Titus update and a few more questions?!??

Hi Everyone!

I am burnt out but still determined on reversing diabetes on Titus, he will not for the life of me let me prick his ears so the paws it has to be for now....and 30% of the time it works which is much better than the 0% I was at before, I think the percentage will go up as Titus is hating it but being more tolerant or i'm being less tolerant to his squirms maybe a bit of both.

I contatced my vet about changing Titus's insulin from NPH to either Levemir or Lancet and she wasn't thrilled about the idea and said that Titus is a special case because he's so tempermental/usually needs to be sedated before anyone touches him and therefore she can't do a curve on him it may be best to stick NPH, I told her from the studies I read that NPH metabolizes better in humans and dogs rather than cats and that I was worried that Titus may not react well to it, I am only able at this point to home test before I give him the insulin (he wont let me do a curve after both are done he hides and not even treats will get him out, he really is the most persistent thing i ever met besides myself so I can't even really say if the NPH is good or bad for him and that makes me feel like an awful cat parent. My vet said that it's not NPH it's just every cat is different and some react just fine on it and others need a diff type, She said she would call me back in 48 hours and see if perhaps switching over will be good for him or not.......I dunno if i should stick with her at this point or find a vet that shares my beliefs...I'm in the Los Angeles area and they are all over the place....around here...Titus and myself has never needed to build a special relationship with a vet since he has been healthy always and just needed to go once a year etc....and they were fine and dandy for that...

This morning I tested Titus and his BG is 350 so I'm about to give him just 1U (someone tell me if that is to low of a dose for his # or what I should do?) of the NPH and try my damnest to check him in 4-5 hours from now...and then again before the evening dose, I hate the idea of giving him insulin and not knowing his numbers. The burrito method did not work....he will try and break his leg before he is restrained, he rather it be a free thing where I hold him on my lap and poke him and he squirms all over the place and i reach for the monitor and get 30% of the time get the reading (but i poke him every time...poor thing) and 70% of the time he runs away right after the poke regardless every time if i do or do not get it I say good job in the kitty voice and try and cuddle him and mend to his paws and then give him a few treats.

I am just lost right now....on what to do. Any advice would be good advice. Thanks.

Rach

 

You have to give yourself a break! You are doing the best you can and sound determined to do even better. That is all Titus would ever ask of you.

Your vet is a bit out to lunch (as you suspect) if she thinks that Humulin N is better in a non hometested cat than lantus; lantus does not have the steep peaks and valleys and is generally a much better insulin for cats. So yeah, perhaps getting references would be a good idea, and there are a few folks in the LA area.

Have you tried NOT restraining Titus for his tests? Squeak hates to be restrained, so I put him inbetween my legs while I sit on the floor. I warm his ear while rubbing or brushing him, and then poke him when we are both relaxed. Now he doesn't even care (but I hardly ever poke him as he's off of insulin). It really does make a difference to NOT restrain him...just a thought.

You are doing good and can do better and we'll help!

Jen

 

I agree, if I could only hometest part of the time, I'd be giving Lantus.

Another thing about hometesting, if you're stressed, your kitty is going to be stressed.

I adopted a fiesty young lady who was let go for being FD. For months Sadie would not come out from behind the computer cabinet and she hated me, to make matters worse, her ears were black so it was hard to see. But, I'm used to testing diabetics in all sorts of weird places, so we endured, and over time she learned that treats came with the test and she learned to really enjoy those treats so she gave in on the test time and came out.

So as Jen suggested, maybe a little less restraint and try to be natural.

 

Thank you for your replies.

I talked to another vet late afternoon and she was very knowledgable about the benefit of Lantus first on cats and perfers it, she made me feel a ton better so much in fact that Titus has an appointment tonight at 6 there. She mentioned the diet is great for titus but she wants to check his urine for ketones since the other vet did not since she couldnt find any urine...so I am having my current vet fax over tituses paperwork as I type.

I havent been giving him the NPH since yesterday morning because I don't want to confuse his body when he does get the Lantus but I fear his BG may be really high without it and he can possibly get DKA (i think thats the right abbrev.) I just HATE not knowing what to do, I tried doing a BG paw test but Titus wont let me do it right now and I dont want him to further stress him out before his new vet appointment. I am going to start brand new and while he relaxes on my lap (eventually...) start touching his ears a ton more and warm them up and have a lancet nearby and poke him with it but not get a BG reading the first few times i figure baby steps may be best for him....I dunno at this point titus is really difficult and not like the average cat who gives in....its a blessing and a curse my boyfriend says LOL. I hate that my cat does not trust me thats the hardest part through all this, before i pet him he stares at my hands and he doesnt sleep with me anymore in the bed he sleeps in the bathroom (the furthest room away)

On another note my vet who prescribed NPH called me this morning saying she read up on Lantus (she said the proper name lglarine or something and she feels it will be a good match for Titus but on a much lower dose....(really?? could have fooled me) I am trying to make the executive decision to say good bye to them and take Titus to this new vet who would have I feel do things "right" the first time...I mean my current vet doesnt believe in the accuracy of home testing, thought NPH was better than Lantus for cats...etc, but I feel guilty about it....but that shouldnt be a problem right now...right now Titus needs the best care and thats most likely at this new place (it has amazing yelp reviews too)

So I'll keep you all updated and would love to know what to do if I try home testing and I cant get it to ever work for him (I watched youtube videos of it and how easy they made it look and i cried hahaha) how should I treat his diabetes....like I said 30% of the time it works but....Titus HATES me all day and that just makes me hate it more...I miss my best friend loving me but I want him healthy.

 

Guilt has zero place in making medical decisions. The other vet sounds much better, to me at least.

You should continue giving the N until you switch to lantus; there need be no weaning off period.

Jen

 

So great news, I LOVE the new VET and Titus loves her as much as he can love a vet
She prescribed us Lantus 1.5U BID (he is a 14.5 pounder) and she checked Titus's urine and said she will call me tomorrow with the results but he has no ketones. She said to come back in about 3 weeks for a fructosamine test. I told her that Titus hates me because of the home testing (he doesnt mind the insulin shots) and she recommended to me that I stop for now and purchase Purina litterbox glucosetest strips so I am ordering them after I type this message. I feel so much better and she answered everything and we are on very similar pages on how to treat him, she said she hopes we can get Titus into diabetic remission/honeymoon soon and hopefully forever and just put him on a good diet for him.

 

First off, awesome that you and Titus like the new vet! Sounds like it'll be a much better match.

You might have already tried this, but for testing, can you get some of the blood onto your fingernail as soon as you prick? That way you can let Titus run off and do the test from your fingernail.

Good luck,
Odiesmom

 

Hi there-

I had some thoughts for you for dealing with your less than cooperative kitty. I'm learning my way around this home testing/dosage stuff myself, but I'm a behavior analyst, so I know a think or 2 about shaping behavior. I would recommend identifying a place that you always give the shot (I sit with my girl on the couch...some people have a spot on the counter or particular room they use). Take your kitty to that spot often and give a little ear massage, but no ear pokes, and deliver a treat or two (I would presume a low carb treat would be best...someone can chime in here as to whether it makes a difference). He'll start to learn that the ear massages = treats, instead of ear massages = pokes. You'll basically be desensitizing him to the ear massages and teaching him that coming to that spot and remaining calm during his massage results in something good for him (i.e., treat!). I'm not sure how often you're trying to do BG tests now, but the trips to the spot for the massage/treat/no poke, should way outnumber the trips to the spot for the ear poke. Some other questions that come to mind are: 1) Does he lose it when you bring the testing stuff out (i.e., he knows what's coming and runs at the sight if it)?; 2) Does the sound of the pen/needle thing (I'm sure it has an official name) frighten him?; 3) Or, does he just get freaked out from the stick itself? If it's yes for #1 or #2, there are some extra steps you can take to desensitize those items as well. I'm happy to help....behavior is the ONE thing I can for sure talk about on this site with confidence. Feel free to message me if you want to chat about more behavioral tips. Best of luck!!

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