New member - diagnosed 2/13 at 455 BG

Discussion in 'Welcome to the Group - Post an Introduction Here' started by Jenni, Feb 21, 2015.

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  1. Jenni

    Jenni Member

    Joined:
    Feb 21, 2015
    Hello everyone,

    On Friday the 13th (coincidence?) my sweet boy, Smudges, was diagnosed diabetes and my little girl, Nibbs, was diagnosed with kidney disease. Smudges will be 14 years old on March 25 that I plan on celebrating with him. Needless to say, this diagnosis was unexpected and has brought a lot of fear, anxiety and tears for me. I've lost 3 kitties to kidney disease and had to say goodbye to my little Lexi last fall due to cancer. I'm still grieving their loss so I'm feeling overwhelmed and defeated right now.

    I've spent a lot of time on this website trying to educate myself about diet, insulin, hypo/hyperglycemia, home testing, etc. I want to do what is best for my kids and it is obvious that the people here are caring, compassionate and kind. I have much to learn! All of the acronyms and information has my head spinning and I think the vet's office is sick of hearing from me.

    Smudges' BG was 455 on 2/13. He also has some weakness in the hind legs (possibly neuropathy?) He is a kibble eater and does not react well to wet food. I've been working on the switch for the past week. Sometimes his stomach tolerates it--sometimes not. It's going to be a challenge switching over completely and my kitties have completely opposite nutritional needs to compound the issue. He's been on 2 units of Lantus 2x/day for 1 week. After reading the posts here, I'm completely freaked out by the possibility of shooting blind. My vet recommended having a curve done after two weeks on insulin, saying that it takes awhile for the cat's system to adjust to the insulin and change in food.

    After posting this thread I'm heading to Walmart to buy the necessary supplies for home testing and buy some different wet foods to try. Smudges had been tolerating FF classic chicken and Wellness Chicken & Herring fairly well until last night. He vomited most of his dinner and started vocalizing nonstop at about 8:30 pm. He was obviously uncomfortable and agitated. I offered him more of the FF and he just gorged himself as if he were starving. I have never seen him eat like that before. Was he experiencing hypoglycemia? I have no idea but he was obviously not feeling well and it scared the daylights out of me. I didn't know if he needed Karo or if that would compound the problem but I put a little in his mouth. After eating, he settled down considerably but wanted to sleep by himself and be left alone. I woke up this morning with him cuddled by my side and he seemed back to normal and happy. I offered him the same wet food but he refused to eat any of it so I could not give him any insulin as scheduled. A couple of hours later he ate some kibble (Hills c/d) which is not low carb but that is all he would eat. As of now, he is still refusing the wet food so I am forced to continue with the kibble until I find a low carb wet food he will eat. I plan to buy some additional FF flavors today.

    I have so many questions. For now, the big ones to me are:

    1) Is is appropriate to wait 2 weeks after starting insulin before doing a curve test?
    2) If I am unable to get blood while doing a home test, am I putting Smudges at risk at 2 units/2x day of Lantus for another week when his curve test is scheduled? According to multiple vets, it is completely appropriate to wait 2 weeks as they feel his body needs this time to adjust to the insulin.

    I'm scared to death that something is going to happen and I will not know what to do other than rush him to emergency. I welcome any advice about how to proceed.

    Thank you all for being such devoted caregivers!
     
  2. Keni

    Keni New Member

    Joined:
    Feb 20, 2015
    Sorry I can't be of any assistance, since I'm in the same boat as you. My Katya was just diagnosed Thursday and also is a free eater with kibble. She has stopped eating and I will have to return to the vets today. I know my vet wanted me to return in 1 week after the start of insulin. This board seems to have many knowledgeable people with first hand experience. I wish you the best of luck.
     
  3. manxcat419

    manxcat419 Well-Known Member

    Joined:
    Jan 14, 2015
    Hi Jenni and welcome

    I'm so sorry you're having to deal with all this on top of the loss of your other beloved kitties :bighug:

    We too have a fairly recently diagnosed diabetic cat and a CKD kitty (diagnosed about 2 years ago) plus 4 other cats with no obvious health issues in the house.

    Can I ask how much Smudges weighed at diagnosis and whether he was over or under-weight? The 2 units twice daily is the same dose my vet wanted to start Rosa on. Her BG on diagnosis was 680! The cats were all confirmed dry food addicts - Rosa and her twin Regan had been on Royal Canin SO dry food for years after Rosa had bladder stones removed at the very young age of 4. I was also told to switch Rosa straight over to wet food (the vet actually wanted her on prescription Hills food, but she wouldn't eat it and I've since found out that there are several better and more affordable alternatives). The 2 units twice daily plus a change to a low-carb diet is a sudden switch all at once and might have sent Smudges' BG low - the only sign I get that Rosa is going low is that she is suddenly ravenous. Whether he was actually low or not, when you aren't able to get a BG reading, I'd have thought the safest course of action was to do exactly what you did and treat him as though he was low - too high is not as immediately dangerous as too low.

    I was also told to shoot the dose blind for a week and then bring Rosa back for a curve test. If you look at her spreadsheet, you can see that after finding this board I actually started her on 1 unit twice daily with home monitoring. 2 units twice daily was the highest dose she got to - and that sent her low. That was the dose at which she started earning reductions - and fairly quickly to begin with too!

    To try and answer your questions:-

    1) Personally, after my experience, I don't think there is a safe period of time to shoot blind. I think buying testing supplies and learning to home test is the most important thing you can do at this point. I hope someone else can add in with more information on dosing as I'm not really experienced enough to advise much on that, but if Smudges is of a fairly average weight for a cat, it's quite possible that 1 unit twice daily might be a more appropriate starting dose for Lantus.
    2) Again, from my experience and what I've read here, it seems that Lantus takes 6-10 cycles (so 3-5 days) usually to build up the depot. That being the case, waiting 2 weeks to see what effect it's having is definitely too long.

    I too was given no information about hypo by the vet apart from to give syrup or honey and then take Rosa to the ER. In my book, that's not enough information for safety and so is unacceptable to me.

    As regards the food - as I said, we have a CKD kitty as well in the house. I have managed to (mostly) transition all the cats over to Friskies Special Diet Turkey and Giblet pate. This is low in phosphorus, which as you know CKD cats need their food to be, and also low in carbs. Sooner or later all the cats have decided it's the best food ever - and it's good for all of them whether healthy or diabetic or CKD!!

    The Walmart ReliOn meters are good for home testing - I use the Confirm but others here use the Micro or the Prime. For starting testing, I would definitely buy the Alternate Site Use lancets - the 26 gauge makes it easier to get enough blood for testing to begin with.
     
    Critter Mom likes this.
  4. Deb & Wink

    Deb & Wink Well-Known Member

    Joined:
    Jan 31, 2013
    Ok, not meant to scare you, but empower you with more information on dealing with a hypo. Here is a good document on hypos and how to manage them. I printed out 2 copies, posted one on my fridge where the insulin was stored and a second copy with the testing supplies.

    Many cats don't show symptoms of hypo. You know your cat best and if you think something is wrong, a trip to the ER vet may save your kitties life.
     
  5. Jenni

    Jenni Member

    Joined:
    Feb 21, 2015
    Thank so much for your reply. To be honest, I'm completely freaked out by this diagnosis. After reading the info link on hypo, I'm convinced that is exactly what happened last night. Smudges has never ever been so ravenous or desperate to eat any food (and certainly not wet food). I was afraid he was going to eat himself into a coma. His meowing was nonstop until he ate something. While he was eating it his head quivered (shivered) for a brief second or two and I thought for sure he was going to start convulsing. Thank God that did not happen.

    I believe the tech said that he lost 2 lbs since his last weight but for the life of me I just can't remember the number right now. I feel horrible like a terrible mommy because I should know that but I think I went into shock when I heard the words diabetes and insulin. What the vet said after that is kind of a blur. I will confirm his weight history tomorrow when the clinic reopens. However, looking at my receipt the vet recorded his weight as follows:

    6/11/14 - 15.18
    10/14/14 - 14.56
    2/13/15 - ? need to confirm tomorrow

    How the hell can my cat have lost so much weight without my realizing it? He has always been in excellent shape--not over/underweight and active.

    I'm concerned that my vet is just not giving me good information. I've consulted with 3 different vets at my current clinic and they all say relatively the same things about the 2 units/2x day being a low starting dose and 2 weeks being adequate to wait for a blood curve. I consulted my previous vet who I just love but has since retired. He agreed with their advice.

    It is now almost 9:30 pm and Smudges just ate. I'm afraid to give him any insulin right now after last night's episode. I just returned from Walmart and purchased the ReliOn Micro meter. I still have to read how to use the darn thing. Do I decrease the insulin and give him 1 unit tonight instead of 2? I don't know what to do!

    Also purchased some new flavors of Fancy Feast and some Friskies wet. He is not interested in trying it right now but seems to enjoy the Evo Cat & Kitten Chicken & Turkey dry. I just purchased that today also and have started mixing a little with the Hills C/D that he has on previous to this diagnosis last week.
     
  6. Jenni

    Jenni Member

    Joined:
    Feb 21, 2015
    I should also mention that Smudges was diagnosed last summer with either asthma or allergies. He was having some infrequent "coughing" fits and would sometimes vomit. It had been more than a year since his last episode so the vet took some xrays 6/14 and gave these possible scenarios: heart disease, asthma or allergies. Those are very different ailments! A second xray in 10/14 was more conclusive that heart disease was not probable. I was given a prescription for Prednisone to administer as needed during flareups. To date, I have not had to give him any Prednisone. However, now I am wondering if Prednisone is safe to give him while also giving Lantus, if necessary. I hope this will not be the case but thought I would put it out there to see if anyone has any first hand experience with this.

    Thanks for reading,

    Jenni
     
  7. manxcat419

    manxcat419 Well-Known Member

    Joined:
    Jan 14, 2015
    If he lost 2lb, that would put him at around 12lb or 5.45kg. The usual starting dose for Lantus is 0.25u per kg twice daily, which would mean that the 2 units starting dose twice daily is in fact high, not low. I make it about 1.36, but I think that would be rounded down to 1 unit or possibly 1.25 maximum - I'd be happier if someone else can confirm that though as I'm no expert being fairly new to this myself. As for 2 weeks unmonitored before his first curve - I haven't yet been able to understand why vets think this is OK. If it was a child with diabetes, no doctor would ever suggest that dosing blind even once, never mind for 2 weeks, is acceptable!

    Rosa lost weight very quickly in the week or two before her diagnosis - she went from 10.5lb to 8.5lb. And it's not always easy to notice because their fur can hide the weight loss for quite some time. We noticed because in the end, it seemed like all her bones suddenly started to be very obvious when we were holding or stroking her. So no kicking yourself for not noticing - OK? Nor for not being able to remember everything that was said at the vet - when the diagnosis comes as a complete shock, it's very difficult to take in all the information you're given immediately afterwards.

    Hypo is something that scares all of us, but as long as you're aware of it and have the right food and syrup in to handle those low numbers - and are checking his BG levels, it's something that most, if not all, of the time you'd be able to stop before it becomes a problem. The risk is in not knowing he's low until he's extremely low which is where the home-testing comes in as a tool to catch the numbers as they start to drop.

    I'd be inclined to try and get a reading from him before you give insulin if you can - it can take a little practice to be able to get blood for testing. There are some step by step videos on Youtube that should help you get the right spot on his ear for testing. I can't give you dosing advice for your cat (not only do I not have enough experience, but he's not my cat), but I will say if it was my cat I would be inclined to dose conservatively especially after thinking he might have been low on the 2 units last night. As you've started switching him to low-carb food from the higher carb dry that he's been on that will probably bring his levels down a little too.

    Prednisone is a steroid so may affect his BG. But if he needs the prednisone to breathe when he's having an attack, that might be something you have to deal with and allow for down the line. I think @phlika29 is most likely offline right now - she's in the UK - but I think her cat has asthma too so she might be able to help you more with that aspect of things.
     
  8. Jenni

    Jenni Member

    Joined:
    Feb 21, 2015
    I'm sorry to hear that Katya is not eating. I hope the trip to the vet today was helpful. After about a week of switching primarily to wet low carb food with a bit of access to the previous dry food, I thought Smudges was on the right path. However, last night was a big setback and I'm pretty sure he went into hypo. He now has no interest in wet food anymore. I've purchase some different flavors and hope he will try some of them...it is very frustrating and heartbreaking for me. I hope to hear some good news for both of us!

    Hugs to you and Katya!
     
  9. Jenni

    Jenni Member

    Joined:
    Feb 21, 2015
    Thank you so much for your guidance! I can't tell you how much I appreciate it. If I could reach out and hug everyone on this site I surely would. I know I could use some. I feel like I'm on the edge of a meltdown....

    I would do anything for my furry kids and I feel like I'm just not qualified or equipped to handle this disease. I hope it get better but right now I'm just so stressed out. I'm afraid to leave my cats alone but I'm afraid that something will happen while I'm here and not know what to do...I adopted my kitties when they were kittens and I love them to death. I can't imagine life without them. After last night I was afraid to wake up and find Smudges convulsing or worse. Now the thought of going back to work on Monday and him having a seizure while I am gone is just unbearable.

    I decided to give him 1 unit of Lantus 1/2 hour after he ate tonight. Now I'm wondering if I should just quit the insulin and try the low carb food only while I attempt to do home testing starting tomorrow. I don't even know if I will be able to do it myself. Smudges is a pretty mellow fellow but does not like to be poked with a needle--who would? I've watched a number of videos on Youtube and most of those kitties just lay there unaffected. I'm single and don't have daily access to someone who can hold him for me while I test or give insulin. Smudges has a habit of wanting to get up and run away as soon as he feels the poke so getting him to sit still until a blood drop forms (assuming I can find the vein) may be a big problem. Not to mention, I just don't want to do it or feel comfortable with it. I'm the lady who has to leave the room if the vet is going to do anything that my cats/dogs won't like. I will do what I have to do for their sake but I feel like I'm going to start shaking just thinking about this! I know I just need to try to relax and be patient but that is easier said than done for me right now.

    I feel like I need to make a switch to another vet but I don't know what the best option is and I'm not sure what to do about any of this. Sorry for my rant--I am sure it must seem ridiculous and dramatic to some. I'm not coping with this very well right now.
     
  10. BJM

    BJM Well-Known Member

    Joined:
    Oct 6, 2010
    You may need to burrito wrap him so he can't evade you when its test or shot time. Just take a towel, lay it on the floor, put the cat in the center across the short width, then wrap the 2 ends around snugly so he can't get out.
    It may help to kneel over him so you've got your thighs able to slightly squeeze him in restraint.
    And always remember to give him a low carb treat afterward.
     
    manxcat419 likes this.
  11. Jenni

    Jenni Member

    Joined:
    Feb 21, 2015
    Thanks BJM. It has always amazed me how cats can contort their bodies in such a way to evade anything sharp or medicinal coming towards them. I suck at the kitty burrito will try it if necessary.
     
  12. manxcat419

    manxcat419 Well-Known Member

    Joined:
    Jan 14, 2015
    I agree - wrapping can help for some cats. Rosa, of course, is an awkward one and reacts much, much worse to being restrained than she does to the needle for testing. Now I have to add that she and her twin were feral as kittens (I adopted them at 4 months old, turned them into lap cats for the most part, and have never spent more than a few days away from them since) and have never taken well to any sort of medical intervention, but she really has surprised me with how easily she's taken to the treatment and testing with this. As long as I don't restrain her, she'll lay on my lap and let me test from either her ear or her paw pad. Some days she gets a little wriggly or growly when I'm having to do frequent testing, but she doesn't scratch, bite or make too much effort to get away. So it may be a case of trial and error to find out what Smudges is most comfortable with.

    You are so, so welcome to any help, support or information I can give you. Managing this condition for our cats is a very steep learning curve - it does seem overwhelming to begin with. But it will get better - even after just a few weeks, I can say that it does become more routing...still exhausting at times, and stressful when you're having to monitor for potentially dropping numbers, but not quite as terrifying every minute of the day.

    Once you can start home testing, you'll feel much more comfortable giving him the shots, knowing that you have the means to check on his numbers any time you're worried - and that you can make sure you're not shooting a number that's already fairly low until you have enough data to know for sure that it's safe. You could try switching to just low-carb food and then reintroducing the insulin at a lower starting dose to see what the food switch alone will do - I know other people have switched food before introducing insulin. However, if you choose to do this, I wouldn't give it too long to work - you don't want Smudges in high numbers for longer than is necessary. I was able to manage transitioning the food gradually and the 1 unit of Lantus twice daily with Rosa both at the same time, but that was because I was able to be home to keep a check on her numbers to make sure the combination wasn't going to take her numbers down too quickly. Again, opinions from others would be much appreciated on this.

    On the plus side with your vet, they have prescribed you one of the longer-lasting, gentler insulins. And the information they gave you, together with the starting dose, is similar to the experience that a number of us have had with our vets. It does seem as though information with a number of vets is lacking in detail and maybe out of date. But as long as the vet is prepared to work with you and will support you home testing and taking control of this yourself, the situation could be a lot worse.

    Please don't apologize for ranting or being upset - it's only a few weeks ago I made my first few posts during days that were filled with crying and wondering how I could possibly ever cope with all the information and all the things I was now meant to do to my precious cat to keep her well and safe. And because, I agree, we all need them :bighug::bighug::bighug::bighug::bighug: to you and Smudges.
     
  13. Jenni

    Jenni Member

    Joined:
    Feb 21, 2015
    I think I'd feel more comfortable backing off the Lantus while finding a low carb food he will eat. I'm confused as to why the vets tell ppl that 2 units/2x day is low even after considering a change to low carb food. The vet became angry with me when I asked about starting at a lower dose--Like how dare I question her instruction! She was also adamant about limiting meals to just twice a day right before the insulin.

    Because Nibbs will need low protein food for her kidneys and Smudges high protein/low carb for diabetes, I will have to separate them when I am not at home so they can each access their own food. That is going to be tough on them. I also want Smudges to be more confined so that he isn't climbing up/down steps all the time in his weakened condition. My hope is to feed them their own wet food diet in the a.m. and p.m and keep them separate while at work with each having a bit of their own kibble to get them through the long day.

    I hope this is the right thing to do.
     
  14. manxcat419

    manxcat419 Well-Known Member

    Joined:
    Jan 14, 2015
    I think if you're out of the house for extended periods each day, you have to do what you're comfortable with knowing that Smudges will be safe while you can't be home with him. Once you know the effect that switching to low carb food is having, then you'll feel more confident starting the Lantus, though quite possibly at a lower dose than the vet asked you to give him.

    Some vets don't like to be questioned. And of course, they see many different animals with different conditions every day. It's difficult for them to keep completely up to date with every possibility I'm sure. Not that that helps much when you feel you've been given wrong information - I was angry when I found out that I might well have overdosed Rosa with insulin if I'd gone with the 2 units twice daily she was prescribed to begin with. I have spoken to my vet since and while she isn't entirely happy with what I'm doing or the way I'm achieving it, it's pretty obvious when she looks at Rosa's spreadsheet that what I'm doing is working whether it's what they recommended or not. Data is going to be your friend when it comes to explaining to your vet why you've changed things - that and the ability to nod, smile and then go home and do what YOU need to do for Smudges when they tell you what THEY want you to do!
     
  15. Elizabeth and Bertie

    Elizabeth and Bertie Well-Known Member

    Joined:
    Sep 6, 2010
    Hi Jenni and extra-sweet Smudges, and welcome to FDMB,

    The symptoms you described (facial twitching following/accompanying ravenous appetite) do sound very much like hypoglycemia. All the available evidence was pointing that way. And you did absolutely the right thing to give Smudges some syrup. Well done!

    If he did have a hypo (and it seems highly likely) that will probably have made him feel a bit 'off'. That's understandable. It may also be that his blood glucose has now swung up very high as a response to his having had the hypo. And that can make a kitty feel off colour too. But these things are temporary and will pass.
    Kitties can be more sensitive to insulin following a hypo, so that is another reason to make sure the dose you give is low and as safe as possible.

    As others have said, the best way to keep Smudges safe from hypo is to hometest. This essentially involves pricking the outer edge of the kitty's ear to get a teensy blood droplet, transferring that to a test strip in a glucose meter, and waiting for the meter to count down and give the result.
    Some people - and their cats - take to hometesting like 'ducks to water'. Others find it more challenging and it takes a bit longer to get the hang of things. But the vast majority of cats can be hometested.
    My cat won't tolerate being restrained, so I decided to test him while he was eating some crumbled cat treats, and he barely notices the tests. (He actually jumps up onto my desk now and 'asks' to be tested!)

    The back leg weakness you're seeing may well be diabetic neuropathy. And giving methyl B12 (methylcobalamin) can help the nerve damage to heal faster. Cats can recover completely from neuropathy.
    Back leg weakness can also be caused - or exacerbated - by potassium deficiency, though. And that may be something that you'll want to get your vet to test for.

    My cat had very bad neuropathy at diagnosis. He had also lost a lot of weight, and his fur looked terrible. I honestly don't know how I didn't notice sooner that he was so ill. But it is not at all uncommon. Many people who post here feel guilty about not noticing the diabetes sooner. And I even remember a vet posting on this forum once and even she hadn't noticed her cat was ill...
    We get on with our day to day lives and don't always notice gradual changes. It's sometimes only when things reach a certain tipping point that we look at our cat and have that 'OMG!' moment.... So please, please, please don't feel badly about that....

    I also have cats with different health issues, including a foster cat with CRF. And, like April ('manxcat') I feed my diabetic and my CRF foster kitty the same food. I feed low carb wet food with the lowest phosphorous content I can find.
    I'm guessing you probably know about the 'Tanya' CRF site and support group, but just in case you don't the link to the main site is here:
    http://www.felinecrf.org/

    I know you feel overwhelmed right now. But it will get easier. And you are not alone. We are walking the path with you. :bighug:

    Big hug to you,

    Eliz
     
  16. Jenni

    Jenni Member

    Joined:
    Feb 21, 2015
    Thanks so much Eliz. I just got our first home test reading! I can't lie--it sucks big time! I had a friend hold him in place just to make sure he did not try to escape before I get the blood on the test strip. Smudges is mellow but likes to bolt after the needle prick. The hardest part was getting enough blood for the sample. I went through 4 test strips and even more lancets trying to get a usable sample. There just isn't a lot of blood that comes out. After a number of pokes in an ear and foot pad, I was finally able to get a good drop from the second ear. This was not easy and I feel horrible sticking him so many times. The friend (who handles stress way better than I do) was way more stressed than me or Smudges. Needless to say, I am on my own for this....

    So here is a recap:
    Added wet food to diet ~ 2 weeks ago
    2/15/15 - Started 2 units of Lantus 2x/day per vet's suggestion
    2/20/15 - 2 hours after dinner/2nd Lantus dose, vomited and exhibited signs of hypoglycemia. Fed again and gave a little Karo. Condition stabilized through the night.
    2/21/15 - A.M. - Refused to eat any wet food but ate his dry Hills C/D. Gave 2 units of Lantus. Continued eating dry food only throughout the day.
    P.M. - Added some Evo Cat & Kitten dry to C/D and a bit of wet food to start the switch from C/D. He is still not very interested in wet food but will eat a bit if
    kibble is mixed with it. Decided to reduced Lantus to 1.0 unit.
    2/22/15 - A.M. - Fed kibble at 6:30 a.m.
    - 1st home test BG reading at 10:30 a.m. - 324
     
  17. Jenni

    Jenni Member

    Joined:
    Feb 21, 2015
    Oops, didn't mean to post that yet.

    Gave 1.0 unit of Lantus after home test and eating a small meal.

    So....I have many thoughts running through my head.

    - How often should I test him today?
    - I do have to work all day during the week and will be unable to monitor him until evening. I've decided to reduced his dose to 1.0 unit 2x/day although this is less than what the vet suggested. I'm just not comfortable with what happened Friday night and the possibility of hypo. Is this the right thing to do?
    - Do I keep the appointment on Friday for a curve test? I understand it can provide some good information but that is only a snapshot of one day while in a stressful environment at the clinic.
    - Do I keep him at 1 unit for awhile to see how it goes? I'm not a vet and have no idea how to regulate insulin. At what point do I make a determination that he needs more or less? What are the magic BG numbers to watch for?
    - What do I do going forward--today? This week?
     
  18. manxcat419

    manxcat419 Well-Known Member

    Joined:
    Jan 14, 2015
    Congratulations on your first successful test. :D It does get easier - I promise. And Smudges will get used to it too.

    If you can, I would try to get at test at +2 hours after his shot. That can give you a good indication of what direction he's likely to go on this cycle. If you can post his number when you get it, that makes it easier to decide when you'll need to test again.

    There are 2 main protocols for using Lantus - the links for them are here:-
    http://www.felinediabetes.com/FDMB/threads/lantus-levemir-start-low-go-slow-method-slgs.129446/
    http://www.felinediabetes.com/FDMB/threads/lantus-levemir-tight-regulation-protocol.1581/
    It's probably best if you can decide which of the 2 you're going to be able to use - the method determines how you calculate the dosage and work out increases/decreases.

    Personally, yes - it does seem as though he was hypo on Friday night. The symptoms suggested it to me, and Eliz has confirmed that she thinks it was likely too. So I don't think leaving him on the dose that caused that when you can't be home to monitor during the day would be a good idea.

    The curve test at the vet shouldn't be necessary once you're home-testing. A lot of vets still want to do them at least the first few times (mine did) but I refused and ran a curve for Rosa at home and sent them the results. Rosa gets severe vet stress and I don't think any test they do is going to give me meaningful data. However, that's not to say that you can't have them do it if you're not confident testing him by then (but you very probably will be).

    When you get a chance, if you can set up a spreadsheet for Smudges' numbers, that will help you to see his patterns as they start to form and will also help people helping you to see at a glance how he tends to react to insulin, food etc. There are instructions for how to do that here http://www.felinediabetes.com/FDMB/...te-a-ss-and-link-it-in-your-signature.130337/ though until you can do that, if you can keep us informed of his numbers as you get tests that will also help a lot.
     
  19. Jenni

    Jenni Member

    Joined:
    Feb 21, 2015
    Holy cow! I just got a reading by myself! Woohoo--happy dance! However, the reading hasn't changed much since the first. I have a spreadsheet set up but can't get it to link in my signature. I will keep working on that now. Here are today's results so far:

    10:30 a.m. - 324
    1:10 p.m. - 326

    I will try again in 2 hours. I am concerning about poking his ear so often. After the first attempts this a.m. there are some little circles of blood pooled under the skin where I poked him. Is this normal? Do I poke the same area?
     
  20. manxcat419

    manxcat419 Well-Known Member

    Joined:
    Jan 14, 2015
    Look at you go on the testing!! :D Don't be too surprised if it's a bit hit and miss for a day or so - for a few days, I'd sometimes get a reading but sometimes have to come back and try again 20 minutes later. So don't be discouraged if an occasional test fails - just give him a break to calm down and try again. We don't usually go for more than 3 attempts before giving them a break for 20 minutes or so. While his numbers are in the 300s it gives you a good chance to learn testing without it being vital that he's tested 'right now' like it would be if his numbers were in the low area.

    I'd have said that's completely normal at this point - he could well be bouncing from his probable hypo on Friday night. That can last up to 3 days and you will see higher numbers while that happens. Testing is still important though so you can see when he's getting over the bounce - you just won't have to test quite as often while his numbers are high and flat like that. You should be fine to wait until +5 or +6 for the next test.

    Are you applying just a little pressure to the place you've poked after you get the blood sample? If you can do that, that makes it stop bleeding quickly and helps to stop it getting bruised. I have noticed tiny red marks on Rosa's ears now and then when I've been doing a lot of tests but they heal up really quickly and don't seem to bother them. The other thing you might want to do is use a little Neosporin ointment with pain relief just before you do the poke (only a tiny dab). That helps the blood to pool up instead of soaking into his fur and also makes it more comfortable for him. Plus it helps any sore spots heal quickly.

    I alternate between ear testing and paw pad testing on Rosa, but that's because she's getting a lot of tests at the moment - she's decided to do another dash down the dosing scale the last couple of days - so I'm trying not to make any one area too tender for her. She was just fine with ear testing every couple of hours when I was only doing that, but once it got to every 20-30 minutes a few cycles in a row, I figured I'd try and give her ears a break at least some of the time. You are going to end up poking the same area - you could try alternating ears if he'll let you as well to give the ear you've already tested this morning a break. You'll find his ears will learn to bleed for you fairly quickly - I was able to switch to the thinner lancets for ear testing on Rosa after only a couple of weeks, though the bigger ones are still the only ones that work on her paw pads.

    It's great that you have a spreadsheet set up for Smudges already. Let me know if you're having any problems with the instructions for linking it - I only did mine a few weeks ago so I should be able to work out how I did it!
     
  21. Jenni

    Jenni Member

    Joined:
    Feb 21, 2015
    Testing to see if the spreadsheet link works
     
  22. Jenni

    Jenni Member

    Joined:
    Feb 21, 2015
    I can't get my spreadsheet to publish correctly. I do not get the option below in Google Docs

    7. A link will be provided; before you copy this link, scroll down and click on "published content and settings". Be sure the box next to "Automatically republish when changes are made" is checked.
     
  23. manxcat419

    manxcat419 Well-Known Member

    Joined:
    Jan 14, 2015
    If you click on the 'File' tab at the top of the spreadsheet, do you get a 'Publish to web' option in the drop down? If you do, then you can use that. Make sure you use the 'Link' option, publish the entire document and again, check 'Automatically republish when changes are made'
     
  24. Jenni

    Jenni Member

    Joined:
    Feb 21, 2015
    It says that I have published to web but I still do not get an option to "automatically republish when changes are made." Here's what my screen looks like.
    upload_2015-2-22_14-9-51.png

    Also, when I add my signature and edit as instructed it looks like this.
    https://docs.google.com/spreadsheets/d/1WavmJDiU4YEeRfAkLUU1qDQ_7ezj1FCo4kET4h4oZhQ/edit?usp=sharing]Smudges' Spreadsheet

    However, once I save the changes it takes off the first part of the link. When I go back into the signature it looks like this:
    https://docs.google.com/spreadsheet..._7ezj1FCo4kET4h4oZhQ/edit?usp=sharing]Smudges' Spreadsheet

    For some reason, it will not keep the "[url=" and I'm assuming this has something to do with it not displaying properly.

    What am I doing wrong here?

    Also, found out that Smudges' weight was only 11.56 on 2/13/15. Previous weight was 14.56 on 10/14/14. That is a remarkable decrease!
     
  25. manxcat419

    manxcat419 Well-Known Member

    Joined:
    Jan 14, 2015
    I wonder if you might need to share it as well - again in the 'File' drop down. If you choose the option that anyone with the link can view, that might work. I'm not sure why it's not working - it looks as though you've done exactly what I did but for some reason you're not getting the option to republish when changes are made.

    That is a big drop in weight for Smudges! Based on that, I'd have said 1 unit twice daily is definitely a better starting dose for him than 2! He'll gain it back quickly once his BG is under control though - Rosa was just about back to her normal weight in a month.
     
  26. Jenni

    Jenni Member

    Joined:
    Feb 21, 2015
    I have it shared as follows:

    upload_2015-2-22_14-25-25.png

    Not sure what is going on.
     
  27. Jenni

    Jenni Member

    Joined:
    Feb 21, 2015
    I so appreciate your time and patience with me. Getting the spreadsheet to share should be the easiest part of this whole ordeal :)
     
  28. manxcat419

    manxcat419 Well-Known Member

    Joined:
    Jan 14, 2015
    OK, that is weird. Have you tried taking the link out of your signature and adding it back in - that's the only other thing I can think of in case it just didn't publish right the first time.
     
  29. manxcat419

    manxcat419 Well-Known Member

    Joined:
    Jan 14, 2015
    Oh, wait - I've got it. For some reason, it's just not linking right on your signature. If you change the link to this (just taking out the last bit that says 'edit?usp=sharing]Smudges' Spreadsheet') then it works https://docs.google.com/spreadsheet...U1qDQ_7ezj1FCo4kET4h4oZhQ/edit#gid=1654299363 It looks as though somehow it's got the name and the url and the sharing all mixed up when you've added the link.

    Only problem with that is, it looks like it just gave me edit access using that link which you don't want anyone else to have. I'd try removing it from your signature and re-linking it first - you only really want other people to be able to view, not change anything!!
     
  30. Jenni

    Jenni Member

    Joined:
    Feb 21, 2015
    Oh my gosh, I hope this works now.
     
  31. Jenni

    Jenni Member

    Joined:
    Feb 21, 2015
    By golly, I think I've got it and ppl should only be able to view and not edit. Can you let me know if you can see it now? lol
     
  32. manxcat419

    manxcat419 Well-Known Member

    Joined:
    Jan 14, 2015
    You've got it - working perfectly now :) Well done! :D
     
  33. Jenni

    Jenni Member

    Joined:
    Feb 21, 2015
    Oh April, thank you. A spreadsheet problem is bound to send me over the edge right now...lol.

    So Smudges appears to be feeling good today. Was sleeping comfortably until I poked his ear. I will be doing another test in ~ 2 hours. Hopefully, his number comes down. At what number does he need to be at that should PREVENT me from giving him a shot later this evening? I'm concerned about being off our 12-hour schedule now also. I gave him a shot at 10:30 this a.m. but because I work during the week his normal schedule would be 6:30 a.m./p.m. I was thinking of splitting the difference and giving it at ~ 8:30 pm tonight and then back to the 6:30 schedule at this lower dose of 1 unit. Does that sound okay?
     
  34. manxcat419

    manxcat419 Well-Known Member

    Joined:
    Jan 14, 2015
    You're welcome :) I'm not sure how much help I really was with that - it looked like you fixed it yourself! :) And yes, the smallest things can be too much when you're trying to take in so much new information.

    It's great that Smudges is feeling good - it's very easy to get caught up in the numbers game, but Smudges is more than a number on a test meter - how he's feeling in himself is also important.

    For people new to giving Lantus, the usual cut-off point would be a reading below 200 until you have enough data to know you can shoot lower. If you get a number you're not sure about, posting in the Lantus/Levemir sub-forum will make sure people look at your question. If someone advises you to go ahead and shoot at a lower number than you're sure about, then they will stay with you or arrange for someone else to stay with you until you're sure Smudges is safe. You'll see a lot of us shooting numbers under 100 on our spreadsheets - I've only recently started doing that with Rosa, but that's because we have enough data to know we can do it and because we've already handled low numbers at least once and are confident that we can bring our cats back up if those low numbers do happen.

    Lantus really likes consistency and is best given at 12 hour intervals. If you need to move a shot time, generally it's only meant to be by 30 minutes a day (or 15 minutes per shot). If you give doses 10 hours apart to get back on schedule, then that might act as a slight dose increase which you may not want at this point.

    I think the options you have are probably to either shoot a very small, token dose tonight at 10:30 so there isn't a lot of insulin in his system still bringing him lower by the time you need to give his shot tomorrow morning. Or to skip the shot tonight and get him back on schedule in the morning. I'm not sure what the best course of action would be in this instance as you don't have a lot of data to work with just yet with Smudges only being recently diagnosed. You should always err on the side of caution though and that makes me think it might be more comfortable for you to skip tonight's shot, get a good night's sleep without having to worry about him and get back on schedule in the morning. I'd appreciate other opinions on that too though - if you can maybe post the question over in Lantus/Levemir to see what other people with more experience think about the options too. :)
     
  35. Deb & Wink

    Deb & Wink Well-Known Member

    Joined:
    Jan 31, 2013
    Please, do not let your fear of "what might happen" rule your days and nights. We can get so worried by what might happen, that we fail to appreciate what we do have, our intense love for our kitties. You would not be here if you did not have that intense love and wanted to try your best for your Smudges.

    I say this because I had a cat with severe heart disease and was told by the vet that I could lose her at any time. Instead of going to bed each night, worrying about what might happen, I poured my love into each day and let the nights take care of themselves. Yes, it was stressful. Yes, I thought I would have a meltdown. Yes, I did get through this difficult time and gave my civie Libby all the love and the best care I possibly could. I got the best smothering snuggles back from Libby in return.

    Hold onto those positive moments. Cherish them. Think positive thoughts for just 5 minutes at a time. Then positive thoughts for another 5 minutes, another 5 minutes.....

    Pretty soon, you will feel you have a better handle on this sugardance you are doing with Smudges and you will gain confidence. We will help you all we can.

    {{{{{Hugs}}}}}
     
    Critter Mom and manxcat419 like this.
  36. Jenni

    Jenni Member

    Joined:
    Feb 21, 2015
    Oh my goodness Deb you brought me to tears. Thank you so much for the kind words of advice. I've been doing a lot of crying and worrying. I can't really help myself. I just love my furry kids so much I can't imagine life without them. I will do what I have to to ensure his safety and well being but I am scared to death about this disease.
     
  37. Deb & Wink

    Deb & Wink Well-Known Member

    Joined:
    Jan 31, 2013
    Didn't mean to make you cry. Just wanted to let you know we all have those fears about our cats.

    Hang in there. It took time for Smudges to develop diabetes. It will take time to get Smudges better regulated and acting like his old self again.

    Look for those little signs of improvement. Playing a bit more. Giving himself a bath. Being more spritely.

    We have something here called the WCR or Whole Cat Report. It's a combination of the 5 P's (peeing, pooping, preening, purring, playing) and your cats appetite. It's a great way to help you see how your kitty is doing.

    It does get easier and less scary. It will take time for you to gain the confidence you need to help Smudges feel better but you will get there.

    A little over two years ago, I brought home a very sickly Wink from the local shelter. He had severe diabetic neuropathy, ragging diarrhea, huge nickel sized flakes of dandruff from the dry skin, uncontrolled high blood glucose levels, he had lost half his fur, dull lifeless coat, he couldn't jump, wouldn't play. You would not recognize him today as the same kitty, jumping everywhere, chasing the other cats around my home, gorgeous shiny silky full fur.

    Smudges will get there too.
     
  38. Jenni

    Jenni Member

    Joined:
    Feb 21, 2015
    I am so happy to hear that your kitty Wink is doing great today. I'm sure we will get there I just want it to be now.:( it's funny because Smydges used to jump on the kitchen countertops all the time and it drove me crazy. He hasn't done that for a couple of months and it didn't dawn on me until the diagnosis that he even stopped doing it. What drove me crazy I would now love to see. He is the only kitty I've had who does what I call "nesting" in my hair. He loves to just bury his face in it and I am the type of person who will totally be uncomfortable in order to make my kitties happy. I can't tell you how much sleep I've lost because there is a cat attached to my head but it's so darn cute and sweet I just can't deny him, at least not too often anyway.
     
  39. BJM

    BJM Well-Known Member

    Joined:
    Oct 6, 2010
    See my signature link Glucometer Notes for cat-specific reference ranges using various meter types and measurement units.
    And see Secondary Monitoring Tools for additional assessments you may wish to make.
     
  40. Deb & Wink

    Deb & Wink Well-Known Member

    Joined:
    Jan 31, 2013
    One of our sayings here is that learning to take care of your diabetic cat is a process. You may take a couple of steps forward in this sugardance and then a half step back. It's not always forward momentum as you go along in treating this disease. Your kitty is leading the dance and you are following along the best you can.

    It can be easy to get discouraged but over time you will see those small improvements in your kitty. Looking forward to hearing that Smudges is jumping up on the counters again.

    You've got the great help of all those people on the Lantus/Levimir forum to assist you in your new journey. Great group of people.
     
  41. Jenni

    Jenni Member

    Joined:
    Feb 21, 2015
    Just got another BG test result. Smudges has decided that he does not want to tolerate me poking him multiple times a day. Deep breaths not working right now :-(
     
  42. Critter Mom

    Critter Mom Well-Known Member

    Joined:
    Jun 16, 2014
    Wish I'd seen the above earlier. Here are a few (somewhat belated) :bighug::bighug::bighug:.

    It is scary at first, but as you learn more and develop a routine that works for you and Smudges, it does get easier. Promise. :)

    Are you giving treats after the tests? Treats are great bri... erm ... 'persuaders'. ;) Things like freeze-dried chicken are diabetic-friendly.
     
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