Days Since Setback: 13

Discussion in 'Feline Health - (Welcome & Main Forum)' started by Jackie & Ms. Soleil, Mar 23, 2019.

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  1. Jackie & Ms. Soleil

    Jackie & Ms. Soleil Member

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    Mar 15, 2019
    Before Soleil was diagnosed, she was vomiting on a regular basis. Initially it was only once or twice every couple of months. And because I had never seen her get sick on food before, and her brother inhales anything he can get his teeth on, Flash was the one getting the blame. But then it started to become an every other day incident, and I noticed her weight loss. That's when I realized she was sick and set up the appointment that returned results for her being diabetic. It was after her first night on diabetic food that I realized that most of the vomiting was coming from her based on the amount of vomit in the room she was in for the night.

    The day after her diagnosis, my parents came down to help me vomit proof what I now call her studio apartment. We cut a thick piece of plastic and fit it to the room so that if she were to get sick again, it'd be easy to clean up. Since then, she hadn't gotten sick. Up until either late last night / early this morning. It wasn't dry, but it wasn't super wet still; so it hadn't been there for too long. And it looks like a cross between a hairball and a little bit of food. When she first got sick on the food, it was a little bit of hairball and mostly food. I had just taken up the plastic yesterday because I was confident another vomiting incident wouldn't happen for a while, this morning after checking her numbers, I put the plastic back down. It wasn't the easiest task for one person, but I got it done. I gave her some fresh water and fresh food after putting her litter box and lounging / hiding furniture back in place. She also tested in the mid-200's (spreadsheet updated). Since then she’s gone back into the mid / low-400’s, so she received only 1U for the morning.

    I'm thinking this is the aftermath of her dropping as low as she did a couple of nights ago from having 3U instead of 1.5U or 2U. I'll definitely take a little vomit over a night of trying to fix a crash. It's a minor setback that was easy to clean up and pro-actively prepare for in case it happens again over the next few days.

    This weekend I want to attempt to get a urine sample from her on a ketone strip so that I have all of my bases covered in regard to her monitoring. This will be difficult because she's a private litter box user, but if I'm stealthy in stalking her, I may not be able to get the strip right under her while she's going, but I'll at least be able to dip it in a pool of urine while it's still warm. In a few hours I'm going to line a shallow amount of litter on some plastic shopping bags so that it pools before becoming a clump from the litter.

    Any suggestions in regard to getting a successful sample would be great. I'm not getting a fruity scent from her, so I don't feel so pressed to get a reading from her like I felt pressed to get a glucose test done before giving her insulin, but I do want to get it done so that I can be sure she's good in that regard at least.

    Some good news, though. Her new vet asked some of the other doctors and they confirmed that they have patients taking Lantus. As of yesterday, she's been prescribed this insulin in the form of a pen. Thanks to DCIN, I'll be receiving assistance to help get this for her so that she's getting better help with regulating her levels. So she'll only be on the Novolin N for a little while longer until I receive her new supplies. She prescribed 1U every 12 hours. So I'll have to go over to that forum to read up on this insulin.
     
    Last edited: Mar 23, 2019
    Reason for edit: updated glucose reading
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  2. Idjit's mom

    Idjit's mom Well-Known Member

    Joined:
    Apr 3, 2018
    What wonderful news about the Lantus insulin Jackie! Please also look at this:
    http://www.felinediabetes.com/FDMB/threads/muffin.212306/#post-2352841
    You may be able to increase your supply of Lantus this way and have it stored safely in the fridge for future use.
    The folks on the Lantus forum are going to be a very valuable resource and reading the information is going to be a great start. You can use the pen as a mini vial with syringes, and use it to the last drop. Using the syringes also gives you the ability to fine dose, and not have to be confined to doses in full units.

    Ms. Soleil is on her way to feeling much better and you will be able to provide her even better care. You have been so diligent about learning and finding answers, it shows just how much you care. :cat:
     
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  3. JanetNJ

    JanetNJ Well-Known Member

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    Jun 8, 2016
    My cat is very hard to catch on the box, so I got a blood ketone meter instead.
     
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  4. Idjit's mom

    Idjit's mom Well-Known Member

    Joined:
    Apr 3, 2018
    Jackie, I just wanted to add this so you would see it regarding using the Lantus pens. I saw this just a few minutes ago on another member's thread.
    One important thing. Do not inject air or insulin back into the pen. It can turn the insulin bad.
    So, it works just a little differently with the pens than using the bigger vial.
    There is a video of drawing insulin from the pen in the sticky http://www.felinediabetes.com/FDMB/...info-proper-handling-drawing-fine-dosing.151/
     
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  5. Jackie & Ms. Soleil

    Jackie & Ms. Soleil Member

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    Mar 15, 2019
    I didn’t know there was such a thing. Where did you get yours from?
     
  6. Marje and Gracie

    Marje and Gracie Senior Member Moderator

    Joined:
    May 30, 2010
    Jackie

    Good job getting a curve today!

    When starting Lantus or Levemir after kitty has been on another insulin, we start close to the dose that was working while receiving, in this case, Novolin N.

    While you generally dose Novolin N on the preshot number, Lantus is dosed primarily on the lowest number in the cycle or the nadir. When I look at her SS, IMHO, even with Novolin N, the dose has been jumped around too much. I can’t follow your dosing strategy.

    With Lantus, we dose much more consistently than you are dosing the N. Without a bit more testing on the N, it’s going to be more difficult for us to help you with what the best starting dose for Lantus is; it might or might not be 1u. I’ve seen vets before arbitrarily pick 1u when the kitty needed much more; the result was the cat sitting in high numbers a lot longer than necessary.

    Lantus is a depot insulin and you have to give the depot time to fill before you change the dose. Therefore, we like to start as close to a good dose as we can when there’s data from another insulin.

    Vomiting, especially bile or foam, is due to acid tummy. It wouldn’t be from bouncing although if she was hypoglycemic, she might have vomited from being too low. However, vomiting, even hairballs, is typically an indication of GI issues. It’s possible it’s a food sensitivity. Often the culprit is IBD but cats with chronic kidney disease also vomit.

    It will improve her QOL and yours if you can determine what is causing the vomiting.
     
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  7. JanetNJ

    JanetNJ Well-Known Member

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    Jun 8, 2016
    Amazon. They are pretty popular now with people doing low carb keto diets. I'll link to the one I got. This meter helped me as well. I tested myself and learned I was severely anemic.... (This meter also read hct and hg levels). I was Almost to the point of needing a blood transfusion. I went to my dr and she confirmed it. My partner also learned she was low as well.... Now we are both taking iron.


    This is the kit I bought.

    KETO-MOJO Blood Ketone and Glucose Testing Kit, Monitor Your Ketogenic Diet, 1 Meter, 1 Lancing Device, 10 Lancets, 10 Ketone Test Strips, 10 Glucose Test Strips, Carrying Case https://www.amazon.com/dp/B0789G8KTG/ref=cm_sw_r_cp_api_i_D9ZLCbW2S9PF5
     
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  8. Jackie & Ms. Soleil

    Jackie & Ms. Soleil Member

    Joined:
    Mar 15, 2019

    By the time I receive her first pen, I should hopefully have enough readings recorded to know where she should be. I think .5U for the Novolin works best for her right now because it appears as though it takes her down, but not too fast or too low. I’ll be home all day today so I can take more readings and monitor her. I’m also attempting to ween her off of the dry RX food so this morning she got two fresh bowls of different wet food, and only a little bit of the RX just in case. Hopefully she accepts only wet food after some time.
     
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  9. Marje and Gracie

    Marje and Gracie Senior Member Moderator

    Joined:
    May 30, 2010
    Just remember as you pull away the dry, the numbers are likely to drop more. It’s best to wean off dry slowly or you could be dealing with crashing numbers.

    If at all possible, it’s best to have her off dry before you start Lantus because you aren’t dealing with a depot on Novolin. She gets the insulin you shoot or, if you don’t shoot, there’s really not much residual the next shot. However, with Lantus, once the depot builds up, even if you skip, there’s residual insulin in the depot which can leave you working harder to keep low numbers up as the dry leaves her system.

    However, if you think it will take a long time to get her off dry, go ahead and switch insulins when ready. You can always really eek the dry food down slowly if need be and we can help you adjust the insulin dose, as needed.

    Does that make sense?
     
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  10. Jackie & Ms. Soleil

    Jackie & Ms. Soleil Member

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    Mar 15, 2019
    It does make sense. I don’t think I’ll be able to have her off of dry completely, but I can try. Right now I’m questioning if she has an issue with the bowl it’s in. She’s started turning her nose up again but if I put a little of the Freshpet on the carpet, she goes for it. I clean it when I give her fresh food, but she decides to get finicky and I end up laying with her until she eats as many pieces as she feels like eating (10+).

    I’m actually seeing the change in her numbers today since I’ve been trying to test every two hours. Depending on where she is this evening she should only need .5U again for the evening until the next morning.
     
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  11. JanetNJ

    JanetNJ Well-Known Member

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    Jun 8, 2016
    those are really steep drops quickly. are you doing the preshot tests BEFORE all food?
     
  12. Jackie & Ms. Soleil

    Jackie & Ms. Soleil Member

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    Mar 15, 2019
    I’ve been doing them before her shots assuming she hadn’t ate much of anything. After her test I make sure she’s eaten before her insulin. Her food stays down so I can’t be sure if she had eaten right before. A lot of the times I was catching her for a test during a nap or she’d come and get my attention.
     
  13. Marje and Gracie

    Marje and Gracie Senior Member Moderator

    Joined:
    May 30, 2010
    You might want to frontload her food over a few hours to try and slow those drops. The first meal would come before her shot but then you’ll want to try and feed her hourly the first couple hours to see if the food can help offset the insulin onset.
     
  14. Jackie & Ms. Soleil

    Jackie & Ms. Soleil Member

    Joined:
    Mar 15, 2019
    Okay, I just want to make sure I’m understanding / doing this correctly. Bear with me; this is based on my schedule throughout the week:

    Between 7 pm and 9:30 pm: if possible another test is taken (food and water is still available)
    From 9:30 pm to 5 / 5:30 am: Soleil is left with food and fresh water overnight
    Between 5 and 5:30 am: I’m awake and checking her numbers. I’m also freshening her food and water so that she has something in her stomach before giving her insulin
    Between 6 and 6:30 am: if I’m able I take another reading and she’s getting her insulin (food and water still available)
    From 6:30 am to 4 / 4:30 pm: she’s left with the fresh food and water throughout the day while I’m at work
    Between 5 and 5:30 pm: I’m checking her numbers and freshening her food and water so that she has something in her stomach before getting her insulin (she could have nibbled on food up until I’ve arrived back home and gotten settled)
    Between 6 and 6:30 pm: if I’m able I take another reading and she’s getting her insulin
    Between 7 pm and 6:30 pm if possible another test is taken (food and water still available)

    I’m trying to work around my schedule while also ensuring she’s got access to food in case she needs to eat while her numbers level out when I’m at work, so it’s difficult to know is she’s already eaten when I get home or when I wake up in the morning to start the cycle again. I’m also trying to give her 30+ minutes between her initial test and eating before giving her insulin.

    I also have to fine tune her spreadsheet to reflect the actual windows I’m using to test and give her the insulin.
     
    Last edited: Mar 25, 2019
    Reason for edit: Updated response with actual schedule
  15. Marje and Gracie

    Marje and Gracie Senior Member Moderator

    Joined:
    May 30, 2010
    Yes, that looks fine and thank you for posting it. The one thing I would say is that you should always get a test within 15 minutes of giving her insulin. Even if you got a test 30 minutes before, numbers can change rapidly. Since you’ve already fed her so she has food for the N to work with, then you should really test her immediately before giving insulin. As in, test, shoot. There shouldn’t be any reason why you shouldn’t.
     
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  16. Jackie & Ms. Soleil

    Jackie & Ms. Soleil Member

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    Mar 15, 2019
    Okay, I think I know how to tweak her spreadsheet so I can see what I’m doing based on the windows I have for testing / feeding shooting. Thank you!
     
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  17. Marje and Gracie

    Marje and Gracie Senior Member Moderator

    Joined:
    May 30, 2010
    You’re welcome!
     
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