Lethargic, uncoordinated movements, 25mg/dL

good morning sam!

glad to see Shivee's done ok. don't beat yourself up at all. as i said yesterday, many people arrive here in a crisis just like you. Most of us have made mistakes with our diabetic cats. When you saw symptoms, you did the right thing to bring her up and post here to learn how to keep her safe. We just move on from here. You can only work with what you know - now you've gotten familiar with testing and some ways to keep her safe. That's the important thing.

About testing her blood sugar - ears are often easiest, although the foot pads work well for some people. One thing that will help tremendously is to get some neosporin ointment with pain relief to ease the owie of the pokes. Some people put it on and rub it in about 15 minutes before they are going to test to numb it. I put it on afterwards and then wiped off any excess before the next test. It's very effective at numbing. You can also put it on at night and by morning the ears appear to be healed. When people begin testing, it's common to not get blood at first. It might take several pokes, or even then you might not get any. But the poking is doing some good - it stimulates the growth of capillaries in the ear and after about 2 weeks you'll get blood every time. Always give a treat when you test and soon Shivee will accept the testing without trouble. You can boil a chicken breast and dice it small (1/2" cubes), freeze most and keep a little out in the fridge to dole out. Some people buy freeze dried meats (no sugar) to give as treats.

One trick that people use if the cat is hard to handle is to scrape the blood drop off onto your fingernail and then test it from there.

My previous computer died so i don't have all the resources i'd bookmarked in the past, but there is a diagram of a cat's ear and where to test that works best. Hopefully someone will post that for you. We test in between the vein that runs along the outside edge of the ear, starting about 1/2" down from the tip and going down about an inch. She may tolerate the ear testing better than the foot pads.

One other thing worth noting - cats that are newly diagnosed have an excellent chance at healing and becoming diet-controlled, ie, no longer getting insulin shots if their blood sugar is kept in non-diabetic cat numbers. Cats have the unique ability to have their pancreas heal and begin producing their own insulin again. You mentioned the problems you've got coming up with going back to college and having your family taking care of her in another month or so. I'd encourage you to read this page on the Tight Regulation Protocol, especially the PDF link about 5 paragraphs down from the top called "Management of Diabetic Cats Using Long-Lasting Insulin." Not every cat goes off, but many do. We'll have to wait and see what the consequence of yesterday will turn out to be, but I want you to have this information to look at now. That's the protocol that people on the Lantus/Lev Tight Regulation Insulin Support Group are following. There is a lot of good information on the top of that page that might be helpful to you as well - look for the posts with the yellow stars.

Do you have any questions?

 

Don't beat yourself up! I found this site right when Cobb was diagnosed in April of 2013. And you know what? I thought these (awesome) people were crazy! It was too much work testing every day. We shot Cobb blind for 6 months with absolutely NO change in his BG. He was persistently in the 500-600 range. Who knows the damage that was done to his organs? I finally got pissed off at my vet :evil:, because she wasn't doing or suggesting anything that helped, and I found my way back here last Thanksgiving and Cobb is seeing some great numbers now.

I say all of that to say, we've all been there! You're in the right place now.

 

Very good job.
Low as you found out is extremely dangerous. High, a cat can live with within reason 200-300 (?) beyond that you run into other problems but not nearly as critical as a low, unless you let it go on for days.
The "bounce" is like a superball, for that little insulin which drops the numbers low, the body will release sugar into the blood and you will test that artificial rise. You can chase that number by giving more insulin then necessary and it bounces more. It seems that you making some good low carb homemade food which brings down the numbers but even that is not instant, it can take a few days for it to fully work itself out.

As you have learned, don't shoot without a test.
Restock all your gravy food. As stated so kitty doesn't get too full, you could give the gravy portion to raise the carbs along with a bit of the food.
Make sure you order some more strips as you sure made a dent in your supply.
Get that rest and then ask about the ear testing. I've hit that vein and then had him shake his head, blood everywhere. I'll poke and then squeeze the drop out, using a tissue to back up the lancet.

 

Just used the picture here and got blood on the first try, without even a meow! I don't know how I was messing up earlier, but this is great.
Tested 211. No insulin since noon yesterday.

 

Great job, Sam!

The reason I like to do the neosporian about 10 minutes before testing is that for whatever reason (I am sure someone here knows why) it helps the blood bead up...I was having difficulties at first EVER getting blood from Skooter's ear and that trick helped out so much.


The other trick I learned recently is if you don't get blood from a lancet after a few pokes (I free hand it, could never figure out the lancet device), pull out a new lancet and start again. I was shown a picture of what a lancet looks like after even a few pokes....NO WONDER I wasn't getting a sample. Now that I use a new lancet after a few tries, I am going through less test strips and causing less stress for my cat.

I shot blind for about a month or so before I started testing. There is so much information to learn and so much information given to you, I found it easiest to take it in bits.....

The spreadsheet, however, is the BEST thing I did as when people would be explaining things to me about Skooter, I could look at the same thing they were looking at and have been able to start noticing trends with him.

Keep up the great work Sam!

 

Just want to say, Sam, that you did a brilliant job; and in very difficult circumstances too.
You kept your cool and did what needed to be done.

I hope you did manage to get some decent rest. You must have been exhausted after all that effort.

Keeping fingers and paws crossed here that things for you and Shivee improve in leaps and bounds! :smile:

Eliz

 

160

 

Hmmm, a nice number, Sam. And is this around 24 hours since her last shot? Shivee seems to have dropped a bit on her own.
Who knows, maybe she even has her eye on remission...? ('Remission' means that the diabetes can be controlled by diet alone)

Eliz

 

+27.5 = 160

looking good.

by the way, did you say what kind of meter you are using?

 

160. What a nice number! I certainly wouldn't be in any rush to resume insulin just yet.
Very interesting...

 

163, and another painless test.

 

Awesome! You're doing so well with testing, too!

Just out of curiosity, what time do you usually shoot everyday?

 

It's usually right before I go to work at around 9AM.

 

Congrats that you've been able to get blood from her ear!!! Nice numbers this afternoon.

I have to jump on the "don't beat yourself up" bandwagon. We trust our vets. And most of the vets are doing everything they can to stay on top of different health issues. But they are generally seeing more than one species and probably not a lot of diabetics. And the ones they do see, they are happy if they can get the caregiver to agree to even give insulin because many CGs will just say "I'm not treating diabetes; put him/her to sleep". My vet said most vets are cautious because they want you to keep the BG high as they don't have the ability to help CGs monitor anything close to tight regulation.

But there's almost always someone here 24/7 and we live it, breathe it 24/7. Lots of experience, lots of scientifically based research, lots to learn.

I hope the door that opened for you and Shivee with this experience will lead her to renewed health.

 

Latest test is 260. I'm not sure what dosage to go with, if any. Suggestions?

 

Nowhere near 2U.
A bit of useful information that would help those who know. They type of meter you are using as different meters give different numbers.

 

Ah, it's a walmart ReliOn Confirm.

 

If you would, please put that tidbit in your signature by using User Control Panel in the upper left hand side of the page. Browse through the tabs to see what you can configure - there's quite a bit - and on the 2nd tab, edit your signature.

Thanks.

 

Testing at 12:30AM, she's back down to 163. I'm going to hold off on a shot and test again tomorrow morning.

 

Good idea. She's dropped on her own again.

What are you feeding Shivee at the moment, Sam?
And I don't know what your feeding schedule is, but small frequent snacks/meals (rather than a couple of large meals) can help stimulate the pancreas to work without overloading it with too much to do at any one time.

It's looking good...

 

sorry, I was actually watching for you to post tonight but then I fell asleep. It sure does look like her pancreas might be working at least some of the time, but that she may still need some help from insulin. But, you never know what tomorrow will bring. I think waiting until morning is a good idea. If you would like to get back to a 9:00 shot time, maybe test an hour or two before that and see where she is.

If you do need to resume insulin, definitely choose a dose lower than 2 units. Maybe 1.5 if you want to be aggressive or 1 if you want to be more conservative. Keep in mind that with no past data, we are basically plucking a dose out of thin air, so any insulin given will need to be monitored.

Get some sleep! You guys are both doing well.

 

After lying low for a few days, I've been testing twice a day when I feed her and would normally give a shot, but her levels have been quite low. I'm thinking the 48 and 63 were because she wasn't eating a lot, and after I added some parmesan to her food she ate more and it looks like her levels are stabilizing at around 100.

With regards to her diet, it's the exact recipe from catinfo.org, using bone meal and chicken thighs. I just made a 6lb batch today too.

 

Happy to hear that Shivee is doing so well and you are having an easier time with testing the ears!

Hope she continues to do well!

 

Sam, there have been times when a cat that has had a symptomatic hypo has had their pancreas kick back on. It is looking like that might be what's happened with Shivee. For now, she doesn't seem to be needing insulin. When a cat has been on insulin and then goes off, they are still considered diabetic, but it appears she may have become diet-controlled.

So for the time being, i'd break up her food into small meals around the clock - same total volume of food, but maybe 6-8 meals spread out. A timed feeder might be very helpful for you and your family in accomplishing this. (If you want a suggestion on that, we loved the PetSafe 5 Compartment Feeder. As long as you have the food tray fully seated in its base unit, it is a great little machine.) Continue feeding low-carb food and small meals for the rest of her life. The raw food diet is great. You do want to be careful leaving raw food out for too long. The smaller meals make less of a burden on her pancreas.

Continue checking her blood sugar a couple of times a day at the normal breakfast/dinner times for the next week or two. If it's under 100 you don't need to do anything. If it's over 100, feed her and then recheck it about 3 hrs later. The food will often stimulate the pancreas into producing a little insulin, which will then bring down the blood sugar into normal range.

If she stays in normal range like this (under 120), i'd continue testing blood sugar weekly for the next few months and then monthly forever.

For the rest of her life, avoid medications with sugar in them and steroid medications unless they are medically essential. It's a good idea to weigh her monthly. Her weight should remain stable. If she seems "off" or sick, or is showing symptoms of diabetes (excessive drinking, eating, urinating, weight loss) test her blood sugar right away. Keep the teeth clean; dental issues can bring a cat out of remission.

If you see rising blood sugar numbers, post here before you restart insulin and ask for advice on how to proceed. And just as an aside, cats not on insulin can't become hypoglycemic except when there are unusual medical conditions, so if you aren't giving insulin and you see a number in the 40's, for example, that is ok.

Congratulations! For now Shivee seems to be doing well. I am so glad for you and her both that this has turned out like it has.

If you have any trouble or questions, let us know and we'll be glad to help.

 

Oh, wow, Sam. Things are looking really good for Shivee!
It looks like remission (diet-controlled diabetes) may be possible for her.

Remission can be temporary or permanent so to give Shivee the best chance - as Julie says - it's important to keep her on a low carb diet and to remain vigilant for any symptoms that indicate that she may have a problem. Infections (dental and urinary tract are quite common) can result in loss of remission, as can certain medications.

Please keep us updated about how Shivee is getting on.

Keeping fingers and paws crossed for ya!

Eliz

 

:mrgreen: :mrgreen: :mrgreen: :mrgreen: :mrgreen:

Looking great!