? Newly diagnosed - Just started testing

My kitty, Teddy is recovering from an insulin overdose. (see other thread in the main forum) He was at the hospital for a few days. This is his first morning home. I worried about him all night, concerned that he would get too low. I tested him today but after he ate, maybe around 15 minutes or so. His BG is 241. I'm supposed to give him .5 unit of insulin this morning but not sure if I should with that BG. Also, after I give it, I have to go to work so Im nervous abut him getting low when Im at work. I have a camera on him but he moves around some so I can't always see him. Should I give him his dose?

 

I think you are safe to give the insulin now as even if there was food spike he's in very safe territory. I would get a +1 and +2 but see you need to leave. How soon? That might change things. Your new time will be 12 hours from when you shoot. I just saw your post in the main forum but didn't read it all yet. I will now. I'm glad he is home.

 

Thank you. I have to go to work and I will not be here to give him a +1 or +2. I would love to stay home but I have a vital meeting today.

 

I don't see a ss and after a hypo they can be very sensitive to insulin. If he were mine I would skip.

 

Sorry, what is a "SS"?

 

Oh! Spread sheet. Yes, I will need to start it today. He was just diagnosed about 1.5 or 2 weeks ago. He has really been through a mess. The Hypo part of it this week, was my fault. He's been at the hospital more often then home in the last two weeks. I can skip the dose, if you think its correct. He has CHF, so I am really trying to keep his BG as normal as possible.

 

I'm going to tag a few people to see what they think. I'm worried about a shoot and leave.

@Doodles & Karen @Marje and Gracie @Chris & China @Sienne and Gabby (GA)

 

If you can't monitor this morning Cheryl, than I would skip considering the last few days events.

 

Here is Cheryl & Teddy's original post. http://www.felinediabetes.com/FDMB/...-giving-injections.162966/page-2#post-1754077

 

OK. I feel the same. I'll wait until tonight till his next dose. He's supposed to take .5 every 12 hours.
He looks good this morning and I don't want him to get low when Im not here. Thank you.

 

I'm glad you agree Karen. I didn't want to advise without backup.

 

When you start gathering data on Teddy there's a good chance you can shoot on these types of days but until then...better to high then too low even for a minute. Let us know if you need help setting up the SS - spreadsheet. Glad Teddy seems to be feeling good today.

 

Thank you. I will set it up after work. Sad I have to leave him for a few hours.

 

Normally, I would have recommended shooting "some" insulin but I don't like to make those recommendations without a spreadsheet.

If you need any help with it, I can and would be happy to do it for you. It will take me absolutely no time at all. If you would like me to do it, please send me a private message by clicking on "Marje and Gracie" under Gracie's photo to the left and then "start a conversation".

Welcome to L/L Land!!,

 

Cheryl,

I see you skipped this morning, considering what happened I would have done the same. If your worried about possible lows while you work or have to go out. Look into an automatic feeder. Some can take dry or wet food. This way he can eat at key times to keep him safe.

If your home over the weekend, a few extra tests might be in order to see when the insulin kicks in, has it's lowest point (nadir), and how long the dose lasts. This way you will have an idea of when mini meals might be necessary.

 

Except those numbers vary for many of us, especially the nadir. Still the more data you get, the easier it will be to dose and help advise.

 

Question about the feeding. My vet has said he can "free feed". He is a grazer and I have two cats so I was very happy about that. He usually eats a few bites walks away then comes back for more a little while later, etc. Do you think this is bad for him? Last night he ate 3 different times during the night. I was pretty happy about it since he wasn't very interested after the first snack when he got home, then ate well after midnight.

I have a camera on him so I can see him live and he looks pretty good. I have learned the way he lays is a good indicator of how he feels. I have an appointment so I'm going to try and stop to see him for 10-15 minutes around 3:30 PM PST. I may not be home until around 7:30 but my husband can feed him and look after him until around 5:30. If I can get out of my last appointment, I could be home sooner - not that hopeful.

 

Is the food you are leaving out dry? If so, is there any chance you can transition your cats to eating all wet? It is much better for all cats to eat wet, but for diabetics it's really important. Even a supposedly "low carb" dry has too many carbs and is overall not good for an FD kitty. Timed feeders like this one (more than one, since you have more than one cat) would help to keep the food fresher for all day distribution. If you want to transition your cats, we can help you with tips on doing it.

It's not a bad thing to let them free feed, but to get a really accurate BG reading before giving insulin, it's best to withhold food for two hours before shot time. Many people here feed most of the food in the first half of the cycle (12 hours between insulin doses) because when they eat after their nadir (lowest point), it can take the numbers higher as the effect of the insulin is waning.

To help you understand some of the terms we use around here, we have a "dictionary".

Ask lots of questions. We love to help! Welcome to Lantus & Levemir Land, the nicest place you never wanted to be!

 

Grazing is fine....except you want to take all the food up for the 2 hours immediately before shot times so the Pre-shot test isn't influenced by food

 

Thank you!

So today, I didn't give Teddy his morning dose. He looked good all day (I have a love camera while Im working). Then to night I got home - he was walking around and looking great, really like his old self. I tested him and he was 298. We took up his food two hours earlier. Then I gave him the .5 lantus, and he ate some. He now looks tired and weak. Not really sick looking but way less vim and vigor than he had.

 

A lot of people report that when they first start insulin, their cats seem a little "off"...not really sick, just less active and sleeping more

It would really help if you'd start charting your test results on our spreadsheet....it's a very valuable tool here and it really helps to look for the "patterns" we look for to see how the cat is responding.

Here are the Instructions on getting the FDMB spreadsheet ...but if you have any problems with it, feel free to contact me by private message...just click on my name and choose "start conversation"...it's really no trouble to set it up for you and only takes about 30 seconds

298 is too high...it's not horrible, but it's above renal threshold so it's putting added strain on his kidneys

 

Hi Tricia,
Teddy has only eaten wet food for a long time. He was on a prescription diet of DD Duck for most of hie life. Thank you for the dictionary. I think I need to do some reading!

 

So during the night, Teddy threw up an actual hairball (not an asthma attack like usual), then I heard him throwing up a little later but found nothing. He went and "hid" under the table the rest of the night. I tested him this morning and he is 292. He will not eat his heart meds or his regular food. I got him to eat a little tuna juice and a few bites of tuna, but Im not sure if thats enough to give him his insulin. I need to give to pretty soon or it messes up his schedule. Should I give it?

 

Only if you can monitor closely...getting a few mid cycle tests. I get concerned when a heart kitty is not eating. Are you home to try and give him food over the next few hours?

 

Yes, I will be home. I also worry about the heart issues and possible kidney issues starting up. I'll give it now. When should I test him again?

BTW, he still hates the ear pricks and fights me even when he doesn't feel good. He starts meowing very loudly bites me and gets very stressed.

 

I would get a +2 test. If it's lower than the AMPS it could mean an active cycle and you would want to monitor closely. The ear pokes will get better it's hard at first. Before long it will just be routine. Offering a treat like freeze dried chicken after each one seems to help. Doodles gets cranky with the ear pokes especially when he's in high numbers and he's well trained after 15 months of this nonsense

I'm in the same boat. Sending lots of vines and prayers that he's just having an off moment.

 

Because they had to give Teddy fluids after the Hypo, I have been on the alert. Im hoping he just has an upset tummy.

How many time has Doodles been tapped? Teddy has been tapped 6 or 7 times.

 

Is there anything I can give him in case he has an upset tummy? I have Mirtazapine, should I give that?

 

None thankfully. He was fast tracked to 30mg Lasix twice a day. The HCM is progressing and his heart is getting bigger.

I'm not familiar with that. If you've used it in the past and worked it should be OK.

ETA: @tiffmaxee do you have any opinion/knowledge that could help?

 

Mirtazapine is an appetite stimulant that his vet gave me.

 

Hopefully he is a little off still. I was typing when the above came out. I was going to ask I'd you had cerenia or zofran in case he was nausea. I have read mirtz can have hyper symptoms.

 

I don't have either of those things for Nausea. I can call and ask his vet if she will prescribe. I don't know if she will without bringing him in. I may need to do that if he doesn't start eating but he's been in the vet hospital so much that I only want to stress him out again if he needs to go in.

 

I'm thinking I'm going to syringe his heart meds. He really needs those.

 

Probably a good idea. You might want to syringe a little food too.

 

Has he eaten since being home without the mirt? Have you tried some tuna juice on a little of his food or mix tuna with his regular food and see if he eats.

 

Yes, he has been eating before this morning. He had some tuna juice and a couple of bites of tuna first thing today and I tried again just now. He did the same. Ate all the juice and just a nibble or two of the tuna. At least thats two nibble sessions this morning.

 

I would try mixing the tuna with just a little of regular food to see if he will start eating it. And then transition the tuna out.

 

So I tested Teddy at 10:15 and his number is 76. He still doesn't want to eat other than the nibbles and he is drinking water. Should I syringe him some baby food?

 

Your SS isn't up to date. How many hours is it after your shot time that you tested and got the 76? Has Teddy been eating at all since shot time?

 

Sorry, I just added it. He had 292 at 8AM and then 76 at 10:15. He is only eaten some nibbles. He drank the tuna juice and he nibble the tuna little on 3 separate occasions. Not really eating.

 

Tried all his favs, tuna with juice he drinks the juice, baby food, his new low carb hi protein Purina, which he really likes. He doesn't want to eat.

 

You need to be ready to syringe some honey or karo..that's a huge drop.

 

Please test again in 30 min. and post.

 

Can I give him some karo now?

 

Hes not loving the force feeding.

 

Can you syringe some regular LC along with the karo? He's getting too low. You're going to need to keep testing him.

 

It's either you keep him up or you'll have to bring him to the ER if he keeps dropping. Based on that +2 it's very possible he will get into too low territory unless you keep propping him up.

 

I see you were answered.

 

what is LC?

 

Just a little at a time, you don't want him to vomit.

 

But I'm also 1/2 a sleep. Can you help too?

 

Will he eat off your fingers?

 

LC. Like carb. Probably his regular food.

 

I gave him a little karo in a syringe. He likes the taste. He doesn't seem to be interested in food at all. I will keep trying. We got a little baby food in him with the syringe. about 1.5-2 cc

 

Do you have pure maple syrup in the house

 

Ok that's good...please test in 30 min.

 

Cheryl. Can you take a picture of the syringe your using with the plunger pulled back to the dose your giving and post it here.

 

I borrowed some Fancy Feast from a neighbor and he ate some! Not the whole thing but a nice amount. Maybe 1-2 tablespoons.

And. Yes. I will send the pic of the syringe. Its such a small amount that you can barely see any insulin.

 

Glad he ate. Don't over feed and still retest 30 minutes after last one and post.

Don't need insulin in the syringe. Just a picture, you can even use a used one for a pic.

 

That's big relief! Can you borrow a few more cans? Some cats won't eat left overs but will eat more from a fresh can...it's a just in case.

 

Or can your neighbor run out and get you a few cans of pate and the fancy feast gravy lovers one? You can't leave Teddy yet.

 

Im trying to figure out how much he ate since there seems to be a lot left on the plate. I think he may have done the separating trick (like kids do). He did eat some but not as much as I thought. Still, I'm encouraged. How do I upload my pic? I don't see the button.

 

OK, try this for the pics. And, he is eating more!

 

I had a cat that responded differently than expected to mirtazepine, became very lethargic and had the opposite effect it's supposed to have. Just sharing ECID...
You are in good hands for help...

 

Do you have another reading on him?

 

He just ate enough to be considered a meal!! Not a huge meal, but a meal. Do I test him now? Or wait 1/2 hour?

 

Ok, all good stuff. Can you get another test to see where he is?

 

Test now.

 

I know this is a pain, but when you see a drop in numbers and don't have a lot of data, you really need to test every 20 or so minutes. You don't want your cat to drop into way low numbers. The 76 was 2 hours after you shot. The lowest point in the cycle with Lantus is somewhere around +6. What's your latest set of numbers? I don't see any info on your more recent test results.

You might want to review this post on Shooting & Handling Low Numbers.

If your cat isn't eating well, have you tried the mirtazepine?

 

I pricked him twice with plenty of blood but the machine is not working. Its happened to me a few times with this machine. It never happened with my human machine, but i don't have strips for that one.

 

Can your neighbor or someone go get some strips for the human meter? In the meantime try again with the AT please

 

OK, 5th try poor guy. its 152

 

With the AT the ports to get blood are on the side of the strip. You have to get the port on the side of the blood drop. Not the top of drop. Very very slightly tip the port up. You can not use both ports on a test. Only one port.

I learned the hard way. If you try to use both at same time it won't work.

 

You have GOT to get a working meter. Get strips or, like Karen suggested, see if a friend can pick some up for you. Home testing is the best way to keep your kitty safe.

The 152 is a safe number. How about getting a test in an hour to make sure that this isn't a number resulting from stress?

 

That's good. No more syrup or food and test in an hour. If he is still up, can you get to the store?

 

Thank you for the AT port info. I think you are right I may have been doing the tip instead of then side. I'm not leaving him so I'll test again in an hour. He is now so upset with me that he wont stay with me. He's hiding under the table again. I feel terrible since he hates it so much but it better than a vet visit. He really hates that. They call him "spirited" and fractious". Basically he bites growls and scratches as if his life depending on it.

 

I borrowed two more cans of the fancy feast he liked. I'll see if I can reach my hubby to get him more food/strips.

 

The AT strips are much more expensive than strips for a human meter. Most of us use a human meter.

I'd give Teddy some treats and lots of praise. He's been a very good kitty!

 

Ok good, so relieved. Please test hourly for the next few hours. I'm going to have to nap soon was up all night with Doodles. If it were me I'd reduce Teddy's dose tonight to .25 units which is eyeballing 1/2 way between the first line and the .5 line you shot this morning. I believe he is super sensitive to the insulin after his overdose which is common.

@Sienne and Gabby (GA) what do you think. Can you check on Teddy for the next few hours along with @Woodsywife ?

 

He has been a trooper. I cannot tell you how much we both appreciate your help. I will test him every hour and give him 1/2 dose (.25).
So you think its because he's sensitive to the insulin or its because he didn't eat before and after his dose? I would not have know any of this without you all. am still concerned since I don't yet know why he didnt want to eat.

 

It's hard to tell if it was because of the lack of food or the sensitivity. Personally it's probably a combination but that was a huge drop. If his appy doesn't pick up it might just be best to skip and figure out why he's not eating. Why don't you post later before shooting and yes please test him every hour for now. You now know how to bring him up should need it. Testing is the only way to make sure he's safe

 

The AT strips are much more expensive than strips for a human meter. Most of us use a human meter.

My vet bills since he was diagnosed with first Asthma, then HCM and CHF with a collapsed lung and now the diabetes with the overdose, have been astonishing. He goes to a specialty hospital and it is very pricey. He is worth it. I will most likely switch to the human ones since the strips are very expensive, but the strips seem like a small price at the moment. My husband may not agree, but I love my boy.

 

Yes, excellent advice. If I hadn't been testing, I wouldn't even have known he was in trouble. So grateful!

 

Ok anything over 68 on AT is considered a safe number. If he starts trending down again try to intervene with LC food. We usually don't give karo or H C gravy until they drop below the 68. BUT with Teddy's overdose, not eating and you being very new it was very wise what you did at that 76 reading. I'm signing off for a nap. If you get into trouble do what you did and test. There is also a 911 button on the right side of the title bar. You can select that by editing the title which will grab everyones eyes.

Are you ok and understand?

 

Give me a couple of minutes and I will get back to you shopping list. I got to feed my gang.

 

Yes. I am good. Thank you!!!

 

First you did very well. After Smokey would drop like that chocolate for me was mandatory.

Here are some things you need to keep on hand at least until Teddy is back to him self. It's good to have a few options available at all times.

Food:
Fancy feast classic pate (or any brand you think he will eat) Different flavors even one or two cans of fish or seafood flavors.

Fancy Feast gravy lovers flavor, only 2 or 3 cans. You squeeze the gravy out and give that instead of karo. If kitties go below 68 on AT meter is when you go to karo.

Syrup:

Karo, honey, pure maple syrup. If he won't take one he might take another. He needs the options when he is low.

Strips:

Teddy is very unpredictable right now. You are going to need lots of strips in house.

Minimum of 200. When you open the last box. You get another the very next day. Human meter strips you can buy in store. And much more affordable.

AT you can't buy in store. If that will be your primary meter you need to keep 400 on hand.

I always got mine here and normally received in 2 days.

https://www.countrysidepet.com/coll...phatrak-2-blood-glucose-test-strips-50-strips

My vet charged $70 for one bottle of 50 strips. He could go through a bottle in 2 days time.

If you go human meter route. The Wal-Mart relion micro or confirm are easy and use the same size drop of blood as the AT. And no coding is necessary. The difference between the 2 is the low number. AT is 68 and you start steering with food to get them higher. Human meter is 50. It's easier to go by the color of ranges. When green you start monitoring closely and steer with food. Regardless of which meter you use. Low is low no matter what.

Again good job relax a little have some chocolate. I'm here rest of day. Post your tests I will keep checking. To tag so I get an email notification. Type @woods........... a box will pop up with my name, click if and it should populate.

 

Thank you so much! Teddy just forgave me and joined me on the couch. He then had a terrible dry heave. He must be very nauseous. He clearly doesn't feel well but at least I know its not his blood sugar.

@Woodsywife

 

I called his vet to see if they would give him an anti nausea medicine but both of his doctors are out and they won't prescribe unless he comes in. I don't want to take him in to a new doctor unless it was an emergency. I guess i'll wait it out.

 

He is probably a bit full from the karo. I can't give that to Smokey, it will make him sick. So honey and maple syrup is what I use. Being that 76 was so fast after shot and his history intervention was needed. When I have to resort to syrup. I give food (only what fits on a butter knife with 1-2 drops of syrup on it. That way he starts getting food carbs in him and not over feed or over sugar them up.

 

I just tested Teddy again and he's at 214. Still nauseous. He hasn't had any food since the last poke.

 

Now that things have calmed down a bit, I'd encourage you to take a few deep breaths and while you're munching on some chocolate (or sipping on an adult beverage), take some time to read the sticky notes at the top of the Board. There's an overwhelming amount of information in those notes but after several days, much of that information will become second nature. In addition, this is an incredible community of people who are more than willing to help.

The more data you collect, the easier it will be to understand how Teddy responds to insulin. You've been doing a great job. I suspect that Teddy is beginning to understand that despite the poking, what you're doing is helping him to feel better.

It is very hard to know if Teddy is sensitive to insulin due to the previously low numbers. If he's not eating, the drop in numbers could be due to that, as well.

If he's nauseous and the vet won't do any thing, one option is to try Pepsid. You can get Pepsid (famotidine) at any drug store. You would give 2.5mg (1/4 of a 10 mg tablet). You want plain Pepsid. It's not ideal for nausea but it's OK for an upset stomach. It can be very hard to get a nauseated cat to eat.

 

Much appreciated! I need to understand this process. I will take your advise on the adult beverage tonight.
The vet used to give Teddy famotidine when he would take antibiotics. If he stays queasy, I'll give that a shot.

 

You might want to give a pepcid now if you have it. It's best if given 2 hrs after eating or 1 hr before but not close to a meal. You want him to start feeling better before his shot time and meal. Remember no food 2 hrs before next dose.

 

That's okay, he's full. He doesn't need to eat every hour. You don't need to poke now until next shot time. Test 30 minutes before and post. If he isn't eating well then maybe a less dose might be in order. Will have to wait and see.

When is next test?

 

Next test is 7:30 PM PST.

 

Test at 7 don't feed and post. It gives us a little time to figure out best plan.

 

I have a quick work appointment later tonight. I should be home by 7, but it could be a little after.

 

I'm glad to hear Teddy has forgiven you. They always do, we promise. Hope he feels better soon and continues to eat. Watch the dry heaving, for Doodles it was actually more like coughing which usually meant he was building fluid. I won't be around for your next test tonight. Looks like he'll be OK for insulin but I would also consider how his appy is around then and if you can monitor if needed like today.