Human meter questions!

[karizma]

Hi everyone! My cat, Sammy, was recently diagnosed as diabetic with advanced kidney disease (stage3/4). He also has a UTI that did not go away with amoxicillin so we’re trying a new antibiotic this week.
My vet recommended a pet glucometer but after some research and reading through these forums I decided to get a human one. I purchased the CVS brand one. I’m learning how to do paw/ ear pricks and I’ve been successful 2x (just started doing insulin yesterday). my vet also told me I didn’t have to track it everyday but I’m worried about giving insulin unnecessarily. Does everyone take blood sugars before injecting insulin?
I was told to take blood sugars every 2 hours to do a glucose curve for the vet. I think she said a week after starting the insulin so next weekend. With the human glucometer how can I do a glucose curve? His first blood sugar yesterday was 203, I gave insulin and it went down to 121. At the vet his blood sugar was in the 400s the first day and 300s the second time he went in. I’m not sure if there’s a formula to convert human blood sugar to feline.
Any advice or help would be greatly appreciated! So sorry for the length on this post, I’m learning so much and I want to give my guy the best treatment possible.

 

[Diane Tyler's Mom GA]

Hi everyone! My cat, Sammy, was recently diagnosed as diabetic with advanced kidney disease (stage3/4). He also has a UTI that did not go away with amoxicillin so we’re trying a new antibiotic this week.
My vet recommended a pet glucometer but after some research and reading through these forums I decided to get a human one. I purchased the CVS brand one. I’m learning how to do paw/ ear pricks and I’ve been successful 2x (just started doing insulin yesterday). my vet also told me I didn’t have to track it everyday but I’m worried about giving insulin unnecessarily. Does everyone take blood sugars before injecting insulin?
I was told to take blood sugars every 2 hours to do a glucose curve for the vet. I think she said a week after starting the insulin so next weekend. With the human glucometer how can I do a glucose curve? His first blood sugar yesterday was 203, I gave insulin and it went down to 121. At the vet his blood sugar was in the 400s the first day and 300s the second time he went in. I’m not sure if there’s a formula to convert human blood sugar to feline.
Any advice or help would be greatly appreciated! So sorry for the length on this post, I’m learning so much and I want to give my guy the best treatment possible.

@Bron and Sheba (GA)

 

[Bron and Sheba (GA)]

Hi Karizma and Sammy
Using the human meter is fine. That is what most of us use here and the human meter is what our dosing methods are based on.

Yes we recommend testing the blood glucose (BG) before every shot to see it is safe to give the dose.
And we recommend testing during the cycle to see how low the dose is taking your kitty. Lantus dosing is based on how low the dose takes the cat, not the preshot.

The BGs will always be higher at the vet because of cat stress. That is why it is so important to test the BG at home.

Lantus is a depot insulin which means that initially the full effect of the dose will not be felt for 5 days …until the depot fills. And then every time you increase the dose it will take 3 days for the depot to fill again.
If your first preshot was 203 and the BG went down to 121, I would definitely be testing every preshot and during the cycle to make sure the BG is not dropping too low as the depot fills.
Once you get the spreadsheet set up post daily and we will help you with everything.
Make sure you have some honey or Karo at home in case of low numbers.
In the meantime, until you gather some data, I would not give the dose of insulin if the preshot is below 200.
I would stall, don’t feed and test 20 minutes later to see if the BG is rising. And post and ask for help.
What dose of insulin are you giving ?

Because of the UTI I would recommend you get some Ketostix from a pharmacy and test the urine for ketones. There should be no ketones.
Keep asking lots of questions.

 

[squeem3]

Someone on FDMB long ago once compared blinding giving insulin to that as driving a car with a paper bag over your head, just dangerous. Always test the blood glucose level before giving insulin. That's the only way you know if your cat is a safe level for insulin or not. Newbies are recommended to not give any insulin if the level is under 150 mg/dl. This is to prevent a hypo.

Keep track of all the blood glucose levels. By tracking you'll notice any trends. Most basic meters only keep track of up to 7 days of levels before those get erased. Most FDMB users use a Google based spreadsheet which is easily shared with others, even the vet. The instructions are here https://www.felinediabetes.com/FDMB/threads/how-to-create-a-spreadsheet.241706/ @Bandit's Mom can assist you with setting one up. Paper and pencil tracking works in a pinch but not easily shared.

To do a curve, just test approximately every 2 hours from right before the morning insulin shot to the evening shot. It doesn't have to be exactly every 2 hours. Life happens and cats sometimes get cranky and hide. Aim for at least 4 blood glucose checks between the insulin shots.

 

[Sienne and Gabby (GA)]

Welcome to FDMB! And no worries about your post -- it's not long.

We strongly encourage members to test a minimum of 4 times per day. As Bron suggested, you want to test before giving a shot so you know that it's safe to give insulin and once during both the AM and PM cycles so you know how low the dose is taking your cat's blood glucose numbers. The reason for testing is safety as well as to know if the insulin isn't bringing your cat's numbers closer to a normal range (i.e., the numbers are higher than you'd like). The reason to test is not to determine if insulin is not strictly to determine if insulin is unnecessary. You certainly don't want to give a shot if numbers are low but as you'll learn, not all low numbers are created equally.

There is a minimal difference between a glucometer that is calibrated for animals and one that's calibrated for humans. You do not need to convert numbers. You will spend a small fortune on test strips for a pet meter like the AlphaTrack. The strips cost $1.00 each. I'm guessing the cost for the strips for your CVS monitor are much, much less.

How did your vet test for the UTI? Did the vet insert a needle into Sammy's bladder to get a sterile sample? Did the vet run a culture and sensitivity? The latter is a way to determine what bacteria grow so the vet can prescribe the appropriate antibiotic.

Also, how did your vet determine that Sammy was diabetic? Generally, you want the results from a fructosamine test. Any infection or inflammation can cause a rise in blood glucose so it's possible that the UTI was influencing Sammy's blood glucose numbers.

 

[karizma]

Welcome to FDMB! And no worries about your post -- it's not long.

We strongly encourage members to test a minimum of 4 times per day. As Bron suggested, you want to test before giving a shot so you know that it's safe to give insulin and once during both the AM and PM cycles so you know how low the dose is taking your cat's blood glucose numbers. The reason for testing is safety as well as to know if the insulin isn't bringing your cat's numbers closer to a normal range (i.e., the numbers are higher than you'd like). The reason to test is not to determine if insulin is not strictly to determine if insulin is unnecessary. You certainly don't want to give a shot if numbers are low but as you'll learn, not all low numbers are created equally.

There is a minimal difference between a glucometer that is calibrated for animals and one that's calibrated for humans. You do not need to convert numbers. You will spend a small fortune on test strips for a pet meter like the AlphaTrack. The strips cost $1.00 each. I'm guessing the cost for the strips for your CVS monitor are much, much less.

How did your vet test for the UTI? Did the vet insert a needle into Sammy's bladder to get a sterile sample? Did the vet run a culture and sensitivity? The latter is a way to determine what bacteria grow so the vet can prescribe the appropriate antibiotic.

Also, how did your vet determine that Sammy was diabetic? Generally, you want the results from a fructosamine test. Any infection or inflammation can cause a rise in blood glucose so it's possible that the UTI was influencing Sammy's blood glucose numbers.

Thank you so much for your reply! They did a blood test as well, which is how we found out about the kidney disease and diabetes. The vet didn't want to declare him diabetic without seeing the urine sample, as stress can make the numbers rise. His blood sugar on the test was in the 400s, and his fructosamine test also showed he had higher blood sugars, so they decided to treat him. I have changed his diet (he was on Purina Pro Senior Dry), which I think is keeping his numbers lower. I tested him before giving him his meal and insulin, but he is at 156. I'm going to give him the 1 unit of insulin now and check his BS in 2 hours to make sure it's not going down too much.
The UTI was an incidental finding because they wanted to see if there was sugar in his urine. The first sample had trace amounts, and the second, post-amoxicillin, had a good amount (which also prompted them to want to treat). I need to ask if they did a culture and sensitivity- I assume they did. He has no signs of a UTI he's been urinating in his litter box and acting relatively normal. Since going to the vet the first time, he's been lethargic and barely eating. It's stressed him a lot in my opinion. I'm hoping that he will start to improve with the insulin and Abx.

 

[karizma]

Someone on FDMB long ago once compared blinding giving insulin to that as driving a car with a paper bag over your head, just dangerous. Always test the blood glucose level before giving insulin. That's the only way you know if your cat is a safe level for insulin or not. Newbies are recommended to not give any insulin if the level is under 150 mg/dl. This is to prevent a hypo.

Keep track of all the blood glucose levels. By tracking you'll notice any trends. Most basic meters only keep track of up to 7 days of levels before those get erased. Most FDMB users use a Google based spreadsheet which is easily shared with others, even the vet. The instructions are here https://www.felinediabetes.com/FDMB/threads/how-to-create-a-spreadsheet.241706/ @Bandit's Mom can assist you with setting one up. Paper and pencil tracking works in a pinch but not easily shared.

To do a curve, just test approximately every 2 hours from right before the morning insulin shot to the evening shot. It doesn't have to be exactly every 2 hours. Life happens and cats sometimes get cranky and hide. Aim for at least 4 blood glucose checks between the insulin shots.

Thank you! This was exactly what I needed to hear; his blood sugar tested at 156, and I was going crazy trying to figure out if I should administer. I'll be sure to check out that link and start to mark it! Thank you so much!

 

[karizma]

Hi Karizma and Sammy
Using the human meter is fine. That is what most of us use here and the human meter is what our dosing methods are based on.

Yes we recommend testing the blood glucose (BG) before every shot to see it is safe to give the dose.
And we recommend testing during the cycle to see how low the dose is taking your kitty. Lantus dosing is based on how low the dose takes the cat, not the preshot.

The BGs will always be higher at the vet because of cat stress. That is why it is so important to test the BG at home.

Lantus is a depot insulin which means that initially the full effect of the dose will not be felt for 5 days …until the depot fills. And then every time you increase the dose it will take 3 days for the depot to fill again.
If your first preshot was 203 and the BG went down to 121, I would definitely be testing every preshot and during the cycle to make sure the BG is not dropping too low as the depot fills.
Once you get the spreadsheet set up post daily and we will help you with everything.
Make sure you have some honey or Karo at home in case of low numbers.
In the meantime, until you gather some data, I would not give the dose of insulin if the preshot is below 200.
I would stall, don’t feed and test 20 minutes later to see if the BG is rising. And post and ask for help.
What dose of insulin are you giving ?

Because of the UTI I would recommend you get some Ketostix from a pharmacy and test the urine for ketones. There should be no ketones.
Keep asking lots of questions.

I'm a bit confused now because I saw the other poster say not to give under 150- I'm giving him the 1 unit now but I will be sure to keep a close eye on him. We are on lantus 1 unit!
I will get some ketostix from the pharmacy! If it shows ketones what does that mean and what should my next step be?

 

[karizma]

Hi everyone! My cat, Sammy, was recently diagnosed as diabetic with advanced kidney disease (stage3/4). He also has a UTI that did not go away with amoxicillin so we’re trying a new antibiotic this week.
My vet recommended a pet glucometer but after some research and reading through these forums I decided to get a human one. I purchased the CVS brand one. I’m learning how to do paw/ ear pricks and I’ve been successful 2x (just started doing insulin yesterday). my vet also told me I didn’t have to track it everyday but I’m worried about giving insulin unnecessarily. Does everyone take blood sugars before injecting insulin?
I was told to take blood sugars every 2 hours to do a glucose curve for the vet. I think she said a week after starting the insulin so next weekend. With the human glucometer how can I do a glucose curve? His first blood sugar yesterday was 203, I gave insulin and it went down to 121. At the vet his blood sugar was in the 400s the first day and 300s the second time he went in. I’m not sure if there’s a formula to convert human blood sugar to feline.
Any advice or help would be greatly appreciated! So sorry for the length on this post, I’m learning so much and I want to give my guy the best treatment possible.

Update: I gave him the 1 unit and stayed with him making sure he was eating and when he walked away he started stumbling… I gave him honey on his gums and I’m sitting with him. Heart pounding and all. I’m going to call the vet in the morning but any advice would be great.

 

[Tim & Pookey]

Update: I gave him the 1 unit and stayed with him making sure he was eating and when he walked away he started stumbling… I gave him honey on his gums and I’m sitting with him. Heart pounding and all. I’m going to call the vet in the morning but any advice would be great.

That sounds scary! What was the BG reading?

 

[Bron and Sheba (GA)]

'm a bit confused now because I saw the other poster say not to give under 150- I'm giving him the 1 unit now but I will be sure to keep a close eye on him. We are on lantus 1 unit!

Update: I gave him the 1 unit and stayed with him making sure he was eating and when he walked away he started stumbling… I gave him honey on his gums and I’m sitting with him. Heart pounding and all. I’m going to call the vet in the morning but any advice would be great.

Have you taken the BG again after giving honey? If not please do so and tell us what it us

On the main health page, until you get some data to see how your kitty reacts to insulin, we recommend not giving the dose if the BG is under 200.
On the Lantus page they say don't give under 150 to start with. Most people over there have a few weeks data to look at.
Seeing he was symptomatic, I would reduce the dose down to 1/2 unit and see how that goes.
Can you set up a spreadsheet?

 

[karizma]

Yes I’m setting one up! I’ll add once it’s good! I checked his blood sugar now (2 hours after dose) and he’s 162. I’m calling the vet in the morning but so far so good I may have given too much honey but I was worried. Hopefully this doesn’t happen again

 

[Bron and Sheba (GA)]

Yes I’m setting one up! I’ll add once it’s good! I checked his blood sugar now (2 hours after dose) and he’s 162. I’m calling the vet in the morning but so far so good I may have given too much honey but I was worried. Hopefully this doesn’t happen again

I did say this in post 3 as I was concerned the dose could possibly be too high ...If your first preshot was 203 and the BG went down to 121, I would definitely be testing every preshot and during the cycle to make sure the BG is not dropping too low as the depot fills.
I am very glad you were monitoring closely. Please do reduce the dose to 0.5 Unit at the next dose if the BG is high enough. I would not shoot under 200.
Some cats can he very sensitive to insulin after a hypo event so be aware of that.

Keep monitoring because the BG can drop again once the honey wears off.
Is he eating some low carb food for you since the stumbling?

 

[squeem3]

Generally 150 is the cut off number for newbies. Every cat is different, though. As Bron said, some cats are sensitive to insulin. Since your cat had hypo symptoms, you'll need to reduce the insulin dose to 0.5 units or even 0.25 units. And test as often as you can between the insulin shots to see how low your cat is dropping and to give syrup or high carb food if numbers are too low too soon after insulin. A list of items to have for a hypo episode: https://www.felinediabetes.com/FDMB/threads/jojo-and-bunnys-hypo-tool-box.2354/

Did the vet show you how to measure insulin correctly? 1 unit is a teeny drop. And do you have 3/10 cc U100 insulin syringes? The line markings on a 3/10 cc insulin syringe looks like this:

 

[karizma]

I did say this in post 3 as I was concerned the dose could possibly be too high ...If your first preshot was 203 and the BG went down to 121, I would definitely be testing every preshot and during the cycle to make sure the BG is not dropping too low as the depot fills.
I am very glad you were monitoring closely. Please do reduce the dose to 0.5 Unit at the next dose if the BG is high enough. I would not shoot under 200.
Some cats can he very sensitive to insulin after a hypo event so be aware of that.

Keep monitoring because the BG can drop again once the honey wears off.
Is he eating some low carb food for you since the stumbling?

He was good overnight, blood glucose this morning was 138 then I checked after 20 and it was 154. Leaving him for now and calling the vet to see what they suggest for the future.

 

[Sienne and Gabby (GA)]

@Bandit's Mom I tagged Bhooma. She can help you get your cat's spreadsheet set up.

It looks like you switched Sammy to a low carb diet. That may be why you're seeing lower numbers. It's also important to test at least once during both the AM and PM cycles. You need to know how low your insulin dose is dropping your cat's numbers. Symptoms like stumbling might mean that his blood glucose was low.

 

[Bandit's Mom]

Hi @karizma! I can help set up your spreadsheet. Will send you a PM with the details I need. Look for it in the Inbox at the top right corner of this page.

 

[karizma]

Generally 150 is the cut off number for newbies. Every cat is different, though. As Bron said, some cats are sensitive to insulin. Since your cat had hypo symptoms, you'll need to reduce the insulin dose to 0.5 units or even 0.25 units. And test as often as you can between the insulin shots to see how low your cat is dropping and to give syrup or high carb food if numbers are too low too soon after insulin. A list of items to have for a hypo episode: https://www.felinediabetes.com/FDMB/threads/jojo-and-bunnys-hypo-tool-box.2354/

Did the vet show you how to measure insulin correctly? 1 unit is a teeny drop. And do you have 3/10 cc U100 insulin syringes? The line markings on a 3/10 cc insulin syringe looks like this:

She didn’t show me but I did look it up and made sure! My syringe shows by 1 unit not half’s I’ve been giving the correct dose. The vet advised me not to give unless above 300 and she’ll check back in Friday to talk about his numbers. I’m taking blood sugars in the AM and PM.

 

[squeem3]

Good You'll want to buy half unit marked insulin syringes next time. Those will make measuring half and even quarter unit doses so much easier.

You also need to check blood glucose levels in between the insulin shots. That way you know how your cat is responding to the insulin and dose and how low the levels get. This doesn't need to be done daily. People who aren't home during the day tend to get their mid cycle checks after the PM insulin shot and do a few checks on the weekend. And you always want to check levels if you think your cat might be experiencing a hypo or just seems off.

Your signature says baby puree and a meal completer. Are you not feeding a commercial brand of canned food?

 

[karizma]

Good You'll want to buy half unit marked insulin syringes next time. Those will make measuring half and even quarter unit doses so much easier.

You also need to check blood glucose levels in between the insulin shots. That way you know how your cat is responding to the insulin and dose and how low the levels get. This doesn't need to be done daily. People who aren't home during the day tend to get their mid cycle checks after the PM insulin shot and do a few checks on the weekend. And you always want to check levels if you think your cat might be experiencing a hypo or just seems off.

Your signature says baby puree and a meal completer. Are you not feeding a commercial brand of canned food?

I am not feeding a commercial brand, I was honestly struggling with the cost of the canned foods and I have a surplus of baby meat puree at home (I have an infant with WIC who does not eat them) I checked the carb and ingredients (only meat and water). I purchased the EZ complete cat premix to add all necessary vitamins and nutrients. Once we complete the baby purées we’re planning on making food at home (cooking meat and adding the EZ complete).