?Newly diagnosed tested 60 at PMPS help

So my kitty Chloe just got diagnosed with diabetes a week ago. Doctors orders was feed 2x a day half a can each feeding then wait 20- 30 mins to give her insulin. A person on a fb page told me i can actually leave out the wet food all day for her to graze, because i was concerned that Chloe was hungry besides the 2 feedings. So if letting her graze when do i give her insulin? Just a regular time,2x a day or do i make sure she doesn't eat for a certain ain't of time before insulin. This is so confusing!!! I haven't started testing yet im headed to the store today to purchase a glucose tester.

 

The instructions given by your vet are appropriate for some other types of insulin but not for Lantus.

Grazing on lantus is fine, you just want to remove the food two hours before shot time (a timed feeder can do it for you if that's when you should be sleeping) so that you get a BG test that isn't influenced by food. Later you might find its better to not let her eat after nadir if you see (from your testing) that it puts the brakes on the insulin too much (Vyktor was always free fed, we never had that problem) but for now, especially if that's what she's used to and she's not overweight then let her graze.

 

Welcome to the group and glad you found L&LL so quickly. So glad to hear you're going to get a glucose meter. Most of us use the Relion Mirco or Relion Confirm from Walmart.

I see Chloe had DKA so it's also important to pick up some keytone urine strips or look into getting a keytone blood meter. There is more information found here Keytones_DKA which is in The Basics New To the Group Sticky.

Also agree with Vyktor's Mum. You most certainly can let Chloe graze on wet food all day and it's actually better for her pancreas. My vet said the same thing in the beginning and Doodles was miserable. It is important to remove the food 2 hours before shot so the preshot is not food influenced.

Last thing for now so we don't overwhelm you is setting up a spreadsheet. Here are the Spreadsheet Instructions and if you need help please let use know.

One more question about food. Was she always a wet food only eater or have you recently removed dry food?

 

I recently removed dry. Actually when she went into hospital was when she stopped eating dry

 

Ok that's good but it will be essential for you to test ASAP. That alone can create the need for a lot less insulin pretty quickly. Keep asking questions!

 

The removal of dry can make a huge difference so I'd get that meter asap

 

DM wet is only 3% Elise.

However, you should know that there are much less expensive foods that are low carb to choose from. Most of us use this chart and anything under 10% carbs is LC (most stay in the 5% range). You should also pick up some HC food such as Fancy Feast Gravy Lovers incase you need to bring Chloe's numbers up.

http://catinfo.org/docs/SortableCatFoodChartCatinfo.org2-22-13.htm

 

Oops. I never used it but thought that was why people didn't use it. Thanks for catching that Karen. I think she should try some foods a little higher then.

 

Most don't use it because it's expensive and the ingredients are horrible along with lack of availability since you can only get it from a vet.

 

So i purchased the relion confirm and am reading up on it. I left her friskies classic pate out while went to the store to get it and came back to puke on the couch. She was on strict purina indoor and complete before all of this now only on this wet food. Ahhh i just want to get the hang of this all!

 

Sometimes kitties can take a while to transition from dry food to wet food. A quick change can cause stomach upsets with some kitties. Also Chole has had a rough time the last few days with DKA and time spent at the vets. You can try giving her small amounts of the low carb wet food and see if that sits properly. Some kitties are prone to scarf and barf when they eat too quickly.

 

It was sitting properly when only giving her 2x a day but everyone said i could free feed her and so maybe she was scared it would disappear like other times so she scarfed it down. Im really nervous to do this at home test, it seems really confusing

 

Hi Casey,
It's OK. You're doing great. ....Take your time....
And remember to breathe.....
(((Hugs)))

Eliz

 

I thought I had posted this, but it is not showing. This is what Chloe was being treated for

 

So i need some help with feeding schedule. Im allowed to free feed her with the wet food but was told to put it up 2hrs before testing then test and feed then injection. I work weekends 430- 1230. But i get a 30 min break at 1030, how do i know if she hasnt had food in 2hrs to test and feed her again. Im so nervous about testing her though, i dont want to cause pain to her and want to do it the correct way.

 

What time is your shot time? I don't know where in the world you are, but we are all in different time zones. So we usually talk in terms of number of hours after the shot. For example, if your shot time is at 8, the 10 is +2, etc. And you'd want to pick up food by 6, which is +10.

Don't worry about hurting her while testing. Pick up some Neosporin with pain relief gel and dab it on her ears afterwards. If you reward her test with a low carb treat, you'll soon find she purrs through tests or comes running when you get out the test kit.

 

(((Casey))), it's OK to be nervous. Concern is entirely natural: You're a great kitty mama who just wants to do the very best for her girl.

Please know that the vast majority of cats can be tested. And a great many of those cats will come to actually enjoy the process, especially if they associate it with yummy treats - or just some 'quality time' with their favourite human.

Some people (and their cats) take to hometesting like proverbial 'ducks to water'. But others of us need to approach things a little more gradually. (FWIW, I was a very reluctant hometester at first. I felt sure that my cat would be one of those that couldn't be tested: But I couldn't have been more wrong...)

I started out by just popping my cat up onto my desk, massaging or holding his ear for a couple of seconds, and then giving him a treat.
Then I'd pop him on my desk, and click the lancet pen near to his ear, and then give him a treat.
Then I'd put him on my desk and did both things together; massaged his ear, clicked the lancet pen near him, and.....gave him a treat.
Then, I tried a complete test and....it worked!

This should not hurt your kitty. There are very few nerve endings in the edge of your kitty's ear, so she probably won't feel very much at all. (It's nothing at all like the sensation that you or I might feel if we pricked one of our fingers, for example.)

I believe you can do this, Casey. Just take your time, and remember to breathe....

Eliz

 

Chole need you to home test. It hurts us more then them. Doodles now just hears me grab the test strips, I say "let mommy see" and he comes, sits patiently and knows he's getting a treat or a snack.

Because you removed the dry food it's even that much more important to home test. If you need help with the spreadsheet please let us know. In the meantime please read the first line in this link Where Can I Find (loads of information) the story of Chewy and Baby.

I personally didn't home test for the first 2 months and yes, we ended up in the ER. Even after that I still didn't home test enough for the next 3 months and yes, we ended in the ER again. Luckily I finally found FDMB.

 

Ok i finally home tested her and it was 60. Even after a bunch of little pieces of chicken to get her to cooperate lol. So now what? Yayy i did it a couple times actually, and got some error codes because not enough blood. But eventually got it and i am surprised it didnt hurt her

 

Wait.........why did you end up in the ER with your kitty???

 

congrats on your first home test!... the blood will come easier as you test more... Lincoln actually is more cuddly with me since i started testing.... he purrs and cuddles with me the while time i am doing it... how long ago did you give Chloe her insulin tonight? or have you given it yet to her?

 

Yayy thanks and no i haven't given her any yet i tested her then fed her then got right on and posted

 

i ask cause 60 is in the normal range and you havent gotten any data before this to know how she is going to react... think we need more eyes on this

@Chris & China @Doodles & Karen @Wendy&Neko @Jill & Alex (GA) @Marje and Gracie @Bobbie And Bubba

 

When she first wentinto the hospital it was bc she had keytones in her urine abd they said her blood sugar was 400

 

well the problem is if she goes too low it can be very dangerous very fast... why we always say to test first here... i would wait on the shot until we get some eyes on this... not trying to scare you just want to help you keep Chloe safe

 

@Tricia Cinco(GA) & Harvey eyes on this?

 

The shot can make her insulin drop more? I thought insulin raised sugar levels? Ugh so uneducated about all this and now getting nervous. She's really hungry right now can i keep feeding her?

 

no the insulin drops the BG (blood glucose) numbers... personally i would skip her shot tonight because she is so newly diagnosed we dont have the data to know what will happen if you shot this low of a number... i am trying to get more experienced members to look and help...

 

can you change your title -- to maybe something like -- Newly Diagnosed Tested 60 at PMPS Help and then add the ? to the front of it

it would help to get more advice

 

I don't usually give dosing advise. How long until shot time? Can you not feed and stall until someone more knowledgeable comes along with advice?

 

I fed her already after the test...i didnt know!!!!!!!!!!!!! She should have her shot right now

 

That's fine. Next time, you might want to try stalling (if your schedule allows) and not feeding, then test 20-30 minutes later to see if the number is rising.

Are you testing for keytones?

 

I have the strips but idk how to check them when she pees in the liter box?!

 

I was trying the free feeding then putting food up for a while then teat feed shot.

 

you didnt do anything wrong ... we are just trying to make sure that she is safe and you feel good about her treatment.... sadly too low or too high isnt good when it comes to diabetes... its a balancing game... normally here they like to start with .25u and increase by .25... that way you can fine tune and find the right dose... it takes time but its proven to work

 

You can put a bit of saran wrap in the corner she usually uses. You can try sticking a spoon under the cat while it's going (the cat will likely be offended).

For new numbers, it is recommended that you not shoot under 90. With very little data, as long as the cat is eating well, I would suggest not shooting tonight. My thinking is this: keytones are a combination of high sugar levels and not eating. Obviously, with a reading of 60, she doesn't have high blood glucose levels and she did just eat.

You could try testing the BG again to double check your reading of 60. The number should be higher because it is food influenced.
.

 

I'm sorry it takes me so long to post. There is a teenage kitten creating havoc on my lap. She just somehow turned on the printer and made it print.

I'm hoping that a member who is more experienced with dosing will come along soon - but I think they will say the same thing.

 

Ok i will attempt to give another glucose test. And see what the results are, she seems to still be hungry should i feed her more or no?

 

With the history of DKA, yes, do feed after you test.

 

let us know when you get a second test

 

She wont let me test her again shes getting opinionated! And im really making her ears red like i get the poke good but the blood doesnt come so that's why i keep atempting. Now shes irritated.

 

Is there an easier way than her ear? I was even giving her cooked chicken!

 

ok ... i agree that you should skip the shot for tonight and feed her... a sock with some rice in it warmed up and placed on the ear before you test helps the blood to flow.. this will get easier...



if you are able to test in that area after warming it the blood usually flows pretty good

 

That's fine. Testing will come easier with practice. Are you using the lancet device or free-handing? Some people have an easier time getting a blood drop by free-handing. It could also be that the lancet device needs to be set to a higher number.

Since it is difficult to test tonight, do not give insulin. It is not safe to do so. You won't know how low Chloe might go if you can't test easily. Do feed her because of the history of DKA.

But ... do not feed her for the 2 hours before tomorrow morning's regular shot time. And do post tomorrow morning before shooting asking for dosage advice.

(I took my bedtime meds before I checked the forum. I can't stay up much longer. Hopefully, someone with much more experience will be along shortly.)

 

Yeah i have been doing it in that spot over and over but just a little blood appears i will try the sock though lol wth

 

I was using the device. And ok i will skip tonight and try again tomorrow morning thank you so much for the help. If i didn't post i would have giving her the insulin shot. So can she eat as much as she wants tonight then Just take food 2hrs before testing tomorrow?

 

i am going to be here with you... my kitties numbers are dropping so i will be up...

yes let her eat remove food 2 hours before test time

i personally use just a clean new needle to get the blood but its all about finding what works best for you

after you poke are you pressing a little on either side of where you poked to work the blood drop up?

 

Shooting tonight could send your cat into dangerously low numbers.

You could try not using the lancet device and just poking.

Do feed as much as she wants to eat, taking the food away 2 hours before shot time. You might want to get a test in an hour before morning shot time so people have a chance to respond to your questions about what to shoot?

I'm starting to weave in my chair. I hope you have a good night.

 

I started home testing before i joined here and that video was helpful

Night Kel thanks for the help

 

Thanks for hanging in. Hope you have an easy night.

 

If at all possible, if you can get a test sometime before you go to bed, it would help to fill in the numbers on your spreadsheet. A spreadsheet would really help.

 

Kel is right... we need to track when you test and the results.. it really helps the experienced members here in giving advice and you will learn to read the trends and see them after some time yourself... if you click on Lincolns SS or Rovers Spreadsheet in our signatures and look at our kittys SSs... you will see there is a scale on the top... you will see Chloe tested in the Dark Green (or the lagoon as we call it around here)

that zone is actually the normal zone for a cat... its where you hope to get her with the insulin and surf in that area if you can... it gives the best chance of her healing...

but if you look beyond that is the light green... and that area is dangerous.. if a cat goes too low and you arent monitoring to bring her back up with High Carb food or even honey then ... there are links on here about how to deal with a Hypo and what to have in a kit to be prepared for one

It is VERY IMPORTANT that you read this and understand it... http://www.felinediabetes.com/FDMB/threads/how-to-treat-hypos-they-can-kill-print-this-out.15887/

I am not trying to scare you just trying to inform you ... hypos are very serious and i am surprised your vet didnt warn you... but sadly not a lot of vets seem to give diabetes the respect it deserves and the same can be said for insulin

 

Hi Casey, and welcome to Lantus and Levemir Land - the nicest place you never wanted to be. Congratulations on getting your first successful test! I know how stressful and overwhelming this is at first. Take some deep breaths and try to relax a little. If you are feeling stress, your kitty will feel it, too.

I see you've already been given the suggestion about warming the ear before poking. I found that to be very important. Also, you can massage the ear a little to get the blood moving. When you poke, hold the rice sock behind the ear to help keep it flat. Don't panic if you poke all the way through. It happens to everyone and doesn't hurt the kitty. ALWAYS give Chloe a low carb treat after a test, whether you got blood or not. That way she'll associate being tested with something she likes. After you get a successful test, hold a tissue or cotton ball around the edge of the ear and apply gentle pressure to stop the bleeding. Every night before bed, if you rub a little of the Neosporin ointment with pain relief into the ear, it will speed healing. In the morning you can wipe off the excess and it will help the blood bead, making it easier to test.

Have you read any of the stickies at the top of the Lantus & Levemir page? There is a LOT of info there, and it can be very overwhelming. Ask lots of questions. We love to help. The only dumb question is the one you don't ask.

If you can get another test in, that would be great. I am concerned about skipping a shot with Chloe's history of DKA, but if that 60 was accurate, skipping was the best option. It could be that the switch to low carb moist food made a huge difference - it's happened before. We advise new member who get a preshot test number of 150 or lower to stall WITHOUT FEEDING and post for advice before shooting. ALWAYS test before giving insulin, because, as you saw tonight, you need to know if it is safe to give insulin.

If you need any help setting up your spreadsheet, let us know. We're glad you found us. We'll help you get Chloe better.

ETA: Some links to help you get started: http://www.felinediabetes.com/FDMB/...the-basics-new-to-the-group-start-here.18139/

http://www.felinediabetes.com/FDMB/threads/hometesting-links-and-tips.287/

http://www.felinediabetes.com/FDMB/threads/fdmb-spreadsheet-instructions.130337/

 

Another tip on successful testing on new ears is to get some lancets that are 25-28 gauge.....Most of the lancets that come with the lancet devices are 33 gauge and are too tiny to poke a very big hole (we're not talking a huge difference....it's not like the bigger lancets are a lot thicker but they can make a big difference in getting that precious blood drop!)

In lancets, the smaller the gauge number, the bigger the "hole" it makes

 

You did great for getting that PMPS test! So glad @Lincolns Mom and @Red & Rover (GA) & "Cat" were here to help you and skipping the shot last night was the correct thing to do. I wonder how low she was during the day yesterday. Although I can't see any data I'm pretty sure Chloe needs her dose reduced since you removed dry food when starting insulin. Please do not give her insulin without testing first.

Here are the Spreadsheet Instructions . If you need help setting it up let us know.

 

How did it go this morning?

When I first started poking Rover, it was a mess. I only got through it by imagining what Rover would look like if I turned him into a punk cat with multiple piercings.

You might try moving slightly around "the same spot" that you were using last night. Even a bit of a move can make a difference.

Please let us know how you and Chloe are doing.

 

So i had class this morning abd woke up late. Came home and tested her, which is possible food influenced. It was 227. I took her food up and will test again in 2 hrs. Is 227 ok to wait for 2hrs. Isn't that high?

 

Yes please i need help setting a spreadsheet up. I looked at others and it's confusing lol

 

I sent a message to @Marje and Gracie, who is our spreadsheet guru, to give you a hand.

Well, it's higher than we'd like her to be, but for a newly diagnosed cat who hasn't had insulin yet this morning, it's not that high.

Waiting the two hours and testing again is fine, but that will put your shot time much later in the day, and remember, you will have to shoot tonight 12 hours after this morning's shot, and you may need to stay up a while to monitor. Can you do that?

What is your schedule the rest of today? Do you have to leave again for more classes?

 

Yes i can stay up tonight to do her shot. But tomorrow around the 12 hr mark i will be at work. Uggh feel like i need to be unemployed to handle all this! What do you mean to monitor? Like watch her?

 

By monitoring, I mean testing several times during the first half of the cycle, at least, while the insulin is taking effect.

You can move the shot time back by 1/2 hour once a day, or 15 minutes per shot.

Alternately, if you can monitor today, you can shoot now. Remember the above rules, would that put your shot time tomorrow where you can do it? The reason I say you need to be able to monitor today is, if that 227 was higher than it would have been without food, Chloe might come down quite a bit.

 

Ok she hasnt had food in an hr can i test her now?

 

Will you be able to monitor her today?

 

I have to go to work in 2hrs for an 8hr shift

 

Give me a minute.

 

I'm going to send you a private message. Look in upper right corener of this page and click on "inbox" in just a few minutes. I can set up the spreadsheet for you.

 

Casey, I was trying to get some input from other veterans, but they are pretty much all at work, I think, and unable to answer as quickly as we need them to.

Because Chloe had DKA, it's really important to get some insulin into her. How would you feel about shooting what we call a BCS (Big Chicken Shot), which is a one time reduced dose, of .5 now, and testing again right before you leave for work? That test will tell you if she is dropping, in which case you know to leave a higher carb food out for her. Test before you shoot, and if it's lower that the last test, let me know before you shoot. You can then feed her some more, too.

 

Ok so test her now then shoot her the .5 do i feed her at all in that process?

 

yes.

 

So test feed then shoot?

 

Yes, but all in the space of about five minutes, tops. You alway want to be sure kitty will eat before giving insulin, but you don't have to wait for her to finish eating before you shoot. We usually shot Cinco as soon as his head was in his bowl, and he never even noticed.

 

Ok it was 209 fed her then gave her .5 insulin

 

So tonight, I recommend you test Chloe when you get home from work. Then, test again at +11 hours after this shot. You can test/feed/shoot at +11.5 hours, but if you get a number lower than 150 then, please DON'T FEED and post for advice before shooting. If you can post the other tests when you get them, too, that will help us see what's going on. Does this all make sense to you?

 

Please test her before you leave for work. Do you have any higher carb food you can leave out for her if she is dropping?

 

No not really lol. So test her 11hrs after this .5 shot. Then test feed and shoot half hr after that, and if its lower than 150 don't feed her and post for advice. Can i leave food out for her when go to work soon?

 

I have the purina dm wet and purina indoor dry and purina dm dry

 

Test before you leave. If her number is about the same as it is now, leave the wet out. If it's more than, say 20-30 points lower, leave some of the DM dry out, too. Dry affects the BG longer than wet, so that should help hold her till you get home.

 

But don't i want her points to go down? Because isn't 209 high?

 

Yes, you do want them to go down. The problem is, you don't want the BG to drop too far too fast when you aren't there to watch her. Especially with a newly diagnosed cat, when you don't have much data on how she responds to insulin. 209 is higher than we'd like her to be, but she will come down once the insulin onsets. We use food to help slow the drop and keep her safe. With that number, she is most likely at or under her renal threshold, which is when glucose begins to spill into the urine. That means it's a relatively safe number.

When you first start out giving insulin, you don't know how your cat will respond. That's why we encourage testing and using the spreadsheet to chart the numbers. Soon you will see what I mean. That info helps you find the best dose to bring her into healthy numbers without running the risk that she'll hypo while you are at work. Dropping too low is far more dangerous than being a little high. With DKA in the picture, we don't want her way too high, but the low 200s isn't in that territory.

 

Casey

Can you tell me at what time you got the 227 and the 209 today in relation to the time you last gave her insulin please?

 

Those were both without insulin shot. And the 227 might have been food influenced it was right when got out of school. Then the 209 was after an hr of not eating then fed her and gave her the .5 havent tested her since

 

Havent given her insulin since yesterday morning besides the dose i just gave her

 

@Marje and Gracie she was at 60 at PMPS last night, and Casey was having trouble testing, so the shot was skipped.

Nice job testing today, Casey, by the way!

 

Yay thank you. Just hope can figure this all out. Im getting ready for work so ill test again

 

I’m trying to fill in the BGs on the SS for you. So I need to know the actual time of her last insulin shot, what time you tested and got the 227 today (it doesn’t matter if it’s food influenced), and what time you tested and got the 209 and shot today.

 

It was just 242

 

She last had insulin at 1030am yest morning. Got the 227 1:45pm today then 209 at 3pm along with a .5 dosage of insulin and 242 at 4pm. Will she be ok while at work? Do i leave food out for her? I get a break in 6 hrs which i will run back home to test her.

 

Thank you!

She’s got a bit of a food spike. I would definitely leave food out for her.

What time do you normally shoot? Thank you.

 

You can leave her a little food when you go. Canned.

 

I was normally shooting her at like 1030- 11. So now im all messed up and don't know how to get back track

 

Don't worry. We'll help you figure it out. Post when you get home from work tonight and test her.

The soonest you can shoot tonight is 2:30 am. That would make tomorrow's first shot no earlier than 2:00 pm and tomorrow night 2:00 am. You can shoot 30 minutes early once a day, or 15 minutes early each shot. The shots are supposed to be 12 hours apart because Lantus is a slow release insulin and that's about how long it lasts in the system. Shooting any earlier than 12 hours acts like a dose increase. So we want to be sure it's safe to do that tonight before you shoot.

 

In addition to what Tricia said, if she is much higher tonight because of the reduced dose, you can shoot 1-2 hours early depending on how high she is. That will help you get back on track. If you test her at midnight, and she's gone way up, you could shoot at 1 a.m. I would post after you get the midnight test and we can give you some ideas.

But, of course, you will want to test as soon as you walk in the door from work.

We can see where she goes from there and how to get you back to 10:30 or 11.

 

Ok thank you so much i cant handle her being sick i get a break at 1030pm i can test her then on my 30 min lunch

 

Just tested her im on my break from work and it is 115

 

Now what do i do lol

 

@Marje and Gracie and @Tricia Cinco(GA) & Harvey

 

first step enter that on your spreadsheet... how long has this test been since you gave insulin?

 

Feed her now. Post the number you get when you get home again.

 

Can you stay home long enough to test 20 minutes after feeding, or do you have to rush back to work right away?

 

What is the number for right now? And i ggave her .5 of insulin about 6hrs ago