won't need a doctors script if you order from Amazon
This is the info we need for your signature about Dude
Tap on your name up top then tap on signature and add this
  • Add info we need to help you:
    • Caregiver & kitty's name
    • DX: Date
    • Name of Insulin (do not include dose or frequency)
    • Name of your meter
    • Diet: "LC wet" or "dry food" or "combo"
    • Dosing: TR or SLGS or Custom (if applicable)
    • DKA or other recent health issue (if applicable)
    • Bexacat or Senvelgo (if applicable) and dates
    • Acro, IAA, or Cushings (if applicable)
    • Spreadsheet link. Please put the signature link on the bottom line of your signature information, on its own, so it is easy to find.
    • Please do not put any information about your location in the signature for security reasons. If you wish to add your country location, please add it to your profile.
Be sure to click the 'Save Changes' button at the bottom. If you need help urgently it is important we know these things at a glance. We don’t want to waste valuable time finding out information.

Here is a link helping us to help you link. If you noticed, our members have some basic information about their cat's in their signature. This helps us to not pester you by asking the same questions (your cat's name, insulin type, date of diagnosis, etc.) repeatedly. We also have a link to our spreadsheet in our signature. We are very numbers driven. The spreadsheet is a record of your cat's progress. By linking it in your signature, we can follow along and provide feedback should you need the help
 
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@jmichaelp

Hi Mike I see you put this in your profile/ information about Dude
Signature
Mike - Dude, 18, M - Diag 4/24 - Lantus - Human,Contour next GEN - PU, PD, Neuropathy, CRF - Phos-bind, Miralax, Potassium Citrate, Cerenia, B12 injection, Zeniquin, Flovent, Elura/Mirtaz/Cypro - IBD, Pancreatitis, Heart murmur, UTI, CKD, Asthma - Prednisolone - Syringe-feeding FF Salmon feast pate

You actually need to link it with your spreadsheet

https://docs.google.com/spreadsheet...97XeD3F81Uh_LNFCYvwnrxelI7CLo0Fw0jMF-/pubhtml
Your spreadsheet should be at the bottom of every post you do , just not one post

I'll Tag Bhooma one of our members to contact you to help you out
@Bandit's Mom

More of Dudes information
Dude is an 18 y/o neutered male indoor cat. I'm using 2.5 units of Lantus 2x/day. I'm testing every 2-3 days (vet originally told me to wait a week b/c there's a lag from starting until things settle down) using Contour next GEN. Medical history: Asthma diagnosed in 2009 Flovent every other day (EOD), IBD & a benign heart murmur both diagnosed via ultrasound in 2016, Prednisolone 2.5,mg EOD, UTI diagnosed 4/26 Zeniquin daily Pancreatitis, CKD

Mike you need to be testing Dude every morning and evening before giving insulin and additional tests after that ,not every 2 to 3 days
 
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I'll get the spreadsheet figured out later. Dude's blood glucose jumped to 502 mg/dL, the highest I've measured at home so I gave him the 2.5 units I had been. This morning it is down to 58 mg/DL.
 
Wendy&Neko said:
Did he start at 2.5 units? Normally we'd start around 1 unit and increase from there. Seems like he might be on too high a dose. If you can fill in the spreadsheet - details in the link I included in post 2, we can have a better idea what is happening.
Click to expand...

Hi Wendy ,don't know if you saw his reply to your question
He started at 2 units. He had a reading of 144 mg/dL after 3 days at that dosage. The 4th day at 2 units it went up to 459 mg/dL.
The 6th day the vet told me to increase the dosage to 2.5 units. On the 7th day it registered 268 mg/dL. On Day 8 it was up to 418 mg/dL. On day 12 (today) it was 101 mg/dL at Noon & 210 mg/dL at 2:50 pm (4 sticks to draw blood).
@Wendy&Neko

Edit can you read his post #12 that he did today.
I would stick around but just got home ,had to get hip and groin injections this morning and need to rest, in pain from the injections
I made it easy for Mike to understand the SS in my post #10 seems like he didn't understand the link explaining it

He does have a SS set up but it's not linked to his signature ,it's only in this post. His post #6
I didn't find the spreadsheet to be very intuitive, please let me know how to correct it, thanks.
https://docs.google.com/spreadsheet...97XeD3F81Uh_LNFCYvwnrxelI7CLo0Fw0jMF-/pubhtml
 
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The glucose testing isn't working out. This last time it took 7 sticks - 2 errors, 4 no blood to speak of & the last plenty of blood. I don't know how to do this forever, it's very invasive.
 
jmichaelp said:
Dude's blood glucose jumped to 502 mg/dL, the highest I've measured at home so I gave him the 2.5 units I had been. This morning it is down to 58 mg/DL.
Click to expand...
We determine how to change the Lantus/glargine insulin dose based on how low it takes the cat, not the highs. Try to ignore the high numbers. Some cats will go high before they drop low. 2.5 units is too much insulin. Please drop the dose back down to 2 units for Dude's safety.

What really helped me with testing was putting a really tiny smear of Vaseline on the place I was going to poke. It allowed the blood to pool together instead of hiding in the black fur of her ears. Also, when you start out, you should be using larger lancets, 26 gauge would help. Typically smaller lancets come with the meters. Once kitty's ears learn to bleed, you can move to the thinner lancets.
 
Diane Tyler's Mom said:
Hi Wendy ,don't know if you saw his reply to your question
He started at 2 units. He had a reading of 144 mg/dL after 3 days at that dosage. The 4th day at 2 units it went up to 459 mg/dL.
The 6th day the vet told me to increase the dosage to 2.5 units. On the 7th day it registered 268 mg/dL. On Day 8 it was up to 418 mg/dL. On day 12 (today) it was 101 mg/dL at Noon & 210 mg/dL at 2:50 pm (4 sticks to draw blood).
@Wendy&Neko

Edit can you read his post #12 that he did today.
I would stick around but just got home ,had to get hip and groin injections this morning and need to rest, in pain from the injections
I made it easy for Mike to understand the SS in my post #10 seems like he didn't understand the link explaining it

He does have a SS set up but it's not linked to his signature ,it's only in this post. His post #6
I didn't find the spreadsheet to be very intuitive, please let me know how to correct it, thanks.
https://docs.google.com/spreadsheet...97XeD3F81Uh_LNFCYvwnrxelI7CLo0Fw0jMF-/pubhtml
Click to expand...
Sorry about your injections, just got back from pain Dr to evaluate my last injection in my lumbar/sacroiliac area.

I looked at someone else's spreadsheet & it still doesn't click for me. It makes more sense for me to put the insulin dose times in AMPS & PMPS cells for each date & then the test results in columns representing "+" hours from the last insulin dose. The problem with that is when you have "no shot" there's not enough "+" slots & so you have to put the number in the next (AMPS or PMPS) section. That's what makes sense to me right now, but I'm new to this.
 
Wendy&Neko said:
We determine how to change the Lantus/glargine insulin dose based on how low it takes the cat, not the highs. Try to ignore the high numbers. Some cats will go high before they drop low. 2.5 units is too much insulin. Please drop the dose back down to 2 units for Dude's safety.

What really helped me with testing was putting a really tiny smear of Vaseline on the place I was going to poke. It allowed the blood to pool together instead of hiding in the black fur of her ears. Also, when you start out, you should be using larger lancets, 26 gauge would help. Typically smaller lancets come with the meters. Once kitty's ears learn to bleed, you can move to the thinner lancets.
Click to expand...
Since he's relying on me to syringe feed him there's a big gap from the last feeding. Due to pain my sleep is pretty fractured so that drives when I feed him. So his numbers decline with the lack of food. That forces me to miss an insulin dose. Then the glucose numbers ratchet up during the day due to the lack of insulin. I've got to try to get up early & feed him. if I can't do that consistently, should I give him 0.5 or 1 unit in the am if his blood glucose tests relatively low?

Thanks, I've been rubbing his ears & putting Vaseline on them. The vet sent me home with "25g x 5/8" needles but I don't recall that they explained what those were for. I guess for sticking him?
 
jmichaelp said:
I looked at someone else's spreadsheet & it still doesn't click for me. It makes more sense for me to put the insulin dose times in AMPS & PMPS cells for each date & then the test results in columns representing "+" hours from the last insulin dose. The problem with that is when you have "no shot" there's not enough "+" slots & so you have to put the number in the next (AMPS or PMPS) section. That's what makes sense to me right now, but I'm new to this.
Click to expand...
@Bandit's Mom can add separate columns for the times.
 
Lots of tips and videos here: Hometesting Links and Tips It's also important to warm the ears before hand so they bleed better.

Not sure what you'd use the 25g needles for. Typically Lantus syringes are 30 or 31 gauge needles. Lancets are much smaller (and cheaper) than needles for sticking.
 
Wendy&Neko said:
Lots of tips and videos here: Hometesting Links and Tips It's also important to warm the ears before hand so they bleed better.

Not sure what you'd use the 25g needles for. Typically Lantus syringes are 30 or 31 gauge needles. Lancets are much smaller (and cheaper) than needles for sticking.
Click to expand...
Thanks. I watched those in the link as well as many others. I'm trying all the tricks, but have not yet used the lancet pen. I thought it might scare him, but I have to become more successful so I guess I'll try tonight.
 
Well the lancet pen failed me this morning. Drawing blood after 5x but getting an error code before 2-3 more tries & getting a sample. Dude is at 151 mg/dL. I got up at 6 am & fed him 1/2 his usual amount. He had 2 units last night as @Wendy&Neko suggested I give. I'm not sure what to do, I thought I read not to give a dose if under 200 mg/dL?
 
I found two protocols & not sure what to do but this one https://felinediabetes.com/FDMB/threads/start-low-go-slow-method-slgs.129446/ indicated going to 25%, so I gave him 0.50 units (as best I could, very hard to see). That took 1.5 hours of crawling around the shower stall & under the bed to get the test, dose the insulin & feed him. Now to get breakfast, feed the colony I care for behind my house, get groceries/cat food & rest my back before time to feed him again.
 
jmichaelp said:
I looked at someone else's spreadsheet & it still doesn't click for me. It makes more sense for me to put the insulin dose times in AMPS & PMPS cells for each date & then the test results in columns representing "+" hours from the last insulin dose. The problem with that is when you have "no shot" there's not enough "+" slots & so you have to put the number in the next (AMPS or PMPS) section. That's what makes sense to me right now, but I'm new to this.
Click to expand...
@jmichaelp
You don't need the times in the AMPS and PMPS cells, members probably won't understand and you are not putting in the BG numbers when you first test in the AM and PM .We need them to go in those cells. the AMPS and PMPS cells

Then if you do another test 2 hours later you put that in the +2 cell
If you test first thing in the AM ,record it and if you don't give insulin you put NS in the U cell
The way you are doing things I don't think any member will be able to give you any advice on what to do or when you need to increase or decrease his dose to see how low his numbers are dropping

I explained this in my post #10 how the spreadsheet works and how to enter everything :cat:
 
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I'm not sure what to do. The SLGS method states "Above 200 (11.1 mmol/L) but below the cat's normal pre-shot value, a reduced dose might be wise." My vet had Dude on a very high dose, 2.0 units then 2.5 units. Dude is at 264 & his average value right before a shot is 278. Do I reduce it & to what level? I gave 2 units last night & only 0.5 units this morning.
 
Blood glucose down to 62 this morning. I don't know whether to give him 0.5 units or nothing.

I bought some larger lancets & had only 2 failures before getting a reading, so at least that's a little better.
 
Diane Tyler's Mom said:
@jmichaelp
You don't need the times in the AMPS and PMPS cells, members probably won't understand and you are not putting in the BG numbers when you first test in the AM and PM .We need them to go in those cells. the AMPS and PMPS cells

Then if you do another test 2 hours later you put that in the +2 cell
If you test first thing in the AM ,record it and if you don't give insulin you put NS in the U cell
The way you are doing things I don't think any member will be able to give you any advice on what to do or when you need to increase or decrease his dose to see how low his numbers are dropping

I explained this in my post #10 how the spreadsheet works and how to enter everything :cat:
Click to expand...
I've updated the spreadsheet, trying to get it how you all want it. It has zero value to me right now, I keep a much more extensive spreadsheet detailing the timing of all of his food & carb intake, injections, meds, etc.

I'm only able to take two readings per day. I've had so many failures that it takes awhile. I have to syringe feed him, which takes awhile to prep & clean. I have to administer the inhaler & other meds.He also needs sub-q fluids.

Last night I worked myself to collapse. I have to crawl under the bed or the desk to get Dude every time I do something. I have an unrepaired torn left rotator cuff, on the right a delaminated bicep & two full-tear rotator tendons that were just repaired, my neck is fused C3-C6, I have arthritis in my lumbar facet joints, I have instability/laxity in my SI joints, I had a lot of inflammation from the covid shots that messed up my GI system so that I'm severely limited in what I can eat & that takes a lot of prep time. I can neither stand nor can I sit at the computer for long periods.

My priority is on helping my cat, not a spreadsheet. I need help & am doing the best I can. This week it may come down to me no longer being able to care for him.
 
I keep reading about ketones & am unsure as to whether anyone can tell me if I should give Dude a dose, perhaps 0.5 units, or not since his reading this morning was 62. If I give no shot his second test seems to be high.
 
This was the worst attempt at glucose testing yet. It took about 17 minutes of restraint, which I hadn't needed to do, & rubbing his ears. Twice I was able to draw enough blood but he shook his head on one, two error codes & multiple without enough blood. I think the only way to get blood is to hit the vein & he's not liking this anymore.

Tonight's reading was 298.
 
After tonight's episode he jumped into the bathtub. I didn't know he could still do that. He wants to be left alone. I'm not sure what this means.
 
Hey Michael,

There is a newly published, Moderate-Intensity Home-Monitoring Protocol written for Lantus users who are unable to test more than twice a day. Given your circumstances, and the myriad of issues both of you are dealing with, this may just be the one that you and Dude need at this moment in time. Once stability is achieved and the both of you are in a routine and in better spirits, a tighter protocol [SLGS or TR] could perhaps be considered.
 
No one on this thread provided help after last night's trauma. He was trying to hide/get away from me. I watched him to see if he'd want to be fed until I fell asleep watching at 1:30am. I didn't feed him or give a shot. Without any feedback I was resigned to take him in today.

This morning we had a huge storm that prevented me from getting to the vet. I was able to check his glucose. It was at 373 so I fed him & gave him 1 unit of insulin (hopefully, it's such a small amount & I could've pressed it early, I wasn't sure).
 
jmichaelp said:
No one on this thread provided help after last night's trauma. He was trying to hide/get away from me. I watched him to see if he'd want to be fed until I fell asleep watching at 1:30am. I didn't feed him or give a shot. Without any feedback I was resigned to take him in today.

This morning we had a huge storm that prevented me from getting to the vet. I was able to check his glucose. It was at 373 so I fed him & gave him 1 unit of insulin (hopefully, it's such a small amount & I could've pressed it early, I wasn't sure).
Click to expand...
Michael when ever you need help you want to start your title off with a ? Then Help Needed then what ever you need help with .

You might want to ask your vet about this since you are in so much pain with back issues
About the Freestyle Libre
Tap on the blue link , there is a discussion about it
https://felinediabetes.com/FDMB/thr...-diagnosed-with-diabetes.274874/#post-3051322

I found this written by another member
I had the Libre it’s very easy to use but from what I know it’s a temporary use . The sensor is suppose to last for 14 days but rarely does , I got 9 days out of my first sensor before it had to be replaced . Here are you Pros and Cons
Pros - Once on very easy to read . You can read anytime . You can you the reader or your cell phone . The sensor reads BG every 15 minutes on it own but you still have to wave your reader or cell phone to get a reading
and your Vet can access through a computer watching day through the night .
Cons - The sensor is put on with surgical glue some kitties can have a reaction to the glue .
You have to cross your fingers your cat will keep the sensor on and not scratch it off .
The sensor may not last for 14 days and are about $ 40.00 dollars to replace .
If you can’t use your cell phone to read the sensor the reader is about $65.00 dollars

Found this also posted by another member
I made avideo in English about the FreeStyle Libre,which shows how to apply it (complete with built-in blooper, be warned) and gives some explanations as to the interest of such a device for a diabetic cat.

Here are the situation in which I think the FreeStyle Libre can be a precious solution:
  • untestable cat (some really are, I have come to discover)
  • cat who requires a lot of medical care for other conditions or stressed out by medical handling
  • caregiver away at work all day
  • caregiver often away for travel
  • holidays with petsitter, or boarding
  • stressed caregiver
Advantages:
  • less handling of the cat (you can read upto 8 hours of measurements in one swipe)
  • anybody can swipe the sensor as long as they can approach the cat, it's a much simpler gesture than an ear test
  • no need to stick to a "schedule" of testing (way less stress)
  • possible to go out (have a life!) or sleep without losing measurements
  • one sensor application lasts upto 14 days
  • closer monitoring means you never miss anything, takes the guesswork out of interpreting glucose values
  • great for observing trends
  • reader shows visual curve for the day, can be easier to interpret than raw numbers
  • non-stop monitoring can allow for more aggressive dosing with appropriate experience/supervision
Disadvantages:
  • price!
  • need to go to the vet to have the sensor applied, orlearn how to do it (not rocket science but you need to be shown how to do it correctly)
  • sensors do not always last 14 days, some die early (have a spare and expect some failures) and can fail unexpectedly
  • LO reading under 40, so if you want more detail in those values you'll have to resort to ear testing
  • interstitial glucose means there is a 5-10 minute lag behind blood glucose (not a big issue, particularly with Lantus or Levemir, just be aware of it)
  • we are not certain what the safety thresholds for methods developed with human blood/plasma equivalent meters translate to for interstitial glucose readings from a sensor designed for humans placed on a cat (not necessarily an issue, if you are worried you can get some readings at low values with a meter you are familiar with -- I did that and got readings of 60 and 65 on an AT2 for LO on the FSL)
Tips:
  • add superglue to the sensor glue before applying (make sure the chosen glue does not irritate the skin)
  • if needed, use acetone or baby oil to remove the sensor; worst case scenario, you can remove thesensor from the sticker that is attached to the skin, and leave the sticker in place if it is too firmly stuck
  • get a surveillance camera so you can monitor your cat when away and check behaviour during low values after the fact
  • try leaving the sensor bare: bandage or shirt will bother the cat more than the sensor
Summary:

If you can afford it, go for it! I've found it was a huge improvement on my quality of life as a caregiver, even compared to ear testing a very compliant cat likeQuintus. The amount of data allowed me to be much more confident and aggressive in my dose increases -- bearing in mind of course that this is not my firstdiabetic cat, that I've followed hundreds over the lasttwo years, and that I am at home most of the time these days and have a surveillance camera set up.

You can always start a new thread and ask other members that use it
@jmichaelp
 
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There are way more experienced members on this forum to provide advice than I, who's only been dealing with diabetes for over a year, but...

In my opinion [for what's that worth], and 'if Dude was my dude' - I would keep with the 1 IU twice a day for at least 3 days. Ideally we rather see consistent numbers [e.g. pinks] both AMPS and PMPS, rather than a 60 and a 400 like on the 7th of May. The key is to keep the cat as stable as possible, and it's not something that can be rushed, or you'll end up with inconsistent data which let alone will give you the struggle and dilemma to adjust Dude's dose constantly at every cycle, but you'll have a cat who's BG is all over the place, making him feel even more miserable and it'll endanger him greatly.
If those pinks don't turn into yellow after a few days, then I would increase the dose.
With not giving him insulin for a whole 24 hours [so two NS cycles], it is safe ish to assume, that majority of his insulin depot likely has drained, so that pink we saw at today's AMPS is not influenced by much leftover [if any] insulin in his body. Therefore, today could be looked at as a fresh start, or "day 1" for the both of you, and from here on you can slowly build him back up. The keyword here is slowly.

These are my thoughts and observations, but if more experienced members are happy to give advice regardless of the lack of data and your inability to test him more often, then please feel free to ignore me.
 
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I tried a dozen times over 25 minutes. E2 - Used Test Strip or E8 - Strip or Test Errors or no blood. I can't keep doing this to him.
 
Diane Tyler's Mom said:
Michael when ever you need help you want to start your title off with a ? Then Help Needed then what ever you need help with .

You might want to ask your vet about this since you are in so much pain with back issues
About the Freestyle Libre
Tap on the blue link , there is a discussion about it
https://felinediabetes.com/FDMB/thr...-diagnosed-with-diabetes.274874/#post-3051322

I found this written by another member
I had the Libre it’s very easy to use but from what I know it’s a temporary use . The sensor is suppose to last for 14 days but rarely does , I got 9 days out of my first sensor before it had to be replaced . Here are you Pros and Cons
Pros - Once on very easy to read . You can read anytime . You can you the reader or your cell phone . The sensor reads BG every 15 minutes on it own but you still have to wave your reader or cell phone to get a reading
and your Vet can access through a computer watching day through the night .
Cons - The sensor is put on with surgical glue some kitties can have a reaction to the glue .
You have to cross your fingers your cat will keep the sensor on and not scratch it off .
The sensor may not last for 14 days and are about $ 40.00 dollars to replace .
If you can’t use your cell phone to read the sensor the reader is about $65.00 dollars

Found this also posted by another member
I made avideo in English about the FreeStyle Libre,which shows how to apply it (complete with built-in blooper, be warned) and gives some explanations as to the interest of such a device for a diabetic cat.

Here are the situation in which I think the FreeStyle Libre can be a precious solution:
  • untestable cat (some really are, I have come to discover)
  • cat who requires a lot of medical care for other conditions or stressed out by medical handling
  • caregiver away at work all day
  • caregiver often away for travel
  • holidays with petsitter, or boarding
  • stressed caregiver
Advantages:
  • less handling of the cat (you can read upto 8 hours of measurements in one swipe)
  • anybody can swipe the sensor as long as they can approach the cat, it's a much simpler gesture than an ear test
  • no need to stick to a "schedule" of testing (way less stress)
  • possible to go out (have a life!) or sleep without losing measurements
  • one sensor application lasts upto 14 days
  • closer monitoring means you never miss anything, takes the guesswork out of interpreting glucose values
  • great for observing trends
  • reader shows visual curve for the day, can be easier to interpret than raw numbers
  • non-stop monitoring can allow for more aggressive dosing with appropriate experience/supervision
Disadvantages:
  • price!
  • need to go to the vet to have the sensor applied, orlearn how to do it (not rocket science but you need to be shown how to do it correctly)
  • sensors do not always last 14 days, some die early (have a spare and expect some failures) and can fail unexpectedly
  • LO reading under 40, so if you want more detail in those values you'll have to resort to ear testing
  • interstitial glucose means there is a 5-10 minute lag behind blood glucose (not a big issue, particularly with Lantus or Levemir, just be aware of it)
  • we are not certain what the safety thresholds for methods developed with human blood/plasma equivalent meters translate to for interstitial glucose readings from a sensor designed for humans placed on a cat (not necessarily an issue, if you are worried you can get some readings at low values with a meter you are familiar with -- I did that and got readings of 60 and 65 on an AT2 for LO on the FSL)
Tips:
  • add superglue to the sensor glue before applying (make sure the chosen glue does not irritate the skin)
  • if needed, use acetone or baby oil to remove the sensor; worst case scenario, you can remove thesensor from the sticker that is attached to the skin, and leave the sticker in place if it is too firmly stuck
  • get a surveillance camera so you can monitor your cat when away and check behaviour during low values after the fact
  • try leaving the sensor bare: bandage or shirt will bother the cat more than the sensor
Summary:

If you can afford it, go for it! I've found it was a huge improvement on my quality of life as a caregiver, even compared to ear testing a very compliant cat likeQuintus. The amount of data allowed me to be much more confident and aggressive in my dose increases -- bearing in mind of course that this is not my firstdiabetic cat, that I've followed hundreds over the lasttwo years, and that I am at home most of the time these days and have a surveillance camera set up.

You can always start a new thread and ask other members that use it
@jmichaelp
Click to expand...
Thank you for that. I don't want to take him to the vet unless I have to. The last time he was hyperventilating, drooling because of that, and his heart was racing. They had to put him on oxygen immediately. I'd have to do it myself, so I'll look into that.
 
jmichaelp said:
I tried a dozen times over 25 minutes. E2 - Used Test Strip or E8 - Strip or Test Errors or no blood. I can't keep doing this to him.
Click to expand...
Well, before going to buy more strips I tested it on myself & it worked fine. If I can't get results right before time for insulin I guess I'll give 1 unit?
 
Yes.

But I'd still try to get in a second test for today, later on in the cycle after you've given insulin, like at +3 or +6 or whenever you can/before you go to bed. It would provide the more experienced members with a better overview, so hopefully they could be more confident in giving you slightly more specific dosing advice.

Just double-checking: Are you aiming to the outside of the pinna [aka the "sweet spot"] when trying to test him and not in the actual inner triangle part, right?

upload_2024-5-11_2-18-7.png
 

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Don Degludec said:
Yes.

But I'd still try to get in a second test for today, later on in the cycle after you've given insulin, like at +3 or +6 or whenever you can/before you go to bed. It would provide the more experienced members with a better overview, so hopefully they could be more confident in giving you slightly more specific dosing advice.

Just double-checking: Are you aiming to the outside of the pinna [aka the "sweet spot"] when trying to test him and not in the actual inner triangle part, right?

View attachment 70081
Click to expand...
Yep, it's mangled with punctures. I think I have to hit the vein to get blood but it causes him to sometimes shake his head, twice I've lost the blood because of this. I'm using a 26 gauge lancet now but it hasn't helped.
 
I went with 0.5 units since I'd given that amount before & since I can't really see 0.25 units on the syringe - I could've been giving no insulin at all if I tried 0.25. I syringe-fed him 57 calories, about 0.36g carbs.

I can't believe the vet had me giving him 2.5 units! I'm lucky he didn't go hypoglycemic.
 
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jmichaelp said:
I can't believe the vet had me giving him 2.5 units! I'm lucky he didn't go hypoglycemic
Click to expand...
I'm gonna be brutally honest with you, he probably did, we just don't know about it due to the lack of data/tests. But he's clearly been riding them out like a wee champion he is! ;) Their bodies know something is wrong, and when they drop to dangerously low levels they either
a) intuitively seek food to bring their BG up [is there a possibility he'd eat on his own without your knowledge e.g. when you're asleep?]
b) their liver "panic" and secrete extra glucose.
The suggestion to lower his humongously high dose drastically was based on him giving very inconsistent BG values - to me it looked like he was "bouncing" - dropping low, then bouncing sky high as a result of his panicky liver.

jmichaelp said:
First try! Blood glucose 189. From reading, it appears I should decrease all the way to 0.25 units??
Click to expand...
I'm incredibly happy for you have being able to get a test for first try! It'll become easier, once his blood is less concentrated/clogged with sugar, allowing for easier blood flow.
Plus clearly your patience and persistence is paying off, too!

You were meant to decrease by 0.25 IU, so his dose should've been 0.75 IU. Let's see what he gives you for AMPS. Hopefully it's another blue, then you'll know your judgement of injecting 0.5 IU was correct.
However, looking at his sheet where you shot a blue with 0.5 IU, the following PRE was yellow, which makes me think he'll give you a yellow AMPS again.
With that said though, Lantus likes consistency, so perhaps it would be best practice to keep with the 0.5 IU for the next at least 5 cycles.
In these upcoming 2 days, could you perhaps buy a digital caliper, which would allow you to measure out 0.25 units?

Well done Mike and little Dude, you've got this! :cat:
 
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