? New and need advice

Discussion in 'Feline Health - (Welcome & Main Forum)' started by Sebastian, Dec 12, 2018.

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  1. Sebastian

    Sebastian New Member

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    Dec 1, 2018
    So we woke up he morning of November 27th to find our cat Sebastian hiding in a corner, breathing heavily, and fairly unresponsive. I immediately called the vet to tell them what was going on. We had him at the vet by noon that day. They checked his blood and his sugar was 528. They also found a significant UTI and prescribed antibiotics.

    They gave him insulin and kept him overnight for monitoring. We picked him up the morning of November 28th and the vet said he was borderline diabetic and that we should try Purina DM dry before trying insulin.


    His UTI is gone now.


    Upon returning home he refused the DM food. I did some research and found this forum. I immediately switched him to low carb wet food. I looked at the chart and try to keep the food we buy at about 5 or under as far as carb content. He’s been eating the Weruva brand.


    We took him back to be checked on 12-5 and his sugar was just over 400.


    The vet sent us on our way with a 10ml vial of prozinc and a container syringes. Prescribed dose is 1 unit twice daily.

    The vet also told us not to check his sugar at home because he would start to resent us from poking his ear all the time.


    I did purchase a relion prime meter along with necessary accessories Incase of emergencies but have yet to open the box because of the vets warning.


    So after a week of insulin he had a checkup this morning (12-12-18). His sugar was 77. I was told to bring him back in 4-6 weeks for another checkup and to continue the 1 unit twice daily, if his sugar was 77 isn’t that too much insulin? I did give him his 1 unit after returning from the vet(10am). When I got home from work (7:30pm) he was breathing strangely and his eyelids were red and puffy. I don’t believe any of these are telltale signs of low sugar but I thought it worth mentioning. I promptly gave him a can of food and he seems okay now.


    So basically my concern is that we’re giving him too much insulin. And being the vet told me not to check it myself and not to bring him to be checked for 4-6 weeks, I thought it prudent to get some more thorough, if not better information.

    He’s a six year old male, we had him fixed about 18months ago.
     
  2. Beth 73

    Beth 73 Well-Known Member

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    Aug 2, 2016
  3. Beth 73

    Beth 73 Well-Known Member

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    Aug 2, 2016
    Would also be good to post this on the Prozinc thread and refer back to details you’ve posted here
     
  4. Beth 73

    Beth 73 Well-Known Member

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    Aug 2, 2016
  5. Sebastian

    Sebastian New Member

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    Dec 1, 2018
    Should I just copy and paste it or is there a proper way to do it? Sorry I’m terrible with forums.
     
  6. Chris & China (GA)

    Chris & China (GA) Well-Known Member

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    May 10, 2013
    If I hear this garbage one more time I think I'll puke.....It's total nonsense. Pretty much everybody here tests their cat multiple times a day and most of our cats come running when we get the testing supplies out.

    It's all a matter of conditioning...making it a good experience for them. The edges of the ears have few pain receptors, so it doesn't really hurt. Most cats just object to having their ears fooled with, but if they get a reward (a special treat they only get at test times) it doesn't take long for them to associate the testing with the reward and come running.

    Here's something I wrote up for others for testing...maybe it'll help you too!

    It can be really helpful to establish a routine with testing. Pick one spot that you want your "testing spot" to be (I like the kitchen counter because it's got good light and it's at a good height....it also already blocked 2 escape routes due to the wall and the backsplash) It can be anywhere though...a rug on the floor, a table, a particular spot on the couch...wherever is good for you.

    Take him there as many times a day as you can and just give his ears a quick rub and then he gets a yummy (low carb) treat.Most cats aren't objecting so much with the poking..it's the fooling with their ears they don't like, but once they're desensitized to it and learn to associate a certain place with the treats, they usually start to come when they're called! Or even when they hear us opening the test kit!

    You also have to remember...you're not poking him to hurt him...you're testing him to keep him safe and understand what's going on inside his body. There's just nothing better than truly understanding what's going on inside your kitty's body and with this disease, the more knowledge you have, the more power you have against it. The edges of the ears have very few pain receptors, so it really doesn't hurt them. Also, if you're nervous and tense, it's going to make your kitty nervous and tense too. As silly as it might seem, try singing! It forces you to use a different part of your brain!

    It's also important to make sure his ear is warm. A small sock filled with a little rice and microwaved or a small pill bottle filled with warm water (check temp against your wrist like you would a baby bottle) works well

    For new kitties, using a heavier gauge lancet is also really helpful. A 25-28 gauge lancet pokes a bigger "hole" than a 31-33 gauge lancet does, so look for "Alternate Site testing" lancets that are usually a lower number

    Finding the right "treat" will be a great help too! Freeze dried chicken, bonito flakes, little pieces of baked chicken...whatever low carb treat you can find that he really enjoys will help him to associate the testing with the treat! China's Achilles heel was baked chicken, so I'd bake a piece, chop it into bite sized pieces, put some in the refrigerator and freeze the rest to use as needed. It didn't take long for her to come any time I picked up the meter!

    There are more testing tips here:

    http://www.felinediabetes.com/FDMB/threads/hometesting-links-and-tips.287/
     
  7. Chris & China (GA)

    Chris & China (GA) Well-Known Member

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    May 10, 2013
    It could be but without more testing, it's impossible to know for sure. 77 is a wonderful number, but you wouldn't want to give insulin with a blood glucose of 77 until you have more experience and know how your cat responds to food and insulin a lot better.

    He may only need .5 twice a day....or he may need the 1U...or he may need something in between.

    To do those smaller doses, you'll either need to get U40 syringes with half unit markings like these Carepoint or UltiCare syringes , or get U100 syringes and use a Conversion Chart

    Tests done at the vet's office are unreliable due to vet stress. Just like humans' have higher blood pressure at the doctor's office, our cats blood glucose can go up as much as 200 points from the vet visit. Home testing will tell you a lot more about what's really going on inside his body, as well as keeping him safe.
     
  8. Olive & Paula

    Olive & Paula Well-Known Member

    Joined:
    Sep 6, 2015
    In most cases the opposite of resenting you happens. The bond between you and Sebastian will get stronger. My Olive will sometimes let me know she needs to be tested.

    Testing will keep him safe. Since you have the meter, think about starting right away. You don't want to learn during a crisis like I did.
     
  9. Sebastian

    Sebastian New Member

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    Dec 1, 2018
    I didn’t know about the lack of pain receptors in the edge of the ear so that relaxes me a little bit. I’ll be testing him shortly and we’ll see how it goes.

    When I do test him, what is the lowest reading I would give him his 1 unit dose at? I know 77 is too low but say his reading is 200 should I still give him his 1 unit or wait and test in morning?

    Thanks for all the info and advice.
     
    Barbara & Uncle (GA) likes this.
  10. Ella & Rusty & Stu(GA)

    Ella & Rusty & Stu(GA) Well-Known Member

    Joined:
    Jan 11, 2010
    Welcome to you and Sebastian. You will find lots of good information in the "Sticky notes" at the top of this forum. [Sorry: I should have said the Lantus, Levemir forum; I didn't realize that I was responding to a post on the health forum!] There is so much information there that you may feel overwhelmed, but it is not necessary to master everything at once.
    Many vets tell us that it is not necessary to test at home: just come in every 2 weeks and be tested at the vet's. This is not a great idea, because cats dislike going to the vet and the blood glucose readings done at the vet do not give a good indication of what is happening. With my first diabetic cat, Stu, I shot insulin "blind" for 4 years and went every week to the vet for him to be tested. I only found out that there was a better way when I joined this board (Stu's insulin had been changed by the vet to Lantus, but the vet didn't know that Lantus is dosed differently than the previous insulin. We almost lost him because of overdose.)

    PZI is an "in and out" insulin. That means that a shot will last until the next shot; it does not build upon the previous shot. So PZI is not what we call a "depot" insulin (Lantus, Levemir, and Basaglar are depot insulins, which leave some insulin in the body to be built upon and to insure that there are no big spikes in blood glusose when the insulin poops out). There is less danger of an overdose with PZI because it is an "in and out" insulin--no depot. However, the size of the dose could still be too great in Sebastian's case. There is no way of knowing this without home testing.

    Food will definitely bring a cat's blood glucose up if it was too low. When you fed Sebastian a can of food you found that out! Most diabetic cats do better on several small meals over the course of the 12-hour cycle. You will find lots of information on this in the "Sticky notes." [in the Lantus, Levemir Forum]. People here who are at work all day use automatic feeders to dispense food at regular intervals.

    Welcome again. Ask any questions you want. We will help you to the best of our ability. Do check in with the PZI forum, because PZI has it's own idiosyncrasies and the people there will be able to help.
     
    Last edited: Dec 12, 2018
  11. Ella & Rusty & Stu(GA)

    Ella & Rusty & Stu(GA) Well-Known Member

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    Jan 11, 2010
    I think the "cut off" number for a newly diagnosed diabetic is 150. Someone please correct me if I am wrong. So if his number is above 150, I think you can shoot 1 unit.
     
  12. Chris & China (GA)

    Chris & China (GA) Well-Known Member

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    May 10, 2013
    From The Beginners Guide to ProZinc

    • The proper sequence for dosing insulin is: Test/Feed/Shoot. In the beginning, if your cat’s BG is not up to at least 200 mg/dL {11 mmol/L}, if your schedule allows, you can stall (without feeding) for 20+minutes, then retest the BG. You are looking for a number that is rising, not falling and up to 200 mg/dL {11 mmol/L}. If you stall once, but can’t do another round of stalling and your cat hasn’t reached a BG of 200 mg/dL {11 mmol/L}, you’ll need to skip the dose and wait until the next cycle. NOTE: Because pet-specific meters (such as the AlphaTrak2) often read higher than human meters, you may want to adjust the NO-SHOOT number to 225 mg/dL {12.5 mmol/L} or even 250 mg/dL {14 mmol/L} This gives you an added margin of safety when using an AlphaTrak2 or other pet-specific meter.
    • IMPORTANT NOTE: Do not feed your cat within the two-hour window right before the scheduled dose time; doing this can raise your cat’s blood significantly, giving you a higher BG number based on food. This could result in your giving insulin when you should not, or giving more insulin than you should.
     
  13. Sebastian

    Sebastian New Member

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    Dec 1, 2018
    So we tried it. I couldn’t get him to bleed, I hit the small vein on the outer edge of the ear directly after warming it with a rice bag. I tried twice and gave up to give him a break. I could see where the lancet hit the vein because there was a little red mark. I’m using a relion lancet device with 26 gauge lancets. I set the depth at the second setting. One setting up from the shallowest setting for the first try, the second try a went to the next deepest setting which would be the middle of the 5 settings.
     
  14. Idjit's mom

    Idjit's mom Well-Known Member

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    Apr 3, 2018
    Hello to you and Sebastian. You have been getting excellent information from knowledgeable and experienced members. I know it's a bit overwhelming in the beginning, but I just wanted to add my (& Idjit's) support.
    When you have a spare moment or two, just to help members who are advising and answering questions, it would be a good idea to create your signature. This is Sebastian's pertinent information and saves asking and answering the same questions. It displays with each of your posts and you can edit it at need. See the gray text at the bottom of our posts? Here is a link on how to do that: SIGNATURE
    Next is the spreadsheet. Here is where we record the insulin injections/doses and all the BG (blood glucose) tests. It is linked to your signature and then advising members can see what's going on, detect patterns and give you more informed and accurate information. Just click on the "ss", or "spreadsheet" in our signatures to see what I'm describing. Here is a link to the area with the spreadsheet instructions and understanding the grid: SPREADSHEET
    Wishing you the absolute best as you learn the "sugar dance". Hugs to Sebastian. :cat:
     
  15. Chris & China (GA)

    Chris & China (GA) Well-Known Member

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    May 10, 2013
    It's normal to have trouble at first, but as you poke more and more, new capillaries will grow into the area and make it easier.

    I know you said you tried warming the ear, but make sure you really warm it. Heat brings blood into the warmed area.

    It's totally up to you whether you use the lancet device or not. A lot of us just freehand the lancet so we can see where we're poking better and control how deep we "poke".

    It's good that you gave him a break....next try you might try poking twice close to each other and then "milk" the ear a little to get a drop of blood. Another trick is to put a VERY thin film of ointment (like Neosporin with pain relief) or Vaseline so the blood "beads up" for you.

    Don't worry....You'll get the hang of it!! We've all been there!

    Here's where to aim:
    sweet spot diagram.PNG
     
  16. Sebastian

    Sebastian New Member

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    Dec 1, 2018
    I think I’ll give the freehanding a try, in addition to the 26 gauge lancets I have ten 30 gauge ones that came with the lancing device. Which are better for freehand poking? And I feel like I might go through his ear the first time because I have zero experience, is it bad if that happens?
     
  17. Chris & China (GA)

    Chris & China (GA) Well-Known Member

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    May 10, 2013
    The 26 gauge lancets are better right now because they poke a bigger "hole" (the lower the number, the "thicker" the lancet.

    Hahaha....that brings back memories!! When China was new to all this, I poked so many holes in her ears I thought about buying her a pair of diamond stud earrings.

    They heal …..and a little Neosporin helps!
     
    Idjit's mom likes this.
  18. Sebastian

    Sebastian New Member

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    Dec 1, 2018
    I tried a third time, I still wasn’t able to get a reading but I did get some blood on the strip. The meter said E13. I didn’t look the error code up in the manual yet but I’m assuming it means there wasn’t enough blood. With his 77 reading today I’m more concerned about a low event than a high one so I’m going to give up for tonight and try again in the morning. Thanks for all the help and tips!!!
     
  19. Beth 73

    Beth 73 Well-Known Member

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    Aug 2, 2016
    Sorry didn’t respond .... it had been a long Kitty day with one of my civvies and I fell sound asleep on the couch . I am useless in tech department too so glad to see the Wise Ones came along side you to help .
     
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