Brand new and completely overwhelmed

Discussion in 'Feline Health - (Welcome & Main Forum)' started by Mo & Colby, Jan 16, 2020.

  1. Mo & Colby

    Mo & Colby Member

    Joined:
    Jan 16, 2020
    Colby has always been a big boy (22 lbs) When we returned from a trip I noticed he lost a bit of weight and I was delighted and thought to keep the weight loss going by stopping free feeding the crunchables. He continued to lose weight. And then it seemed he was losing too much too fast. His dandruff had also gotten out of control. Water addiction. So much urine.Then he started getting really picky about using the litter box. I realized it was time to call the vet. Now I am here.

    He did lose weight and is now 17 lbs. I flipped out a bit with the diagnosis (my baby!) and have purchased the insulin Lantus as well as the glucose meter, strips etc. and have not used them yet. I first changed his diet to all canned food. I could see a change in him immediately. But it’s been a week now and the time has come for me to test.

    Please point me in the right direction as to which posts will help guide me through this! I know all my questions have been answered somewhere here already. Do I test before food or after. I know I give the insulin after. My prescription says 2 units but I am thinking that might be too much at first?

    Thank you for all your help and knowledge!
    Monique and Colby
     
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  2. Sarah&Soph

    Sarah&Soph Member

    Joined:
    Jun 18, 2019
    Welcome! Looks like you are doing a great job so far!

    What kind of canned food is he eating now? And what meter are you using?

    Here is a link to home testing tips. If you have any specific questions or run into any issues please don’t hesitate to ask! :cat: Some kitties take to it no problem and others (mine) take some.... convincing :rolleyes:

    http://www.felinediabetes.com/FDMB/threads/hometesting-links-and-tips.287/

    The order is test/feed/shoot. I also definitely recommend checking out the lantus forum if you haven’t already! There are some pinned “sticky” posts at the top of the page that have a lot of useful info about lantus and how it works
     
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  3. Jennifer R.

    Jennifer R. Member

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    Dec 20, 2019
    Welcome, I'm fairly new here myself, so take my input with a grain of salt. My vet said my cat must eat at least some of his food before giving him his Lantus, and that was when I was testing him: test, feed, shoot (in the middle of his meal). My cat is a big eater so that hasn't been an issue, but when we first brought him home from the shelter (already diagnosed with diabetes), we only fed him at shot time, so that may have whetted his appetite.
    Are you testing with a human meter? Do you need instructions on filling in the spreadsheet?
     
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  4. Juls and Billy

    Juls and Billy Member

    Joined:
    Dec 28, 2019
    Welcome Monique and Colby! Sarah has already got you pointed in the right direction about testing. With his diet change, it's important to do the testing as you begin to give insulin. Changing to a low carb wet food could drop his BGL over a 100 points.

    I'm a newbie too, and without this board I would have lost my baby. My vet didn't suggest home testing, but I did it anyway, and that kept me from giving my sweet baby 2 units of insulin when his BGL was only 52. Yes, I too was overwhelmed at first, but the things I learned on this site helped me know what I was doing and know that we can totally do this. Knowledge is power! Now my Billy is doing so much better, it's like he's his old self again. And he was super sick when we first got diagnosed.

    I recommend reading all the sticky posts in the forum. There's tons of good information in the Health Links and Lantus sections of the forum. A great place to start is New? How You Can Help Us Help You. I also suggest this awesome food chart to help find canned food that is 10% carbs or less. If you are giving him insulin, make sure you do any diet changes slowly, and they can have a major effect on BGL. For an awesome example of this, take a look at the Billy's Spreadsheet link in my signature.

    Take a deep breath, read read read, and know that you can totally do this. Honestly, If I can do it, anybody can!
     
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  5. Mo & Colby

    Mo & Colby Member

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    Jan 16, 2020
    Thank you both so much! I am attempting testing. I have yet to draw a drop of blood (though had success first try on myself) Is there another spot besides his ear?

    And yes! I will need help on the spreadsheet. Once I have actual numbers to record.
     
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  6. Deb & Wink

    Deb & Wink Well-Known Member

    Joined:
    Jan 31, 2013
    Breathe, hold, release, breath, hold, release.

    No insulin yet.
    You changed the food to low carb before starting insulin.
    Which food?
    Any signs of ketones?
    Good insulin.
    Any sign of infection or inflammation?

    By changing the food first before the insulin, you should start to home test if there are no ketones present.

    Testing basics for Lantus (glargine)
    Preshot test morning and night AMPS (morning pre-shot) PMPS (evening pre-shot).
    Test somewhere in the middle of the cycle to find the nadir.
    Lantus takes time to fill the 'depot'.
    Shoot/no shoot BG (blood glucose) reading for Lantus is 150. You may prefer to have that a bit higher as you learn to test.
     
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  7. Deb & Wink

    Deb & Wink Well-Known Member

    Joined:
    Jan 31, 2013
    Warm the ear first.
    Aim for the sweet spot.
    Reward with pure meat treat.

    I takes time to be successful at BG testing.
     
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  8. Sarah&Soph

    Sarah&Soph Member

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    Jun 18, 2019
    Ears are the most common place used, but some people do use the paw pads. Warm ears help a lot (much harder for me in the winter!) and the more you poke his ears, they will grow new capillaries and start to bleed easier. What size lancets are you using?
     
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  9. Mo & Colby

    Mo & Colby Member

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    Jan 16, 2020
    Oh this is awesome. Thank you.

    No ketones. He is currently eating FussieCat Tuna and Tuna and Chicken. The Purina DM just arrived today and I will start phasing that into his diet.

    No signs of infection or inflammation.
    I 100% believe in testing before insulin. There is no way I would consider flying blind with my baby.

    Having trouble getting enough blood from his ear but it’s just a matter of practice, I imagine. He’s now running from me so I figure I need to make up with him and give him a few hours before I try again.

    Thank you for giving me such excellent help.
     
  10. Mo & Colby

    Mo & Colby Member

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    Jan 16, 2020
    I am using the lancets that came with the glucometer so not certain of size. I purchased 33’s but now I am thinking I ought to exchange them for a larger size. I was looking to give him less pain but if the ones in the kit aren’t cutting it, the smaller ones sure aren’t going to. He hates me at the moment so I’m going to wait a few hours and try again once we are friends again. Thank you so much for your assistance and support!
     
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  11. Diane Tyler's Mom

    Diane Tyler's Mom Well-Known Member

    Joined:
    Sep 21, 2018
    Aim for the sweet spot , You might want to purchase 28 gauge lancets and do it free hand on an angle, eventually more capillaries will grow and it becomes easier

    [​IMG] Diabetic Cat Care Home Testing Your Cat’s BG


    [​IMG]
     
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  12. Deb & Wink

    Deb & Wink Well-Known Member

    Joined:
    Jan 31, 2013
    Look for lancets labeled "for alternate site testing".

    Trying not to overwhelm you any more than you are now.

    2U of Lantus insulin could be too high of a STARTING dose. You may want to consider reducing that to 1u, especially since you have changed the food to lower carb and that has helped him a lot you said. Talk to your vet.

    With no ketones present, no infection or inflammation, the risk of ketones is diminished but not eliminated. Classic setup for ketones are not eating enough + infection/inflammation + not enough insulin.

    ECID Every Cat is Different ECID Every Caregiver is Different.

    You got this.
     
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  13. Sarah&Soph

    Sarah&Soph Member

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    Jun 18, 2019
    Yes I agree with Diane that the 28 gauge would be good to start with! I use 30 now but I started with 28. You can use a tiny bit of neosporin with pain relief ointment on his ears to help them from being sore. I have found with my kitty that treats are an acceptable exchange for the poke :p
     
  14. Diane Tyler's Mom

    Diane Tyler's Mom Well-Known Member

    Joined:
    Sep 21, 2018
    I agree about the 2 units of lantus could be too high of a starting dose
     
    Last edited: Jan 16, 2020
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  15. Mo & Colby

    Mo & Colby Member

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    Jan 16, 2020
    Great info! The images help tremendously. Thank you!
     
  16. Diane Tyler's Mom

    Diane Tyler's Mom Well-Known Member

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    Sep 21, 2018
    You are very welcome Monique, it will get easier, after awhile it will only take one little prick, when you see a droplet you can then just milk it meaning put you finger under the drop of blood and just go upward with your finger on his ear and it will get bigger. I still use the 28 gauge on my cat. Sometimes when he's sleeping I will test him. Believe me it will get easier. Like Sarah&Soph said buy some Neosporin with pain relief and you can just rub a small amount on the ears. You are in good hands here, all the members are so very helpful. Colby is adorable
     
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  17. Chris & China (GA)

    Chris & China (GA) Well-Known Member

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    May 10, 2013
    Feel free to send me a private message and I'd be happy to set up a spreadsheet for you! Just click on my name and choose "start a conversation" so I can get some information!
     
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  18. Wendy&Neko

    Wendy&Neko Senior Member Moderator

    Joined:
    Feb 28, 2012
    Hello and welcome. We have two dosing methods we use for Lantus, each with different ways of determine the starting dose. One, called Tight Regulation uses a weight based formula and for a 17 lb cat it works out to 1.9 units, if 17 lb is his ideal weight. Do you know how much he should weigh? The other dosing method, called Start Low Go Slow, used 0.5 units if feeding an all low carb wet or raw diet.
     
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  19. Deb & Wink

    Deb & Wink Well-Known Member

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    Jan 31, 2013
    How is it going Mo & Colby?
     
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  20. Mo & Colby

    Mo & Colby Member

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    Jan 16, 2020
    Hello! Thank you! We had successful test yesterday morning -273. Was unable to do another test yesterday, but we did have good luck this morning - 315. I went ahead and gave him his first injection of Lantus 0.5 and will attempt a second test at +3 so we can really start getting a spreadsheet together. Gosh, the injection is sooooo much easier than the testing. But we will get the hang of this! Thank you so much for your help!
     
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  21. Deb & Wink

    Deb & Wink Well-Known Member

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    Jan 31, 2013
    There was a 911 emergency post here last night, for a kitty down to 76 BG reading, 1 hour after getting Prozinc. Low numbers can happen with any type insulin, even lantus.

    That member didn't test before each shot either.

    Please, test before each and every shot.
    Have your hypo kit ready.
    Melissa Whitmore did, and it helped save her cat Freckles life last night.
    Read this thread, to see how members here helped Melissa and Freckles.
    76 hour after ProZinc
    She didn't have a spreadsheet setup either, Now Melissa does.
    She wasn't testing before each shot. Now she will.
     
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  22. Mo & Colby

    Mo & Colby Member

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    Jan 16, 2020
    Yikes! Thank you for the reminder! Though I am 100% of the belief that there can be no injection without a BG first. Never. This clinches it.
     
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  23. Mo & Colby

    Mo & Colby Member

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    Jan 16, 2020
    I get error codes on my meter 9 out of 10 times. I cannot seem to get enough blood from his ear. (The vet had to put him under and go through the jugular as even his veins weren’t producing enough blood for his panel). I am using a True Metrix Air which says .5ml is enough for a sample. His ears are a mass of wounds now. I heat the ear. I massage the ear. I rub with olive oil so the drop beads up more. I prick with a 28 gauge lancet by hand as the pen really bugged him. I milk it. And error code after error code. Do I need a different meter? (And hopefully not one that is only sold at Walmart as there isn’t one in the area) Any tips?
     
  24. Wendy&Neko

    Wendy&Neko Senior Member Moderator

    Joined:
    Feb 28, 2012
    Try a 26 gauge lancet to start for a bigger drop, and use a light film of Vaseline instead of the olive oil. Are you holding ear tip below the poke site (towards the head), to create a “dam”. Blood flows down.

    There are meters that take a 0.3 ml droplet. I found them easier.

    It takes everyone a little while to get good at testing. Be easy on yourself. :bighug:
     
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  25. Deb & Wink

    Deb & Wink Well-Known Member

    Joined:
    Jan 31, 2013
    Ok, let's do a little detective work, and try to find out why you are having 9 out of 10 failed BG tests.

    Is your cat dehydrated? Do the tent method to test. Pinch a bit of skin, let go, it should go right back down. If still tented, dehydration likely. Get more water into your cat.

    Cats peeing a lot are often dehydrated. Think uncontrolled diabetes, chronic kidney disease, vomiting, diarrhea, etc.

    Did you read the user manual/owner's booklet/instructions?
    Trouble shooting, page 51 True Metrix Air
    Which error codes are you getting from your meter?
    There should be an owner's manual that came with that meter.
    Are you using the test strips specifically made for that meter?
    Are you putting blood on the test strip a second time? Most meters do not allow you to do that.
    Are you moving the test strip slowly towards the drop of blood? Letting the test strip 'sip' up the blood?
    Try barely touching the blood drop with the end of the strip, to let the test strip 'sip' up the drop.
    You don't want to 'drown' the test strip.

    What country are you in? You don't have a signature set up to help me know what other meter would work for you.

    Will skip the Relion Walmart brand, since you said there isn't one near you. Although, you could order meter and test strips on-line from them.
     
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  26. Ann & Scatcats

    Ann & Scatcats Well-Known Member

    Joined:
    Dec 31, 2009
    Simba got a wrinkled Cauliflower-Ear from a wrestling game with Gustav in his young years.So when Simba got the diabetes and was in the Animal hospital getting started with the insulin and bg tests, they chosed to use the back paw on Simba for bg tests and not use the only normal ear he had then.

    Many cats are however very touchy and sensitive about their feet though, and it has to be along the sides of the largest back paw pad, due to both large veins and nerves goes in the middle of the paw pad and those should not be stuck into.
    But that is an alternative for you and Colby if ear test isn't succesful.
     
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  27. Mo & Colby

    Mo & Colby Member

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    Jan 16, 2020
     
  28. Mo & Colby

    Mo & Colby Member

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    Jan 16, 2020
    He passes dehydration test. Error codes are Invalid Hematocrit E-0 and E-2 sample not detected or wrong strip (yes, I did purchase the correct strip that goes with it) the only time I don’t get error codes are when testing myself. Not reusing strip.

    I think I need a larger gauge as someone else suggested and will also try the Vaseline. Also will see about ordering a new meter that needs less blood since he just doesn’t seem to be much of a bleeder.

    Thank you!
     
  29. Mo & Colby

    Mo & Colby Member

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    Jan 16, 2020
    Thank you! He hates having his paws messed with even more than his ears. But this is a nice option if I need to adjust.
     
  30. Mo & Colby

    Mo & Colby Member

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    Jan 16, 2020
    Thank you! I will try the Vaseline and a 26 gauge. Also will find one that takes 0.3 ml which should help. Great suggestions. Thank you.
     
  31. Deb & Wink

    Deb & Wink Well-Known Member

    Joined:
    Jan 31, 2013
    1. Would you say you get the E-2 error code the most often? In those "9 out of 10" times you mentioned you get an error code.

    Most likely reasons for that is blood drop is too small.
    2. Larger size lancets can help with that. Look for lancets labeled "for alternate site testing" on the box.
    The smaller the number, the bigger the metal poking part. 33 gauge will be hard to get blood until the ears "learn to bleed"
    3. Try poking twice, right next to each other. You are not aiming for the vein.
    4. Are you aiming for the sweet spot?
    sweet spot diagram.jpg

    5. More testing tips are here Hometesting Links and Tips

    I find that Marje and Gracie's Testing and Shooting Tips is a good one.
    I think that Ear Testing Psychologymay be helpful to you. You mentioned your cat was not very cooperative.
    6. Are you giving you cat a pure meat treat? Bribes work wonders to get our cats to accept home testing. Some love freeze dried treats like the pure bites, some like a tiny piece of plain cooked chicken, cheese, fresh cooked meat.
     
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  32. Mo & Colby

    Mo & Colby Member

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    Jan 16, 2020
    Thank you, Deb. Yes. E-2 most often. It’s been fairly obvious that there isn’t enough blood. Sigh. I did get 26 gauge today so we will try those tonight. Yes, he gets freeze dried chicken which he loves as his treat. Yes, aiming for sweet spot. Have read the Ear Testing Psychology but will read it agin and again until we get this! He’s a stubborn guy. Has a mind of his own. But we will succeed. Thank you so much for your kind assistance.
     
  33. Deb & Wink

    Deb & Wink Well-Known Member

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    Jan 31, 2013
    Hey, at least your kitty has short hair and has light colored fur, so you can see the blood drop. Black ears, with long floofy hair inside are much more difficult.
     
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  34. Mo & Colby

    Mo & Colby Member

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    Jan 16, 2020
    Oh I bet! Our other kitty, Sequel is black and I have thought how much more difficult it would be with him. I feel for you!

    Tested with the 26 gauge with heat applied and Vaseline tonight and had success! Thank you!
     
  35. Juls and Billy

    Juls and Billy Member

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    Dec 28, 2019
    Huzzah for the success! And I agree, giving the insulin is so much easier than the blood testing, but it gets better, I promise! Personally, I sucked at lancing by hand, though many members are awesome at it. I had to switch to a clicky. The trick is to find the way that works best for you and Colby. It gets easier as you get more practice, though I still get errors sometimes. Things that helped me most are the second prick close to the first, being patient enough to wait for a big enough drop (sometimes I try to rush it, not good) rubbing Billy under the chin while I wait for that big drop so he won't fidget, and coming at that drop slowly and at an angle so the strip sips it up.
     
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  36. Deb & Wink

    Deb & Wink Well-Known Member

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    Jan 31, 2013
    Meter ideas for you since you mentioned you were thinking along those lines.

    Sticky from Health Links/FAQ's forum, found it in the Index "sticky" at the top of that forum. (So you know where to go looking yourself next time.)

    Blood Glucose Meter Ratings, Comparisons, and Recommendations Has 3 document links.
    Blood Ketone Meters

    In case your cat is prone to ketones, has had DKA in the past, then a Ketone meter may be right for you. Strips are more expensive. Ketodiastix can also test the urine for ketones. Most folks are ok with a normal human glucometer and the ketodiastix, but wanted to alert you (and other's reading posts here) there are options and exceptions. Always.

    ECID Every Cat is Different ECID Every Caregiver is Different

    p.s. Please tell us to stop if we are overloading you with info. We have a bad tendency to do that with new members. You might want to tell us to slow down.

    p.p.s You may want to update your signature, since you have a SS (spreadsheet) set up now. Even if it only has a little bit of data on it, that is a major step forward.
     
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  37. Mo & Colby

    Mo & Colby Member

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    Jan 16, 2020
    Thank you, Deb!
    I do feel a bit overwhelmed with everything but also sooooooo grateful for the suggestions! The 26 gauge “alternate testing site” gauge seems to be the game changer. Going to hold off getting a different meter for now since we are getting results. I know how invaluable it will be to get his spreadsheet filled in but also not going to make myself (or Colby) crazy with it. Was able to get a +3 today to add to it. Will try for a +6 as well. We may be slow learners and it may take us a bit (this means me, Colby is a pretty quick learner, being a cat and all) but we will get there. Should I change my mind and I need a new meter, I will refer back to the link you gave me. Your help has been amazing. Thank you.
     
  38. Mo & Colby

    Mo & Colby Member

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    Jan 16, 2020
    This is the most perfect and helpful instruction. Thank you.
     
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  39. Deb & Wink

    Deb & Wink Well-Known Member

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    Jan 31, 2013
    If cats had thumbs, they would rule the world.
     
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  40. Deb & Wink

    Deb & Wink Well-Known Member

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    Jan 31, 2013
    Are you still having problems with that True Metrix meter? Or did the larger lancets, 26-28 gauge help solve the issue with the E-2 error code? Another member having the same problem with the same meter. Member is in WI.
     
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  41. Deb & Wink

    Deb & Wink Well-Known Member

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  42. Deb & Wink

    Deb & Wink Well-Known Member

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    Jan 31, 2013
    Mo and Colby, Please remove the state you are in from your signature. I mistakenly had you add it and it should not be there. Thanks. Sorry for the bit of extra work.
     
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  43. Mo & Colby

    Mo & Colby Member

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    Jan 16, 2020
    I’m so sorry. I just saw this. We seem to be getting good readings now for the most part. So it was clearly a case of user error. It does need a good bit of blood and most of the errors that I get are because there is just not enough blood. His ears are bleeding easier now and sometimes he even purrs when I am testing him.
     
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  44. Deb & Wink

    Deb & Wink Well-Known Member

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    Jan 31, 2013
    Good to know.
     
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  45. Mo & Colby

    Mo & Colby Member

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    Jan 16, 2020
    Yes. Thank you. I have posted there a couple of times and it has been immensely helpful. His numbers were all over the place and I was given such good advice and much needed hand holding.
     

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