Fast reaction to first ever shot?

So, Rosa was just diagnosed 2 days ago and started on lantus 2 units this evening. She got the shot about an hour and half ago and actually seems a bit happier in herself already - she just cleaned herself well for the first time in a couple of weeks and is definitely a bit more alert and perkier than she has been. Her reading at the vet today was very high - 680. Is it normal with a reading this high that she'd feel better in herself quickly after the initial dose? I'm wondering if even a small reduction on a reading so high would make her start to feel better quickly. Obviously keeping a close eye on her to make sure she doesn't hypo.

 

Hi rosa

It is normal that cats read higher than normal at the vets and at home maybe up to 100 units lower.

The vet has started you on quite a high dose of lantus and my guess is she has dropped quite a lot lower already and so yes she may well be feeling better. Are you able to get a blood test from her. Have you tried yet? It would be worthwhile getting a test in a couple of hours after her dose to see what is happening.

You have your hypo kit ready ?
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/

I am hoping other members can advise more as my experience is limited but I do think the 2 unit is a little high. How much does Rosa weigh? In comparison by Burmese boy who is 5 kg started on 0.5 unit twice a day and we worked up from there. If you start high you might miss the best dose and risk blood glucose going to low.

Keep us updated. You are able to keep an eye on her today?

 

That makes sense. Obviously I'm glad to see her feeling better, but I just wasn't sure if she was having an odd reaction or if it might be normal so quickly.

I don't have a test kit yet - Rosa is very reactive at the vet so they didn't want me to start that at the same time as the shots. I guess they think she's the same at home as she is there - she isn't, she's actually very calm and gentle with me. They did calculate the dose based on her current weight (8.8lb - down from 11 in August 2014) and the reading they got from her. I can say she was extremely stressed at them trying to get blood from her today - I could hear her screaming from the reception area and asked them if I could go back there to calm her down but they didn't want me to. I'm going to really push them to let me home test her levels when she goes back for her follow up next week - I'd be much happier if I could keep a check on it myself to make sure nothing's going wrong. No doubt they think I'm a control freak, but having dealt with diabetes in human relatives, it seems really odd to me and possibly dangerous too not to test her levels at least 2-3 times a day.

I do have everything ready in case she hits a hypo. I was lucky - our housemate always has jars and jars of honey in the house so that was one less thing I had to go and get today.

I'm not working at the moment - I've been looking for work, but right now I'm quite glad to be able to be home with her the first few weeks while she gets more stable. I'm bringing her into the bedroom with us overnight so I can keep a close check on her - I always wake up a few times at night anyway so fortunately it'll be easy enough for me to make sure she's doing OK each time.

 

Hi again. I am glad you can keep an eye on her. Print out that hypo link and keep it near you.

Ideally you would test her at home and you certainly don't need to get permission from the vet. I just went out to my local store and bought a human testing kit, test strips and lancets, low carb treats. It should be nothing like as stressful as at the vets.

Transitioning to low carb food can also dramatically reduce the need for insulin and do this very slowly. Again members advice doing this whilst monitoring blood glucose levels.

I am hoping more experienced members will give you more advice

 

Hi and thanks for the advice. The vet already switched her to the MD food today as well as prescribing the lantus. I will definitely keep the hypo print out close at hand in case everything goes wrong at 3am when I can't think straight!

I'm going to take your advice and get the necessary testing kit tomorrow - I really don't like the idea of dosing when I don't know the starting point, it just makes me nervous especially when I've worked with the complex calculations for working out how much insulin a kid should get based on their current level and what they're about to eat. Blind dosing just doesn't feel right after that! And when she's just been switched to the low carb diet too. For now, she seems to still be doing great - she's alert, more so than recently, and seems very content and happy so hopefully she'll make it through the night with no problems until I can get the testing kit bought tomorrow.

 

I would make sure that rosa has access to food throughout the night in case she does go low (especially when you are asleep). Personally I would leave down her old high carb dry food as you are unable to monitor her blood glucose levels.

When did she have her shot and what has she eaten so far?

 

She had her shot around 930 pm. She ate just about 3/4 of a can of MD - eventually...it took her a couple of hours to get through it as she's not really been eating the last week and a half but I didn't give the shot until after she'd eaten most of it. I took her old food away earlier, but as she and her twin are used to free-feeding on the dry food, they're not so impressed with that idea. I will indeed put it back out for tonight in case she needs it. I wouldn't have thought of that without your advice - thank you so much for that.

 

Here is a link to blood glucose monitors

https://docs.google.com/file/d/0B9RKBhanggleTWhRTFVEc0xYbkk/edit

Hopefully US members will give more advice. I am in the UK and found that whilst the accu chek aviva was good it need a lot of blood and also the test strips were quite expensive (cheaper on eBay). Not sure what US members recommend.

With regards the food it is probably easier to transition slowly so tomorrow just swap 25 % of her old food with the normal. The next day 50%, etc. that way you can avoid upset tummy and also get more used to testing as I do believe the wet will drop her blood glucose levels and hence the need for as much insulin.

 

I'm from the UK originally - I moved to the US in November 2013. I just put some of her old food down - she's eating it as though she's never seen food before. It's good to see her eat so happily even if it isn't the best food for her. Once I can test her properly, I can re-evaluate the food situation. I agree the sudden change in diet isn't usually recommended for cats. I believe Walmart here sells a decent glucose monitor and we have one only about a mile from the house so that will be my first stop tomorrow morning. I'll report back in the morning on what sort of night she's had and how we're getting on with the monitoring. Thanks again for your help tonight and I'm sure we'll talk again soon.

 

It could be a sign she has gone low. Make sure you keep that dry food topped up. Just put loads down. Cats don't always show signs of hypo.

Can I ask that you check back in this thread before giving her next shot tomorrow. I have asked for help from the lantus forum and they might have posted by then. Ideally you would not give the next shot without getting a blood test first.

Sorry I hate to worry you but want to keep rosa safe.

 

You could also add a little honey to that dry food just to make sure. How many hours since your shot?

 

We have two protocols used here for Lantus dosing. For the Tight Regulation protocol, we start cats on .25 units per kg of ideal weight, or actual weight if kitty is underweight. Since Rosa is 8.8 lbs (or 4 kg) that would be a starting dose of 1 unit. In the Start Low, Go Slow protocol, we start at 0.5 units if kitty has transitioned to wet food, 1.0 U if dry food is still in the picture. I would start with either 0.5 or 1.0 units as the dose tomorrow. Better too high for a day than too low for a minute.

A popular blood glucose meter here is the Relion Confirm or Micro. It takes just a very small drop of blood and the price of strips is low. There are lots of videos on Youtube to show you how to blood test your cat.

Good and bad that Rosa is on M/D. The good thing is that it's higher carb food than a diabetic should eat, at 14%, which should help keep her safer tonight. The down side is that it's not a good choice for a long term food. We use the food list on the www.catinfo.org site to help us decide what foods to feed. You want a low carb, canned or raw wet food below 10% carbs. However, you shouldn't transition from a dry food to a wet food until you can test her, as insulin needs can quickly drop.

 

whoa on the honey you wont need that and the dry food. posting more in a sec just wanted to stop the honey if i can

 

Thanks vyktors mum. I don't think she probably did that. I just panicked a little as was the only one about.

 

tee hee better to be safe than sorry, you were doing a great job on your own there

 

Excellent that you're picking up your meter tomorrow it will be much easier, cheaper and less stressful for you to do the tests yourself. As an example of the discrepancies that can arise with stress - Vyktor who is in remission was at the vet for an unrelated matter this week. I test him once a week to make sure everythings still good and happened to have tested him that morning - 79 and at the vet - 196.

It's great that you have some background with diabetes too so you do understand the importance of testing. Often times vets think it's going to be really stressful for the cat - maybe because the cats are so stressed by them doing it - my vet was amazed that I have no problems testing Vyktor since he's such a horro when he's there

 

oops posted too soon, doing this from ipad so a little fiddly.

The vet also loved his spreadsheet (you can find that in the tech board - sorry would post a link but the ipad!) and the fact that they never had to do try and test his glucose themselves.

When you have a moment I highly recommend you pop over to the lantus/levemir board and check out the stickies (posts stuck at the top) to learn about the protocols I'm a big fan of tight regulation if you can manage it as it has a proven track record of remissions in about 80% of cats that start using the protocol when they're first diagnosed. You may wish to start posting there for your lantus advice too as that's where the most experienced lantus people hang out.

Welcome to the board you have found the right place for you and Rosa

 

Another manx cat??? My Dweezil is a manx too, yay!!!!

 

Welcome to FDMB.
When you stop by the pharmacy to get a meter, pick up some KetoDiaStix which test the urine for ketones and glucose.
Ketones form when fat is broken down for calories (the glucose doesn't have matching insulin to allow it to be used). Too many may indicate diabetic ketoacidosis (DKA), an expensive to treat complication of diabetes which can be fatal. If you detect more than a trace on a fresh urine specimen, it can warrant an urgent vet visit.
Glucose in the urine is a rough indicator of control since the previous void. Not as precise as blood testing, but a useful backup when starting out.

 

Welcome!

My hunch is that the formula that your vet used to calculate your kitty's dose is based on the original Lantus Tight Regulation protocol and he hasn't seen the more recent formula. The newer formula is"

initial dose = 0.25 x ideal weight in kilograms​

The older formula used a different constant (i.e., 0.5 vs. 0.25 in the newer calculation).

Depending on what you were feeding Rosa previously, the MD may be a reduction in the carbs in her food.. MD is 14% carb. Most of us feed under 10% as low carb. Here's the link to the food chart we use for carb counts. If you want lots of information on feline nutrition, the website that I linked is a wealth of information and is written by a vet.

As for meters, many people here use the Walmart brand meter -- Relion. The strips are among the most inexpensive around. You'll need to get a meter, a good stockpile of strips, and lancets for pricking Rosa's ear. I'd suggest getting a wider lancet (27 or 28 gauge). Once Rosa's ear "learns" to bleed, you'll be able to switch to a thinner lancet (e.g., 30 gauge).

Just to make sure, please verify that you have U100 syringes. These are they kind of syringes that you need for Lantus. I doubt your vet made an error but it doesn't help to double check. You may also want to read this sticky note from the Lantus board. There's info on meters and on how to get started.

 

Such a lot of useful information - thank you all. Oh and Phlika please don't worry about panicking - I'd much rather have too much help than not enough and I was completely freaked out when the shot seemed to work so fast that she'd be massively hypo by this morning if it carried on dropping her levels all night!

Rosa, I'm happy to report, had a really good night. She didn't eat too much of the dry food in the end - it seems she just wanted a snack! I didn't put any honey on it as I didn't want to go too far the other way and overload the sugar. And she always did love the Royal Canin SO. I know it's horribly high in carbs, but I reckoned better safe than sorry this time around. I think the MD is most likely a massive reduction in carbs over that. What I wasn't aware of until the vet called me back last night with the blood results was that the MD wasn't actually their recommendation. They'd told me they were going to ask the dietitian, but it turns out the dietitian they use works for Hills Science. No surprise then that they recommended MD. They were planning to call them back to find out if it needed to change as her BUN level was a bit high. Of course now I'm wondering if a low-phos, low-carb over the counter brand would fix that one too!

The vet says her ideal weight would be between 10 and 11 lb (or around 4.5-5kg), so aiming for 10 that would definitely still make her initial dose closer to 1 unit than 2 using the 0.25 dosing protocol. That's what I'm going with this morning as I haven't had a chance to get to Walmart just yet - I didn't get a lot of sleep at all last night though I know that will improve once I know she's properly regulated. She insisted on sleeping under the bed not on it (typical cat when you want to keep an eye on them) so I had to keep getting out of bed to check she was OK. I'll be heading out there in an hour or so once I'm awake enough to drive but of course she's due her shot in the next few minutes as soon as she finishes her breakfast. I checked online and our local Walmart seems to have a good range of the Relion monitors and strips in stock and at very reasonable prices. We do already have some of the KetoDiaStix in the house for my husband's youngest when he's here so if they don't have those in stock I can wait until Monday to go further and get those - I really don't want to leave her for long this weekend. Apparently there were no ketones present when the vet ran the urine test on Wednesday so I'd be looking for that to stay the same.

I do have U100 syringes - the vet didn't specify on their prescription but the pharmacist at Costco was very good - they've got a few cats on their system for lantus apparently - and made sure everything was what I needed.

The other question I had - the vet wants her back in on the 23rd for a glucose curve day. I really don't think it's going to go well - she's gone from being fairly comfortable (for her) with this vet to being an unholy terror with them just like she was with her old vet. If I can get the home monitoring sorted out, presumably I could cancel that day with the vet which I think is going to be crazily expensive for probably not the best results and call in her results for the whole week myself? The vet is very good with her and has been great with most things and seemed to know exactly what she was talking about when she explained the treatment and testing but they definitely wanted to be in control of managing her curve tests and really didn't want me doing those at home. She said it would be really difficult for me to get tests from a cat, but I see on here that most people seem to manage just fine. Is there a trick to it that makes it easy to do? And where exactly on the ear do I take the test - I don't want to hurt her more than I have to but neither do I want to subject her to a whole day of stress at the vet for something I could do without upsetting her too much here.

I can definitely do the tight regulation protocol as I'm not working at the moment - I'll cross that bridge when I get to it - so I'm also here to run curve tests when required at least for now. I feel she's more likely to be better regulated like that as it's closer to the way control would work with a human.

And she didn't eat much of her breakfast - I don't think she likes the MD food much - so I guess she has to skip this morning's shot anyway. I daren't give it to her when she's barely eaten. Her appetite was so bad the last week that the only thing she would eat at all was the SO. I'm so tempted to give her a bit more of that just to get her eating so she can have the shot - any thoughts on that one or is she better off skipping the shot this morning and getting back on track later?

Oh, and hi to Dweezil. Rosa isn't Manx by breed, but she, her twin and I are all from the Isle of Man so Manx by nationality.

 

So, if I need to go low-phos on the food as well as low-carb, it looks like the best standard types are going to be Friskies Special (except the whitefish which is higher in phos) or the 9 lives flaked variety. Both are a lot more reasonably priced than the MD and look like they have much better numbers for carbs. I'm still hoping the elevated BUN reading is because her kidneys are under pressure from the diabetes and will stabilize, but taking no chances at the moment.

 

Hi again

Glad things were okay overnight.

Most people in the US seem to use the friskies just fine. I would still transition over slowly. You could always start a new thread just asking about food for kitties with elevated kidney values ( or try to search back).

Lantus likes consistency. So when you get going it is important to keep the dosing the same time twelve hours apart, the dose the same amount. This allows the 'depot' to build up in a cats system and achieve the long periods of good blood glucose levels. Whilst you need a cat to eat before their shot I think it's okay to shoot even if they don't eat the whole thing but again I hope more experienced members can advise more.

With regards the curve I would jut do it at home and email in the results. If you set up the spreadsheet like we all use then you can share it with your vet online. I would go ahead and get the strips and the meter and just start giving it ago. I will link the sticky that tells you how to do it. On phone so give me a second.

Here we go

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

 

Not wishing to overload you but this thread about how to handle and store your lantus is really good

http://www.felinediabetes.com/FDMB/threads/sticky-lantus-levemir-info-proper-handling-storage.151/

You also want some low carb treats for you home testing

http://www.felinediabetes.com/FDMB/threads/list-of-low-carb-healthy-treats.9172/

 

"The other question I had - the vet wants her back in on the 23rd for a glucose curve day. I really don't think it's going to go well - she's gone from being fairly comfortable (for her) with this vet to being an unholy terror with them just like she was with her old vet. If I can get the home monitoring sorted out, presumably I could cancel that day with the vet which I think is going to be crazily expensive for probably not the best results and call in her results for the whole week myself? The vet is very good with her and has been great with most things and seemed to know exactly what she was talking about when she explained the treatment and testing but they definitely wanted to be in control of managing her curve tests and really didn't want me doing those at home. She said it would be really difficult for me to get tests from a cat, but I see on here that most people seem to manage just fine. Is there a trick to it that makes it easy to do? And where exactly on the ear do I take the test - I don't want to hurt her more than I have to but neither do I want to subject her to a whole day of
stress at the vet for something I could do without upsetting her too much here "

Sorry about the bold type, manx cat. The vet did the first 2 blood curve tests on Squiggles, but she hates being at the vets & it's so expensive. She showed me & my husband how to do the blood test & we did buy the equipment from them, & after the first blood curve, ( 2 hrly blood test ) we really got the hang of it & it's not difficult at all

Your vet can't refuse to teach you how to do it.

I'm not experienced enough to give you advice, but I'm sure people will do soon. & give you some links . I'm sure her blood glucose levels will be lower if you test her with less stress, but to start with I think you'll need someone to hold her.

 

I got the test meter - a Relion Confirm but so far haven't had any luck getting her to give me any blood. I tried about 3 or 4 times then left it until later - I don't want to distress her too much. She was really good about it though...just a slight twitch as the needle went in. It's probably going to be practice on my part - I didn't need anyone to hold her for me.

I gave her the 1 unit dose this morning in the end - I decided it'd be better to let her have some of the old food so she can get her shot rather than skip one at this stage. And as the reading yesterday at the vet was based on the old food anyway it should still have helped. I'm thinking now of not switching her food, or at least not all the way, until I can reliably get a test from her to make sure the low carb and the shot isn't going to be too much for her system.

As she sat still on my lap for my attempts at testing her, I know for sure she'll be just fine with me doing the testing at home so I'm going to go with that instead of making her all stressed out by having the vet do it. I'm hoping the sun will show up just for a bit so I can double check the exact location on her ear to make sure I'm not missing it slightly.

I was told yesterday not to give her any treats at all to try and get her to eat the food, but I'd been giving her small pieces of beef or turkey from the deli before that - I still can't think of any good reason why she shouldn't have those. I can't imagine that a tiny piece of meat a couple of times a day would stop her eating cat food - it never has before so I'm going to do my own thing with those and let her have a small treat when it's test time.

 

" I got the test meter - a Relion Confirm but so far haven't had any luck getting her to give me any blood. I tried about 3 or 4 times then left it until later - I don't want to distress her too much. She was really good about it though...just a slight twitch as the needle went in. It's probably going to be practice on my part - I didn't need anyone to hold her for me."

She sounds such a good girl ManxCat ! I hope you manage to get some blood soon, do you squeeze her ear gently to try & get a drop to form ! Have you read the links posted here for hints when doing blood tests ?

From what I've read on here, even if cats are on special diets, people still give them cooked / freeze dried chicken little chunks or something similar when they do blood tests as a reward for co-operating & even when they don't

 

I did follow all the advice - including the rice in a sock trick and squeezing her ear a little. I might just be missing by a tiny amount so she can't give me that one drop of blood. I'll give her another try later and look at her ears under a daylight bulb so I can make sure I'm hitting the right spot, but yes she did get a piece of turkey for being such a good girl. I'm really impressed with how she's dealing with all this already.

 

You are so on the ball most of us arrive here with no experience of diabetes and find it difficult not to trust the vet but you are so onto it I think you did the right thing this morning feeding her the 'old food' and giving her the 1u. I also I agree that it would be best not to change her diet until you can reliably get tests (it won't be long). Treats are a must after tests (or attempted tests) that way they associate the tests with good things. My mum's cat who is newly diagnosed already runs to his testing spot purring when he hears an alarm. It's great that you haven't needed to restrain her as that is something that most cats hate - way more than the actual test.

I think you will find that off the shelf food will be the way to go in the end. Ann and Tess on the lantus/levemir board give a low carb low phosphorous diet. Ann posts daily about the varieties of food and levels so if you starting lurking around her threads (and feel free to ask her questions) you will get some great ideas of the foods that will ultimately suit Rosa. Vyktor wouldn't eat the MD either and trying to make him led to DKA
here's a link to Ann and Tess today

I'm sure the vet's insistence on doing curves himself will change when he sees that you can manage. If they haven't had a lot of clients home testing they won't realise how comparatively easy it is - for everyone involved!

There are a lot of youtubes on testing and also here's some handy links with tips and a pic of the 'sweet spot' just posted by someone else this morning (thanks @bettyandhank)

 

Manxcat I think you're doing really well to have got this far ! Is your lancet encased in a little pen which you click to release the needle ? or are you just using a needle freehand ?

 

@Vyktors Mum. Thank you for the kind words. I have to admit, I've been one of those people who are a doctor's worst nightmare for a lot of years now because I never 100% trust what they say without doing my own research too. I have the feeling that I'm about to turn into the same sort of nightmare for the vet! I'm so glad I found this site as there's no better information out there than other people's experience of dealing with this. I bought her some of the Friskies wet food today so I'm going to try her with some of that this evening, though for now I've left down a small bowl of dry food for both Rosa and Regan. They've always been free-fed and it seems a bit mean and in a lot of ways nonsensical to suddenly insist that they can only be hungry when I say so. I can't be sure of feeling like eating at the same time every day, so I'm not at all sure how I can expect them to always want to eat exactly when I say so either. I am going to take the food away a good 2 hours before Rosa's next shot though so she should be ready to eat at shot time. But yes, she will be getting a treat every time I test. I can't think of anything more high protein and low carb than meat so I can't see it doing her any harm at all. I have a feeling the vet thinks if I only give her MD and she has no choice, she'll eat it. She won't - if she hates it she'll starve for days at a time first and I'm not going to let her do that.

The vet isn't going to have a lot of choice about me doing the curve testing myself I don't think. As soon as I can reliably get tests done, I'll be letting them have the results as often as they like but I'm not repeatedly subjecting her to the sort of stress she went through for a blood test yesterday when they want her all day and I can quite obviously use the lancet without distressing her at all - I just need to actually get the blood now instead of just stabbing her ear with the needle! It seemed to me yesterday as though they thought everyone just wants an easy solution - 'feed this, use this insulin twice a day at this dose and let us worry about everything else'. That approach actually stresses me out more as I can't follow exactly what the food and insulin are doing to Rosa. I'm going to explain to them very carefully that I need control of this so I can help prevent things going wrong because I'm the one who's with her every day.

Thank you for the link - I've followed Ann & Tess so I'll see updates on food etc regularly. That will help a lot as I switch Rosa over to a better diet. Oh, and for the link too - that makes it much easier to pinpoint the exact place I need to be getting the blood from.

@LynRich I'm trying my best to get informed and up to speed as quickly as I can to get Rosa feeling better soon. The lancet does go in a little pen, but I might try using it freehand later on so I can see exactly where it's going a little better. I'm giving her a few hours to relax first though before I try another test. She wasn't at all stressed, but I don't want her to get that way either.

 

Yes Manxcat, you could try using the pen freehand, I think BJM said try it at a slight angle, with the opening pointing upwards if it's tapered. . If using it with the pen, I was told to keep it in place for a few seconds after the needle's gone in, & the blood sometimes wells up round the needle.

Our vet tried to persuade us to let them do all Squiggles blood tests, & they've been rather surprised at the number of questions I've asked them since reading up on here LOL

 

Every one does something slightly different but here is how I feed remi now he is on all wet

Test/feed + give insulin
+2 test and feed
+4 (test if heading low) feed
+6 feed (test if low)
Leave off food until the next insulin time. Repeat for pm cycle

So it's sort of a mix of free feeding and controlled feeding. Little amounts ease the burden on the pancreas and you can use food to steer blood glucose but please don't think you have to get this all down straight away. The main thing is to try to get some tests under your belt.

 

I find squeezing gently either side of the hole you just made helps the blood to pool.

 

" I have a feeling the vet thinks if I only give her MD and she has no choice, she'll eat it. She won't - if she hates it she'll starve for days at a time first and I'm not going to let her do that."

People do have some strange ideas about forcing cats to eat don't they ? LOL

Squiggles has always been free fed as well. I'm probably a lax Mummy, but she'd go mad if I with held food when she sat by her empty bowl wailing !

 

The mix of free and controlled feeding might actually work pretty well for both of them. They both tend to take a nap in the afternoon anyway - they're pretty active in the morning and evening, so I could take the food away for a while then. I could make that work with the 6 hours before Rosa's shot with a little bit of persuasion. Though I agree, they'd both be very unhappy if they aren't allowed food on and off through the day so it's good to know that splitting up Rosa's 2 meals a day certainly won't hurt her and might even help.

And yes, the idea that cats can be forced to eat something they hate always makes me laugh. I was advised by my old vet once to add a little oil to their dry food as they seemed to get dry flaky skin in very cold weather. Neither of them would touch the food once the oil was added, even though it was food they usually loved. And yes, they would go without rather than eat it.

I'll try the new tips on Rosa later to see if I can persuade her ear to part with that one drop of blood. Once I get it once, I'm sure it'll be easy enough after that.

I just hate taking her to the vet because she gets so upset especially now after 3 visits in a week. She got so distressed yesterday that she'd peed and pooped all over herself while they were trying to hold her down to get blood from her leg. I'm sure that can't be at all good for her in her current condition so I'd much rather handle this at home - it's not even as if she objects when I do it, but then I don't restrain her. I'm sure being restrained is a lot of her problem - I'd held her for her old vet to take blood a couple of times and just held her gently and talked to her...no real restraint involved. I have no idea how she'd be if I took her there and just left her for a whole day - she might finish up as an emergency if she got so upset her levels went badly up or down.

 

Other people do feed their cats after +6 so really it's matter of trial and error. I found this worked for me and it helped smooth the part of his cycle when he was dropping and then meant I didn't have to worry about having someone pop in and feed him later in the day. Other people use timed feeders. Just make sure no food 2 hours before next shot /test time as you mentioned.

 

Squiggles messes in her carrier every time I take her to the vet ! The first time it happened, I carried her in gently so she wouldn't tread in the poo, then one of the receptionists took her away in her carrier, swung it a bit & she fell in her poo, so she then got more stressed while they spent 15 mins cleaning her up

They were vey gentle with her when they showed me how to do the blood test, & they always handle her carefully, but I think they're so used to holding cats down firmly , unless I say something to them, they sometimes don't realise what they're doing . She's definitely less stressed at home.

 

Sorry just to add until you get those blood tests going and you know you can keep her safe please keep some dry food available as per last night.

 

Oh I will do - I'm only taking it away for the 2-3 hours before she gets her shot. Then I'm putting it back. I'd rather her a bit high overnight than going hypo while I'm asleep. High, I can adjust for later once I've got the testing working - low is going to send her back to the vet as an emergency case.

 

Check my signature link Glucometer Notes for some info on meters and reference numbers for cats.

 

Oh thank you - that is a great help. I'm going to try the test again later on this evening before her pm shot. As soon as I can get a test, I'll start her spreadsheet even if I can only fill in sporadic numbers for the first couple of days while I get used to doing the testing. She's taking her afternoon/early evening nap right now and I'm having to resist the urge to keep waking her up to make sure she's OK.

 

Welcome April and Rosa! You two are already three steps ahead of most of us when we arrived here, distressed, overwhelmed and confused. You're doing a fantastic job, and you'll have the hang of this in no time. There's definitely a learning curve, but just take it one thing at a time.

The only specific thing I have to add was about this:

Out of curiosity, are you using the blue lancing device that comes with the Relion meter? If so, it comes with a blue lid attached, which makes it about impossible to see where the lancet is hitting. In the lancet kit, there is a clear lid that comes with. Just pull the blue one off, and replace it with the clear lid, and viola! - you can see where you're aiming. I poked in vain for a few days frustrated that I couldn't tell if I was even hitting the ear, until I realized that the lancet device came with a clear lid.

 

Hi Jen and Eddie. Trust me, I feel overwhelmed and confused and of course very sad that my baby's feeling sick and unhappy! I think my way of handling it is to get as well informed as possible and take as many small steps as I can towards understanding and controlling the situation! I've always been one of those people who feel better for taking whatever action I can to fix the problem.

I did notice the clear lid earlier when I was putting everything in the little case and wondered what it was for. I'll definitely give that a try later - it might well give me a more controllable option than working freehand - thanks for the tip.

 

So she's still not giving me any blood to test. The only thing is, I think it's the lancets - our local Walmart didn't have any in stock so I'm stuck with the 10 that come with the unit until Monday. I think they're just too small to get me any blood even with all the hints and tips from everyone. I even used a flashlight to make sure I was getting the right spot on her ear but I've stopped before she gets too unhappy with the whole idea. I've given her 3/4 can of Friskies wet food before her shot - going with 1u again and I'll leave some of her old food down again later in case she needs it. She is, however, eating the Friskies just fine which proves to me at least that she just didn't like the MD. She's been pretty alert and bright all day compared to how she was a couple of days ago so I think it is doing her some good even if I can't check for sure just yet. I will, however, get the hang of this testing before they want her curve test doing next week. I think the bigger lancets will help - it was definitely going in her ear but just not getting any blood out.

 

Sometimes a double poke right next to each other works, and you can aim for the vein directly. If you aim for the vein, be prepared to blot as it can gush.

 

I might try that next - of course now she's just eaten. Always the way. I almost considered trying to just catch the surface of her ear with the very tip of one of the needles we use for the CKD kitty's fluids - we always have more of those here than we need - but I was a bit scared of doing more harm than good with it. I've stabbed my finger with one of those before - they're big and they hurt!

 

If it works, it works. You have about 15-20 minutes before the food starts hitting, so go ahead and get a test. Those needles are a larger bore so you might have better success.

 

Well, I tried but she'd really had enough for the night at that point - she wouldn't settle for me at all and started getting a bit upset with it so I left it in the end. I've kept her dose down to 1u and I'm leaving her some dry food and plenty of water out overnight - she'll be in the bedroom with us again so I can make sure she's doing OK.

 

I've done that and it works great. I think that was plan b for me for about the first two weeks until her ears learnt to bleed. With the poking device have you adjusted the depth. On mine I can change it up and down and found it best on 3.5.

 

As an alternative to dry food you could get some high carb gravy wet food or even medium carb to put down. People use this instead of honey when it comes to a hypo or when a cat is heading low so I feel it would also be suitable for you to put down overnight until you can get some tests under your belt.

Hopefully others will advise.

 

I had tried adjusting the depth, yes. She didn't even seem to react until it was on 5 so I'm not sure 3.5 is going to work for her. My husband says the next Walmart along is usually better stocked so we're going to try the pharmacy there tomorrow for the bigger lancets. If those don't work, then I guess she's getting the 18 gauge fluid needles for a bit until her ears start to co-operate a little more. If I'd started with one of those tonight I think she'd have been fine - she was just tired of me trying by the time I got to using that. And with her starting to move around, there was too much risk of me seriously hurting her or sticking the needle straight through my finger...though I've done that before and survived!

We do have some very high-carb wet food in the house - some of the 9 lives in gravy. It's only ever really been an emergency food for any time any of them are too sick to want to eat but I could put out a little of that for her in case she needs it. I have a sneaking feeling she's self-regulating on some level. The only thing she would eat the couple of days between being diagnosed and starting insulin was a few pieces of cooked meat and she's only picked at a mouthful of the dry food a couple of times today. It's as if she knows what she needs and is figuring some of it out herself - she really enjoyed the Friskies low carb food tonight but didn't really want to eat the MD either yesterday or this morning.

 

I don't think you should put that down until others more experienced members chime in as it might be too much. Remi used to self regulate somewhat. He would get up and tell me when he was hungry and then walk away when done. I guess the worry with putting down high carb wet is that they eat it just because it's so nice

You did the right thing walking away from the ear testing. They say three goes at any one time maximum otherwise everyone will be too stressed. Leave it an hour, you can always try again. The preshot tests are the ones you want to get each day but you also ideally want to aim for one during each cycle if you manage it.

Did you try heating the ear with a rice sock? I would get everything ready, heat the ear and then hold the ear behind where I was going to poke it. This helped the blood to pool in the ear. You might see the blood vessels expand. Then poke and then keep holding behind the spot but also hold and gently squeeze in front of the poked bit. Sort of massage the two bits you are holding. The blood drop should appear.

 

PS. If you ever have an emergency start a new thread and put urgent or 911 in the title. You can also amend the title of this thread by going back to the first post and pressing edit.

 

I haven't put any out yet - only a bit of the dry. And as Regan has to sleep in the bedroom if Rosa is or she gets insanely jealous I think she's grabbing some of it too as it's still her regular food. I have a feeling she would eat some of it regardless - that's why we've always kept a couple of cans in for any time any of them get sick and don't feel like eating anything else.

I did heat her ear with the rice sock (she quite liked that bit) and had my hubby holding the flashlight so I could see the blood vessels in her ear while I was poking it. I think the lancets were just too small as it's not something her ear's used to yet. I know I could've got some with the 18 gauge needle if she'd been OK with it, but as she wasn't by then I'll wait and try either later or first thing in the morning - she'll be well monitored overnight either way. I did try the massage - I could see a pink spot where I'd poked her but no blood actually came out. She's being very good about it all which was why I didn't continue after she stopped being happy to let me try - she actually let me get 4 attempts in with the smaller needle without stressing at all which is pretty amazing given that she's not used to any of this at all just yet. Tomorrow is a brand new day and I'm sure it'll all go better then.

 

Oh, and thank you - I'll keep in mind to post something marked urgent if it's an emergency. Because of the CKD kitty who's had a crisis point with it a couple of times, we're pretty familiar with the overnight emergency vet here and I have the instructions for what to do at home as an immediate measure though I'm 100% sure I'll panic if something does go wrong of course.

 

You are doing great, much better than when I first started. Keep some low carb treats on hand for when you do test her. Stress is the probably one of the worst things about finding out your cat has diabetes. I stopped eating and could think of nothing else. Make sure you can relax and give yourself a few treats too.

I do hope I haven't overloaded you at all with info. I would like to give you one last link. A message from your cat

http://www.felinediabetes.com/FDMB/threads/letter-from-your-kitty-to-you-during-this-time.131186/

 

Trust me, I'm really not. I've cried all over hubby, all over pretty much all of the cats - even at the vet office yesterday. And I forgot to make dinner last night I was so busy making sure Rosa ate hers! We always have either turkey or beef or both from the deli in the house - it's her favorite treat and I reckon fine in small quantities as it's pretty much pure protein.

I do keep reminding myself that I have to sleep and eat and maybe just relax and play a video game or watch a movie at some point - if I get sick too I'll be no good to her and she needs me to get her well.

You haven't overloaded the information at all - I'm really grateful for all the help. It makes such a difference knowing that other people are managing this for their cats and making sure they have a lot of good quality years left. I was so scared when she was first diagnosed that I'd only have a few months or a year left with her and she's too young for me to lose her yet.

Thank you for the link - I really do need to remember some of that. I seem to be checking up on her all the time and sometimes she gives me that look that says 'but I just got to sleep, why are you waking me up now?' I did manage to leave her with our housemate just for half an hour tonight - I felt guilty but at the same time I needed to get out and just breathe for a bit. She was fine of course and he knows exactly what to do if anything goes wrong.

 

It sounds to me as if the lancets could well be the problem manxcat. I'm sure things will go better when you get the right ones.

 

Trust me, I'm really not. I've cried all over hubby, all over pretty much all of the cats - even at the vet office yesterday. And I forgot to make dinner last night I was so busy making sure Rosa ate hers! We always have either turkey or beef or both from the deli in the house - it's her favorite treat and I reckon fine in small quantities as it's pretty much pure protein.

Oh poor you *HUGS* I cried as well when Squiggles was first diagnosed & we were trying to get things sorted out.

 

It does get a lot easier, you will settle into a routine and once the testing becomes easier it isn't half as stressful.

For me I found that by getting up early and testing, feeding and giving the insulin at 6am and then giving it again at 6 pm made all the difference. I could go back to bed at the weekend, sneak in a +1 or +2 test before work and in the evening get the stressful bit out of the way early and then if I found he way going low I could do the things I needed too without it being too late at night and if things were fine and my +1 or +2 test said he wasn't dropping too low or fast I could even pop out and not worry about him (too much). You have to find a routine that will work for you (if you do swap his insulin times you should only do it by 15 minutes per shot).

With regards the chicken from the deli as a treat one thing BJM said to someone else about cooked chicken from the shop is that you have to make sure that it doesn't have sugar added. Sometimes they put a coating on it and sometimes they even inject chicken to make it taste nicer. Is it that type of chicken. Could you ask to make sure or I guess even better you could cook up your own. But that abit of a hassle. Just a thought.

 

Thank you both. I'll get there with it - it's just getting into a routine where I'm not worrying about her every minute of the day. Once she's on a more settled, accurate dose and I know how it affects her and when I'll be fine for sure. She's had another good night and although she's got a way to go yet she's eating much better this morning and looking happy in herself.

I might have to try the waking up early to get everything done a bit earlier in the day. I guess there's no reason I couldn't go back to bed after I give her morning shot if I bring her with me so I can be there if she needs me to be. And of course there will be times when I have to be out in the evening. At the moment she's at around 10 am and pm which really isn't going to be any good long-term - it wouldn't fit around work and it cuts completely into the evening - but I was told by the vet not to give her first shot until she'd eaten so everything finished up being much later than I wanted it to be as it took her so long to eat the food the first day. I'll work on moving her back just the 15 minutes at a time now she's eating better.

None of the meat I buy is meant to have added sugar - I avoid corn syrup completely in everything and only buy things like meat without added sugar. I might well try cooking some myself though - we eat a lot of chicken anyway so cooking up an extra piece plain wouldn't be a bother at all. Both cats are pretty clever at trying to steal little bits of meat from my plate anyway so I think she'd take to that really well and it would mean that she could have it while it's still warm sometimes which she'd like even better.

 

With Lantus, unless you've had a problem with her eating, its OK if she doesn't eat right at shot time.

 

Thanks for confirming that. The vet was very insistent that she has to eat all the food every single time before she gets the shot. I can understand that the first couple of times as she'd been eating next to nothing for a few days so it was likely the right advice for that very first shot to make sure she had some food in her system. I'm a bit more relaxed about it now though - she has the food down for a bit before she gets the shot but I'd say today she's only eaten half the food before shot time - she did the same yesterday and then finished it off about an hour later. She never has liked to eat a full bowl of food all at once.

 

Remi's the same. As long as he ate a little and I was happy that he would eat more a little later I would give the shot. Have you had any luck with getting any blood?

I would try to get a blood test 15 minutes before the shot was due so I wouldn't have to panic.

 

No blood yet - I need to pick up those bigger lancets today, but I only just about managed to get out of bed before her shot time after being awake on and off overnight to check on her again. I didn't want to delay her shot by an hour or more by going and getting them first - the local Walmart that didn't have them in stock is only 5 minutes away, but the other one is a good 20-25 minute drive each way. I'll have more time later of course to try for a test before shot time and if everything's looking OK then and at bedtime I'm going to try and start moving her back just by a few minutes each time so her shot times are a little more workable in the long term and so I can get a bit more sleep by having time to observe her for 4 or 5 hours before bedtime. She is, however, clearly feeling pretty good so far this morning - she jumped up for a fuss and then smacked me round the face with her tail which is something she'd always done until recently. Weird how I'm happy about it now when it was never my favorite trick of hers! Once she starts standing up on her hind legs to greet me when I walk in the door again like she's done since she was a kitten, I'll know she's getting close to feeling back to normal.

 

Manxcat, don't make yourself ill trying to do everything perfectly, you'll be no good to her if you're fraught & exhausted xx
I hope you manage to get the lancets you want , & that the blood test is successful. Good idea to move your timetable around so things are more workable.

 

You can change the shot time 15 minutes per shot or a total of 30 minutes once per day.

 

I just called the next Walmart out to make sure they have the right ones - I do have about 5 or 6 stores to choose from in reasonable driving distance. They said they've got a lot of the 26 gauge so I'm going to go get a couple of boxes of those this afternoon just in case I have problems getting them from the local store again next time.

 

15 minutes per shot should work her back to a reasonable time fairly quickly - good to know, thank you

 

I agree with Lynn. It impossible to get it all right straight away so don't kill yourself trying and please don't think I am every pressuring you.

 

Hi April, fingers crossed that the larger gauge will do the trick. Even the unsuccessful pokies do help the ears "learn to bleed." As strange as it sounds, our kitties ears do actually start to bleed better the more you poke, because they grow more capillaries in the edge of the ear. It does get easier! I promise!

 

I don't feel any pressure from anyone here - just help to try and get this all figured out which is exactly what I need at the moment. I'm sure the larger gauge will make it much easier - I can see the capillaries in her ears with a flashlight, I just need to persuade them to bleed just enough for a sample. I'm sure she'll get there soon - she is trying to help me in her own way by keeping still and staying happy for me even though it must be really strange to her that I'm suddenly poking her with needles for no reason that she could possibly understand.

 

Yay - I got her test first try tonight Unfortunately, the number isn't all that good - 566 at +11 though she was a bit stressed this afternoon as there was thunder which she hates. Any opinions on whether I stick at 1 unit or go back to 2?

 

I am not a very experienced with dosing and so can't advise. How many days has she been on this dose for? It can take a few days to build up in the system and I wonder if she has yet to get the full effect. Also without seeing any more test results it may be difficult to advise. Lantus dosing is based on the nadir ie how low a cat goes not necessarily the preshot level. If possible get another couple of tests in today -preshot and then if possible a couple more say one in the early part of the cycle such as a +2 and then another at +5 or +6.

If you bring forward the insulin dose as you are doing that does act like a small dose increase. Are you doing that is that someone else?

You could start a new thread in the main health section with the title something like new lantus user needs dosing advice asap and do a short recap. Put what has happened so far, how many tests you have got, the weight of your cat,etc. or ofcourse amend the title of this thread.

 

Can't really tell with no mid-cycle test.
The pre-shot number could be high because the middle of the cycle was a low for her and compensatory hormones kicked in to release stored glucose (glycogen).

 

Thanks phlika. I did post in the Lantus forum too and got some useful advice there. I'm keeping things as they are for now in case she's bouncing late in the cycle and planning to get some mid-cycle tests on her tomorrow plus a bedtime test tonight to make sure she's not dropping hard and fast after a couple of hours. I'd run the mid-cycle tests overnight but after the last couple of nights with not much sleep from checking on her, I think I'm just going to be too tired to wake up enough to poke her with a needle tonight. Unless she's dropping badly at bedtime of course, in which case I'll be making coffee and carrying on!

It is me who wants to move the dose forward a little each time until it hits a more reasonable time each day - I moved her forward by 15 minutes tonight and I'll be doing the same until it's back at the times I need it to be. I've nothing but praise and cuddles for her tonight - she was great about the test, though bribed with some low-carb treats before, during and after. And I'm feeling a lot more confident too now I know how easy the test was to get with the right needle size.

 

That's great news about getting your first test. I was also thinking that you are transitioning to a low carb wet food aren't you and so this will hopefully have a positive impact on the blood glucose as well and hence the need for as much insulin. If you feel you can monitor her better now I guess you can go ahead and start adding in more of the low carb.

Have you read through the link on storing, handling and injecting lantus? I think I linked it previously but it is at the top of the lantus forum. Somewhere in there is talks about giving the shot to get the best out of it. I was advised to not withdraw the needle too quickly in case it also pulls out some on the liquid lantus. I would pull up the skin, create the tent, inject, let the skin fall back into place and then slowly take out the needle. Well at least that was my aim, half the time remi would walk away, roll over or jump when I gave it him

 

Thank you. Yes, I think I'm going to start transitioning her over fully to the low carb wet food. She and Regan both really like the Friskies I bought for Rosa instead of the MD the vet wanted her to have so I'm most likely going to switch Regan over to the same (she has to have whatever her twin has of course - I'm just waiting for her to start 'supervising' Rosa's shots to decide if she might be feeling left out about those too)! I did get a second test from her tonight at a few minutes before +2 but it just read HI so I'll have to wait until tomorrow for some more tests to see how low she's actually going later in the cycle. At least I can sleep tonight knowing she shouldn't drop dangerously low too quickly from that point, though of course I'd have preferred to see her number come down a little not go up.

I did go through the link on Lantus, thank you. I'd already told hubby and our housemate that no matter how full the fridge gets, that takes priority unless they want to pay the 300$ for a replacement vial. Fortunately, we're pretty good about anything like that as hubby's youngest is also diabetic so even though he's not with us all the time, we always have his supplies (including Lantus as well as one of the shorter-acting insulins) in the fridge. I've been trying to take the needle out slowly but as Rosa handles everything much better if she's not restrained that is, as you say, dependent on her not deciding she might just wander off as soon as the shot's done. Mostly she'll just sit there, but if she decides something else interests her more than what I'm doing she'll just get up and walk away