? help please

New to this. First day testing had 331 in am , gave 2 units vetsulin after can of fancy feast. Pm was 153, dr said not to give anything. This am was 419. Gave 2 units after eating. Have now tried to test at least 8 times and can't get enough blood, or meter shuts off, or she claws us and runs away. I don't know what to do. Vet said 2 units twice a day. She kind of supports my desire to test, but what do I do if I can't get a result? I'm worried because if I had given her two units last night it might have been bad.

 

Deep breath. Take time out for 10 mins. I would get some treats ready and have your "station" set up to test. Make sure her ear is warm first. Put some rice in a sock and microwave until warm to the touch on the inside wrist. Warm her ear up first as you gently pet her and get her used to sitting there. Once warm do your poke and put the treat in front of her. I found that kept Jones busy while I got my drop and the meter to his ear.

There are a few videos here I will try to find them and post them to you.

 

Here you go, Janet put this together.

 

If she is squirmy you can transfer the blood drop to the top of your thumbnail and test it from there.

 

We havent tested regularly until very recently. When my husband is home, I ask him to keep the meter and test strip ready so when I get a drop of blood, he's quick to push the strip in and hand it over. It helps with the meter issue. If he's not home, like all day today, I lay the strip just inside the meter while I get the drop of blood ready. Having it almost in makes it easier to do one-handed. But that video @Tracey&Jones posted is a life saver.

 

Thanks I watched the video and got a couple of ideas. Biggest problem is she isn't getting big enough blood droplets to go into the strip tonight.

 

That is what I do!

@JanetNJ made the video - very good video!

 

Is her ear warm? If you are new to testing it may take time for her ear to "learn to bleed". It is ok, just keep breathing.

 

My daughter helps and we had everything set up, but my cat got tired of being poked. I finally gave her food, but I don't know whether to give her insulin or not. Vets advice wasn't contingent on testing, but I felt like we dodged a bullet last night, so that makes me more indecisive tonight! I can't get a big enough droplet to transfer anywhere. It just smears or clots.

 

Are you putting neosporin on her ears? It will help the blood make a drop instead of going all over in the fur. If you get the gel with pain relief - it also helps the ears out with healing and dulling any pain there maybe there.

 

Rofl. It makes me feel like a ninja.

@Tracey&Jones is right. Warm up her ear. I massage Bear's ear while scratching his head and petting him, but I like that sock idea. Im also loving the thumbnail idea @Squalliesmom mentioned. Does that really work? You could also use a large gauge lancet. Someone had mentioned that in my panic hypo post. I can't remember who, but it sounds like a decent idea.

 

I'm going to try that. Is there any point in testing again now that she ate? (about 30 minutes ago). Should I just skip it for tonight since I couldn't get a reading before she ate? Should I give her insulin so she isn't worse in the morning again?

 

We tried warming her ears and testing from her large paw pads too.

 

She is just not willing to give up the red gold is she?

The thumbnail works - I have done it a couple of times. Once Jones flicked his head just as I was going to put the meter to the drop. It was on the surface of the table so I just stuck the meter in.

I had 1 gauge lancets and it was harder to get the drop and I had to "milk" his ear sometimes. I purchased the 28 gauge ones and haven't had an issue sense.

 

I would skip it tonight. Better too high for a day than too low for a moment!

 

What type of meter are you using. They vary in blood drop size requirements. The two meters I have used require 0.6 and 0.3 microlitre drops. I find that the one needing 0.6 needs a very big drop and the one with the 0.3 actually just needs the tiniest of a drop.

If your meter needs more than 0.3 you might want to think about trying one of those.

 

Just got 3 more error messages on meter due to insufficient sample. Gave insulin. Leaving food out so she can eat if needed overnight. I guess I'll have to find a different lancet and/or meter.

 

Just saw this (too late). I have honey just in case, and she usually sleeps with my daughter (adult) so hopefully we will notice if she does have a problem.

 

I would suggest setting an alarm for a couple of times during the night to check her blood glucose, if you can.

 

I have a disposable ReliOn that needs 1 uL. My store was out of everything and I didn't know what to get, so I got the all-in-one kit.

We've used up half the strips in 2 days with all the errors though. I was going to get the cheap ReliOn, but maybe I can get the one that needs less sample because the expensive strips will be cheaper than throwing them all away with errors...

 

We'll definitely check on her. Don't know if we'll be able to get a glucose, but at least we can look for behavior etc. Any specific times? She got insulin just before 10.

 

That's a very large amount of blood! Pick up the ReliOn Confirm or Micro, as it only takes 0.3uL or if money is tighter even the ReliOn prime is better than that one, which needs 0.6uL. Also try some larger gauge lancets like 28g.

Did you give full dose of 2.0U?

 

I would probably check her several times between 1:00 and 6:00 a.m. Without more data there's no way to tell when her nadir is.

 

Yes. Vet said to do 2 units 2 times per day (without recommending testing). We have done 3 doses total now (in her two days of diagnosis). I wanted to test, and First day I got blood fine, but tonight we couldn't get it with any of the tricks.

 

2 units is a little high for a starting dose, we generally see starting doses closer to 1 unit.

 

Especially while you are still learning how to home test. I noticed you said her blood clotted, did the Vet mention any blood disorders or notice the clotting when they took blood? There was a kitty here on a blood thinner, I might tag the wrong person @Lillie but I think it was her Leo. My memory isn't great

 

All her lab values were good except for glucose in both blood and urine. They didnt mention any problems with clotting. She wasn't spilling ketones when they tested her urine. Her back legs are a bit stiff, but prior to the diabetes diagnosis I thought that was just arthritis. She has been ravenous, drinks alot, and pees alot. But she is 15, and I thought she was just getting older.

 

Was just curious . As her numbers start getting under better control (regulated) her body will be able to properly absorb the nutrients from the food, so her appetite won't be as ravenous. Right now her body is still starving, literally. Hopefully you will see some improvements, even minor ones, in the next few weeks

 

I think you'll be pleased if you get the meter that requires less blood! In addition to having to throw away the strips because you get an error message, are you also having to poke your kitty repeatedly (so you can try with a new strip)? That's no fun!

I'm not sure whether this will be a controversial suggestion--I'm pretty new--but have you tried aiming for the marginal vein rather than the tiny area between that and the edge of the ear that is usually recommended? Using the vein may hurt more and probably isn't a good approach to use forever, but I have had to do it with my cat on occasion. I figure the faster I can get enough blood, the less traumatic it will be for him and for me. (I basically never have to do this any more--it truly gets easier with time!)

People gave me a couple of tips in addition to the rice sock that have helped:

• If you're using a lancet device (the plastic thing that makes the lancet pop down and prick the ear), be sure to hold it firmly against the ear. I put a cotton pad on the other side of the ear.
• If you're not going to go for the vein, try to get really really close to the edge of the ear.

And I realized one other thing myself:

• If the poke went ok and you're not seeing blood, look on the other side of the ear (the furless part). Sometimes my lancet has gone right through and the blood drop is on the other side. This is disturbing, but at least I don't have to waste the drop.

 

I find I do a lot of things its suggested not to do. Such as don't use your finger directly in supporting the ear. I first started using folded paper towel, so about 4 or 8 layers, but I didn't like it so I went with just my finger and find I get a better feel of the pressure I'm applying. I 've never once drawn blood from my finger doing this.

Just one of the things I do that are not recommended to do.

 

Today went better. I checked on her frequently during the night and she was fine. Then I skipped the morning test because she had access to food overnight, and because we were all still stressed out. My toddler donated a sock to make her ear-warmer. I turned a large lemon juice bottle into a sharps container. Midnight held still and bled enough to test on the first try tonight, despite not having been able to replace the meter yet. I plan to buy a new one tomorrow after work and then try to get a curve either Sunday or Monday.

 

I'm very new to this too. I got the Relion confirm for $15 at my Wal-Mart for the kit. I've gotten a test on a surprising small bit of blood. I've been very happy with the meter. Another thing I do is I put my strip in all the way, and then poke the ear without the pen thing, just using the Lancet. I'm fast enough (when though sometimes it feels like I'm taking forever) to get the blood on the strip in time.
She does have one ear that bleeds better than the other, but I don't want to poke her in the same spot all the time. (I test 4 times a day right now.) So sometimes I have to milk the ear by the poke to get the blood out.
I'm lucky she lets me.
Good luck to you and your kitty!

 

Hi - me again. Off sick today, so decided to test Midnight again to get a curve now that her feeding times and numbers seemed more stabilized. I'm freaking out! She was 350 mg/dL at AMPS. Ate 3 oz Fancy Feast and gave 2.0 units Vetsulin. As recommended by @Yong I started testing at +2 - she was at 41 mg/dL. I checked other ear to be sure and that was 43 mg/dL - thus very reliable. I gave about an ounce of a Meow Mix cup (shrimp and salmon in a sauce) to pull her up, and will retest at +2.5. She was showing no signs of being hypo and was pretty resistant to testing (she's been pretty good about it previously), but when the food was put out she started eating ravenously.

Her recheck with the vet is tomorrow - my impression is that 2.0 units is too much for her (since she drops so much so fast). I'm not usually home to get numbers during the day though, so I'm worried about the rapid drops with noone home and at night I've got two toddlers to deal with too, plus she hasn't been getting a pm shot most of the time since I'm not willing to give her 2.0 units if she is under 200 mg/dL since I think it is too much. Also she appears to go hypo without symptoms.

What should I do? Any questions I need to ask the vet tomorrow?

 

Aren't you glad you were testing . A few of our kitties tend to be a little more feisty when they are near those "take action" numbers. And keep in mind some kitties don't show any signs of hypo around the 40-50 range but we prefer to leave 50 as the take action number to prevent them from going into dangerous territory. If / when you get lower readings they are the one's you don't want to ignore. Doesn't necessarily means she is hypoglycemic and we want to prevent that . Any idea if she had eaten anything 2 hours prior to AMPS? Kind of scares me thinking what happened the last 3 days with 2.0U given on yellow PS .

I think it's fine you are not giving insulin if she goes under 200 PS. It really does sound like 2.0U might be too much after all, especially after seeing almost 4 PM's that you skipped or could have skipped. Tends to indicate a dose is too high when it gives consistent lower next PS.

You've probably already been/gone to Vet by now but I hope they don't try to discourage you from home testing.

 

I didn't catch this post early enough. How's Midnight's numbers now?
I saw on another recent hypo thread that if the numbers dip to hypo level the person should feed/sugar and retest every 30 minutes until the numbers are up.

If she's not getting her night dose because she's not at 200 then I too think 2 units twice a day is too much.
It sounds like you have this down as much as I do. If her vet check up is tomorrow, definitely bring up your concerns and find a better course of action.

 

I agree - its been worrying me too, since she hasn't been symptomatic, I wouldn't have known! We have been giving a lunch, but nothing extra overnight, so she didn't have anything before amps - unless she found something that the kids dropped.

 

I gave her a little high carb wet food and she went back up to 53 within the first 30 minutes, and 86 at an hour. She was 202 @ pmps.

 

Vet appointment is this morning. She doesn't eat or get insulin until afterwards. I'm going to show her my spreadsheet. I like seeing blue and green, but I think she needs a smaller dose so she can get it more consistently and not go so low. I'll update after the appointment.

 

you were just diagnosed a few weeks ago.... You should really have started at 1 unit and raised it slowly from there. I suggest doing just 1 unit for a few days (midnight may bounce a bit after those lows) and then test and reassesss.

 

Vet told me to start with 2 units, and I have since I didn't know. I'm hoping she agrees it is too much. She okayed not giving insulin when Midnight was under 200, but didn't want to change the dose until after this appointment.

Edit. Ultimately I'd like to use a scale like I've seen in other charts with smaller doses for lower ps #s.

 

That's definitely possible. This morning please don't give the full 2 units. As I said the typical starting dose is 1. If you want, post the preshot. Be sure to bring the spreadsheet with you to the appointment

 

Ok, will do. I won't be able to do anything until after the appointment anyhow since vet wanted her to come in fasting. Thanks!

 

@ JanetNJ - I just noticed your siggy mentions young again zero carb. I had been thinking of trying that since one of Midnight's fur brothers is a dry food junkie who likes to graze and I haven't been able to leave food out for him since she'll get it too. It looks like it really helped you! How much do you go through - it seems expensive, but if it helps it would be worth it. Any tips?

 

It is expensive but because it is nutrient dense and high in calories they eat much less of it than regular kibble. In 8 lb bag lasts me about 4 weeks with several cats eating it in addition to wet food. I still have a 25 lb bag I bought the end of January with about a months worth left in it. So while it's pricy it lasts awhile. You can get a free sample of the Young Again Zero carb food if you ask.
Youngagainpetfood.com

 

Just to give you another reference. Maury is an only kitty and he gets some YAZ too. An 8lb bag lasts me about 2 1/2 months. He has been eating all of his cycle portion (3/16 cup) after his breakfast but he's not as hungry throughout the day .

 

Good news. Vet agrees 2.0 units is too much and says to do 1.0 unit bid. She supports the home testing - said it was good we were checking and able to catch her hypo yesterday. Thinks she may be able to be food controlled since the diet change to low carb wet food has helped her numbers, and likes the idea of using young again zero carb as a freefed grazing food between meals. She seems to look for food when her numbers are dropping, so that could help her self-regulate as long as she maintains her weight on it.

 

fantastic! glad you are on the same page with the vet. that's always so much better when you can work TOGETHER on treatment.

 

Ok, so we're 2.5 -3 hours later than usual due to vet appt this morning. Midnight's numbers have been better today with 1.0 unit, but tonight (pmps) she was only 170, so I'm trying to figure out what to do. Is it reasonable to just skip tonight's shot so I can move her amps back to ~6:00 where it needs to be for a 6:30ish insulin?

 

First time <200 PS and you need to get back on schedule, I think it's ok to skip. Would grab another test to see how she's doing without

 

When should we retest - +2 from food?

 

+2 is good and if you don't go to bed immediately after, another before bed. It's what I would do, you can ignore me and just do +2

 

Sounds good. Thanks!

 

Good call on the no shoot

 

Hi Sarah!
Realized it's been a bit since you've posted. Checked in on Midnight's SS, she's looking very nice! . Noticed some NS in the evening so thought I'd give my 2 cents . If your syringes have half unit markings, would you be open to trying to give her 0.25U? It could help balance her out so she can receive two shots a day. While 1 a day is nicer for us, it seems better for their little bodies to be able to receive the 2 shots.
As always, the decision is yours

 

Yong - thanks for our post. I had been thinking about asking for someone else to take a look again too. We've worked down from 2 units bid to 0.5 units with PS results from 150 - 250 and 1.0 units with PS results over 250. I thought about moving down more, but it'll be challenging with the syringes we have. I will ask our vet about options at our appointment next week. I'm also wondering if she is bouncing some since she seems to be higher in the morning regularly. What do you think?

 

Possibly because the dose is too high. Most Vet's don't believe in 0.25U doses but there is plenty of evidence here that kitties don't usually go from 1.0U to remission. You can get syringes with half unit markings to make the 0.25U easier to draw . Even if her number is a little higher in the morning, do not give more than the 0.5U. How many hours after PMPS do you go to bed? Getting a before bed test can help figure out where she's going overnight . I still think she would do better with 0.25U to help even out the PS numbers. Should also help bring the AMPS numbers down too.
@JanetNJ @MrWorfMen's Mom What do you ladies think?

 

Agreed 1 is too much. I might tRye 0.5 and see if it evens out, but If not enough do 0.75. 1 is def too much though.

 

I too think 1 unit is a bit too much. I agree with Janet....try 0.5u and see if that doesn't level her out a bit and if she needs a bit more, then up it to 0.75u. I wouldn't aim for mid cycle lows in the 50s with Vetsulin...I'd leave a bit more cushion and aim for between 80-90 as minimum lowest readings. That said, Midnight is looking pretty good. Nice work!