New Here - It's Official :(

Discussion in 'Feline Health - (The Main Forum)' started by KarensPoe, May 21, 2013.

  1. KarensPoe

    KarensPoe Member

    Joined:
    May 21, 2013
    What started out as an asthma attack, turned into the discovery of diabetes.

    After a trip to the emergency clinic in my area in the midst of a full blown asthma attack, they got him stabilized and ran some tests. His blood sugar was through the roof (partly stress related, but still serious).

    As of today, I have $200.00 worth of meds sitting at my local WalMart pharmacy and an appt with Poe's vet for a crash course on 'Treating Your Diabetic Cat"

    He was a dry food cat, with servings of wet in the morning and evening...yes, he was a grazer ugh

    Once I started reading on catinfo.org, I immediately stopped the dry...trashed it all...ran to pet store...and picked up cans of high protein/low carb. His blood sugar level did drop about 100, but its still high and vet found traces of ketos in his urine.

    Fortunately for me, there was no issue in taking away the dry food except for the "habit" of food being around all the time. He's getting used to that too now.

    The emergency clinic gave me RX for the Hills and Purina...I know how that goes and thats when I started reading.

    So, Poe is approximately 6 years old. His first asthma attack came about 4 years ago...with another rush to an emergency clinic, but has been stable ever since, until a week ago.

    Thats pretty much it in a nutshell

    Sorry and glad at the same time to be here

    Karen
     
  2. MaryB & Chester

    MaryB & Chester Member

    Joined:
    Dec 7, 2012
    Welcome aboard. THere are lots of good people here with a lot of good information.
    Have you done much reading about home testing? Testing Blood Glucose levels at home is very important. You can use a human glucometer (no matter what the vet says). Someone here has a great "shopping list" and I'm sure they'll be along shortly.
    Breathe. You can do this!
     
  3. BJM

    BJM Well-Known Member

    Joined:
    Oct 6, 2010
    Are you familiar with the Aerokat for cats? It allows you to administer an inhaled steroid, rather than giving so much oral or injected steroid.

    With the asthma possibly needing steroids, you will adjust the diabetes management around that.

    Recommended insulins are Lantus, Levemir, ProZinc, or PZI. The first 2, Lantus & Levemir may be bought as pens, which are treated like vials, and this helps let you use all of the insulin before it expires. This is about 6 months if handled carefully, despite what the packaging says.

    Take your time reading the stickie posts near the tops of the forums; they contain lots of information.
     
  4. KarensPoe

    KarensPoe Member

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    May 21, 2013
    I have been reading the catinfo.org site, suggested by my vet, plus she has a diabetic cat as well, which will be very helpful.

    The vet will loan me a meter for now...I have insulin, syringes, and I think lancets and strips waiting at Walmart to be picked up.

    I go later today to the vet for the training.

    I know this isn't a death sentence...its treatable/manageable, etc., but the costs really frighten me as it's just me and him, and my income is pretty stretched already.

    So...one day at a time...he's been good about taking his inhalers, so I'm hopeful I won't have issue with pokes and shots.

    Karen
     
  5. Sue and Oliver (GA)

    Sue and Oliver (GA) Well-Known Member

    Joined:
    Dec 28, 2009
    Welcome! Sorry you have to be here but hope we can be helpful.

    We have a very successful protocol for feline diabetes:

    1. A slow, long lasting insulin. Lantus, Levemir and ProZinc are popular as they have a slow onset; they are not harsh and they are easiest to use for regulation. Humulin and Canninsulin are less popular because, in most cats, they have a rapid onset and don’t last as long. We like new diabetics to start low and go slow. That is, start at a low dose of .5 or one unit twice daily every 12 hours. And increase slowly, by .25 or .5 units as the numbers indicate. Do you know what kind of insulin your vet is planning on?

    2. A low carb, wet diet. We like to feed under 8-10% carbs. There are several food charts you can use: Dr. Lisa’s food chart
    Hobo’s Food Chart Rhiannon’s 8% and under list We don't think there is anything "prescription" about prescription foods except the price. The OTC foods have as good or better ingredients and much cheaper.

    Whatever food you can afford that your cat will eat in that lower range. BUT do not change over to wet until you are hometesting. With our Oliver, the switch meant an overnight change of 100 points downward. If we hadn’t been testing and had given our usual amount., he could have hypoed.

    He can graze on wet food. Lots of us use automatic feeders and freeze the wet food. (A silicone cupcake pan works great for this.)

    2. And most importantly, hometesting. We think cats tend to be stressed at the vet and we know stress raises blood glucose levels. So we test our cats at home. You want to know what the number is before you give the shot to be sure the amount you are planning to give is safe. And testing midcycle will show you how the insulin is working. We use human glucometers and test on their ears or paws. Here is a video that shows you how it is done: Video for hometesting Some vets worry that home testing will stress the owner; we find it makes them much more comfortable, knowing exactly how their kitty is doing.


    Let us know how we can help.
     
  6. Larry and Kitties

    Larry and Kitties Well-Known Member

    Joined:
    Dec 28, 2009
    Has Poe been on any steroids since those can induce diabetes. If you stop the steroids the diabetes may resolve itself. That is one reason why home testing Poe's BG at home is important.
     
  7. KarensPoe

    KarensPoe Member

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    May 21, 2013
    I have the aerokat, which I purchased back when the first asthma attack happened.

    Back then, I was giving him liquid steroids, but now he gets the inhaler version.

    The vet ran a blood panel on saturday...high sugar, traces of ketones, and the fruit_____ something test.

    The only real change in food was eliminating the dry...I had already been feeding him canned 2x's a day, just not one geared toward high protein/low carb. Some of the high sugar level from the emergency clinic was due to stress they said.

    The vet checked him over on Saturday, was pleased, he shows no signs of anything really...he does not hide, no excessive drinking/peeing, his hunger was off the charts for a few days, but that it leveling out now.

    The only thing I noticed which I told the vet about was he seemed to be restless...catnapping mostly...and clingy to me, but he's pretty much always been clingy.

    Karen
     
  8. Sue and Oliver (GA)

    Sue and Oliver (GA) Well-Known Member

    Joined:
    Dec 28, 2009
    He doesn't have the usual diabetic symptoms - excessive eating and peeing. What were the results of the fructosamine test?

    You might start testing at home, see how his numbers are without vet stress and without any dry before you start insulin?
     
  9. KarensPoe

    KarensPoe Member

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    May 21, 2013
    I think she said the fruit test was higher than normal also. His BG was in the upper 300's, and they did find ketones in his urine, but this was a test from Saturday.

    When I look back before the asthma attack, I do see that there was excessive peeing, but now there are only maybe 1-2 clumps a day, and they are not massive. His bowel habits have changed with the new food also, its maybe 1 every other day instead of daily.
     
  10. Sue and Oliver (GA)

    Sue and Oliver (GA) Well-Known Member

    Joined:
    Dec 28, 2009
    If he had ketones, you don't want to mess around. Are you testing for ketones?


    http://www.felinediabetes.com/ketones.htm

    If you start insulin, I'd be sure you are confident about testing and start with a tiny dose -.5 maybe?
     
  11. KarensPoe

    KarensPoe Member

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    May 21, 2013
    No. I'm not doing anything yet. I just got the official diagnosis less than 24 hours ago. Other than the change in food, that is all. He will probably get his first dose of insulin tonight after I get the RX and see the vet to be taught how to do it.

    Karen
     
  12. Deb & Wink

    Deb & Wink Well-Known Member

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    Jan 31, 2013
    That 'fruit test' is know as the fructosamine test. It measures an average level of blood glucose over the past 2-3 weeks.
     
  13. BJM

    BJM Well-Known Member

    Joined:
    Oct 6, 2010
    Gently pull up a tent of skin.
    Gently push through the skin with the needle.
    Gently push down the plunger to inject the insulin.
    Gently pull out the syringe.
     
  14. KPassa

    KPassa Well-Known Member

    Joined:
    Oct 23, 2012
    I'm also sorry you're here, but glad you found us! Welcome to the board! :YMHUG:

    You can still leave wet food out for them. Just add more water to it so it doesn't dry out as fast and get all gunky. You can also make "meatcicles" and freeze it into ice cube trays, allowing it to sit out much longer on hot days. Finally, you can also invest in a timed-compartment feeder and some of them come with places where you can put ice packs.

    6 years old is quite young for a diabetes diagnosis and I have a feeling the steroids for the asthma is partially (or fully) to blame. As BJM said, in cases where steroids are a necessity, you adjust the diabetes management around it. This also means that you'll have to be extra vigilant with testing and dosing as Poe's doses could change depending on his steroid usage.

    Let us know how the vet visit goes and if you have any specific questions or need any further help.
     
  15. Wendy&Tiggy(GA)

    Wendy&Tiggy(GA) Well-Known Member

    Joined:
    Nov 15, 2011
    In terms of cost, the biggest ones I found were vet visits, blood Glucose strips and food. When I started testing blood at home I didnt need the expensive vet curves so that got rid of that cost. I didnt buy the vets meter, and instead got a human one which was just as reliable but much cheaper (ie relion confirm or micro from Walmart). And I didnt get the prescription foods, like most people here I feed the cheaper fancy feast classic pâtés or friskies pâtés which are just as good for diabetic cats in terms of carbs.

    Insulin sounds expensive as an upfront cost but lantus and levemir last up to six months when kept in the fridge.

    Plus check our "supply closet" board for freebies!

    Wendy
     
  16. KarensPoe

    KarensPoe Member

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    May 21, 2013
    Had the visit with vet...got all the necessary supplies I need now...OMG the Lantus cost me $171.00 at WalMart...

    I wanted to start him tonight, but I had fed him around 3:15 and to start him at 7 pm, I could not get him to eat enough for a dose of insulin.

    I called the vet, she said to start him tomorrow night instead of the morning because she wanted me to monitor his first dose.

    He doesnt have the ravenous appetite anymore...and just as I was typing this, he vomited a tiny bit...maybe 2 teaspoons if that.

    I was told to stop the albuterol and just keep him on the inhaled steroids for now, once every 12 hours.

    His insulin dose is the very first line on the syringe, every 12 hours, so its like a couple of drops really. His keytones were trace...which is why she started the insulin. She said that if the keytones had not been there, she might have let me go a bit on just the diet change.

    I have not done a reading yet....not much I can do if I cant give him the insulin. I'm hopeful that tomorrow we can get this started and he might have a chance at being insulin free in a couple of months or so.

    Karen
     
  17. KPassa

    KPassa Well-Known Member

    Joined:
    Oct 23, 2012
    I'm guessing she has you starting on 1 unit of Lantus, which is generally a good starting dose for most cats. :thumbup It sounds like you have a good vet on your side.

    From the cost of the insulin, I'm assuming you got the vial. If so, that vial should last you a good 4 to 6 months before you might see it losing its potency. Be sure to keep it refrigerated in the main part of the fridge (storing it in the door leads to possibly faster expiration).

    As for eating with his shot, this is only required with Lantus if your cat is having appetite problems (mostly to make sure they're eating and won't drop too fast because they've fasted too long). If your cat doesn't have problems eating, then you can give the shot without food. It's also best to have food available for them at the nadir/lowest point in the cycle. With Lantus, this usually comes about 5 to 7 hours after a shot.

    Over the next few days and weeks, if you ever start to feel overwhelmed, remind yourself that this is more of a marathon than a sprint and things do get easier, much easier. And you can always vent your frustrations here. :D We've all been through or are going though what you are so you'll always have a sympathetic ear. ;-)
     
  18. KarensPoe

    KarensPoe Member

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    May 21, 2013
    The dose is the very first line on the tiny syringe...so I guess thats 1 unit. I wasn't able to start the lantus because I couldn't get him to eat enough.

    This morning, he stuck his nose up at breakfast, but was frisky and friendly. I had to go to work, so the food is there...I'm guessing he just don't like this particular food, so I'm going to stop at the pet store and get the Friskies pate because I know he will like that as he's had it before.

    At the vet last night, I was told that bringing my cat was optional as the stress might make things harder, so they showed me how to administer the insulin on one of their cats using saline. I couldn't do it...I had a meltdown..I got as close as understanding the "tent" procedure and feeling that little pocket, but I just couldn't go any further.

    They showed me how to draw blood from his ear, but vet said she wanted me to wait and do a "curve' this weekend after he's had a few days of insulin.

    I have the monitor, she loaned me one, with lancets and strips, but I know I have to purchase one.

    So, I'm hopeful that when I get home after the food stop, I will be able to give him dinner and his first shot.

    Karen
     
  19. Sue and Oliver (GA)

    Sue and Oliver (GA) Well-Known Member

    Joined:
    Dec 28, 2009
    Karen, if you want to share where you live (city and state) maybe we have someone nearby who could come help you do the testing and do the shot the first time?
     
  20. KarensPoe

    KarensPoe Member

    Joined:
    May 21, 2013
    I'm about 20 miles NW of Chicago, IL, in Palatine.

    Karen
     
  21. hmjohnston

    hmjohnston Well-Known Member

    Joined:
    Dec 30, 2011
    If you look at the top of the page there is a box that says home-testing kits. They send a meter, strips, lancet and device, plus a rice sock- usually for just the cost of shipping.

    That can get you started and it should be a pet friendly/wallet friendly meter :D
     
  22. KPassa

    KPassa Well-Known Member

    Joined:
    Oct 23, 2012
    Try practicing giving air/water shots on a sliced apple or cut potato first. It helps you visualize the angle of the needle going in and helps you practice how to hold the syringe and how hard to press and release.

    The "curve" you can do any time, but I strongly suggest you don't wait on getting started with testing. It lets you know if it's safe to give a shot and it lets you know how that shot is affecting him. Plus, it might take a few days for you two to get used to testing enough to tackle a curve. It's recommended at minimum to test before each shot and before you go to bed for the night. If possible, it's also recommended to test at around the halfway point (~6 hours) from one shot to the next as this is usually the peak/nadir of the insulin. There are a few other times that are good to spot-check throughout the day or week as you can, but those I mentioned above are the most imperative (most of us have busy schedules and some days, I only get in the bare minimum Pre-Shots and Before Bed tests).
     
  23. KarensPoe

    KarensPoe Member

    Joined:
    May 21, 2013
    I know that in time this will all level out...and the firsts are the hardest...but emotionally I am a wreck. I'm scared that I won't be able to get him to eat so I can give him the shot...I'm worried financially cause I'm already strained...and then there is the guilt.

    About 4 years ago, I had to put down another cat I had...and I know now what happened...he was in diabetic keto_____....and was so sick...I didn't have the money to find out what it was...and when he was visibly suffering, I put him down.

    I watch Poe like a hawk now..when I'm home...and I'm worried sick when I'm not home. Last week, I was afraid he'd have another asthma attack, now I'm afraid of the diabetes.

    He's all I have. My kids are grown and on their own...I'm divorced...poor thing has been through 3 moves since 2011.

    I don't really fear giving him the shot or drawing the blood...I WANT to do it...like NOW...but concerned cause his appetite has changed now, which presents another risk.

    Karen
     
  24. KarensPoe

    KarensPoe Member

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    May 21, 2013
    Came home to find he had finished almost all his breakfast...so I ran to pet store and got some of the friskies suggested since I know he likes those.

    Had a coupon for Natural Instincts and got a trial bag of that. I want to start his insulin tonight around 6:30 CST, so gave him a few bites of the natural instinct which he don't seem to care for...but trying to hold off so I know he will eat a full mean closer to shot time. I plan to test first.

    He's happy...playful...friendly...purring. A bit upset maybe that I'm not feeding him something he wants, but I only have to wait about 2 more hours and apparently if he really is hungry, he will eat it. It's possible my own paranoia is freaking him...considering how I've been practicing the "tent" procedure on him and rubbing his ears like mad, I guess he is justified in his "what in the blazes is her problem?" thinking.

    It seems that now he's just getting picky on what he likes to eat...where up until a few days ago, there was never enough of whatever it was.

    My question is this....do I feed him then test then dose or test him before i feed him?

    Karen
     
  25. KPassa

    KPassa Well-Known Member

    Joined:
    Oct 23, 2012
    Yay that he's eating!!

    I'd probably donate the Natural Instincts to a rescue or shelter place if your kitty doesn't like it. No point in feeding him dry he doesn't like. :lol:

    You want to test, feed if he's over 200, and shoot within 15 minutes of the pre-shot test. If you test and he's below 200, don't feed, don't shoot, but post here first for advice.

    Hehe! You'll both soon become accustomed to it so it won't seem so weird and you won't be so paranoid.
     
  26. KarensPoe

    KarensPoe Member

    Joined:
    May 21, 2013
    I replied privately, but I already fed him..I just missed your post :(

    Do I go ahead and give him his first dose of insulin? vet wanted me to make sure he had eaten before I shot him...and I'm starting him at the very first line on the syringe, the really tiny syringe..

    Now I dont know what to do...I gave him half a can but he didnt finish it..

    Karen
     
  27. KarensPoe

    KarensPoe Member

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    May 21, 2013
    Any one can help? I fed him...now I dont know if I should test or dose him
     
  28. KPassa

    KPassa Well-Known Member

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    Oct 23, 2012
    How long ago did you feed him? I'd still test before his shot, either way. How big was that can? If it was the Friskies, that's about 5.5oz and roughly 170 calories a can. How much does he normally eat at a meal?
     
  29. KPassa

    KPassa Well-Known Member

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    Oct 23, 2012
    Since he's been running high and this is his very first dose of insulin, he's probably going to have a fairly high number at his "pre-shot" test, so don't stress too much that you fed him first before testing. Today, it won't make too much difference. Tomorrow morning, however, it will be important to test to make sure he's come into a safe enough range for his second shot.
     
  30. KarensPoe

    KarensPoe Member

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    May 21, 2013
    it was the friskies...and now I'm trying to test him and I cant get the blood from his ear..ugh..poor thing hes gonna hate me and I dont blame him

    maybe I should just give him the shot? the last number we got was a test on sat at like 356 I thinik
     
  31. KarensPoe

    KarensPoe Member

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    May 21, 2013
    his eating has been so unregular ...he only ate maybe 2/3 of the half of a can...
     
  32. KPassa

    KPassa Well-Known Member

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    Oct 23, 2012
    It's up to you if you want to keep practicing at the testing or give the shot and try testing again later. You're doing fine and it's expected to not get blood every time for the first couple of weeks. Just make sure you give plenty of treats!
     
  33. KarensPoe

    KarensPoe Member

    Joined:
    May 21, 2013
    ok I've poked him so many times with no luck UGH

    Gonna give him the shot and pray that I dont kill him...and lots of treats
     
  34. KPassa

    KPassa Well-Known Member

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    Oct 23, 2012
    That should be fine for a while. Since it's Lantus, it's much more forgiving if he doesn't eat (or eat much) at shot time. Give both of yourselves a break and try testing again in a couple of hours. You're really doing a good job already! :thumbup
     
  35. KPassa

    KPassa Well-Known Member

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    Oct 23, 2012
    I might have missed if this was already posted earlier, but just in case, here's a great link for ear testing tips that might be helpful.
     
  36. KarensPoe

    KarensPoe Member

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    May 21, 2013
    The shot was much easier than the test...I just couldn't get the blood to come...and he was such a good boy allowing me to poke him so many times UGH but now hes eating the rest of his dinner and I gave him a few treats...

    So..my first insulin dose for my diabetic cat is now complete...so damn emotional...I can feel a meltdown

    Thank you for helping...tomorrow will be better...if I can get the testing down

    Karen
     
  37. KPassa

    KPassa Well-Known Member

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    Oct 23, 2012
    haha_smiley Don't you start stressing yourself out about getting the testing down! It might be tonight, it might be tomorrow, it might be next week, but it will come. You've just accomplished giving a shot! You deserve an award, so go pour yourself your drink of choice, open a bar of chocolate, and kick off your shoes and relax for a bit. You did great, Poe's Mama!
     
  38. KarensPoe

    KarensPoe Member

    Joined:
    May 21, 2013
    I'm so afraid of giving him a dose that he doesn't need..the vet started us on the lowest dose, but he seems so normal now..not like last week when everything went south.

    But he's laying here on my lap as I type this...prancing on my hands...purring like wild now. Looking up at me like a child does...I feel so bad that he got so sick because I wasn't more conscious of what I fed him

    Karen
     
  39. KPassa

    KPassa Well-Known Member

    Joined:
    Oct 23, 2012
    It usually takes the Lantus a couple of hours before it starts kicking in. On top of that, Lantus is a depot-style insulin so you won't be getting the full impact of the dose until usually ~6 cycles later (3 days), even longer for first-time users. That gives you plenty of time to get a couple of (successful) tests in to see where he's at. You can also use Secondary Monitoring Tools in the meantime. And finally, you know your cat best. If you're ever significantly worried about him, you can take him back into the vet to make sure he's okay.
     
  40. KarensPoe

    KarensPoe Member

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    May 21, 2013
    Shot #2 successful this morning, although I still haven't tested. Going to work on that when I get home from work.

    He seems pretty mellow, and his appetite is nothing like it once was, but he does eat, and I found that he likes the Friskies. He had that before, so I knew that would be successful.

    Now, I'm concerned about timing because I still have to give him his steroid inhaler every 12 hours also. That should be done by early next week.

    Karen
     
  41. hmjohnston

    hmjohnston Well-Known Member

    Joined:
    Dec 30, 2011
    Sounds like the usual- and harrowing first test that many of us go through.

    It WILL get better. Your both new, the ear doesn't know it should bleed, and Poe is unfamiliar with the new routine. That is okay as you are both learning (and that pesky little ear is learning to bleed, too). It can take a weekend or a month to get it down. I vote for the former as Poe doesn't seem to be fighting you.

    Just make sure you warm up the ear really good and the continual poking will get those capillaries going to the edges like you need them. Over the course of history cats ears got torn by fighting and stuff they don't have a lot of ready blood vessels. So first blood testing is difficult and hard-won.
     
  42. KarensPoe

    KarensPoe Member

    Joined:
    May 21, 2013
    It's 3:03 pm...he ate about 5:30 am then got his dose...

    I got home, gave him about a 1/4th of a can of the friskies...he wanted more but trying to hold off so he has enough for dose at 5:30 pm

    I decided to give him a test...after unsuccessful ones last night, I got a good drop...the meter read 44...I have a call into vet now.

    Help?

    Karen
     
  43. KPassa

    KPassa Well-Known Member

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    Oct 23, 2012
    44 is lower than we like to see in diabetics, but it's not dangerously low yet. The fact that he just ate means that you've already done a bit of good in getting that number to come higher. He should also be starting to head back up already since Lantus peaks around 5-7 hours after a shot. Test him again in 30 minutes and see where his number is at (it should be higher). Post here and let us know. If he starts acting weird at all, rub some karo syrup or honey on his gums. If you're really worried, take him to the vet!!

    For tonight's shot, he's earned himself a mandatory reduction! Any time a cat drops below 50, you want to reduce the Lantus dose, usually by .25u. Since you've just started giving insulin and he hasn't even been on it for more than 3 cycles, I suggest you drop it to .5u instead. If he's below 200 at shot time (which he most likely will be), DO NOT GIVE A SHOT.

    party_cat And CONGRATULATIONS on getting your first test in! party_cat​
     
  44. KarensPoe

    KarensPoe Member

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    May 21, 2013
    I dont know how to measure it any less...there is no marking..and the markings as it is are sooo small...I dont know if I can accurately measure it.

    So I test again now in about 15 min, then see what it says...maybe give more food then?
     
  45. KarensPoe

    KarensPoe Member

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    May 21, 2013
    No weird symptoms...hes playful friendly..wanting to eat...

    I fed him the 1/4 can and when he finished that I tested him...and gave him a couple of treats.

    I will test again in about 10 min and post...still waiting for call from vet

    Karen
     
  46. KPassa

    KPassa Well-Known Member

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    Oct 23, 2012
    You don't want to feed him too much food because if he stays low, you might have to be doing this for a while and you don't want him too full to eat. In 15 minutes if he's still below 50, give him some gravy from high carb food, if you have any. If not, you can make your own "high carb gravy" with a little bit of his wet food, a little bit of water, and some honey or syrup.

    Here's a link for hypo information to give you an idea of what we're trying to do. Because he's doing fine right now and it's towards the end of the cycle, we don't want to significantly raise his numbers; we just want to keep him from going lower than he already is. We basically want him to "surf" along where he's at (preferably slightly higher so you don't have to hover over him and test every half hour).
     
  47. KPassa

    KPassa Well-Known Member

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    Oct 23, 2012
    I have to step away for a bit (gotta go home and test my own kitty), but I'll be checking up on you on my phone. The board seems relatively quiet today for some reason, so if it becomes an emergency, start a new post using the 911 icon to get people's eyes on it.
     
  48. KarensPoe

    KarensPoe Member

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    May 21, 2013
    Newest test performed just now....65
     
  49. KPassa

    KPassa Well-Known Member

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    Oct 23, 2012
    Much better! :thumbup I think you can breathe for the moment. Test again in a half hour if you can. If not, keep an eye on him to make sure he's doing all right and try to grab another test in an hour or so. The food alone should keep him up for probably the next couple of hours.
     
  50. KarensPoe

    KarensPoe Member

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    May 21, 2013
    hes screaming at me to eat lol Should I feed him more of the same as I gave him at 3?
     
  51. KPassa

    KPassa Well-Known Member

    Joined:
    Oct 23, 2012
    At this point, give him just a tablespoon or two. You still don't want him to eat too much because we're not yet sure how long this dose might last in his system (since he just started on insulin, we have no previous data to gauge his reaction).
     
  52. KarensPoe

    KarensPoe Member

    Joined:
    May 21, 2013
    Test just now...came in at 60

    Karen
     
  53. KarensPoe

    KarensPoe Member

    Joined:
    May 21, 2013
    I dont know where the post went about the one or 2 tblpsn of food, but I just tested him at 4:00 and he came in at 60
     
  54. KarensPoe

    KarensPoe Member

    Joined:
    May 21, 2013
    I'm going to give him 2 tablespoons of food...then test him again in 30 min I think...if I should wait longer let me know..I'll be checking

    Karen
     
  55. KPassa

    KPassa Well-Known Member

    Joined:
    Oct 23, 2012
    Yep, 60 is still a great number. :mrgreen: Go ahead and feed him and he should be fine. Feed him and test again in a half hour if you can or try again in an hour.

    Now, onto the dose you're giving him. I was assuming it was 1u, but now it sounds like your vet might have had you microdosing. (If so, great for the vet to know about it!)

    Here's a picture of a mirco-dose:
    [​IMG]

    Which line on the syringe are you pulling to? FYI, the syringe in the picture has 1/2 unit markings (the lines on the left), whereas your syringes might not have them.
     
  56. KarensPoe

    KarensPoe Member

    Joined:
    May 21, 2013
    Ihave the BD U-100 Insulin syringe ...it says .03 mL/cc on the side

    the first number read is 5 and I pull to 1
     
  57. KarensPoe

    KarensPoe Member

    Joined:
    May 21, 2013
    Im going to test him again now...its been about 30 min since he ate the 2 tblspns
     
  58. KarensPoe

    KarensPoe Member

    Joined:
    May 21, 2013
    he came in at 55 just now
     
  59. KPassa

    KPassa Well-Known Member

    Joined:
    Oct 23, 2012
    Okay, so that sounds like you're giving 1u. Going forward, at his next shot time if he's above 200 (you're probably going to end up skipping tonight so it won't be till tomorrow morning), you want to give him half that amount. So, in the picture above, the one that shows .25u, you want to draw the end of the plunger up to that little half-mark on the left. If your syringes don't have half-unit markings on them, you'll have to eyeball it between the 1u (what you're giving currently) and the 0 line (the last right line right before the top of the syringe). You might need to grab a magnifying glass or borrow a pair of eye glasses to help you see it.
     
  60. KarensPoe

    KarensPoe Member

    Joined:
    May 21, 2013
    So do I feed him around 5:15 his normal amount and then test?
     
  61. KPassa

    KPassa Well-Known Member

    Joined:
    Oct 23, 2012
    He's holding steady (all meters have about a 20% variance so a 55 vs. a 60 is pretty close together). You're doing a great job on keeping him from dropping too low and he is surfing beautifully right now. :thumbup

    And look at you go with all that testing! [​IMG] Great job!
     
  62. KPassa

    KPassa Well-Known Member

    Joined:
    Oct 23, 2012
    Yep. Test first, then feed. But don't worry if he doesn't eat it all since you've been feeding him off and on already.
     
  63. KarensPoe

    KarensPoe Member

    Joined:
    May 21, 2013
    Can I feed him dinner now? Do I plan to give him a shot tonight? I need a step by step here please its so appreciated.
     
  64. KarensPoe

    KarensPoe Member

    Joined:
    May 21, 2013
    tested again just now..came in at 70

    I gave him about another 1/4 of a can...do I give him a shot tonight?

    Thanks

    PS No call back from vet yet :(
     
  65. KPassa

    KPassa Well-Known Member

    Joined:
    Oct 23, 2012
    Beautiful number! When is his shot due? If it's right now, you definitely do not want to give him a shot.

    I think right now you can breath easy and leave some wet food out for him to graze on.
     
  66. KarensPoe

    KarensPoe Member

    Joined:
    May 21, 2013
    yes, it would be due right around now. He didn't finish his last serving, so I'll leave it for him to munch on.

    He's very content now..snoozing..after he ate and groomed.

    I can't thank you enough...I'm so afraid..and I live alone..its just him and me...no other pets either.

    Should i be testing him anymore tonight or wait until the morning...and if I wait til the morning, do I test before I feed him?

    Thanks

    Karen
     
  67. KPassa

    KPassa Well-Known Member

    Joined:
    Oct 23, 2012
    Since you're skipping his shot, you can test him whenever you want tonight or not at all. Just consider it as data on how he does without a shot. Have I provided you yet with a link to the handy spreadsheet we all use for keeping track of numbers? Let me know if you need any help getting this set up.

    You're doing fine and that's exactly what this Message Board is for: to hold your hand and help you in any way you need us to. We've all been through this and we've all needed our hands held at one point or another.

    The plan for tomorrow is:
    • Test (this is called the morning "pre-shot" or AMPS test)
    • If <200, DON'T feed, but post here first for advice. (I probably won't be up yet since I'm West Coast, but someone should see it and be able to help; it's just been unusually quiet the last couple of days.) If no advice given, skip this shot as well.
    • If >200, feed and give .5u with the instructions I mentioned above.

    If you give a shot tomorrow morning, try to grab a test two hours after the shot (it's called a +2) and another test or two around 4 to 8 hours after his shot to see how low he's going.
     
  68. BJM

    BJM Well-Known Member

    Joined:
    Oct 6, 2010
    You may find it helpful to read my signature link secondary Monitoring Tools while you continue working on home blood glucose testing. It has some additional assessments you might make to evaluate your cat.
     
  69. KarensPoe

    KarensPoe Member

    Joined:
    May 21, 2013
    I wont be able to test him at all after I test him preshot and all that, as I leave early for work, and don't get home til about 3 CST.

    I left his food out to snack on...will test him maybe tonight before I go to bed...I'd rather not if I dont have to since I really put him through a bunch already. I did notice too that he wasn't restless...he actually slept, not catnapped, for the first in probably a week.

    He even slept in the spot where I kept pricking him for blood..such a precious boy he is

    Thank you again...I will be up and about first thing in the morning...

    Karen
     
  70. Wendy&Tiggy(GA)

    Wendy&Tiggy(GA) Well-Known Member

    Joined:
    Nov 15, 2011
    Kpassa, good job in managing this when nobody was around!!!

    Am I right with these readings?
    5.30am AMBG no test, gave 1 unit
    +10 44 (10 hours after shot?)
    +10.5 65
    +11 60
    PMBG 70? Skip


    Wendy
     
  71. KarensPoe

    KarensPoe Member

    Joined:
    May 21, 2013
    Yes...I did skip the PM dose, did not test after the 70. Vet called me around 9 pm last night and apologized as it wasn't conveyed to her that I was calling about his low reading. I told her that I was walked through the low reading by a member of this board and she was very pleased as she used and recommends this board as well.

    She said all the same things about the plan for today, and even confirmed that I did not need to give him a shot last night.

    Her instructions to me for today:

    If his BG is below 200, feed, no shot
    if its above 200, feed and 1 unit

    I tested him at 5:15 this morning with a 276 reading. Fed him, and then gave him 1 unit at 5:30 am. She wants me to do a +2 test, so I am now waiting as it's only 6:45 am right now.

    I'll be keeping this open until I have to leave for work after his 7:30 am test.

    Thank you all so very much
    Karen
     
  72. KarensPoe

    KarensPoe Member

    Joined:
    May 21, 2013
    Just tested...came in at 351

    Is that ok? Do I need to be worried?

    Karen
     
  73. Wendy&Tiggy(GA)

    Wendy&Tiggy(GA) Well-Known Member

    Joined:
    Nov 15, 2011
    Nope nothing to worry about - test for ketones though if you can. He might be bouncing off those lows.

    I think we really need you set up on a spreadsheet so we can see whats going on here better, Both you, we and your vet will be able to watch it..

    Heres how: http://www.felinediabetes.com/FDMB/viewtopic.php?f=6&t=18207

    If you have issues setting it up, let me know and I can ask another member to help.

    Also I think 1 unit is too high given you got a 44 yesterday. I would drop to 0.75.
    Wendy
     
  74. KarensPoe

    KarensPoe Member

    Joined:
    May 21, 2013
    I don't have the supplies to test for keotones, and I have a call into the vet as well. I'm going to work on the spreadsheet...I have all the numbers and info written down to put into it.

    I will test him as soon as I get home, hopefully around 3:00 pm CST, so that will be a 6.5 hour stretch between tests. I can't give him a dose until 5:30 pm if he needs it.

    Thanks
    Karen
     
  75. Wendy&Tiggy(GA)

    Wendy&Tiggy(GA) Well-Known Member

    Joined:
    Nov 15, 2011
    The logic with lantus is that you dose every 12 hours so you wouldnt be shooting before 5.30pm anyway... no matter what you see with the numbers.

    You can buy the urine ketone test sticks for like $10 at Walmart.

    Wendy
     
  76. KarensPoe

    KarensPoe Member

    Joined:
    May 21, 2013
    Ok that makes sense...so it's kinda slow acting which might be another reason his number was 351 2 hours after the dose. I have to get to WalMart today if they would quit putting me on hold and get a meter, strips, lancets, and the ketone strips.

    I am hopeful that soon I will get the rhyme and reason in all this testing and metering...but I still panic a bit when he went so low and then high...

    Thanks
    Karen
     
  77. Wendy&Tiggy(GA)

    Wendy&Tiggy(GA) Well-Known Member

    Joined:
    Nov 15, 2011
    Lantus takes a few hours to kick in. And food can raise BG levels too . As can being low (body overreacts and shoots out glucose to compensate). so dont worry.

    shopping list!:

    1. Meter ie Walmart Relion Confirm or Micro. Prime is cheaper but needs more blood.
    2. Matching strips
    3. Lancets - little sticks to poke the ear to get blood . new members usually start with a larger gauge lancet such as 28g or 29g until the ear learns to bleed. Optional - lancing tool.
    4. Cotton balls to stem the blood
    5. Neosporin or Polysporin ointment to heal the wound
    6. Mini flashlight (optional) - useful to help see the ear veins in dark cats, and to press against
    7. Ketone urine test strips ie Ketostix or ketodiastix - Important to check ketones when blood is high
    8. Sharps container - to dispose of waste syringes and lancets.
    9. Treats for the cat - like freeze dried chicken
    10. Karo syrup/corn syrup or honey if you dont have it at home - for hypo emergencies to bring blood sugar up fast
    11. A couple of cans of fancy feast gravy lovers or other high carb gravy food- for hypo emergencies to bring blood sugar up fast
     
  78. KarensPoe

    KarensPoe Member

    Joined:
    May 21, 2013
    ok printed that all out. I've been fortunate that he bleeds pretty easy, although with all the sticks I did the other night, I'm sure I helped that part along ugh

    Thanks again...I'm going to read some more about all this...just is overwhelming and a bit hard to comprehend.

    Karen
     
  79. Wendy&Tiggy(GA)

    Wendy&Tiggy(GA) Well-Known Member

    Joined:
    Nov 15, 2011
    Ok cool then get the prime as its reliable and cheap. Some cats are good bleeders, you are lucky. And the ears "learn" to bleed which helps over time.
     
  80. KarensPoe

    KarensPoe Member

    Joined:
    May 21, 2013
    Just spoke with the vet...his high reading makes sense since he had eaten 2 hours earlier...so I imagine when I get home and test, he will be on the low end. I'm getting the ReliOn Confirm hopefully today.

    Thanks all again so much
    karen
     
  81. KarensPoe

    KarensPoe Member

    Joined:
    May 21, 2013
    Tested when I got home about 3 pm...244...1 tspn of Friskies pate (see next line) to keep him from screaming at me.

    5:00 PMBG before dinner...262...half can of Friskies pate (supreme supper...yummm lol) and now I wait for him to finish so I can give him his shot. Shot due in about 10 min.

    I started my spreadsheet, but its kind of a mess yet. No consistency really.

    Karen
     
  82. Deb & Wink

    Deb & Wink Well-Known Member

    Joined:
    Jan 31, 2013
    The spreadsheet (SS) link is not working correctly.

    When you are in your google spreadsheet, you need to click on File, Publish to the Web, make sure the checkbox for 'automaticaly republish when changes are made' is checked and click on the 'Start Publishing' button.

    Try those steps and then we'll see if the access to your SS is working.
     
  83. KarensPoe

    KarensPoe Member

    Joined:
    May 21, 2013
    I went in and made the changes, added more data. Hopefully it's right and up to date.

    Thanks
     
  84. Deb & Wink

    Deb & Wink Well-Known Member

    Joined:
    Jan 31, 2013
    I still can't access it. Which link do you have in your signature? The one that popped up when you said Publish to the web, and is down towards the bottom of the screen in that window, or the URL in the web address bar? You do NOT want to use the URL in the web address bar.

    There may be a share option somewhere that needs to be changed. Maybe post over in Tech Support forum to ask for help?
     
  85. KarensPoe

    KarensPoe Member

    Joined:
    May 21, 2013
    ok...will fix that again.

    In the meantime, I'm doing a curve for my vet...5:30 AMBG was 91, fed, no dose. He didn't finish breakfast.

    9:30 am (4 hour test) came in at 59...have call into vet...still food left from breakfast...I know this isn't dangerously low...but low enough to be concerned. He's fine..no symptoms...nothing unusual.

    Not sure what to do since he won't finish his breakfast.

    Karen
     
  86. KPassa

    KPassa Well-Known Member

    Joined:
    Oct 23, 2012
    Under the File -> Publish to web, there should be a box that says something along the lines of "Share published link" that contains the published URL to copy into your signature. It should contain "pub" within the address and not the "ccc."

    (Sorry, on my iPhone so I can't copy/paste very well or access my own googledocs from here, otherwise I'd be more specific. :lol: )

    And I see you've been doing a fantastic job! No shot since how long ago now? :mrgreen:
     
  87. BJM

    BJM Well-Known Member

    Joined:
    Oct 6, 2010
    If no insulin and no other conditions, he isn't going to hypo. Skip until the regular time and only shoot if he's high enough.

    It looks like 1 unit is too much if 1 or 2 shots takes him that low. I would not shoot 1 unit again. We suggest new users not give insulin if the pre-shot test is under 200 mg/dL. If he is over 200 at the next shot time, you might consider 0.5 units or 0.25 units.
     
  88. Wendy&Tiggy(GA)

    Wendy&Tiggy(GA) Well-Known Member

    Joined:
    Nov 15, 2011
    So you got a 59 even though you didnt shoot since last night? Nothing to worry about - 59 is normal numbers and without insulin, he shouldnt have a hypo. Keep measuring though every few hours, we want to see what he does now. Can you put 0 in the dose column for this morning?

    Honestly, I am not sure he even needs insulin with what I think the numbers have been recently.. so want to see what he does today.

    Wendy
     
  89. KarensPoe

    KarensPoe Member

    Joined:
    May 21, 2013
    I spoke with the vet..I guess the ReliOn meter is a bit off from the Alphatrack I been borrowing from her, so even though it read at 59, it was really a bit higher.

    So...she thinks I need to stop dosing him...stop testing..until Monday am for his regular 5:30 am test/food/shot (?). She has had another kitty that did so well just on the food change and the insulin for about 2 weeks, that the kitty no longer needed it. She's thinking Poe might be another example of this.

    His last dose (1 unit) was his 5:30 pm last night, 5-24-13. His +12 reading was the one at 59, which is probably higher, so he is in good range.

    I will be home, except maybe to run to store, all weekend. I'm prepared for any emergencies (God forbid). His appetite is leveling out alot...although I did find out the particular "flavor" I gave him of the Friskies this morning did not appeal to him (it was a new one).

    On Monday, she wants me to do the curve. Also said that if he gets over 350 to dose him, so just out of my own peace of mind, I may test him AMBG and PMBG.

    He may be OTJ soon...and that would be awesome !

    I hope my spread sheet works now...I've taken the steps as directed...never used google docs before.

    Thanks
     
  90. Wendy&Tiggy(GA)

    Wendy&Tiggy(GA) Well-Known Member

    Joined:
    Nov 15, 2011
    59 is a good number. Sounds like a good plan but I would definately not stop testing (? why would she say this) - you need to get a few more tests in to see how he is doing - maybe 2 more today and a couple tomorrow so you can see how he is trending - see how his pancreas is working. If he goes superhigh tonite or tomorrow then you will know and be able to shoot (but lets discuss first)

    On Monday morning test and dont shoot if he is still low obviously. Call the vet then and discuss.

    Spreadsheet works great!

    Paws crossed for OTJ

    Wendy
     
  91. KarensPoe

    KarensPoe Member

    Joined:
    May 21, 2013
    I am going to test for sure...probably for the PMBG. I haven't normally tested after the last one of the night. Then I will test AMBG also.

    All my fingers, toes, and Poe's are crossed for OTJ
     
  92. KarensPoe

    KarensPoe Member

    Joined:
    May 21, 2013
    I just did a PMBG about an hour earlier than usual...about 4:10 pm instead of 5:00 pm...came in at 121. Fed him his dinner...he sure don't eat like he was...he eats a bit...leaves...comes back later for a bit more..sometimes takes hours now for him to finish it.

    I'll probably test him either +4 or +6 just to see how it's holding out, especially since he eats a little bit at a time.

    Karen
     
  93. KPassa

    KPassa Well-Known Member

    Joined:
    Oct 23, 2012
    Actually, try to grab another test an hour after he eats and then again at 2 hours after he eats, if possible. Since he hasn't had any insulin now for quite a while, what you're seeing might be that his body is producing insulin on its own. A "Food Test" should show whether his numbers go up from eating (a sign he might still need insulin) or go down after eating (a sign that his pancreas is working, at least a little bit).

    And now that his numbers are in a more normal range, his body is able to efficiently process food so he's no longer needing to eat more. It's great to hear he's grazing so effectively. :thumbup
     
  94. KarensPoe

    KarensPoe Member

    Joined:
    May 21, 2013
    I missed this post...I'm past the 2 hours I think...will try to get one shortly...trying to eat myself lol

    Thanks
     
  95. KarensPoe

    KarensPoe Member

    Joined:
    May 21, 2013
    PMBG +2.5 is 223...he is still snacking here and there
     
  96. Wendy&Tiggy(GA)

    Wendy&Tiggy(GA) Well-Known Member

    Joined:
    Nov 15, 2011
    Drat - he is getting a little high.

    Lets see how he is tomorrow. If he keeps this up he will be back on the insulin. Maybe on a smaller dose though. to quote BJ
    Are you checking for ketones?
     
  97. KarensPoe

    KarensPoe Member

    Joined:
    May 21, 2013
    no..not checking for those
     
  98. KarensPoe

    KarensPoe Member

    Joined:
    May 21, 2013
    I'm going to test again in about an hour just to be sure...I got distracted and might have misread that number and now I cant get it back on the meter
     
  99. Wendy&Tiggy(GA)

    Wendy&Tiggy(GA) Well-Known Member

    Joined:
    Nov 15, 2011
    Sounds good.

    Next time you are at the pharmacy you should pick up a pack of urine ketone strips. They are cheap and you test the urine with them for ketones.ketones can happen when a cats blood is high and its a serious and expensive condition to treat. Fortunately Poe is low right now but if he sneaks up it will be a good idea to spot check for those.

    Wendy
     
  100. KarensPoe

    KarensPoe Member

    Joined:
    May 21, 2013
    its 8:12 pm and he's at 247 now
     

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