Greetings from Mr. Boops and his mommy!

Hi! I'm Boops' mommy, Erin. We have been together since his birth on April 18,2000, when my high school boyfriend's cat gave birth to my sweet boy. Boops is an only child and he won't have it any other way. His daddy and I live him so! We were devastated to learn that he had developed diabetes, but are hopeful we may have caught it early. (Vet seemed to think so). This all started with a larger than usual appetite for water and mommy wanting to make sure everything was normal. Well, it wasn't. Initial glucose reading was 366, but that was of course in the middle of the day (not after eating). We are now trying to learn everything we can to try to lessen the stress of this new journey together!

 

Hi and welcome to the forum boops and Erin.

Sorry to hear about the diagnosis but I am sure he will settle into his new regime just fine.

May I ask what insulin and dose he was prescribed and what food you are using? If you could add these to your signature it would be really helpful.

Feel free to ask any questions you have. We tend to recommend that you post over in the main forum as more people tend to look in that forum.

 

Sure! They have started him on Humilin-N- 1 unit twice daily. We are feeding diabetic royal canin- he will actually eat it! I am so torn over the insulin thing because so many boards say it's not good, but the vet disagrees. They also said home testing wasn't necessary, but I disagree!

 

Is that dry or wet food?

Yes you are right we tend to recommend a long acting insulin, humilin tends to not last the whole twelve hour cycle, alongside a low carb wet food and home testing.

I think the best thing would be to work with what you have for now and report back to your vet. I am glad you get the reason we recommend testing at home. For one thing cats get stressed at the vets and so can test a lot higher than at home. We recommend that you try to at least get a preshot reading (before you give food) and then during the cycle. If you are able to do this the you can report your results back to your vet and this will help save you money because you won't have to take your cat in for a curve, keep him safe and inable you to fine tune the dose and maybe show him that it isn't keeping boops under control for long enough.

Treatment guidelines
http://www.felinediabetes.com/FDMB/threads/aaha-feline-diabetes-treatment-guidelines.80813/

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

I am linking the low carb food but until you are testing you should change him over in case the carb content is lower than the royal canin
http://www.felinediabetes.com/FDMB/threads/dr-lisas-food-charts.88162/

Finally recognising and knowing how to deal with a hypo situation (low blood glucose) is a must. Please read through and print out this post and make sure you have the suggested items. In an emergency they need to be right at hand.

http://www.felinediabetes.com/FDMB/threads/how-to-treat-hypos-they-can-kill-print-this-out.15887/

 

Don't forget to amend your signature

 

Amended signature! It is the wet food. We had a terrible time finding something he would eat yesterday! After his first injections - Friday night and Saturday morning- he hid in the closet and acted puny all day. Then, he threw up around 4pm and only ate a few bites of food by 8pm. I was at my wit's end not knowing whether or not to inject him again. He also has a kidney infection associated with the diabetes that he is taking oral clavamox for. We rushed him to the vet last night and they did a BG. It was 488. They also gave him an anti-nausea shot and an appetite stimulant pill. Today, he is MUCH improved. He wolfed down his breakfast (royal canin diabetic) and has been much more like his old self- purring, following me around, sitting with me on the couch. Hoping this is a good sign! He is scheduled for a BG curve with the vet on Friday.

 

If you swapped him over to a new food it might have upset his tummy slightly. You need to be careful giving an appetite stimulant without any anti nausea medication as it forces them to eat even if they feel sick. You should ask the vet on Monday for some anti nasea medication such as odamsetron or cerenia (better choice if vomiting). Nausea can be licking of lips, grinning of teeth, gulping, going up to food and walking away.

Sorry if i am throwing lots of things at you but I want to make sure you are as prepared as possible. So Another point to think about- did the vet base his starting dose on the numbers you got when he was on a higher carb food? As along with the stress from being at the vets and changing food can also decrease blood glucose significantly.

The high blood glucose last night. How long after the his last dose? I am guessing that it would have worn off by then.

I suppose what I am saying is to closely monitor him during the cycle. Watch for any signs of low Blood glucose as described in that link and be ready to act. If possible get the home testing kit sooner rather than later.

Is he allowed to free feed?

 

Yes, he did get anti-nausea meds too. He is pretty good with switching foods, but is also very picky. He gets a 3 oz can at around 7-8 am. He mostly eats it all, but sometimes goes back and eats a little at a time for a few hours. He was previously on Iams 3 oz cans, which were not low carb, so that has been something I've worried about as far as dropping too low. He has done alright today- been home with him all day. I have to go to work tomorrow, but am thinking of having my mom check on him midday. We have already ordered a BG testing kit on amazon. Should be here this week. This brand had good reviews from other pet parents about needing very little blood and being fairly painless. Not looking forward to my first lancing experience though.

 

I think I would leave good down when you go to work and get your mum to check in on home and if need be give him some more. This is what I do. Most people give their cats small meals over a number of hours or free feed as it is easier on the pancreas and can help if a cat is going low.

You might like to look into getting a timed feeder. Again I've seen a lot of people mention the pet safe 5.

Whilst you are waiting for the meter I would start trying to get your cat accustomed to having his ears touched. You could start rubbing them to warm them up or start using a warmed rice sock do he gets used to it.

Off to bed now. Hopefully others will chime in.

 

Antibiotics are notorious for wiping out the good bacteria right along with the bad bacteria. A good probiotic, given a couple hours after the antibiotic may help some. Forti Flora - available at Amazon, or possibly from your vet (at a greater cost) is one that many cats enjoy. You just sprinkle it on the food. You might also try 1-2 teaspoons of plain yogurt with active cultures if your cat is not dairy sensitive.

 

Here's the latest: Boops had a curve done at the vet's office about 2 weeks ago. He was extremely stressed, and his numbers were in the 300s for the first stick and 400s for the second stick. They didn't proceed with further sticks. They upped him from 1 unit 2x daily to 2 units 2x daily. Since then, things have been seemingly OK. He has seemed more hungry than usual, but I didn't think too much about it. We have also switched him to Fancy Feast classics 3 oz cans. We also haven't been regularly testing him at home, which I know is not good practice. Last night, he seemed very lethargic and just "off." He was sitting in the meatloaf pose and not very responsive. I was very concerned and we decided to test him. His BG read was 26. I immediately ran to put some more food in his bowl, which he did come to eat. I also put some karo syrup in his mouth. The vet recommended doing a home curve since stress can jump their sugar so much. We will do this, but I feel like we should dial back his insulin as well. I am also looking for tips on lancing. We have tried the ear with little success, so have been using his upper paw pad. I hate sticking him, and I can feel his little heartbeat racing. Please help!

 

Vet stress may raise the glucose 100-180 mg/dL.

Instructions on How to Handle a Hypo.

 

Hi Erin, and welcome to FDMB

Did you see this link that (I think) Sarah posted above?
http://www.felinediabetes.com/FDMB/threads/hometesting-links-and-tips.287/
It has lots of info, tips, tricks and little videos on hometesting.

Things I found particularly useful are:
1. Warm ears bleed better. You can massage the ear to get the blood flowing, or hold a 'rice sock' or pill bottle filled with warm water inside the ear to warm it.
2. It's important to put something against the inside of the ear, opposite to where you're pricking, otherwise the lancet can just push the ear away. The lancet needs something to 'resist'. Some folks hold folded tissue or a piece of cotton wool inside the ear. I just use a finger tip, but doing this may mean that you get blood from yourself occasionally.
3. Massaging immediately below the ear prick can 'milk' more blood. I almost always do this. The blood flows from the tip of the ear downwards, so massaging below the prick site 'catches' the blood on the way down.
4. Two ear pricks very close together will often produce enough blood for test.
5. A teensy smidge of vaseline on the outer edge of the ear will help the blood to 'bead up' rather than disappear into the fur.
6. One ear usually bleeds more easily than the other. Strange but true...

Some cats are OK with being held. Some aren't. My cat doesn't like being restrained so I just crumble a few low carb treats for him and quickly test him while he's hoovering those up.

Even when you aren't actually trying for a test it can be useful to just massage the kitty's ears briefly and then give a treat. It helps to build an association that 'ear handling' means 'yummy stuff'.

There are some folks here who test the paw instead of the ear, and maybe they will be able to give you some tips on that also.

Eliz

 

Yes he definitely should get a dose reduction following such as low number. He may be more sensitive to insulin after going so low and now he is on the low carb food he won't need as much. What are you thinking of dropping it back too?

Hometesting really is key to getting the dose right and keeping him safe. The more testing you do the more routine it will become. Giving treats afterwards really helps and soon your cat won't be stressed by it. You need to test before each shot and then try to retest during the cycle to see if he is dropping hard or fast so maybe a +2 or +3 and depending on that maybe again.

We recommend that you test each cycle and fill the results in on the spreadsheet which you link in your signature

http://www.felinediabetes.com/FDMB/...te-a-ss-and-link-it-in-your-signature.130337/

With regards the food I would leave food down for him to eat in case he begins to go low.

 

We gave him only 1 unit this morning after the low. I've been watching videos all afternoon about ear pricking. I bought a new meter since I ran out of test strips and amazon won't deliver more until Tuesday. I HATE the new test strips and meter- relion brand. It's so hard to get the blood in the right spot! I can't help but wonder if he needed the increase to 2 units at all since he was so stressed by the vet visit.

 

Erin, are you using Neosporin or an antibacterial ointment on your kitty's paw? I was also having some issues with getting enough blood from a paw prick, but someone suggested using an ointment as it helps keep his paw sanitary, plus it helps the blood "bead" on the paw, which helps me get enough onto the strip. I am amazed at how well it works! Before, I was pricking twice just to ensure I would get enough and now, I only need one prick with my lancet gadget on setting "6".

I do:

1. Alcohol swab
2. Ointment
3. Prick
4. "Milk" the paw to get a blood bead
5. Grab a strip!
5. Gauze
6. A little paw massage to make everything better

 

I agree that the 1u it seems sensible if you factor in the low carb food and reduced stress when not at the vets. I would stick to this dose for a few cycles and you have gotten readings at different times throughout the cycle to make sure you know the effect it is having. Then if need be increase slowly. Ideally by no more than 0.25 units at a time or a maximum of 0.5 but please test before each shot and then ideally at least once during the cycle. If you change the times you do the second test you will get a fuller picture over the course of the week. On the weekend you could always do a few more tests and then amend the dose depending on the results.

You will get used to the new meter, it just takes a few goes, I always make sure I have a load of test strips in stock in case of emergencies. After the first vet visit I never took remi back for a curve, much easier and cheaper and more realistic to do it at home.

It really would be helpful if you amended you signature so people could quickly see what insulin you are on and what food he is having, his age, etc. this is where you would also add a link to the spreadsheet which I linked the details of before. This spreadsheet is a fantastic way of keeping track of insulin dosage, blood glucose results as well as food intake and anything else you may want it to be. I found it invaluable in monitoring remi.

Just to make sure you know what to do with low blood glucose

http://www.felinediabetes.com/FDMB/threads/how-to-treat-hypos-they-can-kill-print-this-out.15887/

The important thing here is if you get a low result you give your honey, karo or high carb gravy and then you continue to monitor as the levels may drop again once that wears off and then you have to give it again, etc. it is important to not just give it once and then assume this will keep him high enough.

 

So...we started a curve today. He had not been fed or had any insulin in 12 hours, so his read was 360. We have dropped him back to 1 unit after his hypo scare. I'll keep you posted as the curve progresses throughout the day.

 

We'll be watching for your posts, Erin.
Good luck with the testing.

Eliz

 

Second read at around 10 am was 169.

 

Great job with the testing, Erin. That's a significant drop.

Because we're all in different time zones, it would help if you could post the BG results so we know at what time in the insulin cycle the reading was taken. For example, three hours after injection time is +3. Six hours after is +6.

e.g.

360 @ AMPS
169 @ + <number of hours since injection time>

 

3rd read- 74 at 12:54. Still going down, I presume.

 

Initial was 360
Administered 1 unit
+2 was 169
+5 was 74

 

That's quite a drop in 5 hours, Erin. Am so glad you reduced the dose...

It looks like the onset (the point where the insulin starts working) happens quite early after the shot.
And that 74 at +5 may be the lowest number of the cycle (but only another test will tell....)
It would be good to see another test in maybe 15 -20 mins if you can manage that..? (Just to make sure he isn't dropping much further)

If this drop has been too fast (or too low) for Mr Boops' comfort then you may find that his blood glucose bounces up high after this. But don't worry if that happens.

Is Mr Boops eating 'normally' today?

Well done for the testing.
How is Mr Boops coping with it? And are you OK, Erin?

 

You're doing a great job with the curve, Erin (and the notation! ). I second Eliz's recommendations above.

 

Just got back home. Will test again. He is such a good boy- he doesn't love the testing, but is so sweet-natured. I am doing well with seeing these numbers. It's just crazy to me that he tested in the 300s at +3 in the vets office and in the 400s later that day. I knew when I picked him up that I would never do that to my sweet boy again. He is acting so much more like his old self on one unit.

 

That's one of the best indicators going, Erin!

 

+8- 155

 

That's nice, Erin.
Looks like a gentle rise so far.

Well done for today!
Will be interesting to see how his numbers are at +12....

As you probably know, we recommend that folks new to dealing with diabetes don't give a shot if the BG is below 200 (11).
If you have any concerns at all about giving the next shot (or about how much insulin to give) then don't hesitate to post on the forum and ask for help. And if you need to get folks' attention start a new thread if you need to.

Eliz

 

Great job on the curve today, Erin.

 

+11- 328
Just now fed and administered 1unit as scheduled. (Morning dose was a wee late)

 

How do I get started with the spreadsheet? Is there a template? Thanks!

 

Yep. Here's the link:

http://www.felinediabetes.com/FDMB/...te-a-ss-and-link-it-in-your-signature.130337/

If you get stuck, just post and ask for help.