Newbie - 3 weeks in - advice?

Status
Not open for further replies.
She tested 336 as expected (due to syrup and dry) She is still licking syrup off her face :oops:
Thank you for all your help again.
 
Jena4277 said:
She tested 336 as expected (due to syrup and dry) She is still licking syrup off her face :oops:
Thank you for all your help again.
Click to expand...

Not really a surprise, Between the syrup and dry food combined with the expected bounce after that low number this all looks perfectly normal. With having gone so low earlier this causes a "bounce" which means stored glucogen (glucose) in the body is released as the body tries to deal with the low glucose levels. This can cause higher numbers for a few days, so don't be concerned about high numbers at this point. You can keep doing some testing and see how Abby is doing without any insulin
 
Thanks. Not to open up a different can of worms, but she isn't pooping regularly. On the dry, her poops were firm at least 1-2 times a day (yikes). I always put mineral oil in her food twice a day bc of her arthritis pain She hasn't pooped since the night before last. I have seen her go in litter and not produce anything and then come out. I also read freeze dried treats absorb water from the system which can cause constipation. I have been giving her a lot of those...I will decrease that. She pees normally. No signs of distress there. I will keep an eye out. I read pumpkin is good. Will look into that too. I doubt she will eat it! Lol
 
Jena4277 said:
Thanks. Not to open up a different can of worms, but she isn't pooping regularly. On the dry, her poops were firm at least 1-2 times a day (yikes). I always put mineral oil in her food twice a day bc of her arthritis pain She hasn't pooped since the night before last. I have seen her go in litter and not produce anything and then come out. I also read freeze dried treats absorb water from the system which can cause constipation. I have been giving her a lot of those...I will decrease that. She pees normally. No signs of distress there. I will keep an eye out. I read pumpkin is good. Will look into that too. I doubt she will eat it! Lol
Click to expand...


I used pure pumpkin...not the pie pumpkin. My one kitty would eat it just as it was...he thought it was a treat. The other kitty was not too keen but if I put a bit of tuna juice on it she would eat it.
 
Jena4277 said:
Thanks. Not to open up a different can of worms, but she isn't pooping regularly. On the dry, her poops were firm at least 1-2 times a day (yikes). I always put mineral oil in her food twice a day bc of her arthritis pain She hasn't pooped since the night before last. I have seen her go in litter and not produce anything and then come out. I also read freeze dried treats absorb water from the system which can cause constipation. I have been giving her a lot of those...I will decrease that. She pees normally. No signs of distress there. I will keep an eye out. I read pumpkin is good. Will look into that too. I doubt she will eat it! Lol
Click to expand...
Try adding extra water to all her wet food meals. Hydration can help constipation and many cats don''t drink much out of a water bowl. Plain canned pumpkin works for some, as does Miralax for others. There's a product called Natural Moves people buy online that has helped many kitties too.
 
Tuxedo Mom said:
I used pure pumpkin...not the pie pumpkin. My one kitty would eat it just as it was...he thought it was a treat. The other kitty was not too keen but if I put a bit of tuna juice on it she would eat it.
Click to expand...
She went #2 but it was very soft, not quite liquid, but runny. I'm going to hold off on any measures and see if her body regulates.

I just tested 533- you told me not to worry about high numbers right :(

ETA hoping its from the dry she ate before...god I'm so worried every minute.
 
Jena4277 said:
She went #2 but it was very soft, not quite liquid, but runny. I'm going to hold off on any measures and see if her body regulates.

I just tested 533- you told me not to worry about high numbers right :(
Click to expand...


After the low and all the syrup/HC she had it may take a day or so for the glucose readings to level out. I remember one time I slurged on licorice...major sugar content...my sugar levels were through the roof for about 12 hours...and I am NOT diabetic...let's see how she is in the morning.
 
Could also be the lack of pooping influencing that test too. Try not to get too upset about a couple high numbers :bighug:. You did very well today, Jena!
 
I tested for the first time today a little late to give her body time to process things. It's 354. Hopefully tomorrow or day after tomorrow will be lower number...trying to give her time...
 
I would do another test today tonight and see how the numbers are. She has come down from the 553 to 354 with no insulin so that is positive. In order to know whether stopping insulin is the correct approach let's see how Abby does through the day. If her system is working on its own she should be able to regulate back to normal numbers within a short period of time.

Fingers crossed that she can regulate her numbers on her own.
 
I would do one around the time that the usual PM test was done. You can leave about 2 hours without food before you do it so that the number is not too food influenced. Then another test about 3 hours after that test and feeding (of course no dry or HC food). If her body is functioning correctly the numbers should be continuing to come down.

There is always a possibility that she may need a very small bit of insulin for a short period of time, but let's see how the numbers today work out.

images
 
It went up to 402. I'm going to see what tomorrow is like too before I jump to conclusions. I want to keep testing her in the morning to see what her numbers are off insulin. That will maybe give me a better idea of how much she can handle.
 
Last edited:
@Tuxedo Mom @Yong
Hello! So off insulin she is holding steady in the 300s, hitting 4 at some points. This is what I'm thinking: I don't want to have her be this way for a prolonged period of time, so what if I start to admin a micro dose of .25 2x a day doing what I can with the syringe and colored water to make dosing consistent and see how she responds?
 
I think that sounds good :), I think I suggested before you may need to try that 0.25U dose since 0.5 pushed her too low. Definitely don't want her staying in those 300's for much longer. If the 0.25U still puts her lower, she may do better on a longer, gentler insulin. Let's see how this works though :cat:.
 
@Yong @Kris & Teasel
Can you look at my spreadsheet? Ive been shooting her .25 since Saturday. She is holding steady testing AM and PM in the 300s. Today I couldn't test throughout the day bc I was at work. I'm thinking to increase to .5 tomorrow. Ideally I would like her in the 100s, nothing lower at her nadir. It gives me peace of mind. OR should I wait until Friday to decide to get better numbers? I will be home tomorrow to get some numbers throughout the morning for whichever dose I give. I'm really nervous about the increase but I think it's the right call. Can I have your opinions? I ordered 1/2 mark syringes to make dosing easier.
 
You could try the 0.5 u experiment because you'll be home to monitor. Make sure you have high carb food on hand or else honey or karo syrup in case you need to boost her BG. You should also have a good supply of test strips. These experiments are the way we pin down the good dose range - stressful but necessary.
 
Fully stocked.
Do you really think she will plummet that much based on her nadir in the 200s the past two days? Will one day be enough for an "experiment?" Just asking advice/thoughts from experience. Thanks!
 
Also - some diabetic kitties will never be in that perfect 60-120 range. What is a good range to reach for? Less than 200? Less than 300? What is a "decent" range for diabetic kitties who are touchy responding to insulin?
 
Jena4277 said:
Fully stocked.
Do you really think she will plummet that much based on her nadir in the 200s the past two days? Will one day be enough for an "experiment?" Just asking advice/thoughts from experience. Thanks!
Click to expand...
It's really hard to say. The 0.5 u gave you a lime green a week ago but it might not do that now. I use the word experiment to mean a dose decision for which you have limited data on response. When you're in the early days of building up your SS reference data base every dose change is an experiment. Once you have a ton of data and have learned your kitty's patterns from it you can be a little more confident in your ability to predict the most likely response. However, cats make it their mission to surprise us. Some kitties are easier to predict than others.

The decent numbers range you're aiming for is PSs in the low 200s and nadirs in the low 100s or high double digits. Vetsulin is known to cause steeper dives so we recommend dosing that leaves a bit of a cushion at nadir, so maybe low 100s is a better goal.
 
I agree with what Kris has said, including the nadir not go much lower than 90 with Vetsulin, so low 100's does sound better for peace of mind and she'll still be in a healing number :). How long after her PM shot do you go to bed? Most members it's between +2 and +4, so sneaking a before bed test can let you know where she's headed overnight too. I can't go to bed without testing my boy. Although I have passed out a couple times on the couch trying to stay awake for his before bed test lol. He is usually right near me and if he needs me, he will paw at me to wake up ;).

Big reason for the before bed test is that most kitties run lower over night for an idiopathic reason :cat:.

Here's an excerpt from a document on the forum for what numbers you're looking for, in general terms:
Q6.1. What is regulation?

A6.1. There are different definitions of regulation. As hometesting becomes more common, we've been getting a better understanding of what cats and their humans might be capable of. Janet & Fitzgerald propose the following "regulation continuum":
  • Not treated [blood glucose typically above 300 mg/dl (16.7 mmol/L), poor clinical signs]
  • Treated but not regulated [often above 300 (16.7) and rarely near 100 (5.6), poor clinical signs]
  • Regulated [generally below 300 (16.7) with glucose nadir near 100 (5.6), good clinical signs, no hypoglycemia]
  • Well regulated [generally below 200-250 (11.1-13.9) and often near 100 (5.6), no hypoglycemia]
  • Tightly regulated [generally below 150 (8.3) and usually in the 60-120 (3.3-6.7) range, no hypoglycemia, still receiving insulin]
  • Normalized [60-120 (3.3-6.7) except perhaps directly after meals -- usually not receiving insulin]
There may also be an extra category of "mostly above 300 (16.7) but with good clinical signs" which occurs with some cats who are getting insulin. We don't know why it happens, but such a cat probably should not be considered to be regulated. On the other end of the spectrum, it is possible for a cat who is not getting insulin to have blood glucose as low as 40 mg/dl (2.2 mmol/L) on a home glucometer. If you have a non-diabetic cat, try testing her with the same meter to get a safe comparison figure.
 
@Tuxedo Mom @Yong
Hi again- she isn't breaking 200s with .5, so I'm going to try .75. Her AM and PM tests are still in the 300s which I don't like. I swear it's like she has built an immunity to insulin LOL
I haven't been home to test as often as I would like bc work is starting up again soon, but the numbers are still in the mid 200s around nadir.
 
Jena4277 said:
@Tuxedo Mom @Yong
Hi again- she isn't breaking 200s with .5, so I'm going to try .75. Her AM and PM tests are still in the 300s which I don't like. I swear it's like she has built an immunity to insulin LOL
I haven't been home to test as often as I would like bc work is starting up again soon, but the numbers are still in the mid 200s around nadir.
Click to expand...


The problem is without getting some mid cycle tests at night you don't know where the numbers went during those cycles. If possible try to get a +3 or +4 test in the evening. If Abby is dropping lower at night this can cause bouncing into higher numbers for a day or two later. She may very well need an increase but an evening mid cycle would be helpful. You want the numbers to drop into lower ranges, but you also want to make sure they don't drop too low. Especially with a faster acting insulin like Vetsulin you want to know where the numbers are especially before each shot and during the cycle.
 
Tuxedo Mom said:
The problem is without getting some mid cycle tests at night you don't know where the numbers went during those cycles. If possible try to get a +3 or +4 test in the evening. If Abby is dropping lower at night this can cause bouncing into higher numbers for a day or two later. She may very well need an increase but an evening mid cycle would be helpful. You want the numbers to drop into lower ranges, but you also want to make sure they don't drop too low. Especially with a faster acting insulin like Vetsulin you want to know where the numbers are especially before each shot and during the cycle.
Click to expand...
Ok - will do tonight.
 
I agree with Mary Ann. I think many of us are big advocates of before bed evening tests to see where kitty is going. Most tend to run lower overnight for an idiopathic reason. Also, just checking, you are not rubbing the injection site after giving the shot, correct? It is very possible she'll need another increase but we want her to stay safe too. Helps you stay sane :smuggrin:
 
Yong said:
I agree with Mary Ann. I think many of us are big advocates of before bed evening tests to see where kitty is going. Most tend to run lower overnight for an idiopathic reason. Also, just checking, you are not rubbing the injection site after giving the shot, correct? It is very possible she'll need another increase but we want her to stay safe too. Helps you stay sane :smuggrin:
Click to expand...
She just tested 290 at +3.5. Should i bump her up to .75 starting tomorrow?
 
As long as you will be able to do a few tests during the cycle tomorrow it looks like an increase may be in order for the morning. However if possible a +5 or +6 test tonight might be in order just to be sure. Abby seems to like having a later nadir than the "usual" for Vetsulin. She has shown some lower numbers at +5 or +6 in the past.
 
Tuxedo Mom said:
As long as you will be able to do a few tests during the cycle tomorrow it looks like an increase may be in order for the morning. However if possible a +5 or +6 test tonight might be in order just to be sure. Abby seems to like having a later nadir than the "usual" for Vetsulin. She has shown some lower numbers at +5 or +6 in the past.
Click to expand...
@Tuxedo Mom @Yong She dropped 100 pts at +5.5 to 192. I think .75 might be ideal for her. I will check at +4 and +6 tomorrow as well as at night.
 
Jena4277 said:
I do check it to make sure I didn't miss. I guess it's a soft rub? Why, is this bad?
Click to expand...
Rubbing/massaging, any noteable pressure on the injection site can effect how fast the insulin is absorbed. Actually makes it absorb faster, which is not ideal for an already somewhat fast acting insulin like Vetsulin.

As for increasing her to 0.75U, what was she this morning? You won't want to increase on a bounce number :)
 
@Tuxedo Mom @Yong just tested her. She tested 420 - the highest she's been in 5 or so days, so I decided not to increase today thinking it was an odd bounce. I don't understand why that may have happened, it is quite defeating seeing red on my spreadsheet.
 
Although (Jennie) should have said Abby :banghead: went down into blues last night it was not an overly large drop. The drop was just over 50% which is what can be expected with Vetsulin. Huge drops are more likely to cause a bounce into high numbers. Because Jennie has a history of DKA if her numbers stay on the higher ranges it may be time to increase. If possible try to do a few extra tests during this cycle....+2 +4 +6 would show how well the dose is bringing down the glucose levels.

Is she still only eating the DM wet food? If so make sure she is not eating the DM Savoury Slects as it is a bit higher in carbs. With Jennie's numbers in the higher ranges it would be prudent to be testing the urine for ketones. If you don't already have Ketodiastix test strips they can be purchased at most pharmacies.
 
Last edited:
Tuxedo Mom said:
Although Jennie went down into blues last night it was not an overly large drop. The drop was just over 50% which is what can be expected with Vetsulin. Huge drops are more likely to cause a bounce into high numbers. Because Jennie has a history of DKA if her numbers stay on the higher ranges it may be time to increase. If possible try to do a few extra tests during this cycle....+2 +4 +6 would show how well the dose is bringing down the glucose levels.

Is she still only eating the DM wet food? If so make sure she is not eating the DM Savoury Slects as it is a bit higher in carbs. With Jennie's numbers in the higher ranges it would be prudent to be testing the urine for ketones. If you don't already have Ketodiastix test strips they can be purchased at most pharmacies.
Click to expand...
Was this meant for me? Just making sure.
 
Tuxedo Mom said:
Sorry I called Abby Jennie by mistake :banghead: That's what happens when I post before I finish my :coffee::coffee:
Click to expand...
Ok just making sure.
Yes she eats pate only.
It is difficult for me to get readings so frequently. Today I will just grab a +6 because I overslept. It is pretty exhausting and it does take its toll on me more often than not.
I can do more frequent testing tomorrow if u think it's necessary or should I just go with an increase? I don't have many days left where I can stay home all day so it's really getting down to it here and I have to make a decision...
I'll test for ketones too. I have the strips.
 
If you are not able to test much today then wait until tomorrow to do the increase and get some extra tests in then. That way if this is a bounce today it should have settled down and you will be able to monitor how an increase works. Depending on how the readings go in the next few days it might be worth considering a longer acting gentler insulin such as Lantus or Levemir. They tend to have a longer duration and gentler drops, "usually" with less variance during the cycle. They are more expensive than Vetsulin, but there are reputable places you can buy them much cheaper. Some kitties do well on Vetsulin and some don't. Something to keep in mind.
 
Tuxedo Mom said:
If you are not able to test much today then wait until tomorrow to do the increase and get some extra tests in then. That way if this is a bounce today it should have settled down and you will be able to monitor how an increase works. Depending on how the readings go in the next few days it might be worth considering a longer acting gentler insulin such as Lantus or Levemir. They tend to have a longer duration and gentler drops, "usually" with less variance during the cycle. They are more expensive than Vetsulin, but there are reputable places you can buy them much cheaper. Some kitties do well on Vetsulin and some don't. Something to keep in mind.
Click to expand...
Sounds good thanks.
 
@Yong @Tuxedo Mom
In a cat with FD, is it "normal" to have glucose in the urine on a test strip? Abby is not regulated yet, and I know there are factors like when she's last ate etc...trying not to freak out. I forget to use the test strips I bought bc I am so focused on blood testing. I'm going to test ketones and glucose again the next time she pees, but this last glucose strip was very high. I assume unregulated diabetic cats who have >300 like she does for prolonged period of time will have high spillage of glucose...can I assume this correct? (Didn't test ketones yet - I grabbed wrong stick!)
Her bg at PM +3.5 was 225. Really hoping to remain optimistic but this dark stormy rain cloud isn't breaking anytime soon...:(
 
On the urine test strips you will see glucose showing when the glucose levels are higher. With the numbers that Abby has been showing it would be totally normal to see a higher glucose reading on the urine strips since her glucose readings are in the higher end.. What shows on the ketone panel of the strip is of greater concern than the glucose strip. Ideally you don't want to see any more than a trace..especially with a kitty that has been through DKA before.

Looking at Abby's numbers today a dose increase to 0.75 units would be in order for the morning...unless for some strange reason she shows a low preshot number. Trying to find a good dose can be very frustrating sometimes. :bighug::bighug:
 
Tuxedo Mom said:
On the urine test strips you will see glucose showing when the glucose levels are higher. With the numbers that Abby has been showing it would be totally normal to see a higher glucose reading on the urine strips since her glucose readings are in the higher end.. What shows on the ketone panel of the strip is of greater concern than the glucose strip. Ideally you don't want to see any more than a trace..especially with a kitty that has been through DKA before.

Looking at Abby's numbers today a dose increase to 0.75 units would be in order for the morning...unless for some strange reason she shows a low preshot number. Trying to find a good dose can be very frustrating sometimes. :bighug::bighug:
Click to expand...
Definitely increasing tomorrow. Thank you so much. I don't know what it was like for you when you were just starting but I am so overwhelmed and you both really help keep me sane. I am imagining the worst all the time - why is she itching, is her breathing too fast? Is she eating Enough? Is she peeing or drinking normally? - I am driving myself super crazy and the worst is I am alone in this and I feel so helpless sometimes...my entire summer I have felt like a prisoner in my house unable to travel, go out anywhere... Is that awful? I love my cat so much- I can't even describe the agony I feel when she is in pain or distress...the amount of tears I have shed for her...but I have lost a part of me in this process and I'm just so discouraged and constantly afraid of what the next day holds. I live in constant unwaiverif fear that I am going to screw up and lose her or that I won't know what it looks like if she ever needs help and it will be my fault...
I am taking one day at a time but each day is getting harder than the last. I don't know how you guys got through it. I pray to God that there is a light at the end of this unending tunnel...
Sorry to rant...it's one of those days. Thanks for reading ... :(
 
Please take a minute to step back and BREATHE!! Dealing with feline diabetes is definitely a hard road to walk and the ups and downs can be very very frustrating. When I first started I don't think I slept more than 3 hours each night so I added sleep deprivation to my already frazzled out state of mind. We all love our furbabies...that is why we are all here...to try to do the very best we can for them. What you are feeling is so normal for FD petparents..but we need to keep our sanity and health while we are dealing with our furbabies. I swear the first 2 weeks after my first one was diagnosed I had more notes on EVERYTHING...I would regularly count the respiration rates while following him around to catch every pee and poop he did. Everyone I knew was sure I had gone off the deep end...totally normal :smuggrin:

The more you learn...the more you test and watch for patterns..the more you learn and understand and the more empowered you become. Treating FD is not a linear process..there are many many ups and downs and all we can do is document and do the best we can. The whole point that you are doing what you are doing and learning everything you can shows your commitment and how much you care. Some people never get to the point of learning more and just give up on their kitties..sad to say, but it happens.

I have had so many mental breakdowns over the time I have been dealing with FD, but with the help of people on FDMB and learning as much as possible it has helped me keep (some of) my sanity:rolleyes: Taking it one day at a time is sometimes the best way to approach it because it CAN be so overwhelming sometimes. Sometimes we need to be kind to ourselves...a nice glass of wine and/or some fine chocolate can sometimes boost up our sagging spirits.

turndown-wine-chocolate.jpg


Hang in there...you are doing a fantastic job!! :bighug::bighug::bighug:
 
Tuxedo Mom said:
Please take a minute to step back and BREATHE!! Dealing with feline diabetes is definitely a hard road to walk and the ups and downs can be very very frustrating. When I first started I don't think I slept more than 3 hours each night so I added sleep deprivation to my already frazzled out state of mind. We all love our furbabies...that is why we are all here...to try to do the very best we can for them. What you are feeling is so normal for FD petparents..but we need to keep our sanity and health while we are dealing with our furbabies. I swear the first 2 weeks after my first one was diagnosed I had more notes on EVERYTHING...I would regularly count the respiration rates while following him around to catch every pee and poop he did. Everyone I knew was sure I had gone off the deep end...totally normal :smuggrin:

The more you learn...the more you test and watch for patterns..the more you learn and understand and the more empowered you become. Treating FD is not a linear process..there are many many ups and downs and all we can do is document and do the best we can. The whole point that you are doing what you are doing and learning everything you can shows your commitment and how much you care. Some people never get to the point of learning more and just give up on their kitties..sad to say, but it happens.

I have had so many mental breakdowns over the time I have been dealing with FD, but with the help of people on FDMB and learning as much as possible it has helped me keep (some of) my sanity:rolleyes: Taking it one day at a time is sometimes the best way to approach it because it CAN be so overwhelming sometimes. Sometimes we need to be kind to ourselves...a nice glass of wine and/or some fine chocolate can sometimes boost up our sagging spirits.

turndown-wine-chocolate.jpg


Hang in there...you are doing a fantastic job!! :bighug::bighug::bighug:
Click to expand...
Thank you :cat:
 
Well said, Mary Ann! I was definitely in "hawk mode" with Maury his first couple months. Crying when I kept getting black and red numbers. I still take his respiratory rate once in a while because of his heart. Still trying the pulse but its not super easy to find on him lol. Lots of fur :D

I was dosing blindly too due to a back injury, which I currently have done again. But I have decent data on him so I'm saving my strength for his PS tests. Those few minutes of sitting are very painful but I won't blindly dose him again.

Don't worry about the glucose strips, it will spill over if her bg is over like 250. Just focus on ketone strips. You want negative and no more than trace. Adding extra water to her meals and getting her slow increases of insulin should help keep them at bay. Definitely try to go do something for yourself between the 12 hours. :)
 
Yong said:
Well said, Mary Ann! I was definitely in "hawk mode" with Maury his first couple months. Crying when I kept getting black and red numbers. I still take his respiratory rate once in a while because of his heart. Still trying the pulse but its not super easy to find on him lol. Lots of fur :D

I was dosing blindly too due to a back injury, which I currently have done again. But I have decent data on him so I'm saving my strength for his PS tests. Those few minutes of sitting are very painful but I won't blindly dose him again.

Don't worry about the glucose strips, it will spill over if her bg is over like 250. Just focus on ketone strips. You want negative and no more than trace. Adding extra water to her meals and getting her slow increases of insulin should help keep them at bay. Definitely try to go do something for yourself between the 12 hours. :)
Click to expand...
@Tuxedo Mom @Yong The PM reading is 282. I usually shoot above 300. Should I reduce to .5 or not shoot? Keeping in mind .5 didn't lower her that much, but that overnight kitties go lower like you said....needing some advice.
 
Status
Not open for further replies.
Back
Top