Caninsulin dosage advice needed please

Discussion in 'Feline Health - (The Main Forum)' started by Monica Lewis, Jun 10, 2017.

  1. Monica Lewis

    Monica Lewis Member

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    Apr 16, 2017
    Hello everyone, I need advice regarding Josie's dosage please. She's on 1 unit of Caninsulin twice a day at the mo and her numbers seem to be fairly consistent plus her very recent fructosamine test results were 333 but she still has a lot of pink and red numbers. How can I bring her numbers down more into the yellows blues and greens?! Should I up her dose? How do I know if Caninsulin is the best insulin for her?
    I have to go abroad for 10 days at the end of July leaving my dear husband in charge of EVERYTHING! :nailbiting:
    I am really hoping that by then Josie will turn into a pretty straightforward and easy maintenance case so hubby can handle it and we'll have a happy kitty. And a kitty mummy who won't lose her sanity with constant worry!
    Your input and helpful suggestions would be much appreciated, thank you!
     
  2. Larry and Kitties

    Larry and Kitties Well-Known Member

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    Dec 28, 2009
    Josie's curve is typical of Caninsulin (Vetsulin in USA), a fast steep drop. I would ask your vet to change to ProZinc since that pet insulin is better and is now available in the UK.
     
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  3. MrWorfMen's Mom

    MrWorfMen's Mom Well-Known Member

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    Hi Monica,

    Your spreadsheet is missing pre-shot readings and doses for a number of days so it's difficult to say for certain what's going on. It looks like your dosing has been a bit inconsistent too and while in some cases I can assume you gave a lesser dose due to the pre-shot reading, at other times, I am not sure what the reasoning was for a lowered dose. My gut feeling is that Josie is bouncing from low numbers she is not used to. I notice she had a very low reading of 2.5 mmol on the 18th of May on a 0.5u dose but then you held that dose for a good run and her numbers were creeping upward.

    Your goal is to have a drop between pre-shot and nadir (lowest reading in a cycle) numbers of no more than 50% to try to keep bouncing at bay as much as possible. Bouncing happens when kitty drops to numbers they have been unaccustomed to, they go into unsafe low numbers or if they are dropping so much and so fast that the body senses danger and pumps out hormones to bring the BG back up to the higher levels it has been accustomed to as a result of the diabetes. The best way to get a handle on a situation like this is to ease kitty's numbers down gradually so the body becomes re-acquainted with normal BG levels.

    It does appear she is metabolizing the insulin quickly and a change to a longer acting insulin like Pro-Zinc might help too but in the meantime, if she were my kitty, I think I'd try a dose of 0.25u for about 3 days barring any low pre-shots and see if she starts to level out a bit even if her numbers are still starting at pinks but going into the yellows mid cycle. If you can get her level off a bit, then a gradual increase might not precipitate such drastic bounces. If you can get readings pre-shot and then at +2, if she seems to be dropping fast (more than 6mmol) you can give her a snack of low carb food to try to slow down the drop.

    Curiosity......have you changed Josie's diet recently because that can have a big effect on the amount of insulin needed?
     
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  4. JanetNJ

    JanetNJ Well-Known Member

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    You've only done the 1 unit for a few days. Is just keep with that for a while and see what happens.
     
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  5. Monica Lewis

    Monica Lewis Member

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    Apr 16, 2017
    Yes I agree Im trying to be consistent with dosage and been doing preshot numbers every time for a while now.
    Didn't help that she wasn't eating yesterday and vomiting yellow foam..

    Great point and yes I was thinking as well of giving her very low carb snack during the day to slow down the drop.

    No I haven't changed her diet, took away dry food completely at the very beginning, about 10 days before she started receiving insulin. Have changed the wet food couple of times as she lost interest quickly in some flavours but they were all similar ingredients and all below 10% carb. I try to feed her the same thing but she gets bored with it and doesn't want to eat. Now I think we finally settled for two different ones, Sheba Flakes 2.5% and Butchers Classic Really Meaty 3.5%

    We were going to try her on 0.25 unit on vet's advise as her numbers were going down nicely and have started but the preshot numbers become considerably high so been advised to increase the dosage..? so we did. It didn't help. So you think we should've kept it low for a while to prevent bouncing?

    Thank you for taking the time to advise me!
     
  6. Monica Lewis

    Monica Lewis Member

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    Yes we asked the vet if should change insulin but she said give this a go for a bit longer as it seems to be working and we might just need to get the dosage right..
     
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  7. Monica Lewis

    Monica Lewis Member

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    Thank you everyone for your replies, after yesterday's sickness and little food Josie ate better this morning but not her usual amount and her AMPS numbers were much lower at 14.5 / 260 so gave her a reduced 0.5 unit shot. I don't know if this was the right or wrong decision, I had to decide quickly and I based it on her lower food intake and the significantly lower preshot numbers.

    Some of you advised to keep her on 1 unit and see how it goes and some of you advised to lower to 0.25 to even out the bounces.
    They BOTH make sense!! It's hard to decide which way to go...

    Now Im not sure if it's a good idea or not but shall we meet half way and keep her on 0.5 unit for a few days to be consistent regardless her preshot numbers as you suggested and see how she responds?

    And thank you, I really appreciate your support!
     
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  8. Diana&Tom

    Diana&Tom Well-Known Member

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    It's really hard to know what to do, Monica, I do sympathise. Pre-shot numbers vary and we have to think on our feet and dose what is often our best guess at the time. Achieving a spreadsheet that makes some sort of sense can take a while, while you try different dosing options for different pre-shot numbers.

    I'm not the world's best at deciphering spreadsheets but I think perhaps sticking to a lowish dose for a few days might at least give some clues as to whether Josie is bouncing or not.

    ... just seen your last post as I was typing the above! Yes, people will advise different ways to go and they both make sense! So try one way and if that doesn't work, try another way. As Josie isn't eating much at the moment, I'd go from here with a lowish dose and see how that pans out. The key to all of this is testing - I know it isn't easy when you have things to do but the more tests you can get in to give the clearest possible picture, the better.
     
  9. Diana&Tom

    Diana&Tom Well-Known Member

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  10. Monica Lewis

    Monica Lewis Member

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    Thank you Diana!
     
  11. JanetNJ

    JanetNJ Well-Known Member

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    They usually vomit stomach acid when their tummies are empty. It's better to feed more often than just twice a day... That will solve that. Just no food two hours before preshot testing.
     
  12. JanetNJ

    JanetNJ Well-Known Member

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    With a significantly lower preshot you are wise to do 0.5. It's what I would have suggested.
     
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  13. JanetNJ

    JanetNJ Well-Known Member

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    Can you get a +5 and +6?
     
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  14. Monica Lewis

    Monica Lewis Member

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    She's normally always asking for food so we feed her 4-5 times a day smaller portions. Although it always makes me wonder how is that affecting her BG readings especially when doing a curve? I guess her numbers will never be exactly accurate..?
     
  15. Monica Lewis

    Monica Lewis Member

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    I will most definitely try! Just did a +3 and it was 12.4 :). I hope that's good at this point..
     
  16. JanetNJ

    JanetNJ Well-Known Member

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    It's fine but a bit flat. What I might suggest is that over 300 do 1 unit and 250-300 0.75. But let's see how today plays out. Your cat doesn't seem to really drop until +4.
    For curve days feed her however you normally would. Cats gotta eat. Lol its ok if the numbers during the day are food influenced. You don't want the preshot test to be food influenced because you have to make sure the numbers are naturally high enough to shoot. If she's 250 at preshot and it's only because of food, when the food wears off in an hour or two she could drop too low, ya know?
     
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  17. JanetNJ

    JanetNJ Well-Known Member

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    i see she hasn't been eating well for two days... gotta stay on top of that. I'm hoping it resolves itself soon... try to get her to eat whatever she will. cooked chicken, tuna, a favorite cat food... you don't want her to stop eating. add extra water to her food too... If she's starting to get a bout of pancreatitis they tend to get dehydrated pretty quickly.
     
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  18. Monica Lewis

    Monica Lewis Member

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    Thanks Janet.
    Just had to drag her out from under bush in garden where she loves staying daytime for test. She was not interested in boiled chicken cubes or tuna but was willing to eat two pieces of small naughty emergency dry treats whilst testing her. At +5 11.8 / 210. Might have to go to vet tomorrow if not improving. Shame I was very hopeful after this morning's promising feed but she's looking uninterested and frail again..
     
  19. Diana&Tom

    Diana&Tom Well-Known Member

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    Today's yellow numbers could be a lot worse, Monica, and you said she did eat quite well this morning so maybe she's just having a quiet day. It's quite warm here in Surrey and maybe the same for you too? Warmer weather can put cats off food. I wouldn't worry too much atm unless she is showing other signs that concern you...?
     
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  20. Monica Lewis

    Monica Lewis Member

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    Thanks Diana, agreed!

    Not sure at this point if her low food intake yesterday affecting her today or the heat or something more serious.. Will wait and see.

    Although not helping that she just disappeared from her usual spot in the garden, I just looked everywhere but she's not coming back to calling her..!:(

    I don't think she liked it that we knew her hiding place and dragged her out from under bush for blood test...
     
    Last edited: Jun 11, 2017
  21. Anthony Morgan

    Anthony Morgan Member

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    Hi Monica,
    I just wanted to say sorry to hear you are having a difficult day with Josie. I hope all's OK.
     
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  22. MrWorfMen's Mom

    MrWorfMen's Mom Well-Known Member

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    I hope Josie shows up soon!

    This sugar dance can be a lot of guess work especially in the early days and it's definitely not a one size fits all condition. You will get differing opinions and that may seem confusing but it also gives you options to consider. Above all, I believe each of us as caregiver's have to do what we are comfortable with no matter what suggestions are provided. It would be very helpful to get a BG test each night before you head to bed. Many cats go lower at night than during the day so any data you can get on the night cycle will help to fill in pieces of the puzzle and help you get Josie leveled out.
     
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  23. Monica Lewis

    Monica Lewis Member

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    Thank you Anthony, today is looking promising getting back to normal..

    Luckily she's eating enough so I'm able to give her the 0.5unit Caninsulin. I think sticking with the lower dosage started to curb those bounces..fingers crossed we are finally on the right dosage path....

    How are you and Shelley getting on? Nice blue and green numbers on your spreadsheet btw :)
     
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  24. Monica Lewis

    Monica Lewis Member

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    Thank you, that is very true.

    Yes will try to get evening numbers, past couple of days as not well Josie hated the testing and hissed and growled at us when started testing ( which she hasn't done since the beginning ) so I was pleased to get the bare minimum ps tests done and decided to give her a break. Today hopefully will go better..

    Things are looking good with the 0.5 unit at the mo, hopefully numbers will stay consistent..

    Thank you everyone for your support, hope you all have a lovely day! :)
     
  25. JanetNJ

    JanetNJ Well-Known Member

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    Wow nice amps today again!
     
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  26. Monica Lewis

    Monica Lewis Member

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    Thank you :) BG didn't go down much at +4, could be cos I gave her a favourite small carby treat to encourage her to eat? I won't make a habit of it!!

    Janet I just watched your video of how to home test, you are sooo nice and smiley and with your chilled kitty you make it look so easy! :)

    I watched several home testing videos now and all the cats look so mellow as if they were all on drugs putting up with it compare to my Josie!!!:banghead: She is not keen at all and fights sometimes but also purrs at the same time?! Weird!

    I must admit I cannot test her on my own. She used to put up such a fight at the beginning but now we worked out that we are able to do it if I hold her cuddling which she likes and my husband does the poking and test which she puts up with most of the time. I tried to do it on my own a few times but she didn't like it and in 5 minutes I made about 6 holes in her poor ear whilst she kept moving.. I don't want to force or push it as I don't want to rock the boat now that we've been able to do it for a while together with my husband and got into a little routine. The problem is that most of the time my husband goes to bed around 9pm.. plus starting a new job tomorrow and won't be around daytime..
    So that is something I still need to master somehow asap. One of the FDMB ladies really got angry with me for being unable to test on my own which didn't really help and only made me feel even more bad about it and more frustrated...

    Was your cat always this easy to test?
    Josie NEVER sits on our lap so always wants to jump off as soon as I try to get her there to attempt to test on my own..

    Any suggestions apart from the usual warm rice socks, soothing music or singing, hot water bottle, holding down, giving a treat, gentle stroking, wrapping in towel, firmly holding down between legs... etc. would be greatly appreciated! Thank you
     
    Last edited: Jun 12, 2017
  27. Diana&Tom

    Diana&Tom Well-Known Member

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    Hi Monica, just catching up here today! Ref your spreadsheet, it may be that the dose you're trying at the moment is just enough to keep Josie steady for a few hours... she may have dropped a little before this test or she may drop afterwards, we don't know. This is why it's so important to collect data, to see patterns etc on different doses.

    I'm sorry to hear you have rather a fight when it comes to testing and I'm even more sorry to hear that someone here got angry with you. There is no excuse for that. The vast majority of us here recognise that treating FD isn't easy, and we stick around on this site because we want to encourage and help each other. So well done you for still posting here - try to put that one negative experience behind you because as I said, most of us really do want to help.

    I think you do sort of find a way of testing that suits you, but it may be trial and error. In some cases it can help to do the test while the kitty is tucking into food - ideally you don't feed for a couple of hours before a shot is given, so by that time an appetite may have been worked up! So maybe try that - make sure Josie is concentrating on her food, and maybe add a few tuna flakes on top - and do the test as quickly as possible, she may not notice!

    My own experience is that rice socks etc can be rather bulky and therefore off-putting for the cat... instead of a rice sock, I used to use those disposable facial wipes... rinse them out, cut them into small strips, fold over a few times, rinse again in warm water, and use that to hold against the ear. It's not bulky at all and has the added advantage that you can use it to hold against the ear for a few seconds to stem any flow of blood.

    You will get there! You have a great positive attitude and that's half the battle!
     
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  28. Monica Lewis

    Monica Lewis Member

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    Wow cut up disposable face wipes..?? Never would've thought of that! :) You must've tried many things til you got there!

    Actually whenever I tried testing her on my own I had tears of frustration running down my cheeks and I couldn't see a thing! But tried over and over again just kept poking several times squeezing and milking until just about managed to do it. So I put aside trying and stayed with doing it with hubby and everyone's been happy.

    We just about manage to inject her now whilst she's eating and lets us do it with very little protest. Again must admit I can't inject on my own either. My hubby is around for that every day morning/evening so I will leave that like that for a while. Again don't want to rock the boat as we had such a heart wrenching struggle trying to inject her at the beginning..

    Anyways, thank you very much Diana for encouraging. I will persevere, I know now I have no choice or excuse as I'll be on my own a lot. Just need to source a tranquilliser for the cat! :)
     
  29. Yong

    Yong Well-Known Member

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    We are here to hold your virtual hand :bighug:
     
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  30. Monica Lewis

    Monica Lewis Member

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    Yes my virtual hands always feel very warm and sweaty from all the holding..! :)

    I find it incredible how dedicated you all are to helping others and how much of your time this must take up! I am in awe of all of you, really. And very grateful.
     
  31. Diana&Tom

    Diana&Tom Well-Known Member

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    You will be fine, Monica, really. But I had to smile about a tranquilliser for Josie! If you really think she needs calming, you could try Feliway, a plug-in thing that is supposed to be helpful to calm anxiety in cats (and maybe humans too, I don't know!!)

    The cut-up facial wipes thing was just a progression for me from cotton wool and then folded-over tissue. The wipes are easier to warm under the tap and not too bulky.

    One other thing - I'm sure this has been mentioned... do you give Josie a little treat after testing her? Many of us have a special store of goodies for just that purpose... it helps the cat to associate test time with something positive, a reward afterwards. Oh and reward yourself too (seriously) - chocolate, wine, cake, whatever... it helps a lot!!
     
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  32. JanetNJ

    JanetNJ Well-Known Member

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    She put up a little bit of a fight in the beginning... Esp when it would take multiple tries. She was definitely more cooperative when she started associating the test with food. Then she would purr when she saw the kit. I always gave a bit of deli turkey or roast beef... Sometimes catnip. Those high carb treats can be substituted.... When cc was going low and I wanted to steer her up I once gave 4 temptations.... She zoomed up about 100 points in a matter of minutes. Lol. I was like ok... Overcorrection. And it became quite clear how I unknowingly ushered her into diabetes. (Smacks forehead)
     
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  33. Monica Lewis

    Monica Lewis Member

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    Yes we do reward her with tiny treats before during and after, I think that's why she is willing to put up with it these days..

    And never mind rewarding myself, the tears of joy, relief and satisfaction of finally being able to do it by myself will be my greatest reward! :)
     
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  34. Monica Lewis

    Monica Lewis Member

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    :D:D
     
  35. Diana&Tom

    Diana&Tom Well-Known Member

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    Awwwwww! That's a cat mummy speaking!
    And no need to be in awe of people here, Monica... it's what we do! We love cats, all cats, and we want the very best for them and their humans :)
     
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  36. JanetNJ

    JanetNJ Well-Known Member

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    When she's squirming try flicking the drop onto the back of your fingernail and test from there so you can let her go quicker. :)
     
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  37. MrWorfMen's Mom

    MrWorfMen's Mom Well-Known Member

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    Monica, I too have a cat who will not sit on my lap, hates to be held and god forbid if I ever tried to burrito her, she'd rip me to shreds. I thought I'd never be able to deal with her. What she loves is being brushed! So I initially used that as a lure to get her to a specific testing spot and brushies were her reward for co-operating. At this point in time, I can test my girl pretty much anywhere anytime and no treats or brushies are needed. Just a lot of lovey talk and head pets! The only issues I have with her are the occasional head shake particularly when her brother decides he needs to supervise the process!

    If you can find something Josie really likes and use that to convince her that testing means good things are coming, it will help. And try your best not to get worked up before you test because our furkids pick up on our anxiety like little sponges. Go at testing with a CAN DO attitude and Josie will have confidence in you. If need be, do some dry runs on a stuffed toy so you can go through the testing steps smoothly and efficiently. I found initially I was fumbling around for stuff and my girl was getting distracted and impatient as a result. Once I got a rhythm worked out, things improved immensely.

    You will be fine. Practice makes perfect! :D
     
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  38. Monica Lewis

    Monica Lewis Member

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    That is brilliant that you found something like that as a reward and works well for you both!

    Josie tries to scratch my eyeballs out when I try to brush her so I had to give up on that a long time ago... :)

    I think you're right, the secret is in speed and I've been doing it together with my husband for a while now so I know all the prep and ready for action stuff. I think I struggle with the poking bit as I am so squeamish and don't want to poke too hard. That's why I have to do it over and over again until Josie loses patience...

    Will work on finding an great incentive and will get cracking at it myself again! Thanks so much for encouraging!
     
  39. MrWorfMen's Mom

    MrWorfMen's Mom Well-Known Member

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    Monica, I maybe blind but I didn't notice anyone mentioning the size of the lancets you are using. If they came with the meter, they may well be 31 or even 33 gauge and that may be part of your problem. If you can get some 28 gauge lancets (lower number means thicker needle) you may find your pokes are more successful first time.

    Sounds like you are squeamish of hurting your little one which I can empathize with. As embarrassing as it is for me to admit this, I'm a retired R.N. and my hand shook so bad for the first few tests because I was so afraid of hurting my furkid! Josie doesn't feel much of anything when you poke her. There are very few nerve endings in her ear and she doesn't experience anything like you would if you poked your finger. Her agitation is from the new process and having to succumb to handling she is not used to rather than any pain. It will get better!:bighug:
     
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  40. Anthony Morgan

    Anthony Morgan Member

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    Hi Monica, pleased to hear things are settling down. Shelley is in some low numbers, 11 to 12 without insulin today. Just trying too decide whether to give a little or none?
     
  41. Monica Lewis

    Monica Lewis Member

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    Sorry Anthony just seen your message.. 10.6 that's such a great pmps! Are you doing the sliding scale then? I wouldn't have the confidence to advise you about dosage myself but I know that since I've been sticking with the same lower dose for a few days now Josie's numbers been more consistent without the bounce dance..
     
  42. Diana&Tom

    Diana&Tom Well-Known Member

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    Yes that is a borderline number for pre-shot, but almost too low to shoot so best to stay safe... I'd wait an hour and test again, see what direction she's going in.
     
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  43. Anthony Morgan

    Anthony Morgan Member

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    Hi Monica,
    I was advised to use 1.0u consistently by my vet but after a few shots, Shelley's numbers dropped lower and it didn't feel safe to inject 1.0u. So it looks like 0.5u may be appropriate but I don't know if the vet will agree.
    Thanks for replying!
     
  44. Diana&Tom

    Diana&Tom Well-Known Member

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    This is exactly the dilemma isn't it - do what the vet says (ie dose consistently) or reduce the dose when a pre-shot number is low... surely the vet wouldn't say it was ok to give the usual amount of insulin if the cat was borderline unshootable and prone to hypos... this is exactly where home-testing is essential as it allows you to make your own informed decisions.
     
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  45. Monica Lewis

    Monica Lewis Member

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    Well the vet goes for consistent dosage which is understandable, mine says the same but when ps numbers are borderline low I would personally go for the safer option ( which is the adjusted lower dosage) and use that to explain the vet why you made that decision..
     
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  46. Anthony Morgan

    Anthony Morgan Member

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    I would hope the vet would support this way of thinking, I daren't inject 1.0 u at these levels.
     
  47. Diana&Tom

    Diana&Tom Well-Known Member

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    Sometimes we just have to do what feels right to us, whatever the vet might say. Maybe next time you see the vet you could ask - what dose do you give if Shelley is around 10..? Would be very interesting to hear the vet's response!
     
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  48. Monica Lewis

    Monica Lewis Member

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    If your vet is compassionate and cares about your cat's wellbeing without taking risks they would have to see your reasons and support your decision. Besides the ultimate responsibility lies with you so the final decision is yours at the end of the day.
    I would go with my gut feeling and whatever feels right. And the safest option. That always helps me to make up my mind.
     
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  49. Monica Lewis

    Monica Lewis Member

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    Diana one of us could take a break here as we are both saying the same things here at the same time!! :D
     
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  50. Diana&Tom

    Diana&Tom Well-Known Member

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    Ha ha! Yes - I'm off for a while now anyway!
     
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  51. Anthony Morgan

    Anthony Morgan Member

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    Diane and Monica, thank you both!
    The vet asked me to contact him if I wasn't going to inject 1.0u. He does seem genuinely interested in Shelley's well being but he is quite adamant in his views and is already frustrated with me.
    But as you say the final decision is mine.
     
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  52. Monica Lewis

    Monica Lewis Member

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    I understand your vet's reasons but I think they need to be more flexible and open to adjusting the recommended dosage if it's not safe to carry on with the current dosage. As your PS numbers indicate I think you would be taking more risks by injecting one unit than a reduced dosage.. When I have to make a decision I always go with the more sensible option.
    To me the vet's frustration is secondary compared to my pet's safety.
     
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  53. Diana&Tom

    Diana&Tom Well-Known Member

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    Agree 100 per cent!
     
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  54. Anthony Morgan

    Anthony Morgan Member

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    Definitely but after all that I have just retested and the number has shot up to 18.1!
     
  55. Diana&Tom

    Diana&Tom Well-Known Member

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    Ok so 1u.
    You just never know with these cats!
     
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  56. Anthony Morgan

    Anthony Morgan Member

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    Thank you both for your time. They like to keep us on our toes!
     
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  57. Monica Lewis

    Monica Lewis Member

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    Dear all,
    I just wanted to share with all of you nice people as I know you've been rooting for me that I've just done a blood test on my own!
    Took me 26 minutes, 7 attempts and 2 strips and nearly cost me a scratched out eyeball... but I did it!
    I honestly hope that the saying 'things can only get better from here' is going to be accurately describing the situation here!
    And after the 'CAN DO' attitude failed me the 'PULL YOURSELF TOGETHER WOMAN AND JUST DO IT OTHERWISE YOU AND YOUR KITTY WILL HAVE A SERIOUS PROBLEM ON YOUR HANDS' attitude took over..
    Thank you everyone for having faith in me!
     
  58. MrWorfMen's Mom

    MrWorfMen's Mom Well-Known Member

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    mini-graphics-cheerleader-043849.gif Yeah Monica! Congratulations! It does get easier. I promise. Now give Josie a treat and grab some chocolate for you! You both earned a reward! :joyful:
     
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  59. Diana&Tom

    Diana&Tom Well-Known Member

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    Knew you could do it Monica!
     
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  60. Diana&Tom

    Diana&Tom Well-Known Member

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    Monica, just remembered I meant to pick up on this yesterday...I looked on the Boots website where I think you said you got your meter, but couldn't see what gauge lancets come with it. It is worth checking the packet though for the reason Linda says. And I'm not sure if you're using some kind of pen/device that makes a clicking sound when you use it - if so that could be making life harder not easier... I would always just use a lancet freehand, easy to see/control what you're doing and no noise to startle Josie.
    Have a good day!
     
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  61. Monica Lewis

    Monica Lewis Member

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    Apr 16, 2017
    You know I meant to get back to @MrWorfMen's Mom about the lancets as well as I looked into it but completely forgot!! So thanks for reminding me.
    And thank you Linda for pointing this out!

    We got a box of 100 lancets from Boots Pharmacy but even after both of us looking we just cannot find the size on the box! Will try to attach a photo of the box.

    Going to the pharmacy today and ask specifically for a 28 gauge right?

    Ps. The lancet pen device that came with the meter drove us bonkers so we ditched it within a day!
     
  62. Monica Lewis

    Monica Lewis Member

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    IMG_7063.JPG IMG_7062.JPG Here are the pics
     
  63. Diana&Tom

    Diana&Tom Well-Known Member

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    No I can't see mention of gauge on that packet either... too many foreign words to make much sense but no numbers that would suggest what we're looking for.
    Yes 28 gauge... looked again on Boots site and you can get a box of 100 for £4.99... doesn't have to be a Boots store of course, you can get lancets at any pharmacy.
    Much better to use lancet alone so you're on the right track there!
     
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  64. Monica Lewis

    Monica Lewis Member

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    Apr 16, 2017
    They had a few to choose from but we didn't know the difference so just went with the big box with pretty colours! :D

    Will go to town this morning and get the 28 gauge ones. Thanks very much ladies!
     
  65. Diana&Tom

    Diana&Tom Well-Known Member

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    Dec 29, 2009
    Actually... just did a quick search online for these lancets and I think they may be 28 gauge so no need to get more just yet... but to check you could take box into pharmacy and ask them.
     
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  66. Monica Lewis

    Monica Lewis Member

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    Apr 16, 2017
    Only have a few left so due for a new box anyway. This time will get the ones specifically saying 28 on the box..
     
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  67. JanetNJ

    JanetNJ Well-Known Member

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    Those are pretty lancets! Lol
     
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  68. Monica Lewis

    Monica Lewis Member

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    Haha thank you Janet! Well they put me on the spot at the pharmacy to make a snap decision so I had to prioritise and go with what was most important! :D
     
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  69. MrWorfMen's Mom

    MrWorfMen's Mom Well-Known Member

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    You're quite welcome Monica! I did a quick check and the boxes here in Canada don't have a gauge on them either but the website for the lancing device they're made for, says the lancets are narrow gauge which likely means 31 or even 33 gauge. The narrow gauge seems to be fairly standard these days. I believe you can get Freestyle Lite lancets that are 28 gauge in your neck of the woods.

    One other suggestion.....if Josie starts getting fidgety after you get some blood but before you get the meter to it, try to grab the bead on a topside of your fingernail and test from there. Works a treat when my middle furchild decides to supervise Menace and me at the wrong moment! ;)
     
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  70. Monica Lewis

    Monica Lewis Member

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    Apr 16, 2017
    I had another attempt earlier on with blood test and realise now that the problem is me and not the cat.
    Josie sat on the table so patiently for a good 15 minutes letting me do stuff bless her little stripey cotton socks whilst I just kept poking and re-poking as nothing much came out. Wasted two strips as couldn't get enough blood. Eventually managed to do it but by then Josie was quietly growling and tried to scratch me..
    Then my husband popped home two hours later and did another blood test on her on his own within 20 seconds including preparation!
    I am so annoyed with myself for being such wuss. I will carry on as I have no choice but I feel so sorry for the poor cat!
    I know EXACTLY what Im supposed to do and how to do it as watched my hubby probably a hundred times whilst holding Josie and countless videos I just haven't got the heart to pierce her ear firmly as I don't want to hurt her plus she cries every time I poke her so that doesn't help.
    I'm grateful and taking on board what everyone suggested and I will keep trying but just wanted to say that Josie is a superstar and I am the total bum here...:(
     
  71. Diana&Tom

    Diana&Tom Well-Known Member

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    Dec 29, 2009
    Awwww you're not that bad Monica! Don't give yourself a hard time! You're not the only one who finds it tricky at first. It is difficult for those of us who are a bit squeamish and don't want to hurt our babies, but it's best not to think about it, I reckon, just get on and do it, sing to yourself or something as you prepare as a kind of diversionary tactic! The more you hesitate and get anxious, the harder it is to physically do it, take that lancet to your cat's ear, make it bleed... poor little thing, did it hurt her... oh dear I feel terrible about this... I must do it better next time... etc etc. It becomes a vicious circle.

    Wasn't there some tv ad campaign recently with a slogan something like Just Do It.. I can't remember, it sounds vaguely familiar and it's appropriate in this case. The more matter-of-fact you can be about it, the better for you AND Josie, the more in control you make yourself, the less anxious you will be and the easier the whole procedure becomes.

    Here endeth today's sermon.
     
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  72. MrWorfMen's Mom

    MrWorfMen's Mom Well-Known Member

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    Feb 18, 2015
    I second Diana's thoughts. Don't beat yourself up. You'll get there and Josie will help you. Concentrate on how nice and calm she is and use that to bolster your courage. We are all cheering you on but please do be patient with yourself. This is still all very new! :bighug:
     
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  73. Monica Lewis

    Monica Lewis Member

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    Apr 16, 2017
    Haha great sermon thank you! I actually don't hesitate, I do get on with it, I even provide live sarcastic commentary of what Im doing to the cat, I just totally suck at it! lol
     
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  74. JanetNJ

    JanetNJ Well-Known Member

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    Jun 8, 2016
    Poke right through to the other side of you have to. No biggie. The video of me testing my cat I actually did poke all the way through which is why she twitched.... But really it didn't hurt.
     
    Last edited: Jun 13, 2017
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  75. Monica Lewis

    Monica Lewis Member

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    Apr 16, 2017
    Hello everyone,
    I've been laying low for a while for many reasons and just following relevant threads here and observing people's advice.

    I had to take a step back as I've become so obsessed with the whole blood testing, getting frustrated by being unable to do it, constantly checking and analysing numbers and freaking out by seeing high numbers...etc. that general anxiety and no sleep took over my life.
    So had to stop, breathe and remind myself that Josie is not a dummy test project with numbers but a real breathing stripy and very pretty pet creature who is still in need of TLC.
    So I took a chill pill ( or more like a whole damn packet!) and made some changes.
    Now I don't try to get her out by all means for testing from under the bush outside where she's happily laying all day long to hide from the heat. I'm still rubbish at testing but made a rule that if I don't succeed in 2-3 pokes and she's losing patience I just stop and let it go instead of getting both of us all worked up and end up in a cat fight! :) My husband is around for the important PS tests to do them and the rest will be bonus if/when I succeed. I will keep trying. I can only get better at it as I doubt that I could get any worse! :banghead:
    Also accepted that I cannot control everything and make sense of all the numbers why so high or so low and I shouldn't get so obsessed with them just take them as they are. This way I get to keep my sanity! I also started paying attention to the rest of the family. They seem like nice people..
    Josie is a happy cat right now on mid numbers and if I can get her BG well under control it will be great but if I can't it's not the end of the world.

    So anyways now that I'm all chilled and Josie's been on 0.5u for 10 days I would like to ask your opinion on her dosage. @JanetNJ @MrWorfMen's Mom @Yong I think we should increase to 0.75u to get her in the healthy range for longer, @Diana&Tom suggested the same so I was just wondering if anyone else would support this or would suggest any different..?
    I'm really embarrassed and apologise for the lack of readings compared to everyone else's, will try to get as many as I can if and when, we just have to make decisions based on these figures for now.
    Thanks very much guys, have a nice day! :cat:
     
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  76. Kris & Teasel

    Kris & Teasel Well-Known Member

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    Aug 17, 2016
    I have many positive things to say: :bighug:
    • kudos to you for recognizing your limits and that Josie is more than BG numbers!!! (this is a huge leap forward) :D
    • your attitude toward all this - finding a happy medium, recognizing the value of life outside of FD - is stellar :)
    • seeing that it's absolutely impossible to explain every number so there's no point in obsessing is a breakthrough :smuggrin:
    • this dose of 0.5 u seems to be working well for Josie right now - the blues yesterday were great but you still had a "Comfy Caninsulin Cushion" :woot:.
    Many people stay stuck in those earlier fretting stages and then the FD takes over their life and they pay a price mentally, emotionally and physically. I've seen it here on FDMB.

    Keep doing what you're doing - it's excellent! :cat:
     
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  77. Diana&Tom

    Diana&Tom Well-Known Member

    Joined:
    Dec 29, 2009
    It's so difficult to give a definitive answer... there are indeed some nice blues in the cycle but pre-shot numbers in the high pinks means that the Caninsulin isn't lasting as long as we want it to. I think I'd be inclined to try 0.75u on a day when you can be home to monitor and see how that goes... it may be that Josie gets better duration from that but if she drops too steeply too soon, we'd know that it's too much. Only trial and error gives answers sometimes.

    I liked @JanetNJ 's suggestion of a sliding scale recently - can't recall whether it was on this thread or Anthony's latest one - sliding scales make sense to me although I know vets prefer consistency in dosing.

    My overview would be that you're right to chill and not obsess over the numbers, but if you can get those pre-shot numbers down even a little, Josie will feel better for that and therefore so will you!
     
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  78. MrWorfMen's Mom

    MrWorfMen's Mom Well-Known Member

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    Feb 18, 2015
    I too am impressed with your new found attitude. That above all will get you and Josie into a routine and well on your way to dealing with this without getting Josie in a fluff and so you can have a life too! I think you are doing marvellously with the testing.

    I would suggest you try to get a test in every evening before bed. Ideally if you can test at +2 or +3 in the evening, it will give you a better idea of what Josie is or might do overnight. I am wondering if she is going lower overnight leading to more bouncing because a lot of cats do go lower at night. She is dropping more than 50% some cycles and while those low numbers look great on the spreadsheet, they can also lead to bouncing, I find it interesting that at a dose of 0.50u you saw some pretty low numbers mid May and I think at that point in time I would have backed off the dose to 0.25u to see how that worked for her.

    While no one can say for sure, my gut feeling is that she is bouncing and if she were my girl, I'd drop her back to 0.25u for a few days and see how that goes. It can take up to 3 days for bouncing to settle. The goal would be to flatten out the cycles a bit so that the pre-shots are lower. That may mean the mid cycles won't be as low but Josie needs some time to get reacquainted with more normal BG levels so if you can keep the drops in BG to less than 50% of the pre-shot readings each cycle, I think she might flatten out a bit. Then if need be, you can raise the dose back up. Sometimes you have to coax the BG down rather than hit it with a hammer.
     
  79. Diana&Tom

    Diana&Tom Well-Known Member

    Joined:
    Dec 29, 2009
    A few options here, Monica! Raise the dose a little, and monitor; reduce the dose to see if she's bouncing; or try a sliding scale. If she is bouncing as Linda suggests it would be good news because in the longer term you'd likely be looking at a lower insulin dose as the norm, which feels rather less scary than giving higher doses.

    Maybe try one of these options for a few days, monitor as well as you can, and we'll all look in and see how it's going and if you need to stick with that option a while longer or try Plan B...
     
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  80. JanetNJ

    JanetNJ Well-Known Member

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    Jun 8, 2016
    If it were my cat I would keep the dose.5 if the preshot is yellow, and 0.75 if the preshot is pink.
     
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  81. JanetNJ

    JanetNJ Well-Known Member

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    Jun 8, 2016
    What gauge is your lancet? Maybe try a 26 gauge
     
  82. Yong

    Yong Well-Known Member

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    Jan 11, 2017
    Agreeing with the others to your great progress and mindset :). I would be curious to see what the 0.25U does and if that isn't the right direction we can always try the increase. Keep in mind, bouncing can also show as flatter cycles. Wonderful you are able to get the two most important tests, the pre-shots :cat:. We understand the frustration and emotional/physical toll the sugar dance can take, feel free to vent here too :bighug:
     
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  83. Monica Lewis

    Monica Lewis Member

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    Apr 16, 2017
    @Kris & Teasel you actually made me cry with your nice words, thank you.

    I knew I could count on you ladies for support and advice. Now I have 3 totally different approaches to choose from which all make sense, couldn't you all have just come up with the same answer to make it easier for me..?! :D

    Making supper at the mo and generally buzzing around but will sit down later on, re-read your comments properly and have a think which way to go. Also waiting for the vet to get back to me with her advice as well so my DH can't say that I'm 'following some random stranger's advice on some internet cat forum'..:banghead:

    Thanks very much everyone!
     
  84. JanetNJ

    JanetNJ Well-Known Member

    Joined:
    Jun 8, 2016
    pick one, try it for a week or two, if it doesn't work, try something else. The most conservative approach is the .25 "Stop the Bounce" approach. Try it for a week. If it doesn't work, try the "Raise for Pinks" scale approach where you give a little more for the pink preshots. No way of knowing the best approach until you try it.
     
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  85. Kris & Teasel

    Kris & Teasel Well-Known Member

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    Aug 17, 2016
    Oh my, Monica! I'm so glad I could help but I'm sorry I made you cry. :bighug: Yes, it's part of the FDMB thing that you'll get different viewpoints. It can be confusing or, viewed another way, give you options. We all think carefully before we offer our opinions and advice and it's always coming from a place of "do no harm". Think over what's been said along with your vet's take on it. Go with your gut in the end. :smuggrin:
     
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  86. JanetNJ

    JanetNJ Well-Known Member

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    Jun 8, 2016
    IT'S A MARATHON... :) no need to feel rushed to find the solution... you'll get there one step at a time.
     
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  87. MrWorfMen's Mom

    MrWorfMen's Mom Well-Known Member

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    Feb 18, 2015
    So sorry if we've added to, rather than calmed any confusion about how to proceed, but in the early days, there can be a lot of trial and error because every cat is unique. Over time, Josie will reveal her unique way of dealing with the insulin but until then you may feel like you are doing a bit of a two step.....two steps forward and one step back. It's the nature of the beast.....there is no one size fits all. Make a decision that you are comfortable with and know this will get easier with time! :)
     
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  88. Monica Lewis

    Monica Lewis Member

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    Apr 16, 2017
    Well the answer is kinda presented itself as with low food intake and low-ish PMPS numbers decided to play it safe this eve with a reduced dose of .25U

    To start from the bottom of testing out the dosage I suppose now from here maybe we should keep her at .25u for a few days and see how it goes and work our way up if necessary?
    My only question is though shall I stick with the .25u for a few days regardless of the PS numbers being high if that happens to be the case..?

    And Janet as for lancet I just bought a box of 200 28 gauge lancets last week, they seem to be good and working well for my hubby.
    I think my problem is still that I hate piercing through cos I don't want to hurt/upset her and she squeeks and moves most of the time we pierce.. Also hate that 'crunching' sound as Im pushing the needle through ..eeww!!
    But I just have to man up and get over it!
     
  89. Monica Lewis

    Monica Lewis Member

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    Apr 16, 2017
    Ps. Just went to lure in cat from front garden but she's not interested whatsoever. Took her favourite freeze dried chicken treats happily but growled and moved away when I tried to get her inside..
    I honestly don't know what's so fascinating about the front garden bushes that she does not want to move from there day or night!:arghh: Oh well at least she comes in to eat..
    So I guess there will be no testing tonight... :(
     
  90. MrWorfMen's Mom

    MrWorfMen's Mom Well-Known Member

    Joined:
    Feb 18, 2015
    Yes Monica. If you hold the dose for a few days, it will be enough time for any bouncing to clear, if that's what's happening and give you a chance to see if the pre-shot numbers are coming down a bit. If after a few days you don't see any lowering of the pre-shots or the pre-shots are consistently higher, then I'd re-evaluate. It's the pattern of the readings (pre-shot and nadir) rather than individual readings that will shed light on how Josie is reacting and how to proceed. :)

    Glad she made a decision for you! I'm sure you'd be scratching your head raw otherwise! :woot:;)
     
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  91. Yong

    Yong Well-Known Member

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    Jan 11, 2017
    Just curious about "crunching" sound, that's usually something expected when going through cartilage. Shouldn't be any sound from the lancet poking through skin o_O. Even if you do go through.

    [​IMG]
     
  92. Diana&Tom

    Diana&Tom Well-Known Member

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    Dec 29, 2009
    Yes - different viewpoints and options can be confusing for the caregiver trying to work out the best course of action, but "go with your gut" is definitely where I would start off in this situation. Although we are all commenting based on what we see on your spreadsheet, there is inevitably also an element of our own experience and instinct coming into play. You're the one living with Josie and noting her behaviour throughout the day. This is exactly why we encourage people to post on the public forum and not give advice via PM... individual suggestions can be reviewed by other members and you get a nice rounded full picture. It's a bit like going straight to one of your favourite clothes shops for a new outfit v going to several shops and weighing up some other options you hadn't thought of but also look good!

    So yes, make a decision and stick to it until say the end of the weekend. If you're going for the bouncing theory first, it may be tempting for you, if the 0.25u doesn't do enough or sends Josie higher than usual pre-shot, to raise the dose - but be resolute, it takes a while for the results of the experiment to become evident. If you're going for the sliding scale suggestion, you'd see the effect sooner. It will be very interesting to see what your vet says too.

    Oh and don't worry about Josie hiding in the garden... in this heatwave we all look for the coolest places around the home and it may well be that a shady area outside is the most comfortable place for Josie. Hopefully it will cool down over the weekend and we can all - kitties included - get back to some kind of normal!
     
  93. Monica Lewis

    Monica Lewis Member

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    Apr 16, 2017
    Good morning all,

    well AMPS was 19.2 but gave only .25 to get to the bottom of this bouncing ( or not.. )

    On the bright side I managed to do the blood test at FIRST try so Im well pleased with that!
     
  94. Monica Lewis

    Monica Lewis Member

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    Apr 16, 2017
    The crunching sound could just be in my head and I was imagining it as Im so reluctant to pierce..?
    Yes I am aiming for the sweet spot and working my way more towards the edge these days. Got it right this morning, probably just got lucky..! :)
     
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  95. Kris & Teasel

    Kris & Teasel Well-Known Member

    Joined:
    Aug 17, 2016
    It'll get better. You'll still have the odd complicated poke but they won't mortify you as much. Are you putting firm pressure on the poke spot afterward? That stops bleeding and prevents bruising.
     
  96. Monica Lewis

    Monica Lewis Member

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    Apr 16, 2017
    Yes always do the firm pressure tissue afterwards
     
  97. Monica Lewis

    Monica Lewis Member

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    Apr 16, 2017
    Last three tests on my own I did it with only ONE poke I cannot believe it, honestly. There were tears of shock, relief and happiness.. :)

    Next major challenge will be to master injecting insulin..!:nailbiting:

    So PS numbers are high but weather's been hot, not eating daytime, she stayed outside for the night and didn't eat overnight, no exercise... etc. so will keep dosing .25 for a few more days is that right?

    Although seeing red numbers making me a bit twitchy..
     
    Last edited: Jun 22, 2017
  98. Diana&Tom

    Diana&Tom Well-Known Member

    Joined:
    Dec 29, 2009
    OK Monica...
    First, congratulate yourself on getting the knack of testing... I know it's horrible at first for some of us (I'm like you and a bit squeamish) but now you're on a roll and that should give you a boost!

    I was almost exepcting to see those red pre-shots and it could be due to a few things. This dreadful heat is too much for all of us and I do feel sorry for our poor kitties and all animals come to that. It's stressful for them and that can raise BGs at the best of times.

    Disregarding the heat... it MAY be that 0.25u isn't enough for Josie. It MAY be that she is showing the effects of bouncing... I'm just running off to work but I think you know the basic theory? Give it a bit longer and meanwhile do what you can to keep her cool and tempt her to eat. Actually I think thunderstorms are predicted for today so we'll all be moaning soon and wondering where the summer went...

    I'll check in later...
     
  99. Monica Lewis

    Monica Lewis Member

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    Apr 16, 2017
    Thanks Diana,
    I love thunderstorms and I love the wonderfully gloomy grey wet British weather all year round! :)

    Ok will keep it at .25 for a bit longer.

    It's a bit tricky to dose.25 on a 40u syringe and I think you offered me before, when you can find the time could you please give me the link to which ones are the best 100u ones in the UK that I should use? I am totally clueless when comes to needles..
    Many thanks!
     
    Last edited: Jun 22, 2017
    Reason for edit: specify details
  100. Monica Lewis

    Monica Lewis Member

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    Apr 16, 2017
    Oh just one more thing, if Im unable to do curve right now what +hours would be the most important ones to aim for with the blood tests to get a better idea of her response to .25u? +2 +4 or +6?

    I gotta pick one as don't want to push my luck when going so well or drag her out from under bush every two hours... Thank you
     

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