? I really need help! Second Post!!!

Discussion in 'Lantus / Levemir / Biosimilars' started by Cindy Lamy, Feb 7, 2018.

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  1. Cindy Lamy

    Cindy Lamy Member

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    May 29, 2017
    http://www.felinediabetes.com/FDMB/threads/switching-to-lantus.190542/#post-2124840

    My cat has become so extremely hard to test. It use to be so easy. Now he is biting, hissing, swatting at me. This morning before my husband left for work, he held him down and I couldn't get his ear to bleed after several pokes then Butter went nuts, he finally had to let him go. I have not cried during this whole journey that started last May but I am now having a breakdown.

    I switched him to Lantus about a week ago. Vet suggested that I start him on 2 units. She gave me new syringes. I went from U-40 to U-100's. This new syringe is so tiny and the needle is so much smaller that I have no idea if he is even getting any insulin. With the U-40, I felt the needle go in and it took a second to push in the Prozinc. I don't even feel the needle go in him and the insulin is such a small amount I feel like it might be in his fur.

    Since the switch to Lantus, I have no idea if it is too little or too much as I can't test him anymore without a huge scene, me crying and him running away angry at me. This is just awful I am attaching a pic of the syringe. If the Dr. recommends 2 units is it just the 2 very top lines? It seems like nothing! Not to mention drawing the insulin from the pens has not been easy. I'm not even sure if I have it in there sometimes, it is such a tiny amount. It was so much easier administering the Prozinc with the U-40's a the 4.5 units. I am so upset and I have spent so much money on him. I just want to get him better!
     

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  2. Beth 73

    Beth 73 Well-Known Member

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    Hi Cindy ..Would help if you put a purple ? Icon in your title ...will draw attention to your thread . Someone with more experience will have suggestions for your situation . Looking forward to hearing what others think ab Butter’s sudden dislike of test time . You are a great momma bean to be home testing ...:bighug::bighug::bighug::bighug::bighug:
     
  3. Cindy Lamy

    Cindy Lamy Member

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    Thank you for responding. What kind of purple icon? Like an emoji? I'm so distraught!
     
  4. Cindy Lamy

    Cindy Lamy Member

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    Ok I see now. A purple question mark.
     
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  5. Beth 73

    Beth 73 Well-Known Member

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    Aug 2, 2016
    Yes , you got it !!! I feel for you ..we all have gone thru times like this and it is upsetting when what has worked for a long time suddenly doesn’t . :bighug:
     
  6. Cindy Lamy

    Cindy Lamy Member

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    thank you! First major breakdown I've had. He use to be so easy and sweet!
     
  7. Amy&TrixieCat

    Amy&TrixieCat Well-Known Member

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    Has anything changed other than insulin? Have you had any recent labwork to see if something else is going on with Butter?

    You would know if you were giving furshots. Lantus has a very distinctive "band aids" smell to it, and even with 2units you would feel a wet spot on his fur.
     
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  8. Cindy Lamy

    Cindy Lamy Member

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    May 29, 2017
    Not much has changed. He does have stage 2 kidney failure but that is not new. Am I doing it right? Did you see the pic? Is 2 units just the third line on the syringe?
     
  9. Wendy&Neko

    Wendy&Neko Senior Member Moderator

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    Can you give us the name and full description of the syringes? You picture doesn't show any numbers on the scale, and most do.
     
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  10. Tracey&Jones (GA)

    Tracey&Jones (GA) Well-Known Member

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    Breath!:bighug::bighug::bighug:

    You may have to start over with the testing. Find a new spot to do your routine. I am assuming you offer treats or something at test time?

    If he fights to much, let him go...try again a few minutes later.

    Is there any numbers on that syringe?
     
  11. Cindy Lamy

    Cindy Lamy Member

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    May 29, 2017
    I'm getting his labs faxed over now.
     

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  12. Cindy Lamy

    Cindy Lamy Member

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    May 29, 2017
    Yes, here is a better picture.
     
  13. Cindy Lamy

    Cindy Lamy Member

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    May 29, 2017
    Yes, they are U-100 single use. Here is a better picture.
     

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  14. Myagi (GA) and Heidi

    Myagi (GA) and Heidi Well-Known Member

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    Cindy, like we discussed previously, gas and distance is an issue for me right now but if you want me to come to you to help you get more comfortable with the new syringes and insulin, I will. :bighug::bighug:
     
  15. Myagi (GA) and Heidi

    Myagi (GA) and Heidi Well-Known Member

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    I messaged you my phone number.
     
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  16. Moose (GA) & Rae

    Moose (GA) & Rae Member

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    Apr 12, 2017
    Hi Cindy!

    I'm still a newbie so I'm not able to help with the other points, but have you tried "burritoing" Butter when trying to test? Try wrapping him up snugly in a towel like a "purrito", so that you can avoid scratches and bites and I have found that the kitty burrito can be calming for them. Moose is good about his testing, but I used to have to do this with a few of the cats that I had growing up. They did not like having their claws clipped, so we burritoed them and it worked very well.

    Best of luck, I hope that things get easier with butter! There are so many helpful beans on this site, you are in good hands :)
     
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  17. Wendy&Neko

    Wendy&Neko Senior Member Moderator

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    OK, thanks for the new picture. That explains the problem. You are using the 1/2 CC syringes with whole units up to 50 units. You are giving the right dose, but they are way larger syringes than you need. You can get U-100 3/10 cc syringes with half unit markings, which show up to 30 units. It's MUCH easier to do small doses when you have syringes with half unit markings.
     
  18. Tracey&Jones (GA)

    Tracey&Jones (GA) Well-Known Member

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    [​IMG]

    Tagging on to what Wendy said - These are the ones I use.
     
  19. Stacy & Asia

    Stacy & Asia Well-Known Member

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    Oct 2, 2017
    What happened between September and recently? Did you stop giving insulin or stop testing? I found your old post from September that he was getting feisty with testing and you also mentioned he was having some dental issues. Any time a cat has behavior changes like that, it’s worth investigating for a medical cause. Have you had a chance to address the teeth? He could be in pain and sensitive about his mouth/head being handled because of it. My Asia is very relaxed and docile, but she has had teeth issues and you will see a different cat if you go in her mouth! :eek: Try to post the lab values in your SS when you can. We have an awesome person who is very versed at reading labs, although she is out of town at the moment. When you add them, let me know and I will tag her.

    Apart from ruling out any medical problems that might explain Butter’s behavior change, you might just need to start from scratch when it comes to testing. Develop some new routines and see if you can get anywhere with that. Here’s some suggestions:

    • In your September post, someone mentioned paw testing. It may be worth trying, especially if the issue is some sort of sensitivity with his head/ears/mouth. He may not be bothered by paw testing. Someone linked a video in your September post if you wanted to review it and give it a try.
    • Does Butter like treats? Is there some special treat you can reserve only for testing time so he will associate testing with getting this amazingly delicious treat he can’t get at any other time?
    • Give him lots of love before, during and after testing so he starts to associate it with a positive exchange.
    • Have you tried a warm rice sock to help the ear bleed easier?
    • Try some Vaseline, olive oil, neosporin, something oil based on the ear before you poke that will allow the blood drop to bead up and not sink back in to the fur.
    • Most importantly, Butter is your cat, you share a bond, cats know when we are upset and distressed and often times it makes them uneasy. If you are not calm and collected when you approach him to get a test, he’s going to feel that and have anxiety too. Maybe have your husband step in when he’s available if you’re getting upset and you walk away and get calm. If your husband is not available, stop, walk away, and come back and try again when you’re collected.
    • You have a gift in that another board member seems close enough and willing to come lend a hand. Heidi is a wonderful resource, don’t be afraid to take her up on her offer!
    There will be a new learning curve and some kinks to work switching to Lantus, but looking at your SS, I think you will be pleasantly surprised at the change in insulin and breathe a sigh of relief that you made the switch. Butter will feel better too when his numbers are lower. You can do this, we are all here to help. Don’t get discouraged, try to post every day and we can get somewhere and hopefully have you and Butter feeling a lot better very soon. :bighug::bighug::bighug:
     
  20. Bobbie And Bubba

    Bobbie And Bubba Well-Known Member

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    Jun 15, 2015
    Sending you a big virtual hug. :bighug: It is very upsetting when our kitties turn uncooperative during this journey.

    Could you try taking Butter to the spot that you have set up to be the test area and just simply rub his ear a few times and give him a treat and then let him go. Do that a few times to recondition him to his ears being touched and getting a treat. Once you feel he is comfortable with that, then try to test him and see if it goes better. Sing a little song to stay calm while you try as Stacy said, they really do pick up on our tension.
     
  21. Myagi (GA) and Heidi

    Myagi (GA) and Heidi Well-Known Member

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    Oct 30, 2017
    Cindy and I had great talk on phone. Her daughter has the magic touch with testing, so they'll try for a +6 in a couple hours when daughter there. Cindy will pick up correct syringes with half unit markings. Also will holler at me if she needs me to come over. Which, of course, I'll do (providing Myagi not in middle of one of shark dives lol). :):bighug:
     
  22. Sylvie

    Sylvie Member

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    Sep 26, 2017
    i din't see anyone answer... ""If the Dr. recommends 2 units is it just the 2 very top lines?""
    2 units on those syringes would be the third line up, first one is 0, second one is one, third one is two and so on.. once i get near line mark i need to be at, i use a cheap handheld magnifier to see lines better and have found looking through back of syringes (lines not towards me) makes it actually easier for me to finish slowly twisting the plunger to stop at the right area of line..in front view the plunger just blends in with those tiny lines even when i use magnifier.
     
  23. Myagi (GA) and Heidi

    Myagi (GA) and Heidi Well-Known Member

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    She sent me pic, she is properly drawing 2 units. :)
     
  24. Bobbie And Bubba

    Bobbie And Bubba Well-Known Member

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    I like this tip!
     
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  25. Cindy Lamy

    Cindy Lamy Member

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  26. Cindy Lamy

    Cindy Lamy Member

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    May 29, 2017
    Hello. yes, back in August I had his teeth done. They had to extract 3. I have tried the warm sock. Sometimes it works, sometimes not. I am doing my best. I am trying to stay calm. I'm going to try to test when he is sleeping. I have done that a few times with success. I did continually test him but I was not very vigilant about posting. His numbers never really changed and the frustration got the best of me. My father in law passed away and had some Lantus so I asked the vet if we should try it. This is why we switched.
     
  27. Cindy Lamy

    Cindy Lamy Member

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    May 29, 2017
    Thank you I just went to Walmart and purchased these!
     
  28. Wendy&Neko

    Wendy&Neko Senior Member Moderator

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    Great. The narrower barrels mean more room between the numbers, which makes it easier to draw the insulin dose. My vet mostly carried just the 50 unit syringes too.
     
  29. Mandy & Rex (GA)

    Mandy & Rex (GA) Well-Known Member

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    Mar 22, 2017
    Hi Cindy! I just noticed you're in a Feline Diabetes FB group, but that one is not connected to this board. I suggest you search again under Feline Diabetes and look for a cat holding an insulin vial. I'm on my phone so I can't send you the direct link. That way, if you have an emergency, you can post and people will hop on over here to look at your SS and give advice. :bighug:
     
  30. Cindy Lamy

    Cindy Lamy Member

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    May 29, 2017
    I have posted Butter's new bloodwork. Any input is greatly appreciated!!
     

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  31. Cindy Lamy

    Cindy Lamy Member

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    I've added his bloodwork. Still trying to find my way around here. Let me know if you don't see it. Thank you so much! :bighug:
     
  32. Wendy&Neko

    Wendy&Neko Senior Member Moderator

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    The bloodwork page of the labs is a little hard to read. Most of us have a tab on our spreadsheet with the labs put in there. It makes it easier to read, and is good for tracking trends. Neko's isn't a good example, unless you are not in the US. The measurement systems are different.
     
  33. tiffmaxee

    tiffmaxee Well-Known Member

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    Nov 15, 2013
    @Wendy&Neko , I clicked on the labs and was able to enlarge it. Other than kidney disease nothing jumps out at me.
     
  34. Squalliesmom

    Squalliesmom Well-Known Member

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    Jun 26, 2015
    You will find your new syringes much easier to work with! I use the same ones Tracy recommended, I like them best of all the ones I've tried.
    When you go to test, sing, anything, it doesn't matter what, just sing something. It keeps you from focusing on your nervousness, and it releases endorphins and oxytocin, both of which reduce stress and help you feel better. It might even help reduce some of Butter's stress, too! :):cat::)
     
  35. Cindy Lamy

    Cindy Lamy Member

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    May 29, 2017
    Thank you so much for looking. I guess now I concentrate on getting his sugars down and feeding him the correct food that is low in carbs for the diabetes and low in phosphorus for his kidney disease.
     
  36. Sienne and Gabby (GA)

    Sienne and Gabby (GA) Senior Member Moderator

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    Dec 28, 2009
    Another thought in addition to treats at test time... Are you using any Neosporin Pain Relief ointment on Butter's ear when you test? You use just a tiny bit and it slightly numbs the area and causes the blood to bead up.

    FWIW, restraining a cat is probably the best way to get your kitty to fight you. They are fiercely independent -- as you know -- so if you are trying to forcefully hold your cat down, you're going to end up with a whirling dervish that's all claws and teeth. I'm attaching a link to a product called Clipnosis. There's been some research done with this clip. It's supposed to mimic a mom cat holding a kitten by the scruff which may calm the cat. It's available on Amazon. You can always burrito wrap Butter as well but you cat may experience that as a restraint.

    Just a word about Prozinc vs Lantus -- With Lantus, dosing is based on the nadir, not the pre-shot numbers. That means you will want to get at least one test each cycle in addition to your pre-shot test. In other words, you will want to get at the very least, a before bed test every night.

    If Butter is stage 2 kidney disease, you will want foods that are high in protein and low in carbs and phosphorus. I found Weruva Steak Frites and Tiki Cat had several chicken flavors that were appropriate. They were on Dr. Lisa's food chart.

     
  37. Elizabeth B

    Elizabeth B Member

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    Jul 30, 2017
    Hamilton has switched to Cats In the Kitchen and rotates between Chicken Frick A Zee, Fowl Ball, and La Isla Bonita for his CKD. It's from Weruva and isn't quite as expensive as their main line or truluxe. (I tried the Steak Frites for Hamilton, but the carbs were just too high for him as he's quite sensitive.) Someone also recommended the Whole Earth duck if your cat prefers a pate. I bought some but haven't tried it yet as we are still working out the right insulin dose.

    http://weruva.com/catsitk-cans-nutrition.php
     
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  38. Cindy Lamy

    Cindy Lamy Member

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    Thank you! :bighug:
     
  39. Cindy Lamy

    Cindy Lamy Member

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    Thank you! Yes, we do use the Neosporin. Today I tested while he was sleeping. His ear was against the carpet so I poked and Bingo! He barely moved! I looked on the list and I have compiled a list of low carb and low phosphorus food. I will be purchasing tomorrow to see what will work best. My challenge now is that the Lantus dose does not seem to be helping. It is actually higher at +6 then it has been in a long time. We have an appointment at our vet in one week so she can see his numbers on the Lantus. I'm just wondering if I should call her and see if I should increase it before then.
     
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  40. Stacy & Asia

    Stacy & Asia Well-Known Member

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    Oct 2, 2017
    Testing success! Hooray! :) :cat:

    I don't have experience using Prozinc, but Lantus and Levemir work differently by design. They are meant to be peakless insulins and they are also depot insulins, which means they build up reserve in the body over time and get released in little bits throughout the day. It takes several cycles for the depot to build. The results you see won't be immediate and the dose changes are done systematically (in small increments of +/- .25 units at a time, typically).

    If you read some of the stickies at the top you can better familiarize yourself with how Lantus works and also peak/nadir/duration and other concepts which will help you greatly in working with this insulin.

    If you can try to test before every shot and get at least one extra test in am & pm cycle, it will give a much clearer picture on if the dose needs to be increased, decreased or stay the same. There is something we call bouncing here and essentially, it means sometimes you see a higher number and it doesn't explain the whole picture, Butter can be going lower than he is used to somewhere in the cycle and it causes a metabolic response that temporarily increases glucose in his body and gives you those higher numbers. Bouncing is also addressed in the stickies and is a hard concept to wrap your head around at first. It is normal and many cats bounce until they get used to lower numbers, it's actually a good sign, it means he is responding to the insulin.

    You're doing great, keep reading and give the Lantus and Butter a chance to get familiar with each other, while you learn the ropes as well. :bighug:
     
  41. Sienne and Gabby (GA)

    Sienne and Gabby (GA) Senior Member Moderator

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    Dec 28, 2009
    It's not unexpected that you're not seeing movement yet with Lantus. You dropped Butter's dose from 4.5u of Prozinc to 2.0u of Lantus. It's likely that you'll need to systematically increase Butter's dose.
     
  42. Cindy Lamy

    Cindy Lamy Member

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    May 29, 2017
    Thank you! He has an appointment with the vet on Friday. Should I call the vet before then to see if I should increase? I'm scared that I shouldn't of switched him now. His numbers are high. He is still eating and drinking and using the litter box but he seems a bit more lethargic. Testing time has been a nightmare. Seems the only time I can get it is if someone else is home with me. It has turned into a 2 person job. Like today I tried so hard to get a test before his morning shot but he was not having any part of it. I have taken all the suggestions here. Sometimes I get it and sometimes I just can't. I feel like a bad mom but I really am trying. It is stressing me out. All of my friends are making travel arrangements for upcoming holidays and they laugh when I say I can't go because I am trying to regulate my cat and I need to test and give him shots. I love him and I wouldn't have it any other way. I'm just venting! :(
     
  43. Tracey&Jones (GA)

    Tracey&Jones (GA) Well-Known Member

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    Dec 12, 2016
    [QUOTE="Cindy Lamy, post: 2129285, member: 19708". I'm just venting! :([/QUOTE]

    Hi Cindy,

    You are doing your best! Cats have a mind of their own and they are not afraid to use it! I think you are doing great! You keep trying, you are trying new things, you are getting help from family members!

    The fact he is eating and drinking is a good sign! Jones get lethargic every now and again too. Heck so do I!

    These are for you:bighug::bighug::bighug:
     
  44. Elizabeth B

    Elizabeth B Member

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    Jul 30, 2017
    Boy have you come to the right place for venting. We’ve passed on holidays, trips, business opportunities, you name it. But it’s totally worth it. Frustrating for sure, but if anyone understands the complicated heart of a FD cat parent it’s the board. You’re in good company, friend.
     
  45. Ana & Frosty (GA)

    Ana & Frosty (GA) Well-Known Member

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    Jan 19, 2018
    Hi cindy,
    Oh boy, do I feel your frustration! Now, I’ve only been doing this for 5 weeks, but my cat also used to be easy to test, and now it takes 2 people and he bites, and it’s judt not pretty.

    I’m also having difficult getting his ear to bleed, and sometimes I’ve wasted up to 5 AlphaTrack2 strips on one attempt! That’s $5 right there.

    And YES, 2 units is tiny. Mine is on 0.25 units now (drawing takes the longest and i always feel stressed haha). and every day when I push the plunger it it feels like nothing is going in. But it definitely is, and I can see that with his numbers (when i can get them). The reason the units are so tiny on lantus is because it’s developed for humans, and most humans are on a much higher dose (think 12 units). So yes, drawing 2 units of lantus vs Prozinc is an adjustment, but I have no doubt that with time and practice you can do it!

    So for those frustrating times when you just can’t get the blood, my advice is to just take a break. The cats get upset over the ear tug, but they can also sense our frustration as well. It’s not your fault - it’s understandable because you want the best for him, but of course they don’t know that. I know you’re just starting the new insulin, but once he is more stable on a dose, what I personally have done was skip a few days of testing. Most likely other members would tell u not to do that, but for us it got to the point where I was wasting so many strips and his ears were pretty bruised and I just decided that since I’ve been getting the same numbers over the past few days, it would be safe and a good break for both of us. I would then do a curve that weekend to see where we are.

    Also, is it possible to test while he is eating so he is distracted? Or offer him a low carb treat? Just some ideas.

    Ana
     
  46. Sienne and Gabby (GA)

    Sienne and Gabby (GA) Senior Member Moderator

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    Dec 28, 2009
    The other part of the testing equation is you. If you're nervous, frustrated, etc., it gets communicated to Butter. A could of additional suggestions. If you don't have a testing "spot," decide on one. I would test on the kitchen counter. It was well lit, Gabby was facing a wall, it was raised off the ground (so escape wasn't quite so easy). Take Butter to her spot and just scratch her ears, talk to her, and give her a treat. Don't test. Start doing that routinely. You want her to associate the spot with treats. Every so often, test her there once it seems like there's a connection. You need to remember to breathe. It's hard. We get used to it and ultimately, our cats will acclimate. It just takes some cats more time than others.
     
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