Looking for advice on beginning home testing

Hello everyone,

I've read a few articles the past week or so and read lots of advice on message boards but wanted to get an idea on how to begin home testing for my situation. My cat (Joey) was diagnosed with diabetes about 10 days ago and has been on 2 units of insulin twice a day since. I'm at work right now so I don't have the insulin type in front of me but I believe it's Lantus with the U100 syringe. I have a ReliOn Micro glucose meter. Vet gave him prescription dry food which I've since learned is a no no so I want to be able to switch him to wet food (bought Friskies Classic Pates) very soon since he's still peeing a ton so I'm guessing the current dosage isn't correct. I work 8 - 5 Mondays thru Fridays so I'm curious when the best time is to begin home testing. Thanks

Marty

 

Welcome to you and Joey! I'm going to give you an avalanche of info here - just warning you! It includes the basic testing schedule we recommend and a bunch of other useful stuff. Take your time going over it and p0st any questions you have here.
.................................................................................................................................................................................................................................

It would help us if you set up your signature (light grey text under a post). Here's how:

• click on your name in the upper right corner of this page
• click on "signature" in the men that drops down
• type the following in the box that opens: kitty's name/age/date of diabetes diagnosis/insulin you're using /glucose meter you're using/what he eats/any other meds or health issues he has.

Another thing that will help us help you now that you've started BG testing at home is to set up a spreadsheet like the one we use here. We can all see it and look at it before offering advice: http://www.felinediabetes.com/FDMB/threads/fdmb-spreadsheet-instructions.130337/

.................................................................................................................................................................................................................................

Here's the basic testing routine we recommend:

1. test every day AM and PM before feeding and injecting (no food at least 2 hours before) to see if the planned dose is safe
2. test at least once near mid cycle or at bedtime daily to see how low the BG goes
3. do extra tests on days off to fill in the response picture
4. if indicated by consistently high numbers on your SS, increase the dose by no more than 0.25 u at a time so you don't accidentally go right past a good dose
5. post here for advice whenever you're confused or unsure of what to do.

.................................................................................................................................................................................................................................

Here's an explanation of what we call "bouncing". It explains why a kitty's BG can go from low to sky high:

1. BG goes low OR lower than usual OR drops too quickly.
2. Kitty's body panics and thinks there's danger (OMG! My BG is too low!).
3. Complex physiologic processes take glycogen stored in the liver (I think of it as "bounce fuel"), convert it to glucose and dump it into the bloodstream to counteract the perceived dangerously low BG.
4. These processes go into overdrive in kitties who are bounce prone and keep the BG propped up varying lengths of time (AKA bouncing).
5. Bounce prone kitty repeats this until his body learns that healthy low numbers are safe. Some kitties are slow learners.
6. Too high a dose of insulin can keep them bouncing over and over until the " bounce fuel" runs out and they crash - ie., have a hypo episode. That's why we worry so much about kitties that have had too high a starting dose prescribed by the vet and the owner isn't home testing.

.................................................................................................................................................................................................................................

Here are some tips on how to do urine ketone testing (VERY important of BG is high and kitty isn't eating well!):

• put the end of the test strip right in his urine stream as he's peeing
• slip a shallow, long handled spoon under his backside to catch a little pee - you don't need much
• put a double layer of plastic wrap over his favourite part of the litter box and poke some depressions in it too catch pee.

Most test strips have to be dipped and allowed to develop for 15 seconds before viewing the colour change in very good light.


I hope this helps!

 

Thanks! The more information in one spot the better.

I've added the signature to the best of my knowledge for now and I will update once I get home.

I will look into getting a ketone tester as well. I've read a little bit about it but still don't know a ton about ketones, so that will be the diabetic reading subject for the day.

 

You can certainly buy a ketone meter but testing urine ketones is quite easy and a lot cheaper, especially if Joey isn't shy about his litter box habits.

 

How many days of home testing are recommended before beginning to alter diet and insulin?

 

It's wise to spend a few days at the current diet and insulin dose to get some practice testing BG, logging it in the spreadsheet, seeing his response to the insulin at the dose you're giving and what he's eating. That'll be your baseline. So, how about from today/tomorrow through the weekend?

 

Sounds good. I'm a little nervous but hoping he obliges with the testing. He was a stray a month ago and he's usually pretty friendly but he's done some biting and scratching the last couple of days. I'm hoping that doesn't mean a more serious issue is going on.

 

Lots and lots of desensitizing exercises first: choose your testing/injecting spot and take him there several times a day, stroke his ears, talk softly, give a low carb treat and let him go. Repeat multiple times over the next couple of days. Get that in place before you try a test. Freeze dried meat treats are good for this - Pure Bites is one brand.

He might be feeling unwell from unregulated diabetes. Don't lose hope.

This might help:
www.felinediabetes.com/FDMB/threads/hometesting-links-and-tips.287/

 

Hi Marty,
Nugget is newly diagnosed as well. I just tested her for the very first time today at home (I am home sick- prob from the stress). I work M-F too, and commute an hour-90 minutes to get home.

We are also using Lantus, U-100 syringes, 2 units, 2x a day. I have an AccuTrak2 meter. Diet is changed as well- Nugget used to eat Purina One dry, we have since switched to Castor and Pollux Organix and Pristine.

My schedule so far has been:
Human wake up- 4:45 AM
Cat breakfast- 5:30 AM
AM Insulin- 6:00 AM
Cat dinner- 5:30 PM
PM Insulin- 6:00 PM.

Now that I can test at home, I am aiming to test her as soon as I wake up, which gives me about 45 minutes before I feed her to see what her BG looks like. During the week this is not horrible to do since I am awake anyway... but I am still trying to get used to it for the weekend. I don't mind the 4:45 AM wake up for work- but doing that on the weekends???? It is wreaking havoc with my own sleep schedule.

 

Many people have a "btb" (back to bed) routine on days off - cat duties then more shuteye.

 

I understand the stress! Hopefully things will become normal eventually. He hasn't even been introduced to our other cats yet except for escaping his room once and attacking the other ones. Not a great start to things.

 

I have been trying to go back to bed... sometimes I fall asleep again, most times I don't. I am not the best sleeper to begin with and have been trying so hard to get my own routine to sleep better! Oh well. I am sure it will get easier as time goes on.

 

i have a link to a video in my signature showing how I test my cat cc at home that you might find helpful. let us know if you need any other help with it.

 

Thanks. I'll be taking notes when we get ready to test him. Just bought some Pure Bites treats for him so going to do some dry runs the next few days

 

It's been a couple of days of trying to get Joey used to having his ears touched. It's getting slightly better, but he's very active when he knows it's feeding time so I haven't been able to keep him still for very long. Does anyone have any tips for keeping him still long enough to warm his ears up?

Also, I read somewhere that if the cat is getting Lantus then they should be tested a while after they eat instead of before. Does that sound right?

 

Actually, that isn't correct. For all insulins we recommend a pre shot test where all food has been taken away at least 2 hours before. That's to make sure the pre shot BG number isn't inflated by food. The reason for this test is to make sure it's safe to give the planned dose. If there's a possibility the BG might drop more than usual after an insulin injection we often recommend another BG test about 2 hours after the injection. This test can sometimes be a predictor of a bigger BG drop to come if the BG is significantly lower at this time.

 

OK, I thought it sounded different from everything I had read but thought maybe different insulin types required different testing times. Good to know. Thanks.

 

Hi, been a long time since I've logged in. Haven't updated Gus's spreadsheet and I forgot how to get to it now. I kept all his data in a notebook because it was easier for me. He has been off insulin since June, 2016, strict food controlled diet.
Wanted to respond to the question about warming Joey's ear. Gus was difficult to handle when he was first diagnosed, so I had to put him in a multi-level cat cage so I could test him and monitor him for the first few weeks. (he was a feral cat that we trapped and brought inside and he always avoided contact.) I gathered my supplies and got everything ready, then I would carry him into the small bathroom wrapped in a towel, sit on the floor with him in front of me between my legs, his head facing the closed door, his face pressed up against the crack at the door jamb (as most people know, when a door is closed, all they can think about is getting out of that door). I rub his ear with the palm of my open hand (one hand supporting his head, the other massaging the opposite ear) in a gentle but brisk circular motion, and then massage the ear for several minutes until it was warmed up. I usually massage both sides of his head at the same time with the palms of my hands to distract him from trying to escape (still do this when I test him, but he is a bit more tame now and actually lets me pick him up and put him on the feeding cabinet to do his testing). I still turn him to face away from me so he is facing the wall so he can't run, and I hold his body down with my forearms while I massage his ears and quickly maneuver the cotton balls into position and test. (I have to be quick because he still doesn't like to be held.) I use a thick cotton ball on the inside of his ear to stabilize it and I use the Relion brand lancet pen with the blue lancets. (came with the kit) If his ear isn't warm enough, I sometimes have to "milk" the ear to get the drop, but sometimes I have had to poke him more than once, when he's wiggly. With the amount of testing I had to do on him, and with his feral cat temperament, taking it slow wasn't an option. Now he actually enjoys my company and he comes up and lays on my feet when I'm curled up on the couch. He's not the type of cat that will sit still and let you hold a warm compress against his ear. The massage is the only thing that works on him.

 

Thanks. I think my best bet at first might be the towel trick. He's just too wiggly right now to even attempt it.

 

So we've tried home testing Sunday night, Monday night and this morning and haven't gotten any blood yet. He's been real good and has been sitting still for the most part, I think it's just our technique. We've been rubbing his ear to try to get the blood out but think we'll use the rice sock tonight. Also we might manually prick his ear instead of using the lancet, just to see if we get better results.

Looking for advice regarding his eating. Sunday night he threw up a little, and yesterday morning he started eating less of the RX dry food. He was at 1/2 cup, but he's been gradually eating less. Yesterday morning he ate 3/4 of his portions, so we gave him half of his Lantus dose (1 unit instead of 2) as the vet instructed. Last night he ate half of his portion so we didn't dose him at all. This morning he ate about 1/4 of his portion. Since we haven't gotten blood yet, what can we do about changing his diet? I have Friskies Classic Pates ready for him once we get some ample testing completed, but I don't know what to do in the meantime. Anyone have any advice?

 

Be sure to use a 26 or 28 gauge lancets