? Day 3 on Lantus and glucose levels jumping around

[JoseJose]

New here! Greetings and salutations from Sara (human) and Jose (feline).

Jose was diagnosed last week and our vet started him at 1 unit of Lantus every 12 hours. This is my third day giving him insulin.

The second day I was super happy because he went from a reading of 200 at night down to 120 in the morning.

today (day 3) things are jumping around quite a bit and freaking me out. First off the Alphatrak 3 keeps giving me error messages wasting 5 strips. I finally got a reading at 391 which scared me then retested and got 342. That’s a pretty big gap in numbers for two tests 2 minutes apart! Does anyone have any issues with the Alphatrak not working?

These numbers are a bit concerning if the device is in fact working. I did immediately switch him to 9 lives pate against my vets recommendation of putting him on diabetic dry food - so he hasn’t had any dry food since starting this journey.

I’m a total newbie at this so still trying to understand all the numbers.

My vet recommended doing a curve next week after he is on the insulin for about a week. I have the option of doing it here at home or dropping him off and having them do it at the vets office. At first I thought doing this at home would be the better idea but bow I am questioning my and the devices ability to check his glucose levels.

What would you guys do? Is any of this “normal”?

ANY advice would be greatly appreciated and extremely helpful!

Thanks so much and good to cuber meet you!

Sara and Jose

 

[Ale & Bobo & Minnie (GA)]

You don’t have to use an alphatrack meter. Most of us use human meters since the strips are way more affordable and as you’re seeing now, you’ll go through them pretty fast. Is there any way you can set up a spreadsheet so we can give you dosing advice?

Fluctuations are normal for only 3 days on a cat that is not yet regulated. When are you testing and when are you feeding? Are you testing before each shot on an empty stomach, as in no food for at least 2 hours? All meters have a 10-20% variance so even when you do 2 consecutive tests, you’ll get different numbers like when you got the 391 and 342. We like to say here that a high number is a high number so if you get a value above 300, it doesn’t matter much if it’s 390 or 350. When it gets tricky is with the low numbers. You want those to be accurate since that’s how you decide on dosing. I’d suggest you get a back up meter too but note if you go from a pet meter to a human meter there will be a variance as well so we suggest you pick pet or human and stick with it.

Here is a helping us to help you link that has info on how to setup the spreadsheet. 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.

 

[Ale & Bobo & Minnie (GA)]

Meant to add Jose is a cutie and good for you for not following your vet’s advice and sticking with low carb wet foods. It’s okay to give low carb treats as well like anything that is freeze dried and even regular baked chicken.

And thank you for setting up your signature

 

[JoseJose]

You don’t have to use an alphatrack meter. Most of us use human meters since the strips are way more affordable and as you’re seeing now, you’ll go through them pretty fast. Is there any way you can set up a spreadsheet so we can give you dosing advice?

Fluctuations are normal for only 3 days on a cat that is not yet regulated. When are you testing and when are you feeding? Are you testing before each shot on an empty stomach, as in no food for at least 2 hours? All meters have a 10-20% variance so even when you do 2 consecutive tests, you’ll get different numbers like when you got the 391 and 342. We like to say here that a high number is a high number so if you get a value above 300, it doesn’t matter much if it’s 390 or 350. When it gets tricky is with the low numbers. You want those to be accurate since that’s how you decide on dosing. I’d suggest you get a back up meter too but note if you go from a pet meter to a human meter there will be a variance as well so we suggest you pick pet or human and stick with it.

Here is a helping us to help you link that has info on how to setup the spreadsheet. 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.

You don’t have to use an alphatrack meter. Most of us use human meters since the strips are way more affordable and as you’re seeing now, you’ll go through them pretty fast. Is there any way you can set up a spreadsheet so we can give you dosing advice?

Fluctuations are normal for only 3 days on a cat that is not yet regulated. When are you testing and when are you feeding? Are you testing before each shot on an empty stomach, as in no food for at least 2 hours? All meters have a 10-20% variance so even when you do 2 consecutive tests, you’ll get different numbers like when you got the 391 and 342. We like to say here that a high number is a high number so if you get a value above 300, it doesn’t matter much if it’s 390 or 350. When it gets tricky is with the low numbers. You want those to be accurate since that’s how you decide on dosing. I’d suggest you get a back up meter too but note if you go from a pet meter to a human meter there will be a variance as well so we suggest you pick pet or human and stick with it.

Here is a helping us to help you link that has info on how to setup the spreadsheet. 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.

Thanks for the quick response!

By chance can you tell me what meter you do use? The vet told me the difference between human vs pet meters is the amount of blood needed for a strip. I think they were just trying to sell me a meter hahahaha. I ordered one on Amazon because I had credits that dropped it down in price but I am seeing the strips costing $50 for 50 so that makes things pretty expensive when you are blowing through strips because of errors whatnot.

I also did a test on the unit with the solution and it was above the range on the bottle. It also fluctuated when I did another strip - showing a difference of 12 points!

I am uploading the spread sheet NOW!

Thank you so much for your help from both Jose and I

 

[Ale & Bobo & Minnie (GA)]

I used Walmart’s ReliOn Prime. I think it’s called Premier now and most members opt for that because it’s ranked in the top most accurate and you get 100 test strips for about $17. The meter itself is only about $9 I believe. I think the alphatrack and the freestyle are the ones that require a slightly smaller amount. I started with the freestyle and switched over to the ReliOn. I was worried about it requiring a bit more blood but it was a pretty smooth transition. Vets always push for the pet meter which I think it’s ridiculous because the libre is a human meter and they’re fine with that!

Are you having issues getting enough blood right now? Are you warming up the ears before the test? How is Jose handling it? Are you giving him a low carb treat immediately after to build positive association now matter if it’s a success or a fail?

and did you see my questions about when you’re feeding and testing?

great job on the spreadsheet but I don’t have access. Can you set it to public so we can all see it?

Thank you!

 

[Larry and Kitties]

I used Walmart’s ReliOn Prime. I think it’s called Premier now

No, they are two different design meters that use different strips. Like a lot of products, new and improved products are introduces and the only products not longer made. Arkray makes most of the BG meters for Walmart. Strips for the Prime meter are still bing made and sold. The previous meter was the Confirm and even strips are no longer available.

 

[Ale & Bobo & Minnie (GA)]

No, they are two different design meters that use different strips. Like a lot of products, new and improved products are introduces and the only products not longer made. Arkray makes most of the BG meters for Walmart. Strips for the Prime meter are still bing made and sold. The previous meter was the Confirm and even strips are no longer available.

That’s what I meant. The Prime has been replaced with the Premier. I didn’t mean to say they’re the same meter so thanks for clarifying!

 

[squeem3]

I just did a curve on my cat at home. Many vets charge $$$ to do an all day curve with inaccurate stress-induced results. I use the AccuChek Aviva, a relic from my previous diabetic. The Relion meter is popular but only sold at WalMart and Walmart's web site. I'd be cautious ordering off brands of meter found on Amazon. They may work just fine but the test strips are likely only sold on Amazon so you have to plan ahead or set up a subscription to get more test strips delivered before you run out. With big name brands of meters that are sold in most any pharmacy, you can just drop into any pharmacy and buy more test strips if you forget to order more online.

Not getting enough blood on the test strip is a common reason for a meter error. I think some meters "time out" if you don't get blood onto the test strip within a few seconds and an error message is given once you finally get the test strip with blood in. Tip: wait until you get a nice drop of blood beaded up on the ear before you push the test strip into the meter to turn it on and get it ready with the flashing blood drop icon (this may vary among different brands of meter). Once the meter is ready, touch the edge of the test strip to the blood drop and let it suck it up by capillary action. Set the meter aside to think while you praise the cat and offer a yummy low carb treat.

Normal blood glucose levels is roughly 60 to 150 md / dl. A combo of diet and insulin is what will get a diabetic cat in this range. It may take a bit of time to find the right dose of insulin for your cat so have patience

Here's the hypo toolbox link you should read and print out: https://www.felinediabetes.com/FDMB/threads/jojo-and-bunnys-hypo-tool-box.2354/

There's a Lantus forum here on FDMB with info stickies that you should read through: https://www.felinediabetes.com/FDMB/forums/lantus-levemir-biosimilars.9/

 

[Sienne and Gabby (GA)]

Welcome to FDMB!

Learning how to manage your cat's diabetes is overwhelming. There is so much to learn!! However, it will become routine. We've all been there and empathize with what it's like at the beginning of this journey.

First, Lantus is different than most of the other insulins that are used to treat feline diabetes. It is one of the best insulins in use, though. It takes roughly a week for Lantus to start working. One of the reasons you're seeing Jose's numbers jump around is because if he's like most of our cats, there's no way to truly know when he was in the early stages of developing diabetes. His body has likely become accustomed to being in higher than normal blood glucose levels. As a result, when the insulin brings his numbers into a more normal range, his body overreacts and numbers jump back up. We refer to this as a "bounce." It's a normal response -- annoying, but normal.

Whatever meter you pick, it will be fine. As others noted, many people here use the Relion meter given that the strips are the least expensive around. There's no way to really know if the numbers from the AlphaTrack are goofy or not. If you get another meter, just be aware that the numbers on the AT tend to be calibrated a little differently from a human meter. You can't really directly compare the numbers.

If you wouldn't mind, can you set the permission on your spreadsheet so that anyone with the link can view it? Right now, I'm getting an error message.

 

[JoseJose]

I used Walmart’s ReliOn Prime. I think it’s called Premier now and most members opt for that because it’s ranked in the top most accurate and you get 100 test strips for about $17. The meter itself is only about $9 I believe. I think the alphatrack and the freestyle are the ones that require a slightly smaller amount. I started with the freestyle and switched over to the ReliOn. I was worried about it requiring a bit more blood but it was a pretty smooth transition. Vets always push for the pet meter which I think it’s ridiculous because the libre is a human meter and they’re fine with that!

Are you having issues getting enough blood right now? Are you warming up the ears before the test? How is Jose handling it? Are you giving him a low carb treat immediately after to build positive association now matter if it’s a success or a fail?

and did you see my questions about when you’re feeding and testing?

great job on the spreadsheet but I don’t have access. Can you set it to public so we can all see it?

Thank you!

I used Walmart’s ReliOn Prime. I think it’s called Premier now and most members opt for that because it’s ranked in the top most accurate and you get 100 test strips for about $17. The meter itself is only about $9 I believe. I think the alphatrack and the freestyle are the ones that require a slightly smaller amount. I started with the freestyle and switched over to the ReliOn. I was worried about it requiring a bit more blood but it was a pretty smooth transition. Vets always push for the pet meter which I think it’s ridiculous because the libre is a human meter and they’re fine with that!

Are you having issues getting enough blood right now? Are you warming up the ears before the test? How is Jose handling it? Are you giving him a low carb treat immediately after to build positive association now matter if it’s a success or a fail?

and did you see my questions about when you’re feeding and testing?

great job on the spreadsheet but I don’t have access. Can you set it to public so we can all see it?

Thank you!

As of now I have just been writing this stuff down. Good to know the number jumping is somewhat normal. Today he was at 130 before feeding and Jose has been a bit more responsive (less tired) so that did make me feel a lot better.

I am going to roll in over to Walmart today to look into the human meters. Once all of this meter mess is resolved is when I figure it’s time to getting the numbers plugged into the sheet.

Thanks again for all of your help!

Jose and Sara

 

[JoseJose]

I used Walmart’s ReliOn Prime. I think it’s called Premier now and most members opt for that because it’s ranked in the top most accurate and you get 100 test strips for about $17. The meter itself is only about $9 I believe. I think the alphatrack and the freestyle are the ones that require a slightly smaller amount. I started with the freestyle and switched over to the ReliOn. I was worried about it requiring a bit more blood but it was a pretty smooth transition. Vets always push for the pet meter which I think it’s ridiculous because the libre is a human meter and they’re fine with that!

Are you having issues getting enough blood right now? Are you warming up the ears before the test? How is Jose handling it? Are you giving him a low carb treat immediately after to build positive association now matter if it’s a success or a fail?

and did you see my questions about when you’re feeding and testing?

great job on the spreadsheet but I don’t have access. Can you set it to public so we can all see it?

Thank you!

The issue I am having is getting the vein in his ear. The lancets have actually pierced his ear a couple times but I think this bothers me more than Jose - he has been such a trooper! Luckily he LOVES the hair brush so I usually groom him a bit then rub his ear to get them warmed up. His annoyance seems to be more about me trying to find the vessel and pushing on his ear a bit to get some blood out.

I have read bigger lancets may help but considering they have pierced him a few times I don’t know how I feel about going with a larger lancet.

What size do you use?

 

[JoseJose]

No, they are two different design meters that use different strips. Like a lot of products, new and improved products are introduces and the only products not longer made. Arkray makes most of the BG meters for Walmart. Strips for the Prime meter are still bing made and sold. The previous meter was the Confirm and even strips are no longer available.

I am ON IT! This info is super helpful! Thank you so much!

 

[squeem3]

I have read bigger lancets may help but considering they have pierced him a few times I don’t know how I feel about going with a larger lancet.

What size do you use?

I use 28 gauge lancets with the device. Are you using the lancet device or freehanding the lancet? If you're using the device and it has multiple dept settings, adjust to a lower setting so the lancet doesn't poke through the ear.

You're not aiming directly for the vein. The teeny space between the vein and the edge of the ear is enough. If you hit the vein and get a gusher, no big deal. Get the blood onto the test strip and firmly apply a tissue to the area to stop the bleeding.

 

[JoseJose]

This is so so SO helpful! Thank you so much!

The vet techs made it look so easy - nope

Jose is feeling much better today. He even was even playing with “the bird” and I and jumping around! Later on he laid next to me on the couch and did his bizarre nibbling/chewing on my fingers (one of his weirdo ways of showing affection).

We also ordered a Nova Max glucose meter that has tiny blood prick test strips and are $20 for a pack of 100.

Thanks again for all your help