Close, But No Cigar

Discussion in 'Feline Health - (The Main Forum)' started by Jackie & Ms. Soleil, Mar 16, 2019.

  1. Jackie & Ms. Soleil

    Jackie & Ms. Soleil Member

    Joined:
    Mar 15, 2019
    Soleil did well last night with the almost 1 unit of insulin. This morning I went to check on her in her room and there was no sign of vomit, and she had picked at the dry food last night, but didn't touch the little bit of wet food I gave her before I went to bed myself. I gave it a quick stir and gave it to Flash so that it wasn't wasted.


    There HAS to be a way I can get her to warm up to wet food so that I can get her off of the dry food. Yesterday I bought a small pack of chicken breast to boil up for her to try and get her to at least try that since she also won't lap up the turkey & turkey broth baby food with water. And she perks up for a Greenie or two (a dry treat; the version I have helps control hairballs). I read the bag to try and see the carb count, but carbs aren't listed on the label. It does appear to be high in protein. I've dug around online trying to find out if it's okay for her to have to try and entice her to eat or let her know that glucose test time isn't a punishment, but all I've found is that the best treats are pieces of boiled or raw meat. Right now the Greenies is the only thing showing me that she has an appetite and will eat, so I try to stick to only 3 - 4 total a day.


    Could it be possible that I need to try a different wet food format while trying different flavors (flaked / morsels instead of pate)?


    We also sat down this morning after giving her some fresh water and attempted to get a glucose reading from her again. This time instead of massaging her ear with only my finger, I used a washcloth wet with warm water. She sat still and didn't think much of what I was doing for a few minutes until I was ready to set the meter and get the lance stick ready. Today I was able to actually get blood to show up, but not enough for the meter to do a reading (received E1 error). I gave her a quick treat so that she wouldn't be afraid to come near me when she sees the small bag for the glucose meter, and let her go back to her closet to rest.


    I've watched a couple of videos for administering the glucose test. Some showed people using Vaseline to pool the blood. Doesn't that take away from the strip being able to get a reading just on the blood?


    Also, does anyone find that lancing the back of the ear is easier than the inside in regard to getting enough blood for the meter? Do I have to actually lance one of the spider veins in her ear (they're not the easiest to see regardless of how long I massage her ear(s))?


    She seems a little less stiff today than yesterday as well, so I'm not as panicked as I was. The real stressful part for me right now is how to get her off of the dry food, and onto a wet food diet. I feel like if I can't get her to do that that I won't be able to treat her the way I need to. I still have to read the links provided to me on my previous thread, and locate ketone test strips to pick up today. I have plenty of plastic grocery bags that I can line under a thin layer of litter so that I can test her urine the next time she goes. If I'm unable to be present when she's urinating, can I still use what's pooled on the plastic, or does it have to be warm?


    In regard to the buffet for Soleil and keeping Flash separate, since her diagnosis I keep them apart at feeding time, and I put away all of the food when she's enjoying her time outside of her room that way she doesn't eat the food he has, and he doesn't eat her prescribed food. They both have free roam of the house during the day when I'm at home, and this weekend will be the first time I have feeding times for Soleil where I'll have to put her back in her room for an hour or two. While Flash from what I can tell on the outside compared to Soleil is healthy, he will start a wet food diet once the bag of food I initially purchased for them is gone. Worst case I'll feed the dry food to the local stray cats that visit my backyard so it doesn't go to waste. While he appears to be healthy, is it the right decision to move Flash over to a wet food diet to avoid this same thing from possibly happening to him?
     
  2. JoyBee&Ravan

    JoyBee&Ravan Well-Known Member

    Joined:
    Feb 17, 2018
    No, you want to avoid the veins. (it hurts if you hit the vein) Here's a Pic of best place to test
    You can use the back of the ear to get a drop of blood. [​IMG]You only smear a tiny bit of Vaseline on the edge of the ear, it will help the blood to pool up.


    You can get FortiFlora on Amazon I sprinkle a tiny bit onto a spoon of canned food & it gets them to eat. A box has 30 packets & lasts a long time. You only dust the food with a very small amount. A piece of Real chicken is better than any "treat" you get in a package.!
    [​IMG]

    [​IMG]


    Feeding Syringe https://www.amazon.com/gp/product/B00FM8EOBG/ref=oh_aui_search_asin_title?ie=UTF8&psc=1

    Very good idea to stop all dry food for all your kitties. Dr Pierson has a good article in the Yellow Sticky notes on how to wean them off dry food & why it's so bad for all cats. You should also check the food Chart to make sure the canned food is low carb around 4% carbs
    If you decide to switch to Lantus or Levemir insulin I'll look forward to seeing you on the Forum. You'll get a lot of Expert advice from the people there.
    I'm glad your watching videos & trying to learn more. The more you know about the Insulin the easier it will be.

    It's very important you always test Soleil's blood before you give insulin. The more tests you start getting in the better. The data on the SS (spreadsheet) will tell you what her body is doing with the insulin.

    Great Job so far!!:) :bighug: Hope to see you on the Lantus forum! Good.gif
     
    Last edited: Mar 16, 2019
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  3. Julie and Honey

    Julie and Honey Member

    Joined:
    Dec 22, 2018
    Also good instead of Vaseline is antibiotic ointment (not the cream), that will also help ears heal from pricking and helps prevent any possible infection from all the little holes in poor kitties ears (I hate that part). A lot of people get the triple antibiotic ointment with pain relief, you may have some in your medicine cabinet already! Most places like Walmart have a generic. I usually put it on before test, just a tiny bit, rub between your fingers and dab lightly on edge of ear. I do it on both ears, because depending on her mood, I may have an easier time with one ear or the other and don’t know which until I am sticking her, then I am covered either way! After sticking and getting blood, I hold a small section of paper towel on ear I stuck over front and back of ear for 10 seconds to stop bleeding and then I put a little more ointment on to soothe it after sticking. I usually take a washcloth with warm water like you mentioned once or twice a day to gently clean the residue and start fresh so there is not old blood mixing with the next sample.

    Once you have stuck the cat regularly, you won’t even need to warm ears, at least for most cats. I tried rubbing my cats at first, but she did not like that at all, warm washcloth is easier and they seem to like that, at least mine does. Just get close to edge and try to avoid the large vein, no need to try and actually hit the tiny veins on edge in sweet spot, there are enough of them you will get blood. Are you using 28 gauge lancets? Those are best to start with, slightly larger. I initially bought the smaller ones and no luck getting enough blood.

    I have always used the back of the ear edge, thats actually how the ointment helps, so the blood pools on top and does not just soak into fur.

    My kitty was on dry for 6 years until diagnosed. I started her on Fancy Feast chicken pate after finding info here about low carb. I add a couple of spoons of warm water and mix it into a soup. She loves it. A lot of people here use it. I have also given her Tiki cat chicken and Tiki cat chicken and salmon, she loves them both, but I only get them when I have a good coupon as they are a little pricey.

    Although not good to give all the time, I have found a few flakes of canned salmon (people food) mixed into the cats food is incentive to eat. I pull out the bones, and avoid the “juice” because it has salt added. If you take out of can and put in a storage container, it will keep 4-5 days in fridge, just remember they do need regular cat food for the nutrients, plain meat is good as an extra incentive, but not good for all their nutrients. If the chicken breast works, that is cheaper and has less salt.

    I tried several treats before finding Whole Life freeze dried salmon. It isn’t the cheapest, but has decent size chunks in bag and I break them up into 1/4” little pieces. A small bag can last a couple of months if just using for testing and you break them into She now comes over for her tests because she knows she will get these treats, LOVES them. Also any “crumbs” at the bottom of the bag make a great topper for food!

    In regard to urine sample, does not have to be warm, but fresher is better. If you know it is say under an hour or so, should still be okay. I usually keep an eye on my cat when I want a urine sample and just follow her to the litter box, lol.
     
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  4. Idjit's mom

    Idjit's mom Well-Known Member

    Joined:
    Apr 3, 2018
    Hi Jackie, Soleil is a beautiful girl! Right now, it's important that she eats, whatever she will eat. I know that you want to transition her to an all wet diet to bring the numbers down, but that may be something that will take awhile. But if you are injecting the insulin, she needs food - whatever she will eat. It's a marathon, not a sprint in most cases and unfortunately doesn't happen overnight. Not all cats accept these changes eagerly.
    And yes, a wet low carb diet is better for Flash too. It's not just a carb concern with the dry food, it's a moisture issue too, for good urinary health. Perhaps if Soleil sees Flash eating it, it might appeal more to her.
    You can prick her ear on whatever side works for you, inner or outer, and this also is a process of patience and practice. JoyBee gave you the picture of the sweet spot. Some members do the prick, then get the blood sample on a clean fingernail, then use the meter. When it gives the value, then you can compress the ear a little to help prevent bruising. We use a cotton ball to back the ear when we prick and use that for the light compression. You can apply a very light film of the pain relief ointment before and after the poke. It does help the blood bead up if you can get her to hold still long enough to get the meter there.
    The Greenies are a high carb treat, but for right now this works as an enticement and a reward for testing, so use it. You will find something to replace them as you go along. Hopefully little chunks of cooked chicken breast or some tuna flakes will be accepted as a replacement. I realize there are cost issues and although there are suggestions about what works for members, they are just that, when and if you can afford some of the suggestions and want to try them. Everyone just wants Soleil to be better and for you to be able to deal with it all.
    If you get the ketone strips, follow the directions on the packaging. I haven't used them myself, but I have read here that the urine should be fresh.
    Please keep us updated and let us know how Soleil is and what is happening. For now here's a :coffee: and a :bighug:.
     
    Last edited: Mar 16, 2019
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  5. Jackie & Ms. Soleil

    Jackie & Ms. Soleil Member

    Joined:
    Mar 15, 2019
    Thank you everyone for your suggestions / recommendations. It’s helped in more ways than one.

    After recieving the ear chart I tried getting a glucose reading again. I got as close to the edge of the ear as I could and was able to get a little blood, but not enough. She’s been very patient with me and I’m grateful for that. I plan on trying again in the next few hours.

    About an hour after trying to get a glucose reading she came out demanding food. I complied and gave her a bowl of the RX food. It’s the most I’ve seen her eat without getting sick afterward. I’m hoping she does this again in a few hours so I can try to give her wet food instead to see if she’ll accept it. I agree, I have to work with what she accepts for now and gradually make the changes for her while staying light on her treats. I’ll also look into that powder for when she starts accepting wet food. For now whatever she doesn’t eat I give to Flash to start his transition. So far he hasn’t complained. :cat:

    She also hasn’t had any adverse reactions to the insulin. I just need to be able to get a glucose reading. I have Neosporin for healing and pain so I can dab that to numb the lance area a little.

    Wish me luck on my next glucose attempt!
     
  6. Idjit's mom

    Idjit's mom Well-Known Member

    Joined:
    Apr 3, 2018
    I am so glad she is eating, goooooood girl!!! That's a relief isn't it?
    I do wish you luck on the testing! You should have seen us at the beginning, and there were two of us! I can only compare it to a Laurel and Hardy movie routine. We still double team, Idjit is not the most compliant cat in the universe, except when it comes to eating. You will get the first reading and then a second. Then it's just becomes part of your daily routine.
    Just a note, please read the following links just in case, forewarned is forearmed.
    http://www.felinediabetes.com/FDMB/threads/how-to-treat-hypos-they-can-kill-print-this-out.15887/
    http://www.felinediabetes.com/FDMB/threads/jojo-and-bunnys-hypo-tool-box.2354/
    Idjit went into remission very quickly, before we had even figured out what we were doing, and his blood sugar went down fast. He got a little too low at one point, and I just happened to test, but I was not prepared for what I should do. The members helped me out and he was fine, but I try to suggest this reading for all new members so they can be prepared.
     
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  7. Jackie & Ms. Soleil

    Jackie & Ms. Soleil Member

    Joined:
    Mar 15, 2019
    Sucess!

    After thinking about it for a couple of hours, I realized I don't have to use the lance plunger to prick her ear, or use an over-size rag to warm up her ear. Once I got her settled in my lap, I used a cotton ball soaked in warm water to get her ear prepped, and then manually pricked the outer part of her ear. Her reading before eating again to have her evening insulin came back at whopping...

    119

    Compared to what she came back with when she first diagnosed, this reading is WAY lower. And if I'm right, per the vet, she should be under 150. Please correct me if I'm wrong. I'm just so excited I was able to get a reading on her this time so I could get a better idea of where she's at.

    I filled out the spreadsheet as well; including her first insulin dose this morning even though I didn't have a reading for the AM. Hopefully I'm starting it off correctly.

    More updates to come tomorrow. Hopefully I can get two readings. It'll be a small but exciting victory.
     
  8. Julie and Honey

    Julie and Honey Member

    Joined:
    Dec 22, 2018
    Good to hear! I was looking to see who was logged in to give you some advice, 119 is a good number. You may want to post on Novalin board about dosing help. Not sure about to shoot or not to shoot numbers.

    Only thing I might mention, and you probably thought of this, just make sure ear is dry or pretty dry if using anything wet so the blood drop is not diluted with water which could affect reading.
     
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  9. JanetNJ

    JanetNJ Well-Known Member

    Joined:
    Jun 8, 2016
    Don’t shoot 119.
     
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  10. Julie and Honey

    Julie and Honey Member

    Joined:
    Dec 22, 2018
    Thanks Janet, I think she is off now, hopefully she will check back. If she has already shot, can you offer any advice as she may see this after already shooting also if someone can help her in case kitty goes too low?
     
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  11. Jackie & Ms. Soleil

    Jackie & Ms. Soleil Member

    Joined:
    Mar 15, 2019
    Evening! She got insulin but just 1 unit. I’ll look for the Novalin forum to see what range I shouldn’t give her insulin for, but in the case that I can’t find it, is there a general range to not give her a shot for?
     
  12. JanetNJ

    JanetNJ Well-Known Member

    Joined:
    Jun 8, 2016
    We usually recommend that new folks don’t shoot under 200. Be sure to test vigilantly tonight.
     
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  13. JanetNJ

    JanetNJ Well-Known Member

    Joined:
    Jun 8, 2016
    Please update your spreadsheet
     
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  14. Idjit's mom

    Idjit's mom Well-Known Member

    Joined:
    Apr 3, 2018
    Are you able to test again Jackie? The warm wet cotton ball worked, maybe put a piece of plastic wrap between the ear and the cotton, to be sure the blood isn't diluted. I do not see your BG in the spreadsheet. The AMPS means the test you take before the morning pre-shot, then you count how many hours until your next test. So if you tested at 6AM, you enter the BG there. Then if you test mid-day 5 hours later, you enter the BG in the +5 cell. Was the 119 her PMPS (evening pre-shot)? Then enter 119 in that cell, right before the number of units (this evening it was 1).
    If you do not shoot insulin either in the morning or at night, you put NS for no shot in the Units cell.
     
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  15. Jackie & Ms. Soleil

    Jackie & Ms. Soleil Member

    Joined:
    Mar 15, 2019
    @Idjit's mom i updated the spreadsheet through Google Dirve yesterday and twice today. Let me know if you still don’t see the updates on it.

    This morning, in case the spreadsheet isn’t reflecting the changes, her glucose was high again in the 400’s. So after she ate, and I gave her a few minutes to let the food digest, I gave her the full two units. I just tested again a few minutes ago and she tested at 83, so she got some food, but no insulin.

    She been very patient with me during the testing. She only squirms when she feels the prick, but she doesn’t try to wriggle away for the most part. Getting her to stretch out on her side makes it easier to keep her still vs having her sit normally with her feet tucked under her.
     
  16. Jackie & Ms. Soleil

    Jackie & Ms. Soleil Member

    Joined:
    Mar 15, 2019
    Her normal twice per day dosage is supposed to be 2 units. Last night I didn’t give her the full 2 because she was on the low side, and I didn’t give her an evening dosage at all because she was lower than she was yesterday evening.

    My understanding is she should get the full dosage originally prescribed if her numbers are high. I definitely don’t want to give her any if the numbers went down out of fear of causing a low blood sugar incident.

    Once I have an actual glucose range for a few days, I’m sure I can report it to the vet and see if she’d recommend 0 - 1 unit twice a day considering the fluctuation if it continues this way.

    Other wise, she’s in the best mood she’s been in in a few days. Today she’s chosen to bird watch (see attached)
     

    Attached Files:

  17. Idjit's mom

    Idjit's mom Well-Known Member

    Joined:
    Apr 3, 2018
    Hi there, I do see some updates on the spreadsheet, but I am wondering about it. You say she tested in the 400s this morning. So, that red colored 479 I see in the +11 cell should be in the AMPS cell for today's date. Then her PMPS test of 83, if that was indeed the evening pre-shot reading would be in the PMPS cell for today. What times of the morning/night are you testing, your time. Are you testing 12 hours apart?
    You gave her a 1 Unit shot last night, what was the pre-shot number? That number would be entered into the PMPS cell for yesterday's date.
    We use the +hour system on the spreadsheet because members are all over the world, and then we can tell what the levels are in terms of hours for the pre-shot and the in between shot times when you test. I know you are new to testing, but it's good to get some mid-cycle tests as you can, so you can see how low the insulin dose is taking Soliel. Doses are determined by the "nadir" the lowest BG reading in the cycle. A before bed test is also desirable, and that would be in a cell that is however many hours after your evening pre-shot test number.
     
  18. Idjit's mom

    Idjit's mom Well-Known Member

    Joined:
    Apr 3, 2018
    @Wendy&Neko is someone who has experience with Novolin, and I have tagged her so that she can have a look in and perhaps make some suggestions.
    I am trying to learn more about Novolin too, this is from the Beginner's Guide to Novolin:
    In cats, N/NPH tends to be a faster-acting insulin, often with a rapid ‘onset’ and a short ‘duration’. It may not last in the system a full 12 hours. Some cats only get around 8 hours duration. How long it lasts depends on the individual cat: as we often say around here, Every Cat Is Different (ECID).
    N/NPH can start acting quite soon after it’s injected, and it can drop the blood glucose very steeply in the first hours of the insulin cycle. It is therefore very important that the caregiver learns to test the cat's BG at home (‘home test’) as soon as possible, and becomes familiar with the effects of N/NPH in their cat’s system.

    So, I'm thinking, the more mid cycle (between shots) tests you get the better to see what's happening. Read that guide Jackie, and keep re-reading it, the information will become clearer the more you do.
     
  19. Jackie & Ms. Soleil

    Jackie & Ms. Soleil Member

    Joined:
    Mar 15, 2019
    @Idjit's mom Right, so yesterday I did notate that in the AMPS she got 2 units, but I wasn't able to get a reading on her that morning so the rows are blank from +1 through +11. Yesterday I tested at 7/ 7:45 in the PM, and notated that she got 1 unit for 119 in +7. This morning she got 2 units for her reading of 479 at 11 AMPS (+11), and I tested her again today a little after 4 p.m. so I placed her 83 reading in +4 with NS because she's already in the green.

    Should I be using the cells under the AMPS / PMPS column itself? I looked at yours as an example and thought I was putting the information in correctly. Are the AMPS and PMPS columns for the actual number I'm getting before food and insulin and then the +1 through +11 is only for the next test done after the insulin was administered? I'm also working on the every 12 hours part. I'm hoping tomorrow it can start being more regulated based on when I wake up in the morning to prepare for work and when I arrive home after work.
     
  20. Wendy&Neko

    Wendy&Neko Well-Known Member

    Joined:
    Feb 28, 2012
    Sorry, I have never used Novolin. I can't help you there on dosing. Here is the link to the Caninsulin/Novolin forum, you could try posting there. Or change your subject title on this thread to include "Need Novolin dosing help" to see if someone here can help you. Go to the first post you did on this thread, there should be a menu on the top right that allows you to edit the title.

    What I can suggest is how you are testing. You can put warm water in an old pill bottle, or old film canister if you still have those around, and hold that against the ear. That will keep the ear dry.
     
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  21. Idjit's mom

    Idjit's mom Well-Known Member

    Joined:
    Apr 3, 2018
    Are the AMPS and PMPS columns for the actual number I'm getting before food and insulin and then the +1 through +11 is only for the next test done after the insulin was administered?
    Exactly!
    Yes, the AMPS and PMPS are the cells to use for the pre-shot numbers. My spreadsheet is not the best example, not a lot of information there to go on.
     
  22. Jackie & Ms. Soleil

    Jackie & Ms. Soleil Member

    Joined:
    Mar 15, 2019
    @Idjit's mom perfect, I just updated my spreadsheet so that the numbers are in the correct spaces. I'll be sure to it this way going forward, and I'll try to test her again tonight before bed. It's easier getting multiple readings during the day on the weekend because I'm at home, and I'm still trying to ease her into it. While I appreciate her patience with me, I still don't want to maker her ears too raw and she starts to avoid me when she thinks she's getting tested.

    @Wendy&Neko thank you, I'm still working my way around the forums to find what I need. I favorited that particular location on the page in regard to her insulin and will read it over.

    If I have insulin questions in general, I'll be sure to pop over there and read some of the previous comments and the help article first to see if it's already answered.
     
  23. Idjit's mom

    Idjit's mom Well-Known Member

    Joined:
    Apr 3, 2018
    Apologies Wendy, I thought you were the member that posted just recently that she had used Novolin. My mistake. I will try to find that user. :)
     
  24. Jackie & Ms. Soleil

    Jackie & Ms. Soleil Member

    Joined:
    Mar 15, 2019
    I like the bottle ideas! I feel like the cotton ball and wash cloth cool so quickly, but in a prescription or film canister is easy and will maintain the warmth for longer. Maybe I can finally get the testing down to one prick instead of having to try a couple of times.
     
  25. Idjit's mom

    Idjit's mom Well-Known Member

    Joined:
    Apr 3, 2018
    I see and that's terrific. When we test, I use a cotton ball to "back" the ear I'm poking, to protect me in case it goes through. Then I use the cotton ball to compress the poke site, that helps prevent soreness and bruising. You can also dab a little of the pain relief ointment on and alternate ears. I absolutely understand you not wanting to ravage her ears and making her angry, upset or defensive. This does get easier as you become more confident and practiced.
    I do suggest you post on the Vetsulin/Novolin forum HERE for dosing help, skipping shots is not usually the best approach to getting a cat regulated or have a hope of remission.
    I think you have done splendidly so far, she is eating, you have learned to inject and test. That's a lot to deal with all at once. Kudos sweetheart!
     
    Last edited: Mar 17, 2019
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