284 reading, hasn't had insulin since 8 pm last night

Hi,
I apologize if there is a post for this, but I can’t find it if there is...
I used the instructions to copy and create a spreadsheet...
I went out and got all of the supplies...
I watched the videos on how to get blood...
I poked the cat a good 7 times before I got blood and got a reading, I went to record it and realized I don’t know how to understand the spread sheet... I don’t know what AMP means... or the numbers, (although I assumed at first that they were +1 hr after insulin, +2 hrs after insulin... etc, but then I wondered where you put the reading for a test done before insulin was given...) anyway, can someone please point me to any instructions for understanding the spreadsheet and how to record numbers?
Thank you so much!

 

http://www.felinediabetes.com/FDMB/threads/understanding-the-spreadsheet-grid.156606/

AMPS is the test you get before the morning injection. PMPS is the test you get before the evening injection. You always want to check before an injection to be sure the blood sugar is high enough to "shoot".

Yep, the + hours are how many hours after the injections.

 

Testing is a process of practice and patience for both cat and bean! Not many of us are successful at first, but it gets easier. The ears "learn to bleed" because as you poke, more capillaries form to heal the "injury". Here are words of wisdom by Chris & China (GA) that might help:
*********
Here's something I wrote up for others for testing...maybe it'll help you too!

It can be really helpful to establish a routine with testing. Pick one spot that you want your "testing spot" to be (I like the kitchen counter because it's got good light and it's at a good height....it also already blocked 2 escape routes due to the wall and the backsplash) It can be anywhere though...a rug on the floor, a table, a particular spot on the couch...wherever is good for you.

Take him there as many times a day as you can and just give his ears a quick rub and then he gets a yummy (low carb) treat. Most cats aren't objecting so much with the poking..it's the fooling with their ears they don't like, but once they're desensitized to it and learn to associate a certain place with the treats, they usually start to come when they're called! Or even when they hear us opening the test kit!

You also have to remember...you're not poking him to hurt him...you're testing him to keep him safe and understand what's going on inside his body. There's just nothing better than truly understanding what's going on inside your kitty's body and with this disease, the more knowledge you have, the more power you have against it. The edges of the ears have very few pain receptors, so it really doesn't hurt them. Also, if you're nervous and tense, it's going to make your kitty nervous and tense too. As silly as it might seem, try singing! It forces you to use a different part of your brain!

It's also important to make sure his ear is warm. A small sock filled with a little rice and microwaved or a small pill bottle filled with warm water (check temp against your wrist like you would a baby bottle) works well

For new kitties, using a heavier gauge lancet is also really helpful. A 25-28 gauge lancet pokes a bigger "hole" than a 31-33 gauge lancet does, so look for "Alternate Site testing" lancets that are usually a lower number

Finding the right "treat" will be a great help too! Freeze dried chicken, bonito flakes, little pieces of baked chicken...whatever low carb treat you can find that he really enjoys will help him to associate the testing with the treat! China's Achilles heel was baked chicken, so I'd bake a piece, chop it into bite sized pieces, put some in the refrigerator and freeze the rest to use as needed. It didn't take long for her to come any time I picked up the meter!

************

 

Thank you!

 

Thank you for all these good tips. I'll try to find a treat Giles will eat... she's really finicky
I tried again this morning to get a reading before giving her her shot... again, poked her numerous times until she started swatting me with her claws... and I gave up. It was so disheartening. I think I didn't have her ear warm enough, I was rubbing it instead of using something warm, and we were also sitting on the floor of the laundry room where my husband had locked her and her sister for the night. So she was probably already annoyed and ready to get out of that room... I haven't found a good place to do it yet because the lighting in our house is so bad, but I'll give it another shot tonight.
Tomorrow I'm staying home from work and going to attempt a full glucose curve to take in to the doctor on Monday. So hopefully I'll get the hang of it tomorrow. But after so many misses this morning... I feel like I'm the one who's traumatized!

 

I'd like to add to Lou's tips.
>It does get easier, we promise. Because of a medical condition I learned how to test and inject in very low light with the full trust of both my sugar cats. Cats really do know you're trying to help. They're not "aloof" as many people claim, they are trusting souls. http://www.felinediabetes.com/dear-mom.htm
>The testing spot. The routine is so important and establishes a trust. Testing my first cat on the floor near a window seemed like a good idea until one day I saw all the micro blood splatters from where he had shaken his ears. I obviously wasn't very good at it back then. I spread out a bath towel on the kitchen table, good traction for the cat and great lighting. I'm not kidding about this, I would thump the chair and Nigel would just jump up knowing what was about to happen.
>Rubbing the ears, exactly as Lou described. Noah wasn't much for having his ears played with and using a bigger lancet meant first time-every time. I never used a lancet device, found it much easier to do it free-hand. It's not for everyone.
>"you're testing him to keep him safe". I spread all my hardware out first so both cats knew what was coming. They know this might hurt and have the option to run into the basement. And yes I sung too, https://www.poetryfoundation.org/poems/46950/hush-little-baby-dont-say-a-word
>Diabetes never directly killed any cat but it can lead to other complications. This will only bring you closer to your cat and strengthen the bond you already had. I got lucky with both of mine, never came close to a HYPO episode and both were beyond trustful. Although there was that time in the first week (I used to scruff shoot) when Nigel ran into the basement with a syringe hanging from his neck.
>Vacations. Something we'll talk about later, much later.
Remember that we've all been where you are now, we're all volunteers and there's no such thing as a stupid question. Feel any better?

 

Thank you, I'm really hoping tomorrow (when I attempt the full curve) I'll get the hang of it. I'll try the counter idea, and see if I can find a snack tonight...

 

If you aren't yet terribly successful at testing yet, you can try a different method other than the curve (getting a test every 2 hours for 12 hours).

You will always need to get a pre-shot test. Then, as you can, test at different "plus hours" in the cycle. Fill in the blanks in the puzzle. Do you work and are out of the house all day? Then you can perhaps get a test before you leave for work, or in the event that it would take too long and he doesn't want to cooperate, get a test when you walk in the door. A before bed test is good, it's harder to get tests in the night, but they are valuable information. Then on weekends/days off get more mid-cycle tests. Then you can get an idea of when Giles' nadir or lowest blood sugar level happens. Lantus dose is based on the nadir, not the pre-shot levels.

Please visit the Lantus forum and read the stickies at the top of the page.

Giles is on 3 Units twice a day, and that is a fairly high dose of insulin for a cat. Now, a cat needs what a cat needs, and I'm not criticizing, but I am wondering if he started at that dose or has it been increased along the way. Sometimes, if you aren't testing and seeing how low the BG is going during the cycle between shots, the dose can cause a "bouncing effect". Essentially the dose does lower the BG, but the cat thinks "oh no, I'm not used to that, something bad must be happening" and the liver releases hormones and stored sugar to restore what has become "normal". Then the BG has bounced back up to the higher level again. He gets tested at the vet, which can also raise BG levels via stress and the dose gets raised. Perpetuating the cycle...but the "bounce fuel" can run out and that can cause a hypo.

Please keep working on getting the pre-shot tests, and some mid-cycle tests so we can see what's going on with Giles.

Here is a document that can be very helpful and I would like you to read through it:

New? How you can help us help you

 

Ok, I will try to start from the beginning. In an earlier post I mis-spoke, I had thought it was March-ish when Giles was diagnosed. I was wrong. It was January. She was found to have elevated BG and they recommended starting her on 1 unit of Lantus. There was a misunderstanding at this point where my husband (who was handling the appointments) thought the doctor said "come back if it gets worse". He missed the part where they said (and i only know this from reading the report i now have in hand) bring her back in 2 weeks for a BG curve. Fast forward to May when we had run out of Lantus. Husband calls and they tell him to bring her in for a curve. She goes in and the numbers are 8:30- 399 mg/dl base 1 U insulin given, 10:30am 386 mg/dl, 12:30 418mg/dl, 2:30 396 mg/dL, they upped the prescription to 2units. and asked him to come back in 1-2 weeks. We returned 2 weeks later, the cat was too worked up and they could not get accurate results. 8am 445mg/dl, 10 am 499 mg/dl, 12pm 487 mg/dl, 2pm 471mg/dl. Even though they said they didn't have an accurate reading, they recommended upping to 3 Units. They asked us to come again in 2 weeks. At this point my husband was ready to throw in the towel rather than pay for another 400 dollar glucose curve. So we continued to give her the insulin at the dose prescribed until it ran out. We had enough refills that this did not happen until about 1 week ago. We ran out and my husband decided to let nature take its course. After a couple of days he changed his mind due to my daughter's affection for Giles and I called the vet to request another refill. The doctor said she would not refill unless we brought the cat in for another glucose curve. That's when I started doing research and found you all. My husband won't pay for another curve, on top of which we weren't thrilled with the fact that the last curve failed and yet the raised the dose and told us to bring her back again. So last night I got the ReliOn Prime and managed to get a reading 3 hours after her pm dose of 3 units. This morning i tried to get another reading and failed, and just now i attempted to get another reading before her evening dose and failed again. I finally managed to get blood and something went wrong with the reader and it just kept throwing error messages. The cat is traumatized and trying to claw the hell out of me when i get near her. I tried bribing her, petting her, singing to her, everything to calm her down but it doesn't help that i have a 4 and 6 year old outside the door screaming bloody murder at each other. So it looks like the only time i'm going to get a reading is if they go to bed and i manage to calm her down enough to try again. but that would either mean doing it post insulin injection, or delaying insulin injection... but i can't wait every night to do that or i won't be able to give her the shot before i leave for work at 6 am. so i don't know what to do, i am failing at this and i only just began. i can't even describe how i feel like the whole thing is a losing battle.

 

My dear lady, my goodness. You are not failing, not by a long shot. I am sure you feel like whale crap right now, and do not know where to turn or in which direction to turn to.

Thank you so much for taking the time to spell out the events from diagnosis to now. I am going to tag some more experienced members to read through and advise.
@Sue and Luci
@MrWorfMen's Mom
@Marje and Gracie

Perhaps they can make some recommendations that will help. Since you haven't been testing and really don't know what the lowest BG in the cycles are, the dose might be too high.

Meanwhile, take a deep breath, fix a cup of tea or coffee, hug the kids and the cat. If you can, boil a piece of chicken breast or thigh (if Giles likes that), cool and cut into small pieces and when you are both in the kitchen, give her a piece, a head pat or a pet, and on your way.

Perhaps you can take a few minutes to talk to the kids, tell them simply that Giles needs some help and show them the meter, strips etc..show them how you test by using yourself so they know this isn't a catastrophe, and that Giles doesn't yet know this isn't awful either. The more calm you can provide will go a long way to being calm yourself, and Giles too. The kids screaming on the other side of the door doesn't help them, you or Giles much. Kids are pretty amazing when they can understand what's going on and maybe help. They could perhaps be special helpers at feeding time, or be in charge of special brushing or petting time for Giles, to make her feel better.

Is there another vet or vet clinic that you can go to? If you can get Giles' records..and they are yours, you paid for the tests and the visits, you could take them to a new vet and tell them you just need a new Rx right now, and you want to shop around for prices. Get the written Rx and look into getting less expensive Lantus via Marks Marine Pharmacy in Canada. There are ways to save money on effective diabetic treatment I never knew about. I am with your husband on the cost of a glucose curve, $400 seems way over the top. But they got you if you need a new Rx, right? With Marks Marine you can get your refills w/o having to provide a new Rx, or so I have read.

So, no more pulling out your hair....that leaves bald spots and people at work will wonder. You have managed this far, now you have FDMB and a whole bunch of people that previously pulled out their hair over this stuff that will be here for you.

 

There is Lantus and some other supplies available in the Supply Closet that you might be interested in. I am not certain how the Lantus would have to be packaged to be shipped to you, but perhaps we can get some input on that from others??
http://www.felinediabetes.com/FDMB/threads/meter-lancets-lantus-syringes-test-strips-food.220585/

 

Oh my word! You've really been through it haven't you.

Well, first things first: There is free Lantus available right now on the forum's 'For Sale or Free' Board: http://www.felinediabetes.com/FDMB/forums/supply-closet-for-sale-or-free.15/ Please go there and contact some of the people who've posted there and work out something to get some Lantus to get started without having to try to get another script from a vet. There's someone there who's just lost their cat and are offering all of her supplies. Perhaps that'll help calm DH down a bit..

As for the rest of the testing efforts - yep, you need to get the kids involved and help them to understand that poor Giles is very sick and needs this medicine. And you can't give her the medicine unless everyone is very, very quiet so that you can get this little tiny test to see if she is well enough to get the medicine. Yes, I agree with Idjit's mom - you need to give them a task and test yourself to show them how it all works...it doesn't hurt Giles and it's going to help her feel much much better...

Last but not least - I had a heck of a time getting my Luci to sit still while I tested her. I used the kitchen island counter, placing a towel on top and all of her supplies close at hand - then my DH and I would try to hold her still while one of us did the poking - the first time I tried I poked her ear five times...no blood...finally got a drop and dropped it in the floor...got it on the strip from the floor...OMG I was a wreck...we all were...and then I read on this forum that they wanted me to do that MULTIPLE TIMES A DAY! I just about cried...I could not believe that I was going to have to go through THAT several times a day! I then realized what the alternative was...she was going to die if I couldn't help her...I became determined, very determined to help her - not matter how hard or how much it was going to take...I had to give this my best effort!

After a while..she started to get calmer...sometimes I'd put her on the towel, pet her an give her a treat...mess with her ears...no test...just let her go....then the next time, using my warmed rice sock, we'd try again...repeat, repeat, repeat...now this was over the course of weeks to months...I think it as about 2-3 months and then one day she just sat there...and let me test her all by myself...
soon we had a rhythm...she was laying on the test towel waiting for me!! I took pictures of that! I could NOT believe that she KNEW when it was test time and often would get up there on the towel...ready and waiting...now she purrs and sits and waits for me to poke her in the ear...she still gets food or a treat with every test...

So get Giles favorite treats, find a place thats comfortable and quiet - let the kids watch - I'd suggest not the laundry room where she's been locked up...soon you'll have this down pat and will be an expert at the testing thing...

You do not need to get a curve at your vet...I'm appalled that your vet - or any vet would insist on doing expensive curves on any cat and then raising the dose after ONE curve! Insulin takes time to build up....and that's a pretty big dose for a cat..unless Giles is huge! Try to get several tests but also - let Giles have a break now and then on the testing towel...so it isn't making the impression of 'oh, THIS is the torture place - and out come the claws'...try to change her thinking to 'Oh, this is the place where I get a treat'...well...she'll think to herself, I've got her right where I want her...

Find some baby sized socks and fill a bunch of them up with rice, so it's about the size of a golf ball, twist into a knot at the top to keep the rice in then...warm in microwave for 15 or 20 seconds, put it on the inside of your wrist - feel good? Use to support her ears...if too hot, then use less time next time...rub her head and back with the warm sock...just so she gets used to the feel and smell of it. This is all new and frightening to her and everyone involved...give the kids a sock to hold on to ... they're kinda fun just to have in your hand...so everyone will feel like they've got an important role in helping Giles feel better.

I hope this is helpful to you...I know it's a lot to take on...and you're getting stressed and everyone in the household is stressed...and no one, especially Giles understands what's going on or why...it takes time...try to breathe deeply and sing a little song - Giles senses your distress...and will become more upset in response to your mood...so try to relax...this will all come together...I promise

 

Thank you all for the help, I want to give a quick update before getting kids off to school and then replying individually....
Due to several unsuccessful attempts last night, her shot was delayed til 8 pm.
This morning at 7:35 I finally got a successful reading, 145. But that seems so much lower than previous readings from the doctor or the one I got, so I’m afraid to giver her the 3 unit shot at 8 am. (Also, as feared, I am off schedule now and this won’t be sustainable on work days.)

 

I would suggest you do not give any insulin this morning.

Perhaps today would be a good day to focus on getting Giles relaxed and used to testing with the suggestions I made yesterday....that's a lower number than you've seen...it would be good to see how low he'll go without any more insulin...

Let's see what the rest of the days looks like.

 

Will do. I’ll update the sheet to say 0 dose and update readings

 

I'd also like for you to post on the Lantus forum, since you're using Lantus - you could start today - your first post would be like this:

10/18 Giles AMPS 145 - New member...

Copy and paste the url from this post as the top line like this:

http://www.felinediabetes.com/FDMB/threads/145-amp-give-shot.220553/#post-2461665

and then you can chat a bit about Coming from the Main Forum and that you're not shooting this morning since you're having a rough time testing and that this i the lowest number you've seen, introduce yourself and Giles...

Others will respond and you'll get lots of help and support there. I'll be looking for your posts there...we'll get Giles going to better health

 

Ok will do, quick update here though, it’s been 2 hours since last reading. I just got an awesome reading experience but a high number 325... it went up a lot in 2 hours... continue to hold off on insulin dose?

 

Yes, I would. Like you mentioned previously - if you give it to her this late it won't work with your work schedule and 2) I think it's more important to get some tests today to see how she's doing on his current dose...I'm very concerned about the 3 units your vet recommended...

How much does Giles weigh? I think it's best to start conservatively, get more tests...look at her eating habits...a few higher days aren't going to hurt him unless she has had a history of DKA...

Could you add to your signature: Female

I think I've been calling Giles a 'he' - uh oh...

 

Ok, I'll hold off. Just wanted to check. I'm going to aim to keep doing tests every 2 hours, because the vet requested i do this curve and bring results in on Monday in order for her to continue prescribing the medicine...
I don't have her exact weight because we don't own a scale, but she is 10 pounds or under... The doctor was going to weigh her, check her over and then compare our machine results to see if they were close.

 

Did you look on the Forum For Sale/Free section? You could get your next supply of insulin from them...

I'm hoping your vet will give you the Rx based on the curve, but personally I would not give as much as she says to give...

As you'll see when you become more familiar with this forum, there are many of us who do not discuss our cats diabetes with our vets...

Vets unfortunately - not all of them - but most of them - have had very little training about Feline Diabetes and know very little about it. There are some who are willing to learn more about FD but to be honest, they are few and far between. I hope you'll take a few days to get your feet under you here and become more comfortable with doing this with the help of this forum. The collective experience of this group is far far more than any one vet has been able to achieve. See you on the LB&L forum soon

 

Totally agree

 

Will she let you test her paw pad?? I started that way first
I just wiped off paw with wipe and u have to use the lancet pen for the pad

https://www.google.com/url?sa=t&sou...FjATegQICBAB&usg=AOvVaw2_FVWYVCTc-yDcoekhUc1A

 

I have reached out to someone selling some insulin, thank you!

 

So glad to hear this, I was hopeful that you would be able to continue with the insulin therapy while you are getting a handle on testing and dosing. Hooray!

 

Great job with the curve today!!! A huge congrats

 

It can be stressful for you Giles starting out; add to that the children and it ups the stress. Several members have had good advice.

You might want to read these Testing and Shooting Tips. One thing I have heard of new members doing which makes it harder is not poking with the bevel of the lancet up. By having the bevel on the topside, the sharpest part of the lancet goes in first. Another member’s cat used to attack her at first. She learned to wrap him in a towel like a burrito and it calmed him down over time.

Great job getting the curve today. BTW, dosing method on the SS refers to either start low go slow or tight regulation. There’s no hurry to decide which method you want to follow. Take time to read the sticky regarding the two, ask questions, and then decide.

 

i didn't realize there was a bevel.... i'll look at that, thanks!

 

Yes, there is. Check closely because if you aren’t doing it bevel up, it’s duller and less likely to get blood.