Meet Lucy. She's a bit decrepit.

Discussion in 'Welcome to the Group - Post an Introduction Here' started by David Johns, Jan 31, 2015.

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  1. David Johns

    David Johns New Member

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    Jan 30, 2015
    Hello,

    (Apologies for the length of this essay. It felt good to write it all down, a cathartic exercise perhaps)

    Four months ago, a rather scrawny old decrepit cat came into my care. Her name is Lucy and that's her picture on my profile.

    Lucy is now 16 years old and had lived with her elderly owner since she was a kitten. When her owner died in November 2013, her inheritors - daughters - knew that the chances of finding a home for a diabetic, long-haired, elderly cat with one tooth and a dicky tummy were slim so - wait for it - they paid cat sitters for an entire year to feed her night and day in the same house she'd lived in while it sat empty. Lucy rather liked this.

    They did try rehoming her but because she had a dodgy bottom, the new keepers handed her back very swiftly.

    Ultimately the situation became untenable and the daughters looked around again for a mug - sorry, a kind-hearted individual - to take her on. I saw a post on Twitter and agreed, in a moment of weakness, to take her.

    She'd been diagnosed as diabetic in June 2013 and put onto Glipizide which she was happy enough to eat in her food; it was on that basis I was told she'd be no trouble at all ;-)

    Quite when all her teeth bar one fell out or were removed is unknown; I now realise this was presumably due to the diabetes.

    Keeping Lucy indoors for three weeks, as one does in a new environment, showed instantly that the Glipizide didn't seem to work. She drank loads - around 150ml a day (my previous cat would barely touch his water) and would wee like it was a Championship sport. Her poo was runny and horrid.

    Bizarrely, despite the prior diagnosis of diabetes, a vet had put her onto a diet of Royal Canin "chicken and rice" to soothe her tummy. Worse, because the cat sitters only ever turned up to feed her, and as she used the garden for her litter, no-one apparently appreciated that this wasn't actually working.

    She also arrived with fleas - swiftly dealt with so that's one kindness I've been able to sort if nothing else.

    After consultation with my vet, we agreed insulin was a better option so four weeks ago we gave her a shot of Caninsulin and she stayed overnight at the surgery. Naturally, being a cantankerous old lady, she refused to eat anything there and her BG level dropped from 22 to around 3.

    Kindly, the vet instantly changed tack and suggested twice-daily, slower-acting Lantus so for the past fortnight this is what she's been getting, at 7am and 7pm.

    It's not been the easiest of times. Whilst - amazingly - Lucy's actually very patient with me drawing blood from her ear, she HATES the injection. And, because she's a scrawny old thing, there's precious little scruff to inject into. Oh and I'm doing this single-handed as I live alone, so she's scrabbling to escape while I hold her pinched neck, try to form a "tent" and inject her with the other hand.

    Several times at the start she simply jumped off the needle as I pushed it in, and I didn't have enough limbs to stop her. Once she's escaped of course, it becomes even harder to get hold of her again with much hiding under the bed (her, not me) and growling (both of us).

    It doesn't help that she appears less than pleased with the move from her prior abode - where she was quite happy being Queen of her domain with servants turning up twice a day to feed her - to my place, where all I ever seem to do is catch her in order to poke or prod her for something.

    We had very little time to build up any relationship or trust before we started insulin and even before that I seemed only to capture her for vet trips and trying to brush her long, wispy, instantly-matted hair (I can't begin to describe how much she hates this - I think a prior professional groomer who was used may simply have brushed all the knots with brute force, no wonder she yowls and scratches if I go near her with a brush now)

    So as far as dear Lucy views me, I am not to be trusted. I poke her ear; I prick her neck; I cut out her knots, I tease away her hair. These are all Bad Things.

    She's been switched to the wet Hills m/d virtually since I first talked to the vet which she liked at first but has taken a dislike to since going to insulin. Despite her single tooth, she prefers the dry Hills m/d and despite the dire warnings about dry food, I have given in just in order to get her to eat SOMETHING some days.

    (actually I've even given in and cooked her grilled chicken which she likes, no surprise, but she can't have that every day: £ £ £. I also tried Applaws Complete pate which she loves but it makes her backside explode in a shocking manner and I'm not clearing that up again)

    So far, on Lantus she's maintaining a pre-shot BG level of around 14-19 (it varies madly and maddeningly), with dips down to around 4 at its nadir. That's just the 1U.

    Her appetite waxes and wanes, her poos can still be spectacularly fluid (sorry for the graphic detail) but when she's up and about, she can be quite perky; heading outside to patrol the tiny garden, or even further afield by sneaking under the fence.

    Her new favourite spot - when she's not hiding under the bed - is on an upstairs bedroom windowsill in the sun. She does come down for tickles occasionally and mostly trusts me when I'm under the duvet in bed with only my head showing, in which case she stands on me and demands affection. Get up - and she's off like a shot, alas.

    My main concerns now are what foods are OK (I'm in the UK, a lot of the food lists seem to be US based), how to get her used to me injecting her when we start on a position of mistrust and how to get those damned knots out of her hair when she won't let me near them.

    Sigh.

    Thanks for reading.
    David
     
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  2. BJM

    BJM Well-Known Member

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    Oct 6, 2010
    Welcome to FDMB.
    Lantus is a good insulin for cats, however some react to its acidic nature. You may find that Levemir is less problematic.
    Good on you for home testing. We find that giving a low carb treat helps immensely in getting cooperation for this. A small piece of the plain chicken may work for you.
    I've a cat with fur like roll cotton who mats like that. I've found a mat cutter - a comb where the inside of the curved edge is actually a blade - works well. You hold your fingers by the skin so it doesn't pull and comb from the edges inward to remove mats and thin the fur. The small dog size works well for me.
    Food changes need to be done slowly - 10-25% every day or so - or you can get vomiting or explosive diarrhea.
    Another possibility is that she has exocrine pancreatic insufficiency - a lack of digestive enzymes - that is causing the feces to be malodorous. Whatever damaged the insulin-producing cells may have damaged the enzyme-producing cells, too.
    Lastly, we've a thread in Feline Health in the FAQs section with food for UK folks.
     
    Last edited: Jan 31, 2015
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  3. David Johns

    David Johns New Member

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    Jan 30, 2015
    Hello,

    Thank you. I wish she'd eat treats but as soon as I let go of her from the injection she bolts under the bed. I offered her a tiny (very tiny) bit of corned beef a couple of days ago as a treat and she just sniffed it and looked at me reproachfully (but I know she likes it as she'd had a bite of it before)

    I like that idea of the mat cutter; I tried powered clippers and she freaked because of the noise. I'll get one of those and have a go. She does hate her fur being touched though, chances are I'm more likely to slice my hand off at this point in time :)

    Understood about the food. I gave her the Applaws in desperation as she'd barely eaten anything for 24 hours. She gobbled it up. Should perhaps have given her just a taster...

    I'm in the UK - obviously haven't found the UK food thread you mentioned. I'll go and look for it now.

    Cheers
    David
     
  4. BJM

    BJM Well-Known Member

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    Oct 6, 2010
    Take a sample of the feces to the vet as there are a number of parasites and infections which can cause maladorous diarrhea, too.
     
  5. David Johns

    David Johns New Member

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    Jan 30, 2015
    Good idea. She's scheduled for a checkup on Monday anyway...
     
  6. BJM

    BJM Well-Known Member

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    Oct 6, 2010
    Oops - the UK food thread is actually under FAQ, here
     
  7. David Johns

    David Johns New Member

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    Jan 30, 2015
    Nice one, cheers
     
  8. Sharon&Tabitha (TX)

    Sharon&Tabitha (TX) Member

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    Jan 14, 2015
    20141114_195122~2.jpg Hello and welcome. I too am a newbie and I also took Tabitha in back in October. She was from a house hold where she was the only pet. Coming to my house with two adults and then as of December a one month old (as of Wednesday kitten has been adopted) cats. Thank goodness the two adults are mellow cats but Tabitha still hasn't adjusted to them. Tabitha spends her time in the cat room which I am now sharing since last week. My civvies at least are getting some use from my bed. I too am doing this alone. I've learned some tricks of wrapping her in a blanket like a burrito, Texas style, since she bit me last Tuesday and had to get antibiotics (me that is). I really hate to restraint her this way but she has me on a fast and furriest ride on lantus. I would like to let up some if time allows. I just have time to breath sometimes. Thank goodness she hasn't resorted to hiding under the bed. I've just had to worry about her going off her food which she has done a few times. She too will come and lay on me when I am laying down. I feel she was brought to me for a reason and when she was dx January 9th I knew I had to do this. I just had a feeling she had a good chance and I was the one to help.
     
  9. David Johns

    David Johns New Member

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    Jan 30, 2015
    They look lovely! The advantage of my Lucy only having one tooth left is that it doesn't matter if she bites me (which she tries to do if I brush her, I've discovered)
     
  10. Sharon&Tabitha (TX)

    Sharon&Tabitha (TX) Member

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    Jan 14, 2015
    @David Johns

    lol (poor thing I shouldn't laugh) I forgot about the teeth. Have to release the tension somehow. Thanks

    Tabitha is declawed in the front so she tends to bite more because of it. Now that she is feeling better she isn't as bad or hard when she nips. The white Persian is a foster who needed more socialization and the shelter she's from isn't set up for it. She has some mats that are like dreadlocks. I have a few combs and brushes but just recently picked up one of those mat/blade comb. Haven't had a chance to use it yet.
     
  11. BJM

    BJM Well-Known Member

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    Really important: Hold the mat near the skin with your fingers. Start at the outermost edge with the mat cutter. Otherwise, you'll bunch up the mat even more and possibly pull on the skin.With your fingers between the skin and the mat cutter, it will protect the cat from being cut by the blades; even though they are on the inside of the curved blade, it is possible to do this.
     
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  12. phlika29

    phlika29 Well-Known Member

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    Sep 14, 2014
    Hi David

    Your story did make me chuckle. Good for you for taking her on.

    I am also in the uk and might be able to help with food. Depending on how much you want to pay there are a variety of foods that you could go for.

    I needed a high protein, low fat food for my cat remi and so plumped for Thrive wet food which you can either buy from sainsbury's or online at zooplus. But it is ridiculously expensive
    http://t.zooplus.co.uk/esearch.htm#q=Thrive

    This other thread in main may also help. There are no foods coming onto the market all the time as you will see on the thread
    http://www.felinediabetes.com/FDMB/threads/canned-food-brands-in-england.131642/
     
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  13. David Johns

    David Johns New Member

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    What's the composition of the Thrive like? I must always be mindful of Lucy's lack of teeth for chewing (though inexplicably she manages to eat the Hills m/d dry pellets)
     
  14. phlika29

    phlika29 Well-Known Member

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    Sep 14, 2014
    I give remi the chicken and chicken and liver. It looks like thin strips/chunks of chicken in a light non gravy type sauce. How about I take a photo of it in a minute and upload if I can
     
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  15. David Johns

    David Johns New Member

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    Jan 30, 2015
    Superb! Thanks
     
  16. Elizabeth and Bertie

    Elizabeth and Bertie Well-Known Member

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    Sep 6, 2010
    Hi David and supersweet Lucy, and welcome to FDMB.

    I'm also from the UK (Surrey).
    I see others have already given super-duper advice on suitable foods for diabetics in the UK. (So there's not a whole lot for me to do apart from twiddling my thumbs! (and welcoming you, of course!) ;))

    One thing to be watchful of is that a diet change to lower carb food may lower Lucy's blood glucose. And that could mean that her current dose of insulin needs to be reduced in order to avoid hypoglycemia. Since you are hometesting (what a star you are) you will be able to monitor the effect of any diet change.

    What exactly are you feeding Lucy at the moment? It would be good if we could work out the carb content of that so you know in advance before switching to a different food.
    (Edited to add; I see from your signature that Lucy is eating Hill's MD wet and dry.)

    Regarding the runny poop problem, in addition to the possible causes mentioned in previous posts I wonder if food intolerance could be another possibility (I'm sorry if someone already mentioned that and I missed that bit...) Common causes of allergy/intolerance are beef, fish, chicken, grains and soya.

    Welcome aboard, David.

    Eliz
     
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  17. phlika29

    phlika29 Well-Known Member

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    Okay here we go. Click on each image to make it bigger. I don't think I will get a prize for my photos. This is the chicken and liver one. The pieces of chicken and liver are little shreds so I would imagine easy for your cat to eat.

    For reference the fork is a cake/dessert fork, so quite small and the plate is a side plate. I feed remi 20g at each sitting and he eats 8 small meals a day so you are talking at least 2 cans per day.

    Before you swap you do need to check the difference in carbs in the different foods.
     

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  18. David Johns

    David Johns New Member

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    Hello,

    I've spent most of the afternoon reading old posts on this forum, many of which are from you and about diet so thank you, thank you for your extensive efforts and for chipping in for me and "supersweet" (looks can be deceiving) Lucy.

    She was switched to Hills m/d at least a month before I began insulin on the optimistic (but false) hope that the diet change plus the continuation of Glipizide would be sufficient to sort her out.

    So please be reassured that her current 1U dose IS based on her already being on the low-carb diet.

    My problem is that since putting her on the insulin she seems to have gone off Hills (except the dry form, which she still likes, annoyingly) so I'm on the hunt for suitable, not-horribly-expensive alternatives that won't make her bottom explode.

    Weirdly the poo she does indoors in her tray are usually well formed but I've seen her go outside and do some right geysers. Since she also pooed horribly on the Royal Canin chicken and rice which is about as mild as you can get, I think she may just be a delicate old lady...

    Regards
    David
     
  19. BJM

    BJM Well-Known Member

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    A blender will take care of any textured foods.
     
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  20. phlika29

    phlika29 Well-Known Member

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    Sep 14, 2014
    Just wanted to add that the tin is 75 g. I should have put my thumb in the picture for comparison. Might try again.
     
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  21. David Johns

    David Johns New Member

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    Jan 30, 2015
    Thank you! Yes, that looks quite edible for Her Majesty should think. If she continues to refuse Hills, I'll try some of that.
     
  22. phlika29

    phlika29 Well-Known Member

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    Sep 14, 2014
    Just add no more than 25% in the first day and slowly increase from there. You don't want to upset her tummy/ pancreas.
     
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  23. Elizabeth and Bertie

    Elizabeth and Bertie Well-Known Member

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    Sep 6, 2010
    Hi again, David,

    If you switch to different food that new food may well be lower carb than you're currently feeding, because canned M/D is 14% calories from carbs, and dry M/D is 13% calories from carbs according to these lists:
    http://binkyspage.tripod.com/CanFoodNew.html
    http://binkyspage.tripod.com/dryfood.html
    (The info is a few years old though, and recipes change, so the current analysis may be slightly different)

    Typically, for diabetics, most of us here try to feed foods that are no more than 10% calories from carbs, as folks' experience over the years has shown that seems to work well. And many of the UK foods on the list will be much lower than that. Many foods have around 3% - 8% calories from carbs, and there are a few whose carb content is actually negligible.
    So, it is possible that Lucy's blood glucose would drop on a different diet (If the little minx will eat it! :cat:)

    And I'm also intrigued that she "pooed horribly" on the RC chicken and rice diet. (I wonder what it was in there that caused that? Presumably not chicken because you've cooked chicken for her and her guts didn't explode?) And she did badly on the Applaws complete pate also? Did you feed a particular flavour? Will check out the ingredients list. It'll be interesting to see if there are common ingredients in those two foods....

    From what you know of Lucy, is it likely that she would eat a different wet food? Or is she a dry food addict at the moment?

    Eliz

    PS. Bless you for taking this little one into your home and your heart. :bighug:
     
  24. David Johns

    David Johns New Member

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    Jan 30, 2015
    I wish I knew what was going on in her digestive system :-(

    Just gave her her evening jab - minor fight, jumped off the needle again before I pressed the plunger, sigh. Got in in second time round. She's sulking under the bed again. Pre-shot reading of 17.9 on the Alphatrak.

    Is there ever any danger of stabbing her actually in the neck ie in the spine, doing it there rather than on her flank? She's actually less trouble if I do the neck than anywhere else but I worry as there's so little to go into.

    Anyway, I thought the wretched Hills was supposed to be low-carb specifically for diabetes? Damn them. I shall have to try this Happy Cat Company and buy one of everything until I find someone she'll eat!

    I tried the carb calculation with Applaws chicken pate and it gave me a sum of zero / 22 which is zero. Not sure what to make of that.

    I've just given her a little of the Applaws Lamb Pate to make her eat, she likes that too. I'll report back on any ill-effects...

    She likes wet food - used to eat the Royal Canin (and the Hills, 'til I started the insulin). But she likes to graze on the dry, as that's what she was used to before I got her.

    As for taking her in - I'm a gullible idiot, what can I say?

    Sorry, another essay. A journalist by profession, I'm incapable of sub-editing myself.

    Regards
    David
     
  25. BJM

    BJM Well-Known Member

    Joined:
    Oct 6, 2010
    You may need to use a bathroom and towel to restrain her so you know the insulin went in.
    Lay the towel out flat.
    Set her down in the middle and wrap her up with the 2 ends, like a kitty burrito.
    Kneel down over and around her so you can use your thighs to apply gentle pressure while you test and/or shoot.
     
  26. Maggies Mom Debby

    Maggies Mom Debby Well-Known Member

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    Dec 28, 2009
    I hear many of the prescription diets have liver and that many cats will eat it at first than refuse it.

    And some people shoot the insulin while their cats are eating. Might be something to try.
     
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  27. Sharon&Tabitha (TX)

    Sharon&Tabitha (TX) Member

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    Jan 14, 2015
    For Tabitha I find it works best as fold one side over I tuck it under her feet; do the same on the other side making sure she can't get a paw out. This is for testing.

    I do something similar for injection but turn her the other way and have her on her side where she can't push off. The vet wanted to shoot on her lower back side so I had them shave both sides so I knew I was doing it in the right area.

    Also I do this on an ironing board so it can be adjusted to the correct height. Then I tuck her like a football under my arm pit and get a good hold by squeezing my arm to my side.
     
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  28. KPassa

    KPassa Well-Known Member

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    Oct 23, 2012
    Welcome David and Lucy!

    The UK folk seem to have you well-covered in the food department.

    For shots, one thing I do is a "flat" shot, where, instead of pinching up the skin, I do a gentle tug and rollback of the fur to expose the skin. This makes things much easier for us because Mikey is NOT a fan of me pinching him. He also felt the "Lantus sting" when he was on Lantus and spent the entire year and a half flinching from his shots. Once I changed to Levemir, he no longer flinches. If you find her still having a hard time with shots after a couple of weeks, you might want to look into changing her to Levemir, like BJ mentioned.

    For testing, I had a similar problem with my Mikey. He was a feral rescue kitten diagnosed at only 6 months old so I only had 4 months of bonding before I started having to poke and prod him. I wrote up this document on ear testing psychology that you might find helpful.

    One helpful trick is to make sure that not all of your interactions with her are based around testing or giving shots. I do a "Mikey flyby" where I just see what he's up to, give him a few scritches, and feed him a treat. No testing or shooting involved.
     
  29. David Johns

    David Johns New Member

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    Jan 30, 2015
    I'd never get her in a towel; or if I did, it'd never happen twice. But I know when the insulin's gone in, I just have the issue that she jumps off sometimes as I push the needle in. We're getting there slowly though.
     
  30. David Johns

    David Johns New Member

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    Jan 30, 2015
    Yes, the Hills m/d is indeed liver-based. Wonder why they go off it?

    Unfortunately, I can't even touch her while she's eating; she's wary of my being around at the best of times but when she's eating she'll stop and glare if I even stroke her.

    So at the moment it's a case of go and pick her up from wherever she's snoozing and then just hold her as best as I can.
     
  31. KPassa

    KPassa Well-Known Member

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    Oct 23, 2012
    IIRC, it's actually the pork and not the liver.
     
  32. David Johns

    David Johns New Member

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    Jan 30, 2015
    Thank you; I'll try that tug-and-rollback tomorrow morning!

    She's actually OK with the testing, stays still and lets me do it. The argument starts with picking her up in the first place, and then with the injection after.

    I've tried to have "non intrusive" interactions - I've chatted to her ad hoc but she doesn't like being petted much (unless I just sit and let her come to me, which she does if I'm quiet and - oddly - sit with my legs out flat on the floor; she seems to accept that I'm not threatening in that position!).

    But she knows (how?!) when it's injection time and hides under the bed. Then I have to crawl in and get her!
     
  33. phlika29

    phlika29 Well-Known Member

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  34. David Johns

    David Johns New Member

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    Jan 30, 2015
    I haven't done nadirs on the human meter yet, I only got it a day or so ago and have run out of the included test strips already!

    More arriving in the next day or so and I will continue "dual testing" for a bit so that I get the measure of the SD CodeFree against the AT.
     
  35. phlika29

    phlika29 Well-Known Member

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  36. phlika29

    phlika29 Well-Known Member

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    Sep 14, 2014
    Have a look at Aine sheet for her cat Saoirse. She is in the uk and using the aplhatrak. She customised the spreadsheet. Look at the top. It seems to suggest below 4.4 is in the hypo range. Hopefully she can advise @Critter Mom

    https://docs.google.com/spreadsheet/lv?key=0AizC7e2GcQiqdHh5ZTI3aDBFcnlFSGFiT0Voekx2YVE&usp=sharing

    If she has gone low it would mean he earns a dose reduction. I think its time to start a new thread over in main if you can. Could you list out all your recent readings and the dose she has been getting. Or do the spreadsheet. Make it clear you are using the alphatrak . How does that sound?
     
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  37. BJM

    BJM Well-Known Member

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    Oct 6, 2010
    If you get an AlphaTrak test below 3.7 or 3.8 mmol/L, she has earned a reduction of 0.25 units, if you are following any protocol.
     
  38. David Johns

    David Johns New Member

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    Jan 30, 2015
    Yes, I have a jar of honey all ready; my local supermarket hadn't heard of Karo or whatever it's called.

    Given that she only has 1U I can't really see how it can go much lower... my main concern really is getting her to eat and accept me injecting her at all.

    And, and she just came back in from the garden with poo stuck to her back leg fur which I had to cut off; she REALLY doesn't like anyone messing about back there so once again I'm Mr Evil, to be loathed and distrusted. Sigh.
     
  39. David Johns

    David Johns New Member

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    Jan 30, 2015
    At the moment, since she's only been on it for 2 weeks, I'm following Vet Protocol. She's back in on Monday for a check.

    How on earth can you measure .25U? I'm using a .3ml syringe and can only just about get it on the half marks with any accuracy...
     
  40. phlika29

    phlika29 Well-Known Member

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    Sep 14, 2014
    You need to get the syringes with the half markings. It then becomes easier to measure the 0.25 units.

    http://www.vetuk.co.uk/veterinary-s...rofine-0-3ml-insulin-syringes-u100-demi-p-296

    How many times has she gone lower than 4 on the alpha track? You need to steer her with the higher carb food or honey (you can get karo in tesco in the American section) and then retest and repeat as per that link. When you go back on Monday I would discuss about reducing her dose. On here every time they go below a certain number as BJM said they earn a dose reduction.

    Once the lantus gets them into good numbers there pancreas can begin to recover or maybe if she is only tiny she just doesn't need the whole one unit. How much does she weigh?
     
  41. BJM

    BJM Well-Known Member

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    Oct 6, 2010
    We eyeball the quarter unit doses. If you continue with a dose that drops the cat too low, you run the risk of hypoglycemia, which can kill your cat quickly.
     
  42. Sharon&Tabitha (TX)

    Sharon&Tabitha (TX) Member

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    Jan 14, 2015
    It's me again: Tabitha has been on lantus for less than a week and we've gone from .5 to .25 and to .1 within that time. The vet protocol went out the window long time ago. It's like - hang on and enjoy the surfing. I was still wanting the wading pool. At least I've had this group to keep my head :cat:above the water.
     
  43. Nancy and Scotty

    Nancy and Scotty Member

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    Jul 13, 2014
    Kpassa, Thank you so much, I have been giving Scotty shots now for a year, the last 6 months on Levemir and he will come and jump in lap and soon as he sees I am ready to test him but then I have to chase him for 15 minutes to give his shot, as soon as I saw your post I knew the problem was pinching up his skin, this morning I used your method and no flinching and it was so much easier. I feel so stupid because I gave myself 3 allergy shots every week for 3 years and I sure never pinched up my skin, I cannot believe it never occurred to me to ask myself why I was pinching up my cats skin, again thank you so much.
     
  44. phlika29

    phlika29 Well-Known Member

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    Sep 14, 2014
    David

    I hope all is well. I know we bombarded you with info the other night. Let us know Lucy gets on at the vet
     
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  45. David Johns

    David Johns New Member

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    Jan 30, 2015
    Hi, yes, all's well, just been a bit busy. It is a lot to take in but thank you all for your advice, very gratefully received.

    My Tesco doesn't have an American section, oh my, no such thing in this part of Kent. It was in Tesco I got blank looks asking for Karo... anyway I have a stash of honey. She's only gone below 4 on the Alphatrak once but I've been keeping a close eye on her and giving her half doses (0.5U) when she's less than preshot BG of 10, which is working fine.

    Also many thanks to all for the food suggestions, on the Sheba Classics she's having good numbers; she had amazingly low BG on the Sainsbury's Encore - which appears to be identical to Applaws but cheaper but it was almost too low so Sheba it is, though I don't think she's too keen so I'm still experimenting.

    I already have the syringes linked to but wish someone would make a 0.1ml syringe 'cos measuring 1/2U on the 0.3 is still terribly fiddly and needs such a tiny squeeze on the plunger :-( I also don't like those BD syringes as the plunger and top appear to be flat so any bubbles are not directed upon tapping to the base of the needle, they just sit there somewhere on the "roof" of the syringe and don't necessarily get squeezed out upon squirting :-(. Needs a redesign with a slightly concave (convex? I never get that right) shape to the top of the syringe and plunger IMHO.

    Anyway, Lucy's all well, numbers tend to be a bit up and down but generally a lot more reasonable than they were before starting insulin!

    Cheers all
    David
     
  46. BJM

    BJM Well-Known Member

    Joined:
    Oct 6, 2010
    Can we get you started using our grid to record your recent glucose tests and doses? It will help us give you better feedback. Instructions are here.

    Understanding the spreadsheet/grid:

    The colored headings at the top are the ranges of glucose values. They are color-coded to clue you in as to meaning.

    Each day is 1 row. Each column stores different data for the day.

    From left to right, you enter
    the Date in the first column
    the AMPS (morning pre-shot test) in the 2nd column
    the Units given (turquoise column)

    Then, there are 11 columns labeled +1 through +11
    If you test at +5 (5 hours after the shot), you enter the test number in the +5 column
    If you test at +7 (7 hours after the shot), you enter the test number in the +7 column
    and so on.

    Halfway across the page is the column for PMPS (evening pre-shot)
    To the right is another turquoise column for Units given at the evening shot.

    There is second set of columns labeled +1 through +11
    If you snag a before bed test at +3, you enter the test number in the +3 column.

    We separate day and night numbers like that because many cats go lower at night.

    It is merely a grid for storing the info; no math required.
     
  47. BJM

    BJM Well-Known Member

    Joined:
    Oct 6, 2010
    By the way - we suggest you not give insulin below 150 mg/dL at pre-shot without lots of mid-cycle tests showing it is safe.
    From what you're describing, she may be ready for an off the juice trial with no insulin.
     
  48. David Johns

    David Johns New Member

    Joined:
    Jan 30, 2015
    Hi

    I understand the spreadsheet but I've already got quite a long one going on Excel on my laptop with graphs and all kinds of stuff, including a SD Codefree - to - AlphaTrak converter which I'm now using (those Alphatrak strips cost a FORTUNE) so I'm reluctant to start using both or abandon the Excel.
     
  49. David Johns

    David Johns New Member

    Joined:
    Jan 30, 2015
    I don't give her a shot if she's below 8 (approx 150) anyway; she gets 0.5U if she's between 8 and 11, 1U above that. If she goes off the juice, she shoots right back up.
     
  50. BJM

    BJM Well-Known Member

    Joined:
    Oct 6, 2010
    How about doing a copy and past of the tests into our Google spreadsheet with the past weeks worth? Then we can see what is happening.
    By the way ... we don't give Lantus on a sliding scale because of the overlap effect which may result in erratic numbers. Lantus forms small crystals under the skin when injected. These slowly dissolve. Some are still there at the next shot time. This is called the depot or shed, and provides some overlap between doses. When you adjust based on the pre-shot, you may be responding to insulin left over from a shot before the most recent one.
    There are 2 protocols we use here - see what you think:

    Tight Regulation
    Start Low, Go Slow
     
  51. phlika29

    phlika29 Well-Known Member

    Joined:
    Sep 14, 2014
    Hi

    Thanks for the update

    Could you upload your spreadsheet as an attachment?

    With regards the low numbers. When she does that if you follow the two protocols BJM listed above you will see that she has earnt herself a dose reeducation. So for example using the UK numbers on a human meter if she went below 3.2 she would have earned herself a 0.25 reduction from 1 unit to 0.75. She would have stayed on that dose until she headed below 3.2 (human meter) again. That way you slowly decrease the dose until she has no where else to go but an OTJ trial. Ofcourse you need to just the numbers for your alpha trak meter. So maybe that is the 4 ? Have at look at my remi's spreadsheet when he started on lantus and you will see what I mean.

    Do you know the calories from carb content of the Sheba ? It is recommended that you don't give anything over 10% . It is interesting about the encore. It sounds like if you gave her that she may be off the insulin quite quickly. Could you not swap the food slowly and reduce her insulin as her numbers lower. So drop it down to 0.5 until she goes low and then 0.25 until the same happens followed by 0.1.

    Have a look at those protocols. It sounds like you are able to monitor her during her cycles and have the equipment to keep her safe. You could alway post over on the main lantus forum. Those guys are great at helping with dosing.
     
    KPassa likes this.
  52. Critter Mom

    Critter Mom Well-Known Member

    Joined:
    Jun 16, 2014
    Hi David,

    Glad to hear that Lucy's doing better.

    As Sarah says above, going to a low value is the way you will most often read here about Lantus dose reductions being given. However, there is also another criterion for dose reduction. If Lucy's numbers stay completely in the healing TR range for seven days (4.4 to 7.2 on an Alphatrak) that too merits a dose reduction.

    (Very entertaining thread, BTW. Definitely the work of a wordsmith. :) )
     
  53. rhiannon and shadow (GA)

    rhiannon and shadow (GA) Well-Known Member

    Joined:
    Jul 9, 2012
    I didn't see any one mention that you can create a barrier to keep her from getting too far under the bed with shoeboxes.... or just use cardboard and cut it and tape it the right size to fill the space.
    I had to do that to keep mine from getting out of my reach.
    I left the edges so she would feel like she was hiding..... but I didn't give her any space where I couldn't reach her when I wanted.
     
    Critter Mom likes this.
  54. Critter Mom

    Critter Mom Well-Known Member

    Joined:
    Jun 16, 2014
    Shoeboxes. Genius, Rhiannon! :)
     
  55. phlika29

    phlika29 Well-Known Member

    Joined:
    Sep 14, 2014
    I always new all my shoe buying would come in useful in the end. :)
     
    Critter Mom likes this.
  56. rhiannon and shadow (GA)

    rhiannon and shadow (GA) Well-Known Member

    Joined:
    Jul 9, 2012
    thanks.... I needed that chuckle.... and I guess the praise too.....
    :joyful:
     
    Critter Mom likes this.
  57. David

    David New Member

    Joined:
    Jan 17, 2015
    It has been a long time since I posted and I apologise once again, having taken all your very valuable and very welcome advice and gone quiet.

    I am updating this now as it seems right to let you know that Lucy was put to sleep this morning; not because of the diabetes but because she developed an adenocarcinoma - aggressive cancer - in her bowel a few weeks ago.

    In an instant her diabetes became, unbelievably, the least of her problems hence my radio silence here.

    There was nothing the vet could do about the cancer, it got worse very swiftly and ultimately she was getting by on two types of painkiller which, thank goodness, she was quite perky on but when it wore off the horror was all too apparent. She was clearly getting worse and getting fed up with me injecting her and sticking pills and potions down her neck every few hours. In the end she just wanted to be left alone.

    I'm incredibly sad, of course. I looked after Lucy for just seven months and I can only hope she enjoyed that time to some degree, insulin notwithstanding. She's at peace now and no longer in pain and for that I am relieved.

    Thank you all once again for your kind advice which gave me the strength and belief to persist with the Lantus.

    Best wishes to you and your cat companions.

    Regards
    David
     
    Last edited: Apr 14, 2015
  58. BJM

    BJM Well-Known Member

    Joined:
    Oct 6, 2010
    Requiem aeternum, Lucy.
    {{hugs}}
     
    David likes this.
  59. Bron and Sheba

    Bron and Sheba Well-Known Member

    Joined:
    Feb 21, 2015
    So sorry for your loss.:bighug:
    Lucy was very lucky to have found you and I am sure you made her happy in the time she had with you
     
    David likes this.
  60. phlika29

    phlika29 Well-Known Member

    Joined:
    Sep 14, 2014
    David

    I am very sorry for your loss. Lucy found a great friend in you and you couldn't have done more to help here.

    Fly free Lucy and land softly
     
    David likes this.
  61. Elizabeth and Bertie

    Elizabeth and Bertie Well-Known Member

    Joined:
    Sep 6, 2010
    Oh, David, I am so sorry to hear that Lucy has passed....

    I think she was really blessed in having you care for her these past 7 months. You gave her the love and affection that she hadn't known in a long while, and that was a tremendous gift. At the end of her life she knew she was loved; that is a very special and precious thing.

    Huge hugs to you, (((David))),

    Eliz
     
    David likes this.
  62. Larry and Kitties

    Larry and Kitties Well-Known Member

    Joined:
    Dec 28, 2009
    Sending purrs and prayers at this difficult time.
     
    David likes this.
  63. Critter Mom

    Critter Mom Well-Known Member

    Joined:
    Jun 16, 2014
    Oh, David...

    I am so sorry to hear that Lucy is no longer with you. Blessings to you for taking her in and for filling her last months with so much love and caring.

    ((((David & Spirit Lucy))))

    :bighug:
     
    David likes this.
  64. Maggies Mom Debby

    Maggies Mom Debby Well-Known Member

    Joined:
    Dec 28, 2009
    I'm so sorry to hear this, David. I'm sure Lucy truly appreciated all you did for her, even with the pokes. Isn't it amazing how fast they get under your skin?
     
    David likes this.
  65. bsmith

    bsmith Member

    Joined:
    Jan 26, 2015
    I'm so sorry to hear about your loss of Lucy. At least she had a nice "mug" like you to take such good care of her in her last few months.
     
    David likes this.
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