is Insulin working - question

Hi All,
Bailey has been on Insulin for one week now. 1u b.i.d. I have only been successful 3 times in doing the home BG testing but have noticed that each reading has dropped. No major jumps but a steady downward movement. So my question... Is this the way it is supposed to go? A steady downward movement? I just want to make sure things are going the way they should be as I don't go back to the Vet until the 31st for her first Lab BG test since starting last week. I have updated my SS should any of you Seasoned Care Givers out there wish to take a look at her exact BG numbers. Thanks in advance for any peice of mind any of you can give me.

Looking forward to Christmas not only because it's CHRISTMAS but because I get to go from giving Bailey her Prednisolone (steroid) b.i.d. to giving it s.i.d. ! She will love that Christmas present!

 

Lantus is dosed based upon the nadir, lowest point in a cycle which for most is around 5-7 hours after injecting. It can be earlier or later. So it’s hard to say what this dose I’d doing. Please read the yellow sticky on lantus on the lantus board. Have you only gotten a few tests because you aren’t drawing blood when you try or some other reason?

Also why is Bailey on prednisolone? How old is she? Other illnesses? Over under or good weight? It would be good to add more info to your signature.

I just went to look and found your last condition. It’s good to link them. I’ll read it now but a quick look showed it answers some of my questions.

http://www.felinediabetes.com/FDMB/threads/1st-attempt-at-bg-test-failed.223175/#post-2497535

 

Here’s info on testing.

http://www.felinediabetes.com/FDMB/threads/testing-and-shooting-tips.85113/

 

Bailey and I are still very new to this. I test in her paw pad as she has a "thing" about her ears. Despite me wrapping her in a blanket throw to do the test she is a squirmer. The failed tests thus far have been not enough/too thick sample. We are getting better as I just got another successful test this morning.
She is on Prednisolone for her Anemia. The Vet did point out that, due to the steroid, controlling her blood sugar will be tricky.

I will be adding Bailey's specifics to my signature soon. I am somewhat new to forums as well.

I was mainly wondering if the steady lowering of her sugar levels was on track. As of now I am not changing her dosing unless my vet tells me too. In the future as both Bailey and I get more experienced at this then I may make adjustments to her doses myself.

I believe her starting BG when she was first diagnosed was in the 600's. I use a human BG meter so it tests lower but as you could see it is still in the "diabetic" ranges.

She has gained weight back and currently is as an ideal weight having been obese prior to the onset of her condition.

Thanks tiffmaxee for your help!

 

More later but one thing I want you to know is human meters test HIGHER, not lower. It’s what most of us use here. Are you giving a treat after a poke, even if not successful? I used freeze dried protein and it really helped. Max had a special one for fluids as well and it made tests, fluids, and meds so much easier to give.

Every cat is different in how they respond to insulin. If left high too long they can develop insulin resistance making it harder to regulate. I hope soon testing gets easier. Then when you trust the experienced here we will be able to help guide you. For most it’s a marathon. For the lucky remission happens. Max never reached remission but was tightly controlled. I think years of chronic pancreatitis is the reason why.

What is the cause of the anemia? Hang in there. It will get easier.

 

Don’t human meters generally read lower? Isn’t that why the take action number for human meters is 50 and its 68 for pet meters?

 

S

Yes you are right. Sorry. What I meant to say is he’s actually higher. Brain freeze.

 

Thanks again for help. I just had another successful BG test. We're getting Better. I don't know the cause of her anemia. Just that the steroid is helping and she didn't need a blood transfusion like the vet thought she might initially need. As for the human vs pet meters I looked into it and found that the human meters show lower readings in the -100 range and the higher numbers (I believe) are closer to the pet meter readings. But it is good that it reads lower where it matters and you can jump on treating/avoiding a possible Hypo situation. My vet actually agreed with this!

Her overall BG numbers are on a steady decline with each test so I am guessing the insulin is slowly working. Bailey is looking and acting better. And so far not hating me for all of the poking and prodding.
Thanks again and Merry Christmas!

 

You are correct that the meters read closer when on the high side. The same is true of low numbers. It’s good prednisolone is helping with the anemia but sure would be nice to know the cause. Kidney numbers are good?

Merry Christmas.

 

I think I will have some questions the next time I am at the vet. I have no idea what her kidney numbers are. My visit on the 31 will only be with a tech whom will test her BG. I will ask if I can get a copy of her medical records. I know I should be entitled to them.

 

When you put the number on the spreadsheet (SS), if you only put a number and leave out the words "mg/ul", each cell will be color coded. Like the color coded ranges you see at the top of the SS.

 

I learned from having sick cats that were not treated properly to get copies of all labs sent to me. My vet does it automatically now.

 

Thanks Deb & Wink I have fixed my SS. I didn't know that. Like I mentioned in a previous post I am not a SS person. Give me a good ol' Pen and Paper.

I will most certainly ask for Lab Results for my records... and piece of mind. Thanks!

 

Thumbs up on making that little change on the SS and kudos on getting the SS set up in the first place.

I'm with you on the pen and paper method. I don't have a diabetic cat anymore, but I still track the weight and water intake for my little CKD kitty Dancer on paper. Never have set up a spreadsheet to do that even though it would be really simple.

Have you thought about updating your signature? When you do, it actually gives us helpers a place to get a quick look at some basic information, like what insulin you are using and what food you are feeding. It will actually attach that signature info in all your old posts too. Handy dandy.

How to do that is here. Editing Your Signature and Profile. Just click on the blue highlighted area and it will take you to the instructions on how to do that update.

Hope you are having a good holiday. Power is back on here after losing it for a few minutes this morning.

 

Signature updated finally. No luck with either of my BG tests on Christmas. I believe I was angling the probe wrong as it wasn't getting enough blood/sample too thick. I made sure to go in at 90 degrees this morning and got the sample with no problem. Her number is up a bit from last reading but I think it's because she got a few extra Christmas Treats.

 

Like any new skill, it can take time to get better at it.

You have mentioned that the blood is too 'thick'. Have you made yourself a little 'rice sock' to heat in the microwave for a bit? Put a bit or rice or any type of dried grain or bean or pea in the toe of an old sock, tie off the end to keep the rice inside. Heat in microwave for a bit until warm but not hot. Should feel warm on the inside of your wrist. Test on yourself for 20-30 seconds to see how long it takes your microwave to heat the rice sock up to a good temperature.

If you use that rice sock on the ear to warm things up, the blood flows more easily. Especially this time of year, when it is cold, the blood flow is slower to come out after you poke.

Also, if you do 2 quick pokes close together with the lancet at that outer capillary edge of the ear, it can help to form a bigger blood drop.

Different lancets may help also to get a bigger blood drop. With a smaller number, the diameter size of the metal part of the lancet is larger so can help getting blood.. You might want to try a 28 gauge lancet if you are using a 30- 33 gauge lancet.

Some people like to freehand the lancet. Some people like to use the lancing device. With the lancing device, you can select the depth the lancet will poke. Flat on the ear with the lancing device and something firm behind the kitties ear helps when you are poking the ear.

Need to see some mid-cycle numbers in the +3 to +7 hours after preshot test to tell how well the Lantus insulin is working. Hope the testing gets easier for you with some of these tips.

p.s. Thanks for the info in your signature. That will really help all of us going forward.

 

The "Not Enough/Too Thick" is just the generic message my meter gives. I don't do Ear testing. I test in the Paw Pads. I have started rubbing the pad a bit before lancing with a 26 gage lancet. I usually stab twice. If I don't (like this morning) I get that generic message. grrrr. I haven't done any mid-cycle testing yet until I see the vet and she lets me know how Bailey is doing.

Thanks again for your help.

 

That 'rice sock' can be used on the paw pad too, to get the blood flowing better. Seconding that "GRRR" feeling when you get that "not enough/too thick" message on the meter. I'd hate to see those messages too.

Hope Bailey's vet check shows the anemia is better.

Even before the vet check, you should be seeing improvements with the diabetes. Normal pooping, normal amounts of pee instead of huge clumps in the litter box, preening (a cat grooming themselves more), Bailey feeling well enough for playing, purring, good appetite. All of these are positive signs.

Lantus dose adjustments, if needed, are based on the nadir or lowest BG levels. That usually happens between +3 and +7 with Lantus, so without mid-cycle tests, your vet will have no idea how low the current dose of insulin is dropping Bailey and if a dose adjustment is needed.

The tests before giving insulin are showing that Bailey's BG (blood glucose) is high enough to give insulin, but when is onset? how long is the duration? are BG levels dropping below 100 and then bouncing back up before the next pre-shot?

 

Wendy -

I don't want to add to your stress regarding testing. However, with Lantus, dosing is based on the lowest number in the cycle. You need to get at least 4 tests per day -- your pre-shot tests so you know it's safe to give a shot and a test somewhere closer to the middle of the cycle.

I would also talk to your vet about the error readings you're getting. Not enough blood is a common problem in the beginning of learning how to test. The "too thick" reading is not an error message I've ever heard of. I do wonder if it's in any way related to the anemia.

 

Bailey’s current dosage is 1u b.i.d. This is the starter dose that my Vet prescribed and I do not change it myself per her instructions. I cannot do “in between” tests as I am at work during those times.

The “not enough/too thick” is the generic message my meter gives when there is not enough blood on the test strip. I have since discovered the angle at which I was going at the blood drop was wrong and it was not able to “sip it up”. I am doing much better now.

Tomorrow I will be doing Bailey’s first blood glucose curve. I am doing it at home as the time I administer the first dose is 3 hours before the clinic opens and they want her brought in 1 hour after her first dose. So wish me luck!

 

Good luck! A treat with each test after the PS( pre-shot test) would be a nice bribe to hopefully gain some cooperation from Bailey.

How often are you testing? We usually suggest every 2 hours for a 12 hour cycle.

 

Yes on the treats! She loves the freeze dried chicken. She has actually been coming to me when it is time to test her I believe just for the treats!

Per my Vet’s instructions I will be giving her normal PS test followed by food and then her 1u Lantus. I then check it 1 hour later. From that point I am to check it every 2 hours till her next dose. Should her reading fall below 100 I am to check every hour. If this happens I will have my “Emergency Hypo Kit” at the ready! Thank You to this forum for preparing me for that!

 

Curve you are doing sounds good!

Darn, didn't see the new spreadsheet tab for 2020 in Bailey's SS. Instructions and the why's are in this post.

 

Thanks!
Hopefully will have time to update Bailey’s SS when I get home from work today. As Bailey was only just diagnosed at Thanksgiving I will be leaving the small amount of 2019 on the same tab as 2020:

 

Yeah, I did that for my Wink and just renamed the tab to say 2012-2013. Then did a new tab for each year.

 

Thanks Deb! I will do that.

 

Bailey's SS is updated finally. Tomorrow when I do the Curve I will update it with each reading throughout the test.

Thanks Again Everyone! Fingers crossed for a successful test tomorrow.