Alpha Trak 2 strips vs Freestyle Lite or Freestyle Insulinx test strips

[Diane Tyler's Mom GA]

Hi I have been seeing that some of you the Freestyle Insulinx in their Alpha Trak Monitor. Are you satified with the readings. My vet makes me use the sliding scale for adjusting his insulin (Vetsulin). I test him morning and evening. If using the Freestyle Insulinx strips and they may be a 20 point difference, I'm wondering when using the sliding scale would that make a difference in how many units I would give. Also what is the difference in the Freestyle Insulinx and the Freestyle Lite. This is what my vet makes me go by when giving the insulin If >220 increase by 0.5 units . If 100-220 do not change dose . If 80-100 decrease by 0.5 units . If 60-79 decrease by 1 unit. If <60 skip dose. So I go by his last reading when I test his sugar. He is on 6 units right now and just did his first curve test at home. She asked me to send her his reading from the last 2 weeks and here are some of them. 143 . 140. 151. 157. 130. 113 .121. 158. 118. 161. 109. Etc. Nothing really over 200. So when she saw them she wanted me to do the curve test because she said they looked good but maybe to good and might want to lower his unit to 5 units twice a day. So I did it yesterday which was 4-20-19 I started at 9 am. Tested him at 9 am and he was 118, then I fed him his fancy feast chicken pate, waited 20 minutes and then gave him 6 units of Vetsulin. Tested at 11 am it was 99. Tested at 1 pm it was 68. Tested at 3 pm it was 76 . Tested at 5 pm it was 96 . Tested at 7 pm it was 96 again. Tested at 9 pm it was 109. So now I have to feed him and give insulin. I took it upon myself and only gave 5-1/2 units until I speak to her on Monday. I then decided to test him at 11 pm and he was at 84. Then I tested him at 1:25 am and he was 50 so I gave him some dry food because I got nervous. Today I tested him like usual at 9 am and he was at 161 then fed him and still gave 5-1/2 units .Tested him at 1 pm and it was 37 ( what the hell) I gir nervous so I gave him some dry food. Just tested now 3 pm and it went to 111 . That reading of 37 was strange. So I will talk to her on MindaM and see what she wants to do about his units. I'm sorry I have to write it like this , I can't do a spread sheet because my tablet is too old, I checked with the manufacturer and that's why I can't write on it. Someone here ,sorr s can't remember her name right now but she did create the spreadsheet but I was unable to write on it. What do you all think about his numbers . Thanks so much and Happy Easter

 

[MrWorfMen's Mom]

I'm sorry your post got kind of lost in the queue.

I'm assuming the readings you have quoted above were taken using the proper AT2 strips with the meter set to the code on the strip vial and not with some alternative strip like Insulinx or Freestyle Lite.

Please DO NOT give insulin to Tyler at a BG of 109 on the AT2 meter. That is a totally normal BG on the AT2 meter.
Those readings of 37 & 50 are extremely dangerous and means the 5.5u dose of insulin needs to be reduced. Normal BG on the AT2 meter is 68 to 150. Even the reading of 68 is a call for you to feed Tyler to ensure he doesn't drop any lower.

I know you are having issues with your tablet but it's very difficult/impossible to offer specific advice without seeing what has been happening day to day for the last week or 2.

This is what my vet makes me go by when giving the insulin If >220 increase by 0.5 units . If 100-220 do not change dose . If 80-100 decrease by 0.5 units . If 60-79 decrease by 1 unit. If <60 skip dose.

I hate to criticize your vet but that sliding scale is not safe. I'm not a fan of sliding scale dosing as they make it impossible to really see how any particular dose is working for kitty if the dose is changing constantly. That said they do work for some cats once their response to different doses is known and perhaps Tyler's response has been established for each of those dose recommendations. Under no circumstances would I consider it safe to give Tyler 5u of insulin or even 4u at a pre-shot BG of 60 to 79. Given the numbers you have been seeing lately I would definitely reduce the dose, monitor him closely and withhold the shot for a pre-shot BG of 200 or less until you see how low the reduced dose is taking Tyler's BG.

As for using the alternate strips in the AT2 meter, it can be done but without the right code for the strips, you may get a ballpark number but it will not likely be the most accurate possible and it could be either higher or lower than it would be with the proper AT2 strips with the right code. That could be very dangerous when Tyler seems to be getting some pretty low readings recently and not a risk I would personally be willing to take.

If you are looking for a cheaper testing alternative, I would strongly suggest you get a human meter as the strips are considerably less expensive and we can help you understand those readings as the human meter will read a bit lower than the AT2 in general.

 

[AliceMeowliss (GA)]

Those numbers would scare me! You ready received way better advice than I could write up, but I second it.

And at first I was hung up on trying to have an alphatrak because my vet recommended it. But it's more important to be able to afford to test than worry about how much each strip costs. I hope you get things sorted!

 

[Diane Tyler's Mom GA]

I'm sorry your post got kind of lost in the queue.

I'm assuming the readings you have quoted above were taken using the proper AT2 strips with the meter set to the code on the strip vial and not with some alternative strip like Insulinx or Freestyle Lite.

Please DO NOT give insulin to Tyler at a BG of 109 on the AT2 meter. That is a totally normal BG on the AT2 meter.
Those readings of 37 & 50 are extremely dangerous and means the 5.5u dose of insulin needs to be reduced. Normal BG on the AT2 meter is 68 to 150. Even the reading of 68 is a call for you to feed Tyler to ensure he doesn't drop any lower.

I know you are having issues with your tablet but it's very difficult/impossible to offer specific advice without seeing what has been happening day to day for the last week or 2.



I hate to criticize your vet but that sliding scale is not safe. I'm not a fan of sliding scale dosing as they make it impossible to really see how any particular dose is working for kitty if the dose is changing constantly. That said they do work for some cats once their response to different doses is known and perhaps Tyler's response has been established for each of those dose recommendations. Under no circumstances would I consider it safe to give Tyler 5u of insulin or even 4u at a pre-shot BG of 60 to 79. Given the numbers you have been seeing lately I would definitely reduce the dose, monitor him closely and withhold the shot for a pre-shot BG of 200 or less until you see how low the reduced dose is taking Tyler's BG.

As for using the alternate strips in the AT2 meter, it can be done but without the right code for the strips, you may get a ballpark number but it will not likely be the most accurate possible and it could be either higher or lower than it would be with the proper AT2 strips with the right code. That could be very dangerous when Tyler seems to be getting some pretty low readings recently and not a risk I would personally be willing to take.

If you are looking for a cheaper testing alternative, I would strongly suggest you get a human meter as the strips are considerably less expensive and we can help you understand those readings as the human meter will read a bit lower than the AT2 in general.

Hi thanks for getting back to me. My vet called me just now after looking at his 2 curve tests and said they were definitely too low. She wants me to reduce his units to 5 and wants me to do another curve test in 3 weeks. I am using the Alpha Trak test strips when testing him and set to the code on the container. I test him every morning and every night, but I will do a few test in between since lowering him to 5 units. About the sliding scale, she gave it to me, that her another vet uses in her office. I will definitely talk to her about it. This may be a dumb question but other than using a sliding scale , how do you or other people decide on what dose to give.I am going to test him at 9 pm and see what it is. Using the Alpha Trak 2 and the Alpha Trak test strips what is considered to be an acceptable BG level. I asked my vet but forget what she said, this as awhile back that I had asked her, if I remember she might have said 200 or below, but forget what the lowest number was she said. I'm going to definitely call her tomorrow. Hope to hear back from you and thank you

 

[Diane Tyler's Mom GA]

Those numbers would scare me! You ready received way better advice than I could write up, but I second it.

And at first I was hung up on trying to have an alphatrak because my vet recommended it. But it's more important to be able to afford to test than worry about how much each strip costs. I hope you get things sorted!

Hi thanks for your reply, and I have always used the Alpha Trak test strips and will continue to use them. Just so I don't have to re write when I spoke to my vet today , please read what I wrote back to Mr Wofsmen's mom. Thank you

 

[AliceMeowliss (GA)]

This may be a dumb question but other than using a sliding scale , how do you or other people decide on what dose to give. Hope to hear back from you and thank you

There is never a dumb question, only questions that will help you help kitty.

http://www.felinediabetes.com/FDMB/threads/beginners-guide-to-caninsulin-vetsulin.186099/
Have you reviewed this? Maybe some info in the ISG.

I never used vetsulin but I used NPH. With such a fast-acting insulin, and your cat reading lower, I would recommend getting tests frequently, especially during possible peak/nadir, when hypo risk would possibly be higher. I know that doesn't give you a specific time to check, I don't feel qualified for that.

 

[Diane Tyler's Mom GA]

There is never a dumb question, only questions that will help you help kitty.

http://www.felinediabetes.com/FDMB/threads/beginners-guide-to-caninsulin-vetsulin.186099/
Have you reviewed this? Maybe some info in the ISG.

I never used vetsulin but I used NPH. With such a fast-acting insulin, and your cat reading lower, I would recommend getting tests frequently, especially during possible peak/nadir, when hypo risk would possibly be higher. I know that doesn't give you a specific time to check, I don't feel qualified for that.

Hi, yes I will read about the vetsulin again boy is this confusing, I'm going to call my vet again tomorrow. Thank you

 

[AliceMeowliss (GA)]

Hi, yes I will read about the vetsulin again boy is this confusing, I'm going to call my vet again tomorrow. Thank you

The information gets easier to process over time, but I think it can be confusing for anyone.
Check back and let us know how kitty's numbers are and if you can set an alarm for a nighttime check that could be helpful! It's good to have more data when making dose adjustments.

 

[Diane Tyler's Mom GA]

The information gets easier to process over time, but I think it can be confusing for anyone.
Check back and let us know how kitty's numbers are and if you can set an alarm for a nighttime check that could be helpful! It's good to have more data when making dose adjustments.

I definitely will check him a few times during the night. Thanks so much

 

[Diane Tyler's Mom GA]

Ok just. tested. him. at 9:30 pm. It was 127. Do you think I should give him 5 units like my vet just told me after seeing his 2 curves, He was on 6 units before this. He's eating right now .The morning reading was 134.

 

[MrWorfMen's Mom]

No I definitely don't think you should give him 5u. From your current data you gave him 5.5 u and ended up with Tyler going WAY below a safe BG. Without data to really keep all the numbers in perspective it's hard to say what you should give him however if you are able to test him several times tonight, then you could try maybe 3u but no more as long as you have lots of tests strips and some high carb food or karo available in case he starts to drop low again. Ideally you should test him between +2 and +6 post shot tonight and possibly beyond. The number of tests would be dependent on how much he drops.

 

[Diane Tyler's Mom GA]

No I definitely don't think you should give him 5u. From your current data you gave him 5.5 u and ended up with Tyler going WAY below a safe BG. Without data to really keep all the numbers in perspective it's hard to say what you should give him however if you are able to test him several times tonight, then you could try maybe 3u but no more as long as you have lots of tests strips and some high carb food or karo available in case he starts to drop low again. Ideally you should test him between +2 and +6 post shot tonight and possibly beyond. The number of tests would be dependent on how much he drops.

Hi , I think I will only give 3 units , I'll wait 30 minutes after he's done eating, then give the 3 units, and I do have a lot of test strips so I am going to test him like you said and even longer. I definitely going to call my vet and give her the numbers, like I said another vet she works with uses the sliding scale so that's what she gave me, but now I'm getting pissed off about it, will call her tomorrow .If not using a sliding scale how would you know how much insulin to give every am and pm. As you can see I'm new to his lol Also what is considered an acceptable BG for them, Under 200? And what would be the lowesr BG that is ok

 

[AliceMeowliss (GA)]

Some vets do not have the same experience with diabetic cats. It can be tricky.

I grabbed the hypo emergency link for you just in case.

http://www.felinediabetes.com/FDMB/threads/how-to-treat-hypos-they-can-kill-print-this-out.15887/

 

[MrWorfMen's Mom]

It's not my intention to make you upset with your vet but it is my intention to help you understand what is and isn't safe for Tyler. I am seriously wondering if the other vet might (and that's a big "might") have been using that sliding scale for use with a human meter. It's definitely not safe for a cat on Vetsulin with the AT2 meter. Even with other insulins that can be given at lower pre-shot numbers, no one would give insulin with a BG of 60 on an AT2 meter.
ETA Sliding scales are individualized plans based on how an individual cat reacts to the insulin. You can't take the plan from another cat and expect it will work for another cat. Your cat is on a large dose of insulin compared to most cats so while that sliding scale may have worked for others, it is definitely not appropriate for Tyler IMHO.

Can I ask you to keep track of your readings by
AMPS = the reading you take before the morning shot of insulin
and then +2, +3, +4 etc. according to how many hours after the shot was given a test was done.
I am not suggesting you test Tyler every hour but rather just how we need to see the numbers to be able to help you out more.

So for example from your original post, you could type out readings as follows:

20thApr19
AMPS - 118 (6u given)
+2 - 99
+4 - 68
+6 - 76
+8 - 96
+10 - 96
PMPS - 109 (5.5 u given)
+2 - 84
+4.5 - 50 given dry food to bring BG up

21Apr19
AMPS - 161 (5.5u given)
+4 - 37 given dry food to bring BG up
+6 - 111

If you get a reading under 68, feed Tyler some higher carb food. Preferably not the dry food but a higher carb wet food if possible and retest again in 15 to 30 minutes depending on how far below 68 he is. In the case of a number like that 37, a bit of honey or karo added to his wet food would be ideal rather than dry food to get the BG up quickly and again, it's really important to retest to ensure Tyler's BG is staying up.

 

[Diane Tyler's Mom GA]

It's not my intention to make you upset with your vet but it is my intention to help you understand what is and isn't safe for Tyler. I am seriously wondering if the other vet might (and that's a big "might") have been using that sliding scale for use with a human meter. It's definitely not safe for a cat on Vetsulin with the AT2 meter. Even with other insulins that can be given at lower pre-shot numbers, no one would give insulin with a BG of 60 on an AT2 meter.
ETA Sliding scales are individualized plans based on how an individual cat reacts to the insulin. You can't take the plan from another cat and expect it will work for another cat. Your cat is on a large dose of insulin compared to most cats so while that sliding scale may have worked for others, it is definitely not appropriate for Tyler IMHO.

Can I ask you to keep track of your readings by
AMPS = the reading you take before the morning shot of insulin
and then +2, +3, +4 etc. according to how many hours after the shot was given a test was done.
I am not suggesting you test Tyler every hour but rather just how we need to see the numbers to be able to help you out more.

So for example from your original post, you could type out readings as follows:

20thApr19
AMPS - 118 (6u given)
+2 - 99
+4 - 68
+6 - 76
+8 - 96
+10 - 96
PMPS - 109 (5.5 u given)
+2 - 84
+4.5 - 50 given dry food to bring BG up

21Apr19
AMPS - 161 (5.5u given)
+4 - 37 given dry food to bring BG up
+6 - 111

If you get a reading under 68, feed Tyler some higher carb food. Preferably not the dry food but a higher carb wet food if possible and retest again in 15 to 30 minutes depending on how far below 68 he is. In the case of a number like that 37, a bit of honey or karo would be ideal rather than dry food to get the BG up quickly and again, it's really important to retest to ensure Tyler's BG is staying up.

Hey, please I don't think you are trying to get me upset with my vet, but I am going to find out from the other vet about this sliding scale. I will keep track of the reading like you said using the +2 +4 etc, I truly appreciate your help . Well I decided to test him again at ,10:45 and didn't even give him the insulin shot yet, it was 102 , how can that be after eating, maybe I should just skip the shot for tonight, I'm sorry for so many questions

 

[Diane Tyler's Mom GA]

Some vets do not have the same experience with diabetic cats. It can be tricky.

I grabbed the hypo emergency link for you just in case.

http://www.felinediabetes.com/FDMB/threads/how-to-treat-hypos-they-can-kill-print-this-out.15887/

Thanks so much, I appreciate it

 

[AliceMeowliss (GA)]

Well I decided to test him again at ,10:45 and didn't even give him the insulin shot yet, it was 102 , how can that be after eating, maybe I should just skip the shot for tonight, I'm sorry for so many questions

I definitely would not be giving 4u at that number. Better kitty run high for a day than the alternative. I can't dose advise this type of insulin to say if a lower dose would be safe. But unless he has additional health issues or recent DKA, skipping one shot could be the safest choice. Every Cat Is Different.

How is his appetite? Does he drink more or pee more or have sticky urine in the litter box? Has he lost any weight?

No one here will be upset that you have questions! We would all rather your cat be well. I think everyone goes through panic and confusion with this stuff.

Keep checking in.

 

[Diane Tyler's Mom GA]

I definitely would not be giving 4u at that number. Better kitty run high for a day than the alternative. I can't dose advise this type of insulin to say if a lower dose would be safe. But unless he has additional health issues or recent DKA, skipping one shot could be the safest choice. Every Cat Is Different.

How is his appetite? Does he drink more or pee more or have sticky urine in the litter box? Has he lost any weight?

No one here will be upset that you have questions! We would all rather your cat be well. I think everyone goes through panic and confusion with this stuff.

Keep checking in.

Hi I think I'll skip tonight's dose his appetite is good, peeing is normal, hasn't lost weight. I'm going to ask my vet to ask the vet that gave her the sliding scale if it's based on a human meter, I would really like to speak to him about it and tell him what's going on, I really love my vet and don't want her to think I don't know what she's doing, she is really good. I know she has off on Wednesday, so I'll play dumb and ask for her, then say let me talk to the other vet. I'm going to test him later on to see if it went up from 102 which I did at 10:45. Now I'll be up all night watching him lol. Thank you

 

[AliceMeowliss (GA)]

Hi I think I'll skip tonight's dose his appetite is good, peeing is normal, hasn't lost weight. I'm going to ask my vet to ask the vet that gave her the sliding scale if it's based on a human meter, I would really like to speak to him about it and tell him what's going on, I really love my vet and don't want her to think I don't know what she's doing, she is really good. I know she has off on Wednesday, so I'll play dumb and ask for her, then say let me talk to the other vet. I'm going to test him later on to see if it went up from 102 which I did at 10:45. Now I'll be up all night watching him lol.

Someone on here refers to those nights as PJ parties. Lol. It'll happen sometimes.

I love my vet, too, and she is a wonderful support. But I found I had to take more control over Alice's condition. Many vets are cautious too because not everyone home tests. My vet was great just because she warned me to make sure Alice ate before her NPH and explained syrup on the gums for hypo. But she had not had any experience with someone switching their cat's insulin.
Shorter version: it's no disrespect to your vet at all. No human can know all the things or have all the experiences. Hopefully you two can work together, and the more you learn the more your vet can help you, too.

 

[Diane Tyler's Mom GA]

Someone on here refers to those nights as PJ parties. Lol. It'll happen sometimes.

I love my vet, too, and she is a wonderful support. But I found I had to take more control over Alice's condition. Many vets are cautious too because not everyone home tests. My vet was great just because she warned me to make sure Alice ate before her NPH and explained syrup on the gums for hypo. But she had not had any experience with someone switching their cat's insulin.
Shorter version: it's no disrespect to your vet at all. No human can know all the things or have all the experiences. Hopefully you two can work together, and the more you learn the more your vet can help you, too.

Thanks I will call her tomorrow and go over everything with her, thanks for talking with me and I'll let you know what happens.

 

[MrWorfMen's Mom]

That is great news that Tyler's BG was lower than pre-shot roughly 2 hours after his meal. That means Tyler's pancreas is working and getting back to business. You made the right decision not giving insulin tonight. If there is no history of ketones or DKA and you have the luxury of giving shots later than your usual 9/9 schedule if need be, I'd seriously consider checking his BG tomorrow morning, feeding him his normal meal, skip his shot again and recheck his BG 3 hours after his meal to see if he is again lower 3 hours after his meal than at pre-shot.
As counter intuitive as it seems, too much insulin can look exactly the same as too little and it's only when the body gets low on stored glucose it's been using to counteract the excess insulin that you all of a sudden get a drop to a very low BG. That could mean the dose has been too high and needs to be lowered or it could mean Tyler's pancreas has suddenly improved enough to take over and he doesn't need insulin at this point in time. Either way, I urge caution giving him insulin at those low pre-shot readings he's had the last few days.

Please do keep us posted.

 

[Diane Tyler's Mom GA]

That is great news that Tyler's BG was lower than pre-shot roughly 2 hours after his meal. That means Tyler's pancreas is working and getting back to business. You made the right decision not giving insulin tonight. If there is no history of ketones or DKA and you have the luxury of giving shots later than your usual 9/9 schedule if need be, I'd seriously consider checking his BG tomorrow morning, feeding him his normal meal, skip his shot again and recheck his BG 3 hours after his meal to see if he is again lower 3 hours after his meal than at pre-shot.
As counter intuitive as it seems, too much insulin can look exactly the same as too little and it's only when the body gets low on stored glucose it's been using to counteract the excess insulin that you all of a sudden get a drop to a very low BG. That could mean the dose has been too high and needs to be lowered or it could mean Tyler's pancreas has suddenly improved enough to take over and he doesn't need insulin at this point in time. Either way, I urge caution giving him insulin at those low pre-shot readings he's had the last few days.

Please do keep us posted.

I definitely will keep you posted, just to let you know before I get off, I tested him at +5 and it was 94. This is not to good, correct, I don't know lol Talk to you tomorrow. Diane

 

[MrWorfMen's Mom]

Actually 94 at +5 is just fine and dandy. A totally normal BG. Fingers crossed Tyler keeps giving you numbers like that! Good night. I'll be looking forward to seeing how Tyler is doing in the morning!

 

[Diane Tyler's Mom GA]

Actually 94 at +5 is just fine and dandy. A totally normal BG. Fingers crossed Tyler keeps giving you numbers like that! Good night. I'll be looking forward to seeing how Tyler is doing in the morning!

Ok I feel better lol, one last question, if you can answer it, or maybe I would have to ask someone whose cat is on Vetsulin, if they are not using this sliding scale, how do they know how much insulin to give, I don't understand that, I can understand if you do your scheduled time test , let's say like me 9am, so let's say it's 140 , feed and would you give insulin? I mean how many times would you have to test a cat after 9 am in order to know whether or not they need it, this is where I'm so confused. I hope you get what I mean. I'll talk to you tomorrow. Again thank you so much

 

[MrWorfMen's Mom]

In short, you start with a low dose of insulin, you hold that same dose for at least a few cycles (up to a week). You test before each shot and get mid cycle tests to see how low the dose is taking the cat. If the dose takes the cat too low, you reduce the dose and repeat....if BG stays too high you increase the dose and repeat. We do dose increases/decreases of 0.25u to ensure we don't jump over the optimal dose. This helps you see what any particular dose does for kitty. Insulin should be dosed based on how low the dose takes BG with the pre-shot telling you if it's safe to give insulin at all. The pre-shot and mid cycle tests also give you an indication of how much of a drop a dose produces allowing you to eventually (once you have lots of data) develop an individualized sliding scale dosing plan for your kitty. What works for Cat A doesn't necessarily work for Cat B because they are all on different doses, have different drops from different doses and some cats bounce more than others.....they all react to insulin differently.

Bouncing can happen when BG drops too much, too fast or to levels that kitty is not accustomed to. They get used to being in higher BG range due to the diabetes and have to "learn" that lower BG levels are safe. This is a normal phenomenon that can unfortunately lead to kitty being overdosed using a sliding scale because you are only using pre-shot readings to determine how much insulin to give. When kitty is bouncing, the BG numbers are elevated by their defence system. If the bounce stops suddenly and you have dosed based on those elevated numbers you risk low BG.

Curiosity. It appears to me that Tyler may have been started on 2 units of insulin when he was diagnosed. If so that is double the dose we would normally recommend for a newly diagnosed cat. It appears also that the dose has been adjusted upward by 1u at a time....again by far more than we would recommend and making it quite possible if not likely that the ideal dose has been missed along the way.

I also noted a post about the dry foods and that you were considering Dr. Elsey's or Young Again. Your signature indicates Tyler is eating FF Chicken Pate. There is also mention of the Iams Healthy Adult dry food which is definitely high carb and not appropriate for a diabetic cat.

What is Tyler's diet now on a normal day? Is he still getting dry food regularly and if so which type? I am guessing you gave him the Iams the other day when his BG was low.

 

[Diane Tyler's Mom GA]

Hi how are you, as you know we left off at testing Tyler 4-23-19 at 2:30 am and he was 94 which you said was great. 4-23-19. +5 -94. +9- 157. (6:30am . Had to go to the doctor at 7:30 so when I got home is was 9:30 am so I tested him as soon as I walked in
179 at 9:30 am. I feed him his Fancy feast chicken pate. He really only eats about a half of the can, I only give him a little bit of the Iams dry around 3:00 pm for a snack because he just won't shut up lol. First he was on the prescription Hills M/D and vet said he was allowed 2 cans a day. 324 calories a day.He was only eating about a half a can in the am and then the other half in the pm. Never ate 2 cans. He weighed 18 lbs when first diagnosed. But before that he weighed 23 lbs and then I noticed something was wrong , losing weight, eating like a nut, drinking a lot of water and back legs , he was walking like a rabbit. So when I took him in I was surprised he was 18 lbs. She did start him on 2 units like you thought. Then I took him back a week later and she increased it to 3 units, went back a week later, increased to 4 units. Then I started to test at home and follow that sliding scale. He stopped eating the M/D so I switched him to the Fancy Feast. Showed her the Fancy Feast 99 caloris a can so she told me he could have 2 cans a day which would be 198 calories a day right? Well he doesn't even eat 2 cans a day , he eats about 1/2 can in the am and the other can in the pm, sometimes a little more, This is where the dry food comes in . If he is only eating 1 can a day, 99 calories then for a snack I can give him 1/2 cup of the Iams dry which is 200 calories, so that would be a total of 299 calories a day, but he doesn't even eat the whole 1/2 cup. If I did give him the Dr Esleys dry 1/3 of a cup which is 188 calories plus the 99 calories of 1 can of the Fancy Feast that is 288 calories a day. I stopped the Dr Esleys, getting to expensive. Now I just called her to tell her about last night's readings and she in surgery, So I should have given his shot at 30 minutes later which was 10:45 , I haven't done anything yet, I don't know what I should give him because I didn't hear back from her yet. I typed out how you said +2. +3. +4. Etc one reading under the firts reading , then the next one right under it but I see it came out all in one sentence, don't know why it did that when I posted it. Forgot to tell you he's up to 23 lbs again, how I don't know, with the amount of calories he's eating. Vet wants to try to get him down to 16 lbs. I told her and she has no idea why, I definitely think it's because he just lays around all day. His hind legs are not that great, he does walk, uses litter box . If I play with him with a string he will play and plays with his toys, but he has always been a big lump lol. He is just so content guess he's not burning calories. He has a brother Perry and this poor thing has kidney disease and seizures in the past. He's on 2 liquid meds, one is twice a day the other three times a day and now has to be on cerenia because he was vomiting every day. The cerenia is working . I give him a pill every other day . No seizures in about 9 months now. I am just going nuts between the both of them and it's becoming so expensive between the both of them. Perry will only eat dry food so he's on the Hills K/D prescription .Sorry going back to dosing what you are saying is you check the BG mid cycle, so if I test at 9 am, I would check him around 4 pm

 

[MrWorfMen's Mom]

At 179 this morning, knowing how low he went the other day, and with no insulin given last night, I'm absolutely sure the dose has to be lowered considerably but by how much is very difficult to determine. That BG could be elevated to some degree from a bounce from those lower numbers. The dry food you are continuing to feed Tyler may quite frankly be what has prevented him from having a serious hypoglycemic event. If Tyler is hungry in the afternoon, can you give him more FF instead of the dry food? If so, I think you will find that Tyler's BG will come down further and he might not need any insulin at all.
I'd at least experiment with this today and see what happens. His BG is not that high at this point in time and skipping his dose last night didn't result in his BG rising to crazy high levels. Dosing at this point in time is going to have to be done with the utmost caution if you dose him at all.

 

[Diane Tyler's Mom GA]

At 179 this morning, knowing how low he went the other day, and with no insulin given last night, I'm absolutely sure the dose has to be lowered considerably but by how much is very difficult to determine. That BG could be elevated to some degree from a bounce from those lower numbers. The dry food you are continuing to feed Tyler may quite frankly be what has prevented him from having a serious hypoglycemic event. If Tyler is hungry in the afternoon, can you give him more FF instead of the dry food? If so, I think you will find that Tyler's BG will come down further and he might not need any insulin at all.
I'd at least experiment with this today and see what happens. His BG is not that high at this point in time and skipping his dose last night didn't result in his BG rising to crazy high levels. Dosing at this point in time is going to have to be done with the utmost caution if you dose him at all.

Hi yes I can give him more FF for a snack, I appreciate everything , but haven't heard back yet from the vet so right now I haven't given him any insulin at all. I know you can't suggest how much to give, so I guess I will test him in a few hours. Right now he's snoring away. How is your kitty doing, how old is he. Just tested him at 12:30 and it's 96 can't figure this out since he hasn't any insulin since Monday morning at 9 am

 

[MrWorfMen's Mom]

My extra sweet little girl is 8 yrs old now and has been in remission for 7 months. She is a bit of a rare cat in that she also has a secondary condition that made her insulin resistant so getting her into remission took some work, a lot of patience and persistence and was a most welcome surprise.
I'd skip the day shot today even if the vet suggest a dose. Otherwise your schedule will be totally messed up. Try the LC FF for snack this afternoon, get a test 3 hours after a meal and see if his BG is coming down at that after meal test. I would not chance giving him insulin until you figure out if his pancreas is getting back to more normal business.
I'll be out this afternoon but will check back in when I get back around dinner time or just after.

 

[Diane Tyler's Mom GA]

My extra sweet little girl is 8 yrs old now and has been in remission for 7 months. She is a bit of a rare cat in that she also has a secondary condition that made her insulin resistant so getting her into remission took some work, a lot of patience and persistence and was a most welcome surprise.
I'd skip the day shot today even if the vet suggest a dose. Otherwise your schedule will be totally messed up. Try the LC FF for snack this afternoon, get a test 3 hours after a meal and see if his BG is coming down at that after meal test. I would not chance giving him insulin until you figure out if his pancreas is getting back to more normal business.
I'll be out this afternoon but will check back in when I get back around dinner time or just after.

I'm so happy your sweet girl is in remission. Do you mean test after the snack or after his big meal at 9 pm. So let me get this straight , you said get a test 3 hours after a meal , I get what you mean about testing him 3 hours after a snack, no insulin today, yes that would mess me up, or do you mean at 9pm when I usually test, feed him , then don't give insulin at all and test him 3 hrs after that? I'm so sorry I have so many questions and that I am taking up your time.

 

[MrWorfMen's Mom]

You are not taking up my time and there is no need to apologize! I'm here by choice. I'm here because I know only too well how overwhelming and confusing this can all be. I've been down the path and now spend some time here helping others by paying it forward for what I've gained/learned from this remarkable resource and the great community here.

Any time you feed Tyler, his BG will likely elevate slightly right after the meal due to the food he eats however as he starts digesting the food his pancreas releases insulin to allow his cells to take in the glucose they need to function. If his pancreas is working sufficiently, his bloodstream BG should go down by 3 hours after a meal because the insulin from his pancreas allows the fuel from his food (glucose) to get into the cells throughout his body that need nourishment. Doesn't matter really if it's a snack of full meal.....the result should be the same. It just might be a little more apparent after a bigger meal. Insulin is like a key that opens the doors on the body's cells to allow the needed glucose to enter.

 

[Diane Tyler's Mom GA]

You are not taking up my time and there is no need to apologize! I'm here by choice. I'm here because I know only too well how overwhelming and confusing this can all be. I've been down the path and now spend some time here helping others by paying it forward for what I've gained/learned from this remarkable resource and the great community here.

Any time you feed Tyler, his BG will likely elevate slightly right after the meal due to the food he eats however as he starts digesting the food his pancreas releases insulin to allow his cells to take in the glucose they need to function. If his pancreas is working sufficiently, his bloodstream BG should go down by 3 hours after a meal because the insulin from his pancreas allows the fuel from his food (glucose) to get into the cells throughout his body that need nourishment. Doesn't matter really if it's a snack of full meal.....the result should be the same. It just might be a little more apparent after a bigger meal. Insulin is like a key that opens the doors on the body's cells to allow the needed glucose to enter.

Hi ,well the reading of 94 this morning at 2:30 which I told you about without any insulin I did another at 6:30 am and it was 157. I got home from my doctors appointment at 9:30 and tested him and it was 174 then fed him, I did not give any shot because I didn't know how much to give him, remember my vet wanted me to drop him from 6 units to 5 units. At 12:30 tested again it was 96. At 6:00 pm it was 145. So now my vet called me back at 6:30 and I told her what happened and that I skipped his insulin last night and this morning. She was happy I did and said with all the numbers I have given her and his curves she thinks he is in remission for now. So she wants me to do this. Oh I tested tonight at 9:00 pm and it was 140. She told me if his BG is under 200 don't give any insulin, if his greater than 400 give 3 units, then check him a few times. So I was happy with what she said. What do you think about it. I also asked her about the vet that gave her the sliding scale and asked her if the numbers were for a human meter, she said no that it was based on the Lantus insulin. Tyler seemed fine all day and night so far. She wants me to call her tomorrow and give her the BG that I did at 9pm tonight and what it is for tomorrow morning at 9:00 am. So I'm hoping he might be in remission for now. His poor ears are so red because I have been pokeing the hell out of them. I put a dab of Neosporin on them. What's your opinion on what bshe told me to do. I just wanted to let you know what happened. I can't even keep my eyes open , I was up most of the night keeping an eye on him, went to bed at 4 am and got up at 6 am. I will check in with you tomorrow and again thank you

 

[flyingduster]

If I were you I would get rid of all the dry food and feed ONLY the pate food. Let him eat that whenever he’s hungry! And with him eating just the pate food, test his blood twice a day at the usual times you’d give a shot, and see what he is like. Record all the readings you get! He may start to creep upwards and still actually need insulin, but it would likely be a much lower dose than your vet has suggested. Or he might just stay stable in good numbers and be fine! Let’s see how he goes.

Don’t just randomly give three units for one single high number though!!!

 

[MrWorfMen's Mom]

Well I am happy to see that your vet doesn't want any insulin given at 200 or lower but like flyingduster, I wouldn't just suddenly give 3 units because I got one high reading either. And as for the sliding scale, Lantus is NOT used on a sliding scale......it is used with consistent dosing twice daily with doses held for a period of time as it takes a few cycles to see how the dose is working. Unlike Vetsulin which is an in/out type of insulin, Lantus leaves a depot from every shot so doses need to be held to establish the depot for each dose and there is always some insulin working in the body. Lantus is far longer lasting and a gentler insulin.

If you can keep Tyler off the dry food, his BG may drop even further. It will take several days to a week to fully see the effects of stopping the dry food. His BG may drop even further. It appears his pancreas is working when he eats as he is getting drops n BG 3 hours later but his numbers are still a bit elevated at times. If you can, continue to give him snacks of wet food between his main meals as that will help keep him satisfied and hopefully stop the begging.

I'd keep testing him morning and night without insulin for the moment and see what he does. Watch for his numbers rising overall. Try to keep the dry food out of the mix or limit it to the Dr.Elsy's or Young Again only if Tyler insists on having crunchies.

 

[Diane Tyler's Mom GA]

If I were you I would get rid of all the dry food and feed ONLY the pate food. Let him eat that whenever he’s hungry! And with him eating just the pate food, test his blood twice a day at the usual times you’d give a shot, and see what he is like. Record all the readings you get! He may start to creep upwards and still actually need insulin, but it would likely be a much lower dose than your vet has suggested. Or he might just stay stable in good numbers and be fine! Let’s see how he goes.

Don’t just randomly give three units for one single high number though!!!

Hi thanks for your reply, no I would never give him the 3 units for one single high number, at 9 am today he was 140

 

[Diane Tyler's Mom GA]

Well I am happy to see that your vet doesn't want any insulin given at 200 or lower but like flyingduster, I wouldn't just suddenly give 3 units because I got one high reading either. And as for the sliding scale, Lantus is NOT used on a sliding scale......it is used with consistent dosing twice daily with doses held for a period of time as it takes a few cycles to see how the dose is working. Unlike Vetsulin which is an in/out type of insulin, Lantus leaves a depot from every shot so doses need to be held to establish the depot for each dose and there is always some insulin working in the body. Lantus is far longer lasting and a gentler insulin.

If you can keep Tyler off the dry food, his BG may drop even further. It will take several days to a week to fully see the effects of stopping the dry food. His BG may drop even further. It appears his pancreas is working when he eats as he is getting drops n BG 3 hours later but his numbers are still a bit elevated at times. If you can, continue to give him snacks of wet food between his main meals as that will help keep him satisfied and hopefully stop the begging.

I'd keep testing him morning and night without insulin for the moment and see what he does. Watch for his numbers rising overall. Try to keep the dry food out of the mix or limit it to the Dr.Elsy's or Young Again only if Tyler insists on having crunchies.

Hi again, this morning he was 140. I'm going to give him the wet food for a snack like you suggested, thanks for explaining about the Lantus, guess the other vet isn't correct about the sliding scale and Lantus, that's why I'm so appreciative I have you guys to help me out. I always test him am and pm and will let you guys know how it goes. Just have to get him to lose some weight lol

 

[MrWorfMen's Mom]

Getting rid of the dry food will no doubt help Tyler regain his svelt waistline! He's looking good but fingers crossed those numbers come down just a bit more on their own.

 

[Diane Tyler's Mom GA]

Getting rid of the dry food will no doubt help Tyler regain his svelt waistline! He's looking good but fingers crossed those numbers come down just a bit more on their own.

You made me laugh, I am amazed how much you all know about diabetes and everything that goes along with it. About his numbers what exactly do I want to see like for example 110 and no lower than 70.

 

[MrWorfMen's Mom]

Normal range on a pet meter is considered to be 68 to 150 in this community. I've seen numbers start at 72 and go as high as 175 depending on the animal lab being used as a reference. Cats not on insulin can go below 68/70 without any consequence as they will not go hypo unless there is exogenous (injected) insulin in their system. I've seen my girl as low as 58 on her pet meter since she went into remission. The body will regulate itself and only release the insulin the body needs at any given time if the pancreas is working normally. For a cat to be in remission, you want them to remain in the lower/mid normal range the majority of time. The odd higher reading in the higher normal range is fine but any sustained higher readings are cause for more monitoring so if the cat falls out of remission, you catch it early and hopefully are able to treat them to get them back into remission.

 

[Diane Tyler's Mom GA]

Normal range on a pet meter is considered to be 68 to 150 in this community. I've seen numbers start at 72 and go as high as 175 depending on the animal lab being used as a reference. Cats not on insulin can go below 68/70 without any consequence as they will not go hypo unless there is exogenous (injected) insulin in their system. I've seen my girl as low as 58 on her pet meter since she went into remission. The body will regulate itself and only release the insulin the body needs at any given time if the pancreas is working normally. For a cat to be in remission, you want them to remain in the lower/mid normal range the majority of time. The odd higher reading in the higher normal range is fine but any sustained higher readings are cause for more monitoring so if the cat falls out of remission, you catch it early and hopefully are able to treat them to get them back into remission.

Hi thanks you for the information, this afternoon Tyler starts crying for a snack, so gave him some FF and he walked away, then still begging me, he is one stubborn cat. I'll tell you something funny, if I show him a can of air freshener and just shake it, he gets scared and runs away, then doesn't bother me lol, so that's what I do sometimes. I just ordered Dr Esleys clean protein again dry food , so when he starts begging I have it, to tell you the truth when I do give it to him he might only eat about 20 of them and is satisfied.

 

[MrWorfMen's Mom]

LOL! Probably doesn't like the scent you bought! HAHAHA!

While Tyler may only eat 20 pieces of kibble, if it's high carb, it's still going to elevate his BG. Hopefully he'll be happy with the Dr. Elsey's. I know only too well how frustrating it is to have a kibble addict. My girl wouldn't eat wet food at all for the first 7+ years of her life, well into her diabetes diagnosis. She finally got hungry enough one day to pilfer wet food her brother had left in his bowl and I just stopped the dry cold turkey.

 

[Diane Tyler's Mom GA]

LOL! Probably doesn't like the scent you bought! HAHAHA!

While Tyler may only eat 20 pieces of kibble, if it's high carb, it's still going to elevate his BG. Hopefully he'll be happy with the Dr. Elsey's. I know only too well how frustrating it is to have a kibble addict. My girl wouldn't eat wet food at all for the first 7+ years of her life, well into her diabetes diagnosis. She finally got hungry enough one day to pilfer wet food her brother had left in his bowl and I just stopped the dry cold turkey.

Lol about the scent, I've given him the Dr Elsey's before and he does like it, but I will only give him very little if he keeps crying. The rest of the time if he keeps it up through the day before his on meal I just keep shaking the can lol

 

[Diane Tyler's Mom GA]

Hi Mr WorfMen'sMom, Hey Linda I hope this is your name I looked at your profile. I tested Tyler
4-25-19
AM. 146. 9 am
+8- 107. 5:30 pm
+11-1/2. 140. 8:30 pm
No insulin given.
Gave him very little Dr Elsey's dry around 3:00 pm.

 

[MrWorfMen's Mom]

He's not looking bad at all. Ideally it would be nice if his AM and PM pre-shots were a bit lower but they are still in the normal range. Just stay the course for now and keep monitoring. Let's see if he drops down anymore on his own now that he is snacking on the Dr. Elsey's instead of the high carb dry. .

 

[Diane Tyler's Mom GA]

He's not looking bad at all. Ideally it would be nice if his AM and PM pre-shots were a bit lower but they are still in the normal range. Just stay the course for now and keep monitoring. Let's see if he drops down anymore on his own now that he is snacking on the Dr. Elsey's instead of the high carb dry. .

Hi , going to test him at 9 am soon

 

[Diane Tyler's Mom GA]

MrWorfMen's, Hi Linda. Here are some more of Tyler's BG. Without Insulin

4-26-19. Friday
9:00 am - 167
+ 11-1/2 - 113 (8:30 pm)

4-27-19. Saturday
9:00 am - 114
+11-1/2 - 127 ( 8:30 pm)

 

[MrWorfMen's Mom]

Tyler is staying well below renal threshold and within normal by IDEXX lab values standards so far but his BG is still a tad higher than ideal at times. It's tough to coax Tyler into lower range when his mid cycle BG seems to be staying down. Ideally we'd like our kitties to be in the high dark green numbers and he's not quite there. That said, I wouldn't try anything over a drop of insulin and only if his BG is about 175 or higher at pre-shot and you can monitor and steer him if need be to see what that tiny dose does.

The tiniest dose would be a drop of insulin. You can draw up a drop but depressing the plunger in the syringe as tightly as you possibly can and inserting the needle into the pen while still holding the plunger tightly. Once the needle is in the pen, release the plunger and withdraw the needle. There will be a drop of insulin in the needle part of the syringe but it will appear the barrel of the syringe is empty. When you give the shot, depress the plunger once the needle has penetrated the skin and hold it in as you withdraw the needle from Tyler.

Curiosity.....does Tyler have food to eat overnight? I'm wondering if leaving a bit of food out for him to snack on overnight might bring that AMPS down a bit more by prompting his pancreas to pump out a bit more insulin.

 

[Diane Tyler's Mom GA]

Tyler is staying well below renal threshold and within normal by IDEXX lab values standards so far but his BG is still a tad higher than ideal at times. It's tough to coax Tyler into lower range when his mid cycle BG seems to be staying down. Ideally we'd like our kitties to be in the high dark green numbers and he's not quite there. That said, I wouldn't try anything over a drop of insulin and only if his BG is about 175 or higher at pre-shot and you can monitor and steer him if need be to see what that tiny dose does.

The tiniest dose would be a drop of insulin. You can draw up a drop but depressing the plunger in the syringe as tightly as you possibly can and inserting the needle into the pen while still holding the plunger tightly. Once the needle is in the pen, release the plunger and withdraw the needle. There will be a drop of insulin in the needle part of the syringe but it will appear the barrel of the syringe is empty. When you give the shot, depress the plunger once the needle has penetrated the skin and hold it in as you withdraw the needle from Tyler. When you say

Curiosity.....does Tyler have food to eat overnight? I'm wondering if leaving a bit of food out for him to snack on overnight might bring that AMPS down a bit more by prompting his pancreas to pump out a bit more insulin.

Hi when you say the high dark green numbers are you referring to when I look on someone's spread sheet I see on the top in the green area it says 68-99, is that what you mean?If his BG is about 175 or higher at pre shot I'm sorry but I have no idea what you mean when you are talking about depressing the plunger in the syringe, the pen? What pen are you talking about lol, so you are saying when I insert the syringe into Tyler don't pull it out immediately, leave it in the skin and the pull back in the plunger and the take it out of the skin, or do you mean shoot the insulin and then just pull the syringe out, that's what I have always done when I would give him the insulin. Sorry I just don't get what you are saying. Yes I see one of his Am BG was 167 this Friday, but his PM BG was 113. So if I am understanding correctly we want to see his AM maybe 112 or lower and the same for when I test him at night. Or so we want to see 68-99 which I see on others spread sheets that are listed on top of the spread sheets? I don't leave food out for him over night, do you mean leaving some out around maybe 2 am , I would leave a small amount of Dr Elseys , then test him at 8:30 or 9 am like I have been doing. I just put the syringe into the insulin bottle and pull back on it to draw the insulin when I would give it to him, so if I test him and it might be 175 or higher, but still under 200 you are suggesting just try giving him a very small amount of insulin , I use the U-40 insulin syringes that start at 1 unit, so if I had to give it just fill the insulin above the 1 unit mark, I feel like an idiot because I don't know what you mean. So what BG reading am I looking for in the AM and PM without giving any insulin that would be considered that he might be in remission for now. So what you are saying if I give him a small amount of food overnight I'm assuming around 2 am or 3 am or 4 am I might get a lower AM reading at 9 am when I test him

 

[MrWorfMen's Mom]

Sorry my bad. For some reason I was thinking the pen that is available with a number of insulins including Vetsulin. DAH! You are using a vial so just replace any reference to the "pen" with "vial".

All you want to do for a drop dose is basically suck up whatever will go into the syringe without any pulling back on the plunger. You're using the sucking action of the plunger by depressing it as hard as possible, inserting the needle in the vial with the plunger tightly depressed and then letting go of the plunger and removing the needle from the vial. When you inject, you insert the needle, push the plunger like you usually do but instead of letting go of the plunger, keep the plunger depressed as you withdraw the needle from Tyler.

Ideally with Vetsulin, I would aim for getting Tyler to about 90 to 130 if giving him any insulin. You don't want to push his BG too low with extra insulin onboard. If he goes lower than 90 without insulin, that would be great, but the tough part of all this is that none (or at least very few of us) ever have a baseline for our kitties. We don't know what their BG was like before their diagnosis so we don't know if they normally ran in the lower or higher ranges of normal. It may just be that Tyler "normally" ran in a bit higher range.

Re: the food, yes leaving him out a bit of food to munch on during the night might bring down those AMPS numbers. All you can do is try it and see.

 

[Diane Tyler's Mom GA]

Sorry my bad. For some reason I was thinking the pen that is available with a number of insulins including Vetsulin. DAH! You are using a vial so just replace any reference to the "pen" with "vial".

All you want to do for a drop dose is basically suck up whatever will go into the syringe without any pulling back on the plunger. You're using the sucking action of the plunger by depressing it as hard as possible, inserting the needle in the vial with the plunger tightly depressed and then letting go of the plunger and removing the needle from the vial. When you inject, you insert the needle, push the plunger like you usually do but instead of letting go of the plunger, keep the plunger depressed as you withdraw the needle from Tyler.

Ideally with Vetsulin, I would aim for getting Tyler to about 90 to 130 if giving him any insulin. You don't want to push his BG too low with extra insulin onboard. If he goes lower than 90 without insulin, that would be great, but the tough part of all this is that none (or at least very few of us) ever have a baseline for our kitties. We don't know what their BG was like before their diagnosis so we don't know if they normally ran in the lower or higher ranges of normal. It may just be that Tyler "normally" ran in a bit higher range.

Re: the food, yes leaving him out a bit of food to munch on during the night might bring down those AMPS numbers. All you can do is try it and see.

Ok I think I understand, , so just a reminder I'm not giving any insulin at all at this point, my question is without any insulin what would be the highest BG and the lowest BG that would be great. Meaning between what BG readings