Roxi's first week - what would you do?

Discussion in 'Lantus / Levemir / Biosimilars' started by manxcat419, Jun 4, 2016.

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  1. manxcat419

    manxcat419 Well-Known Member

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    I just realized I haven't posted anything for Roxi since her introduction - the reason for this being that I don't actually have any numbers to report on her just yet, so haven't been able to do a daily condo for her. It's been a bit of an odd week. Roxi arrived with us on Monday, absolutely terrified. From Monday to Wednesday night, we were not able to give her insulin as no-one could get within 3 feet of her without being swiped (and bitten if she could get a bite in too). By Wednesday morning, although we couldn't get near her the rest of the time, she was getting friendlier at meal times and we found we could pet her head and neck very gently while she was eating. So on Wednesday night, I took my life in my hands and gave her a shot! Roxi had been on 2.5u Prozinc BID. However, the only insulin I could get without a vet appointment on Monday was Lantus (from a family member who had a little left over). So, given that we couldn't test her - I'm no coward around cats, but this cat put her teeth and claws through a set of fully padded leather welding gloves into my husband's hand, and there's a difference between being a coward and sheer stupidity - I reset her to starting dose based on her weight (1.36u rounded down to 1.25u for a 12 lb cat) and went for it. She had, apparently, been doing well on the 2.5u of Prozinc, but had not been home-tested. I was able to get her to tolerate the shots while she was eating, but she still won't allow anyone to touch her at any other time.

    Yesterday, we took her to register at our vet. Getting a cat you can't touch into a carrier is an interesting experience, but we managed it in the end. The vet ran a full blood work and fructosamine so we could see how she had been doing over the previous 2 weeks - we're trying to fill in a lot of blanks and are still not able to test her. The vet called me today with the results - the fructosamine is almost in the non-diabetic range. And her BG, at +3 with huge amounts of vet stress - she was hyperventilating from the moment we walked in through the door at the vet - was 165. Our feeling is that the fructosamine is probably indicative of times that Roxi has been in hypo numbers given that her dose is now half what it was (I know it's a different insulin, so might not be exactly 1 for 1, but she's definitely getting less Lantus than she was Prozinc). The vet feels that Roxi probably doesn't need insulin at all and is in remission. My feeling is that she may well need a very small dose of insulin but that I have no way to calibrate that dose without home-testing. I am not convinced that the fructosamine or a single BG test tells us enough to think that remission is really all that likely at this point. Regardless of that, I don't think there is any way I can safely give her any dose at all until she learns to trust me enough to let me test her, so this has to be a priority. She is getting better with us, but it's a slow process and we have reason to believe that she has been traumatized by something in the past so we are trying to be very careful not to upset her too much. However, I am concerned about withholding insulin from a cat that quite possibly still needs it. I need some opinions on what my next move should be. Please no suggestions to pin her down and force her to be tested - I HAVE to earn her trust first...if you'd seen they way she is, you'd understand and as everyone here knows, I am able to test my ex-feral Rosa as often as is needed. It isn't fear on my part, it's trying to allow Roxi to adjust to what, for her, is a new and frightening world.
     
  2. julie & punkin (ga)

    julie & punkin (ga) Well-Known Member

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    Feb 17, 2011
    Hmm, what a spot you're in. The only ideas popping into my head are to try to give her Rescue Remedy in her food so she'll relax enough to let you test her, and to put up Feliway diffusers around your house. We've given RR for as long as 2 weeks straight when trying to help a cat adapt to new kittens in the house.

    Beyond that, I don't know. I'd be very hesitant in this situation to give any insulin if I couldn't test. A cat can have a hypo on even a tiny dose.

    I didn't know you'd gotten a new diabetic kitter, though - congrats on your new baby and thank you for opening your heart to Roxi! Not exactly easy to find a home for a diabetic cat!
     
  3. Chris & China (GA)

    Chris & China (GA) Well-Known Member

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    Can you catch her urine April?

    It's not perfect, but it would at least tell you if she's running over renal threshold and alert you if not giving any insulin at all (for now) is causing any ketone development...You'd have to use the strips that measure urinary glucose and ketones though, not just the ketone strips
     
  4. manxcat419

    manxcat419 Well-Known Member

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    Thank you Julie. I can certainly try the Rescue Remedy for her. We already have Feliway up and running - that was our immediate reaction to her being so scared. I can tell she has the potential to be very loving - I've tried bringing Rosa and Regan into our bedroom, where Roxi is currently confined, in the evenings and we all watch a movie together. Rosa and Regan are, of course, on the bed demanding cuddles. And Roxi watches from the dresser - I can tell she wants to join in but she's just too scared yet. And she hasn't shown any aggression towards either of them - just curiosity that they're so confident around us. And a couple of times, she's rolled on her back and meowed at me wanting to be petted, but then if I get too close she hisses and swats at me. Her behavior is a little odd. We can be in the room with her no problem. The first 2 days if we even looked at her or spoke to her she growled - that, fortunately, has stopped now. We can even walk right past her as long as she's high up on the dresser...unless either of us has something in our hand. If we even bring a phone into the bedroom (which we usually do as we need to have our phones with us overnight in case of a family emergency) and have to walk past her with it, she loses her mind and lunges at us. I did ask the vet about a low dose of Prozac or similar just for a few weeks to help her settle in a bit - I'm sure once she realizes we're not going to hurt her, she'll be just fine but it's very difficult for her to work out that we're safe to be around if she won't get close enough to us to find out! The vet is going to look into it and call me back on Monday. There was nothing else concerning in her bloodwork at all - she seems to be very healthy overall. But I do think I'm going to have to withhold the insulin for now as there's no way to keep her safe while I figure out a dose for her. :(

    We rescued her through DCIN - her previous owners had just had a new baby and they said she'd scratched their older child so they felt they couldn't cope at this point. She's so beautiful - she's a long hair and has the softest fur...I just want to be able to cuddle with her!

    Good idea Chris, thank you. :) I do have a litter box set up with aquarium gravel - I'm not sure about actually trying to catch her in the act as it might infuriate her, but if I could get to it immediately when she's done, that could work.
     
  5. Chris & China (GA)

    Chris & China (GA) Well-Known Member

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    I try to have a good idea every once in awhile!!...LOL

    I'm pulling for you and Roxi....it really sounds like her life has been hell so I'm thrilled she has you to take however much time it takes to gain her confidence and assure her that the world isn't such a bad place to be :bighug:
     
  6. manxcat419

    manxcat419 Well-Known Member

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    I think I can safely say you have a lot of good ideas Chris! :D

    Thank you. :) We know she'll get here in the end. She just has to learn that we're not bad people and that we're only here to help her. But we have patience - no matter how long it takes, we can see the loving cat she wants to be...we just have to help that cat have the confidence to overcome the fear she's feeling at the moment. :) :bighug:
     
  7. rhiannon and shadow (GA)

    rhiannon and shadow (GA) Well-Known Member

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    Jul 9, 2012
    That is a tight spot. Is she eating well?
    Food is the best motivator but it's hard to earn trust quickly. I wish you luck in getting her to calm down.
     
  8. manxcat419

    manxcat419 Well-Known Member

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    She is eating well Rhiannon. Food is the only thing that motivates her to get close enough for me to touch her! She'll meow and rub around my ankles (with some hisses thrown in for good measure) while I'm getting her food ready...then she goes right back to growling at me as soon as the bowl is on the floor, though if I ignore the growling I can stroke her head gently while she's eating. I just keep looking at her and wanting to reach a hand out and pet her, but she just won't allow it.
     
  9. rhiannon and shadow (GA)

    rhiannon and shadow (GA) Well-Known Member

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    Does she respond at all to catnip or have you notices any foods that get her attention?
    Shadow couldn't resist shrimp.

    Many cats love tuna....
    I am wondering if you laid on the floor with a bit of tuna in your hand.... and closed your eyes and pretended you weren't interested ....if she might come towards you for the food.....

    it may take several tries.... but it might speed up the learning process that you are trustworthy.....


    I have a semi feral cat in the house who still doesn't want to be held but she's gotten friendly.
    She bit me pretty hard thru roses gloves when we first got her. (she's my son's cat)


    And Shadow had bouts of hating her shots so much that she did growled and hid for periods.....
    I had to make it impossible to get more than 6 inches under the bed so I could always get to her.
     
  10. manxcat419

    manxcat419 Well-Known Member

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    Jan 14, 2015
    I haven't tried her with catnip yet Rhiannon. I'll have to try that. :)

    It seems to be any food at all that gets her attention. I just went into the bedroom but didn't have her food with me yet, and she was quite friendly thinking that was what I'd brought her. I had to go right back out and get her food! I really didn't want to disappoint her when she was asking me for her breakfast!! I could try tempting her with something to see if she'll come and take it. She's very possessive of her food when she is given it - we keep telling her we're not going to take it away right after we gave it to her. And she has stopped eating an entire can in under 10 minutes now she's realized we'll leave it out until she's done with it...I'm wondering if she's only been given a few minutes to eat her meal in the past. Of course I want her to free feed like the other cats here are used to - and I had been a little worried that if I tried that with all of them together, Roxi would eat everything I put out for them in the first few minutes...but that behavior at least seems to be going away now.

    At the moment, Roxi has the whole of the under the bed space to herself - she desperately needed somewhere to hide when she first got here, so we let her have the space. But she does spend a lot of time on the dresser looking out the window - she's definitely not hiding all the time. We could block off the space, but we were concerned that we'd make things worse for her at this point if she thought she'd lost her only hiding place...maybe we should give it a try so she has to interact a little more.
     
  11. Sienne and Gabby (GA)

    Sienne and Gabby (GA) Senior Member Moderator

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    I think urine test strips are an option. However, they do not give an accurate read when it comes to low numbers. In fact, the range is restricted with regard to getting a reading for low numbers. My thought would be to reduce the dose further than what you have done already especially if you think the fructosamine is reflecting situations where Roxi was in much lower numbers.
     
  12. manxcat419

    manxcat419 Well-Known Member

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    Thank you Sienne. :) My issue with thinking the fructosamine has to be reflecting a mixture of some high and some low numbers is that she was on 2.5u (different insulin, but however you look at it, it was double the dose) - if 1.25u was able to put her in normal numbers when she was stressed...and before any sort of usual nadir time for Lantus, then I don't see how she's gone several months on 2.5u without being low a good number of days. I don't actually think she's in remission - otherwise her fructosamine would have been even lower...it was just above (by 10 points) the non-diabetic range. I'm working on instinct really of course because I've no proof of any kind of low number showing up...it's just the only explanation that makes sense to me! I can surely try the urine test strips - though I'd be looking to keep her a little higher (well into readable numbers on a urine test) until I can safely start TR with her - I feel that anything else is too much of a risk at the moment.
     
  13. jayla-n-Drevon

    jayla-n-Drevon Well-Known Member

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    Oct 11, 2015
    Hi April.... Just sending good thoughts and hoping remission is in the picture:cat:
     
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  14. Vyktors Mum

    Vyktors Mum Well-Known Member

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    If I recall correctly @BJM has a link in her signature about monitoring when you can't test.

    Good on you for taking on Roxi, I am sure your love will win her over in the end. She is one very lucky kitty, even if she doesn't realise it quite yet!
     
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  15. manxcat419

    manxcat419 Well-Known Member

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    She does, Serryn, you're right. I think I've just got so used to the idea that a 20 second test is the definitive answer that it's difficult to trust the secondary monitoring anywhere near as much as actually having a number to look at!

    She is getting there...a little more every day. Today, she's asking for attention, but she can't quite hold her nerve long enough to let us pet her. She rolls on her back and meows and is fine until we get just a couple of feet away...then she can't quite hold it together and hisses at us instead. But she did demand food from me a little while ago and just about sat on my feet to eat it...her tail was resting against my leg and she didn't react at all or try to attack me over it for the first time. :)

    Thank you. I just hope she'll let me get her to the point where she can find out that I'm only doing my best for her. And, hopefully, that she feels better for it too. :)
     
  16. Vyktors Mum

    Vyktors Mum Well-Known Member

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    I would have the same trust issues you do with secondary monitoring but you just have to do the best you can at the time and since you won't be trying to keep her tightly regulated until (not unless, until :)) you can test it will be a different ball game. I'm sure she will come around, she really seems to want to already. Just be glad she's not a rabbit - Meg drew blood everytime I went near her for the first two months :blackeye:

    Could be a good idea when you test/praise/treat Rosa to do it in front of her too so she can maybe get some idea of what's coming and not be too freaked out about it when it's her turn.
     
  17. manxcat419

    manxcat419 Well-Known Member

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    Ouch! My cousin had a rabbit like that when we were kids. It would chase after us too! They might look cute and fluffy, but some of them have a real temper!

    Definitely until. We don't do giving up in our house! Especially not when it's so important. She will be a TR kitty sooner or later - it's what I know, and it's the method I trust. Of course I'd like faster progress from her, but we have to do this one at Roxi's speed - we can't risk traumatizing her by forcing the contact too quickly when she's already scared. She's doing her best to get to know us - I can see the progress every day. I just have to get the patience pants out and let her work at her pace.

    That's a great idea - I love it...thank you! :) Rosa is so calm about testing and really doesn't care where I test her - I can easily take her to where Roxi is for her test. And once Roxi sees that another cat can be tested and not be freaked out at all, she'll hopefully realize that it's not anything scary. And of course Roxi will get a treat when Rosa does, even without being tested first - if nothing else, she'll learn to associate the meter beep with a treat. :)
     
  18. BJM

    BJM Well-Known Member

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    Oct 6, 2010
    There are Secondary Monitoring Tools in my signature
    There are suggestions for urine ketone/glucose testing, food and water intake and output, dehydration checks, and behavior evaluation.


    There's also a link to a optional chart for recording those observations. Its ok to just make those notes on your spreadsheet.
     
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  19. manxcat419

    manxcat419 Well-Known Member

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    Thank you. :) I'll use as many of them as I can...and hopefully be able to add in more as time goes on. I don't see me getting close enough to smell her breath at the moment, but you never know! And purring isn't happening much, though playing definitely is. She really likes us to just dangle a piece of nylon cord so she can grab it and play with it - I guess because we don't have to get all that close to her to do that. No interest in toys on sticks or strings...she really just wants the string itself! Fortunately, the ketodiastix I can do as I have a litter box already set up with gravel...it just comes out when we need it...so I won't have to risk life and limb trying to stick a strip under her at the right moment! :)
     
  20. manxcat419

    manxcat419 Well-Known Member

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    We had a huge breakthrough with Roxi this afternoon. I was able to touch her without her head being in the food bowl! Just one finger on the top of her head while she was laying on the dresser, but she let me do it 3 or 4 times. She complained just a little, but in between times she was crying for attention. And no swiping or biting from her either! It might not sound like all that much, but to me it was a massive step forward! :D
     
  21. Chris & China (GA)

    Chris & China (GA) Well-Known Member

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    May 10, 2013
    One paw at a time!! Just keep putting one paw in front of the other and you'll get where you want to go Roxi!!.....Your new mama is looking forward to showing you how really wonderful us hoomin beens can be so you can forget all about the bad and scary things in your past.

    Doing great April!!!
     
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  22. Vyktors Mum

    Vyktors Mum Well-Known Member

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    Nov 15, 2011
    One small scritch for Roxi, a giant leap for the bean kitty relationship :cat::cat::cat:
     
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